Health Committee on May 5th, 2020

[Stephen Laskowski]

I'll back up in terms of the life of a truck driver.

As one owner-operator explained it to me, with regard to exposure, obviously they are going into areas, whether it's in the United States or Canada, where there may be more outbreaks, but in a normal week, a truck driver may only encounter six or seven people. It's a job that's pretty isolated. You're in a truck by yourself.

Make no bones about it. Both the drivers in our industry and our customers are taking COVID responses very seriously with regard to practices. We are doing our best job to protect our workers, as are our workers, as are our customers.

With regard to access to food, that is a challenge. When you do find it, a bottle of water that used to cost a dollar, for example, costs four dollars. That's just a small example. That's why we're asking for an increase in the meal allowance. There's currently a meal allowance allowed in Canada for truck drivers on their taxes. What we're asking the Government of Canada to do, in light of the dramatic increase in food costs on the road is to increase those meal allowances.

[Len Webber, Conservative, Calgary Confederation, AB]

Oh boy. I just froze there. I didn't even get that answer, Mr. Laskowski.

Here is the problem already. I will just continue on then. This can go out to any of our witnesses here.

We know that many Canadians are looking for work now because of this crisis. Have you heard of any—of course you have—labour shortages with your stakeholders? Is there an opportunity right now to highlight employment opportunities for Canadians looking for work with your associations?

Mr. Laskowski, in the trucking industry are there a lot of opportunities now to become a trucker?

[Stephen Laskowski]

I think that once we emerge from COVID the answer will be yes, because prior to COVID, the answer was yes. The reality again is—and I don't want to continually go back to this—we're down substantially. A lot of people think the trucking companies are going full bore, and they may be in certain lanes, but we're down by 30% to 35%. That means trucks are parked, and that means in certain segments of our economy, truck drivers are home because there is no work for them.

The overall message is that we are an industry that's working to move the supply chain, but like other sectors, like those in the food industry that received help, we're going to need some specific help as well.

[Len Webber, Conservative, Calgary Confederation, AB]

How about the Canadian Union of Public Employees?

I'm sure there's quite a demand right now for health care workers, although it is very risky to be working in a long-term care facility right now. Is there a huge demand?

[Amanda Vyce]

There is. The demand for health care workers has been exacerbated by the pandemic. The sector was long desperate for workers before the onset of COVID-19 across the country, in every province.

[Len Webber, Conservative, Calgary Confederation, AB]

Right.

I'll go back to Mr. Laskowski again about the truckers.

What type of training is out there for truckers with regard to protecting themselves from this virus?

[Stephen Laskowski]

In my opening comments, I mentioned the fact that the Government of Canada really stepped up, and here is an example. Both Health Canada and Transport Canada have been working together with our membership and those who are unionized, working with their labour representatives, to make this a safer supply chain, and Mathew can attest to how their members interact with our industry.

Out of all this bad, this has really been an example of great teamwork within the supply chain, both in the private sector and in the public sector. We can always continue to improve, but everyone has stepped up, and everyone is doing their part.

[The Chair, Liberal, Marcus Powlowski]

Thank you, Mr. Webber.

We go now to Dr. Jaczek for five minutes.

[Helena Jaczek, Liberal, Markham—Stouffville, ON]

Thank you, Chair.

First of all, witnesses, I would like to thank all of you today. You've been very specific in your recommendations, and I really appreciate that. I'm sure that each of you will be continuing your dialogue with the various ministries you interact with. The type of coordination and collaboration that we're hearing of is very positive.

My first question is for Mr. Lemaire.

Mr. Lemaire, you mentioned the issue of temporary foreign workers, and I think we've all become very aware of the importance of these individuals. In my former life as the medical officer of health for York Region, under provincial guidelines we would go in and ensure that living accommodation was consistent with good practice and so on.

You mentioned a lack of consistency now being an issue across Canada given the COVID-19 situation. Could you elaborate a little more as to what you actually meant about that and what difficulties that's causing?

[Ron Lemaire]

Most definitely.

A simple example is in Ontario where you see one county or municipality that has a very rigid protocol requiring, to your point, bunkhouses and a certain square footage of bunkhouse that could only maintain four workers. You take a five-minute drive over the road to another county, another municipality, and that same bunkhouse size can hold up to 10, and it is literally a kilometre or two down the road. Those inconsistencies create havoc and added costs, structure and strain to a market in a very stressful environment for a grower who's trying to manage the best-case scenario. For workers who have been coming to their farms for many years and are really, in some cases, part of their family, they have tried to leverage hotel rooms, if they're available, close by at, again, added cost. The funding that has been provided by the federal government of $1,500 per worker has helped, but it's still not enough to offset the total cost of isolation.

How do we look at consistency? Well, the Public Health Agency of Canada did provide guidance and direction, recognizing that the federal approach is that the boots on the ground at the regional level have a better understanding of how those regions need to operate. There still needs to be more discussion at the federal and provincial and territorial levels to ensure that provinces can take a more effective lead to harmonize an approach, at least across the province, to enable, let's call it, a consistent, healthy, safe and competitive world for the farmers.

I'll give you an example. Right now, the challenge we're seeing is that we have 85% of the workers we would normally have at this time, but that's 85% of a total that was already short last year, and so we have a greater shortage in the actual number of workers we need. Adding protocols and restrictions that may be over and above the requirements that even the Public Health Agency of Canada have identified is just creating more of a strain on access to Canadian food.

On putting workers into the field if they are not showing symptoms, there has been some discussion. They're isolated on a farm. Can you just take that isolated group and have them working within an isolated environment? A range of discussions have been proposed, but we do recognize that some of the direction from public health is most definitely warranted.

[Helena Jaczek, Liberal, Markham—Stouffville, ON]

In other words, you're thinking of a bit of a stronger guidance role for the Public Health Agency of Canada. Even beyond this pandemic, you would like to see more consistency across the country. Is that essentially what you're saying?

[Ron Lemaire]

We need a harmonized approach and a review of the protocols as well. Again, every work environment is different. We've seen that in some of the discussions relative to meat packing, produce packing lines, the retail environment, the grower environment. Not every work environment is the same. We recognize that those protocols need to be adapted, but we also have to recognize what the risk is of some of these protocols, and if we need to have that same level of stringency on lower risk environments for a spread.

[Helena Jaczek, Liberal, Markham—Stouffville, ON]

Mr. Lemaire, you made some reference to some increased flexibility that CFIA has introduced around labelling and so on.

What are some of those measures that you would like to see maintained post COVID-19?

[Ron Lemaire]

What is important right now is that if we have product that is perhaps destined for the U.S. market—a Canadian product that has U.S. labelling on the package—we need to ensure that all of the allergens and all of the correct information to ensure the safety of Canadians is on that package.

At the same time, though, Canadian consumers are smart. As long as the information is there, even if it's not in the same format they're traditionally used to, they will be able to navigate that package, and we will be able to service and provide for food gaps in the Canadian market. The flexibility on consumer packaged goods and consumer food packaging is essential to making sure that we don't have a product that's sitting in Canada, not moving to the U.S. because of other issues, which could easily be redirected to the Canadian consumers without, again, adding costs of unpacking and repacking that product in a Canadian label.

The flexibility is key. CFIA is looking at how they can adjust those requirements, and we have provided recommendations for that. I'd be happy to share those with the committee.

[The Chair, Liberal, Marcus Powlowski]

Thank you, Dr. Jaczek.

We'll go now to Mr. Thériault, for two and a half minutes, please.

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Chair, my question will be brief.

Ms. Black and Ms. Vyce, underfunding of the health care system has made some living situations such as long-term care homes, in particular, vulnerable. Earlier you mentioned that long-term care networks will need a significantly larger number of beds.

What's the best approach to deal with this issue? Do you think that home care could partially meet that need? If home care had been well established and people had been properly trained to provide this type of care, would the situation in long-term care homes have been the same during the pandemic?

[Amanda Vyce]

I don't think the answer to that question would be an either/or type of situation.

There was a recent study published out of Ontario that polled individuals who were in hospital but could not return home yet. They couldn't live completely independently without some supports in place, but they also did not require the level of care provided in a long-term care homes. The majority of individuals in that poll indicated that what they would like to see in Ontario is an increase in access to home care services.

I believe that we need both. I believe that we need more funding for home care services. I believe that home care should be publicly funded and publicly provided at the same time that we increase the number of beds in long-term care, because we know that the size of the aging population is going to grow quite rapidly over the next couple of decades.

[Luc Thériault, Bloc, Montcalm, QC]

With the recent decline, and considering the fact that we have PPE, would it be wise and advisable to find a safe way to allow at least one loved one to be near our seniors, so that our fathers, mothers, grandfathers and grandmothers aren't dying alone in long-term care homes?

[Amanda Vyce]

In some provinces, this is already taking place. The administrators of homes have the opportunity to assess each individual case and determine whether it is safe to allow one family member into the home to visit with someone who is dying. In some provinces, this is permitted. I believe that family members are provided with proper PPE.

This could be something that could be slowly reintroduced to ensure that no resident living in long-term care dies alone.

[The Chair, Liberal, Marcus Powlowski]

Thank you, Mr. Thériault.

We will now go to Mr. Davies for two and a half minutes, please.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Mr. Chair.

Ms. Black, we heard I think a rather startling statistic of some care homes having a patient-attendant ratio of 1:75 at night, which is almost unfathomable to me considering the risk to that population. I'm wondering how far off most long-term care facilities are from having the level of staffing that would be considered necessary and adequate.

[Lou Black]

As Ms. Vyce said earlier, it's hard to know across the country exactly how far off we are, given the way that staffing levels are collected and reported.

I can give you the example of B.C. We have a guideline of 3.26 hours per resident per day. On average, they're being funded for 3.25 in B.C. right now. When Ms. Vyce spoke about the 4.1 figure, I would point out that it was recommended by the most comprehensive study to date. It was a report to the U.S. Senate in 2001. The complexity levels of seniors have increased radically since 2001, so it needs to be updated. The study looked at over 5,000 facilities in the U.S. seeking Medicaid funding. It used regression analysis and extensive modelling, following care aides and staff to see what length of time...they're like time-motion studies. It used hundreds of key informant interviews, with directors of care, with heads of administration, with care aides. It's hard to replicate a study like that, so we do rely on that old figure, but the number needs to be revamped and undoubtedly it's going to be higher than 4.1 when we do that.

Right now in B.C., the 3.36 guideline obviously falls shy of that 4.1 figure. The 4.1 figure in that study refers to direct care hours: the nursing team, the care aide, the licensed practical nurse, the RN. In B.C. the 3.36 guideline includes allied health, including dietitians and occupational therapists, who are all essential, but in a way it's like padding the numbers. If you get down to the direct care hours, it's even lower than the 3.36. As I mentioned, we're not hitting it right now; the average is 3.25, so there's certainly a gap.

[Don Davies, NDP, Vancouver Kingsway, BC]

If I could turn you quickly to the issue of PPEs, what is the situation with PPEs in care homes in British Columbia? What have you learned from this pandemic on a go-forward basis?

[Lou Black]

We have members going without PPE at this point. Our members are fearful. We're being assured by our medical health officer, who is doing an incredible job, that we have a three-to-five-day supply on hand.

As Ms. Vyce said earlier, there is a hierarchy in doling out the PPE. It's the same in B.C. It goes to acute care first, then to long-term care, and then home care and community...so we're facing that situation as well. I think a lesson to take from it is that there has to be an adequate supply upfront. We've got to make sure it's stored, that we have it on hand for our members, so there aren't these divisions that are being created on the team. Nurses are being given this equipment, but not necessarily other people who are in direct contact with the patients. We can't be in that situation again. It's not a time when you want the team divided, and ultimately you want the workers to be safe.

[The Chair, Liberal, Marcus Powlowski]

Thank you, Mr. Davies.

We'll start round three.

Ms. Jansen, please go ahead for five minutes.