Thank you. I'll pass.
Thank you, folks.
Evidence of meeting #19 for Health in the 43rd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was data.
A recording is available from Parliament.
Evidence of meeting #19 for Health in the 43rd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was data.
A recording is available from Parliament.
3:50 p.m.
Liberal
3:50 p.m.
Liberal
The Chair Liberal Ron McKinnon
Thank you, Mr. Fisher.
We'll go now to Mr. Jeneroux.
Please go ahead. You have five minutes.
3:50 p.m.
Conservative
Matt Jeneroux Conservative Edmonton Riverbend, AB
Thank you, Mr. Chair.
Mr. Villeneuve, would you agree with me that one of the most significant challenges that nurses are facing right now is the lack of PPE?
3:55 p.m.
Chief Executive Officer, Canadian Nurses Association
It's uneven across the country, but it is an ongoing concern for all health care workers.
3:55 p.m.
Conservative
Matt Jeneroux Conservative Edmonton Riverbend, AB
Going back, when was it first raised by your association, the importance of having PPE, and enough PPE, on the front lines?
3:55 p.m.
Chief Executive Officer, Canadian Nurses Association
You raise a great question, because we sent a joint letter with the Canadian Medical Association and the Canadian Pharmacists Association fairly early on. I'll find that for you. It was the first public statement we made in an open letter saying that we were concerned about mental health issues, as many of us talked about, but also about PPE.
It was early on, because of the SARS experience. It wasn't really so much a complaint as beware that this is coming, it's spreading across the country, and people need the right equipment to protect themselves in this situation. We were on it very early.
3:55 p.m.
Conservative
Matt Jeneroux Conservative Edmonton Riverbend, AB
Again, we want to make sure that we're getting the best response possible for any future potential pandemics, so knowing that these sorts of things are being raised early and often is exactly what we're trying to get at.
3:55 p.m.
Conservative
Matt Jeneroux Conservative Edmonton Riverbend, AB
That brings me to what we've understood with the national emergency stockpile and how that was mismanaged.
Was that something on the Canadian Nurses Association's radar at all? Until it was in the news, did you know about that?
3:55 p.m.
Chief Executive Officer, Canadian Nurses Association
Our concern was the unevenness of it. For example, we had heard from one source that there were masks sitting at an airport, blocked, that couldn't get through some customs hurdle, or something such as that. I don't remember the specific date or details. However, it seemed to us as though there was an unevenness about it. Of course, part of that, we assumed from our own research and talking with people, is because some of these products come from places in other countries that themselves are shut down.
A key lesson from this going forward for all of us coming out of this is for personal protection, just as we do for firefighters and others, so that the stockpile is there when we need it.
3:55 p.m.
Conservative
Matt Jeneroux Conservative Edmonton Riverbend, AB
Help me understand the unevenness. Are you talking about within jurisdictions or within products? What do you mean by unevenness?
3:55 p.m.
Chief Executive Officer, Canadian Nurses Association
I'm particularly thinking of personal protective devices, masks here and in different jurisdictions, different employers and different rules on different shifts.
I'm not trying to dodge the question at all. It's a problem we often have in health care: I think we should do it this way on the surgical ward, whereas this leader thinks we'll do it that way on a medical ward. Even within institutions, practices can be quite different.
3:55 p.m.
Conservative
Matt Jeneroux Conservative Edmonton Riverbend, AB
One of my colleagues, Mr. Davies, asked a question about how many nurses have been diagnosed with COVID-19. We'd also be very interested in that.
Can you confirm, and I think you did, but just to clarify, that most of the confirmed cases of nurses diagnosed with COVID-19 are in long-term care homes?
3:55 p.m.
Chief Executive Officer, Canadian Nurses Association
No, I don't know that. I'm sorry, I don't know. I checked with my colleague while we were talking and we will get that information for you this week.
3:55 p.m.
Conservative
Matt Jeneroux Conservative Edmonton Riverbend, AB
Do you have any ballpark numbers, just to tide us over until then?
3:55 p.m.
Chief Executive Officer, Canadian Nurses Association
I would totally be guessing. However, we noted in Ontario that among what I believe are seven deaths of health care workers, not that it should come to death, but if we're counting the worst outcome, five were personal support workers in home care and long-term care and two were custodial workers in hospitals.
3:55 p.m.
Conservative
Matt Jeneroux Conservative Edmonton Riverbend, AB
Touching on mental health, I know you touched on it already, but what support measures for the nursing profession should be provided now that weren't necessarily provided before and should be considered in light of COVID-19?
3:55 p.m.
Chief Executive Officer, Canadian Nurses Association
We know from, I believe, the Pollara research last week that both anxiety and depression have risen across society. The level of burnout was about 40% among nurses before this even started, and I think it's pretty high among a lot of physicians.
We're taking part in a rapid review of the research, Mr. Jeneroux, coming out of the University of Toronto to define the top-level mental health interventions that work. Is it a phone line or is it one-to-one counselling? Then we can identify which among those we think works the best. The issue then will be: Can we get it to people quickly and without a high cost or without any cost? Mental health care in this country is expensive. It was hard to get before all this.
4 p.m.
Liberal
The Chair Liberal Ron McKinnon
Thank you, Mr. Jeneroux.
Dr. Jaczek, please go ahead. You have five minutes.
May 11th, 2020 / 4 p.m.
Liberal
Helena Jaczek Liberal Markham—Stouffville, ON
Thank you very much, Chair.
In view of the fact that it is National Nursing Week, my first question will be for Mr. Villeneuve.
I will have my T-shirt at the ready. Tomorrow is International Nurses Day and I will wear it with enthusiasm to celebrate our wonderful front-line nurses.
Thank you so much for giving that shout-out to public health nurses who are not quite as visible as the nurses on the front line. I know here in the York region that our public health nurses have been working around the clock on contact tracing which, as you know, is a very detailed type of activity. It's very time-consuming and requires considerable skill as, obviously, some people really do not want to disclose exactly what they have been doing for the previous 14 days.
Going back to the issue of mental health, there's a strain on our front-line workers, which I think is self-evident. My recollection post-SARS certainly in the GTA was that a number of nurses did take early retirement following the SARS epidemic and the work and stress that they had been involved in.
I know the Canadian Nurses Association has been concerned about shortages in the nursing profession, so are you thinking ahead to consequences post-COVID as to what that's going to look like from a labour point of view?
4 p.m.
Chief Executive Officer, Canadian Nurses Association
Yes. I'll give a very brief answer around SARS. I happened to be stationed out of the country that year, so I wasn't very close to it, but I have colleagues who worked right in the middle of it at Mount Sinai who, even now when you talk to them all these years later, are so traumatized they can hardly talk about it.
In our long-term care sector here, we have a colleague who reported from one of the homes. She volunteered to go in to help. Sixty of the residents out of the 170 had died in the previous three weeks, and eight had died that night. She looks completely haunted, and this is a 32-year-old, I guess; she's young. Everyone looks young compared to me, but she's just a young woman, a doctoral candidate, full of energy, and she just looks defeated. Then she got COVID herself as a result of the experience and feels she doesn't even know if she can go back into it.
We haven't had the ICU decision-making where I have to decide if you get a ventilator or you don't, or we're taking you off one because this one might do better and all that horrible stuff that came out of New York, Italy and Spain. We may have it hit harder in the long-term care sector, and I don't think that even at CNA it was so much on our radar that we thought it would sweep through there.
Yes, we are concerned about what comes out of this. We're really concerned that, for example, in Ontario it was suggested.... I think it was Mr. Ford on Thursday or Friday who suggested that the estimate for the catch-up for the surgeries that Dr. Dorian mentioned is two years. Who is going to do that? If all of these people are already working full time, where are those surgeons, techs and nurses going to come from?
We are concerned and we are also working with a different research team to measure some of the impacts of this on the workforce. Does it cause people to retire, to move and change? It's all sort of, at this point, a bit of a messy middle, but it's on our radar.
Thank you very much for that question.
4 p.m.
Liberal
Helena Jaczek Liberal Markham—Stouffville, ON
Thank you.
My next question is for Dr. Dorian.
I think many of my colleagues have been questioning the whole issue of why the data isn't much more readily available. CIHI has that responsibility, in order, hopefully, to create some sort of national database that makes sense. You have referenced privacy concerns. I remember, when I was commissioner of health services and medical officer of health for York region, I was the health custodian for six different datasets, and according to our legal counsel, I couldn't talk to myself. In other words, I couldn't cross-reference patient X in one dataset with the same patient in another dataset.
To what extent have you talked to privacy commissioners to ensure that they understand that aggregating data analysis is just so vital for us to understand the science behind disease patterns, etc.? Have you as an association had those types of conversations?
4:05 p.m.
Representative and Department Director, Division of Cardiology, University of Toronto, Canadian Cardiovascular Society
We've had some of those conversations. We work very closely with CIHI, and I just want to make sure that there's no misunderstanding. CIHI has been extremely collaborative and supportive of the kinds of efforts we make. It's limited by its budget, its bandwidth, and its ability to collect and aggregate information. That's a challenge we face together.
It's also limited in that it has access to some data, which is collected inside hospitals, but CIHI doesn't have the mandate to collect, for example, emergency department data or data from long-term care homes, at least some data in physicians' offices, laboratory data and so on.
I think you hit the nail on the head when you said it's a challenge to even be allowed to talk to yourself. My sense is that the firewalls that are up there are not because of anybody's ill will but because of levels of concern—perhaps appropriate, perhaps not appropriate—that will only be surmounted if we can get all of the individuals, groups and custodians into one room at one time with some leadership and direction from public health agencies, at either the provincial level or national level, who will help adjudicate between these various concerns and come up with a single type of strategy.
I think we have tried to have individual conversations with individual privacy commissioners, but I'm not sure that is the most fruitful way of trying to solve this problem.
4:05 p.m.
Liberal
The Chair Liberal Ron McKinnon
Thank you, Dr. Jaczek.
We go now to Mr. Thériault for two and a half minutes.