Evidence of meeting #22 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.

On the agenda

MPs speaking

Also speaking

Amir Attaran  Professor, Faculty of Law, University of Ottawa, As an Individual
David Fisman  Professor of Epidemiology, University of Toronto, As an Individual
Richard Schabas  Former Chief Medical Officer of Health for Ontario, As an Individual
Kamran Khan  Professor of Medicine and Public Health, University of Toronto, Chief Executive Officer and Founder, BlueDot
Vito Ciciretto  President and Chief Executive Officer, Dynacare

5:10 p.m.

Prof. Amir Attaran

I will just add one last thing to this. There was a time in this country when the federal government did provide a contract to somebody to develop such an epidemic data reporting system. It was given to IBM Canada. The system did not function, and they are the same ones who are behind Phoenix, so there is not a good history here.

5:10 p.m.

Conservative

Tamara Jansen Conservative Cloverdale—Langley City, BC

Okay. Thank you.

I've asked numerous witnesses if they would give PHAC a grade on their pandemic response. So far no one has been willing to give me a straight answer. I've been hearing of some backlash by PHAC to those who are vocally critical in their response to the pandemic.

Are you willing to give me a grade, or could that disadvantage you in your work in some way?

5:10 p.m.

Prof. Amir Attaran

My grade is a C-minus or a D. And there is retaliation, yes. Since the last time I appeared in front of this committee, and was negative about some of those efforts, I was asked to join a grant application with people from PHAC. I understand they said they wouldn't participate unless I stood off it, which I did willingly because I didn't want to cause trouble for my colleagues. But I don't feel there should be retaliation against witnesses simply for providing our democratic government what we think is the truth.

5:10 p.m.

Conservative

Tamara Jansen Conservative Cloverdale—Langley City, BC

Okay. Thank you for that direct answer. I appreciate that.

Yesterday, Dr. Nemer talked about the task forces she set up to tackle the Canadian pandemic response. She mentioned that, although she could share the agendas, she couldn't share the deliberations or findings because they are secret. I believe other countries around the world that have set up similar task forces are sharing their research papers publicly, which helps us all.

Do you think the findings of these task forces should also be public so we can have that timely data sharing for a better pandemic response?

5:15 p.m.

Prof. Amir Attaran

I can't even believe that's a question. Of course, it has to be public. Science is always conducted in public. If you look at a country like Switzerland, they too have a task force on COVID, a scientific task force. If you go to the website over two dozen public reports by that task force are published. If Switzerland, little Switzerland, can get two dozen reports out of their task force by now, why does Canada have zero? It's shameful.

5:15 p.m.

Liberal

The Chair Liberal Ron McKinnon

Thank you.

Mr. Fisher, please, go ahead. You have six minutes.

5:15 p.m.

Liberal

Darren Fisher Liberal Dartmouth—Cole Harbour, NS

Thank you, Mr. Chair.

Dr. Fisman, you have a wealth of experience in the battle against infectious diseases, yet you've publicly explained that predictions you made earlier this year on the virus were wrong. I think we can both agree that hindsight is 20/20. There's been a lot of discussion at this committee about why certain decisions were made in the early days of this virus.

I wonder if you could explain to this committee, and to Canadians, about the difficulties of making predictions around a novel virus, and why what's considered the best advice one day can change and evolve so quickly the next?

5:15 p.m.

Professor of Epidemiology, University of Toronto, As an Individual

Dr. David Fisman

I think part of the difficulty relates to the fact that viruses are the troublemakers, and Dr. Khan alluded to this. The troublemakers tend to be RNA viruses, that's their genetic material that comes from animals. RNA viruses are very good at mutating. What we see with this virus, which is a cousin of SARS 1, and bears a lot of similarity to SARS 1, is that it behaves differently in important ways. Being 80% similar can still translate into some very important differences, but some very important similarities.

What we tend to see, what we almost always see with infectious diseases as they emerge, is we find out about hot spots first. Typically we have this sense of the virus being more virulent than it ultimately turns out to be. That's certainly been the case with some outbreaks. What we saw with this virus, also initially, was it looked a lot like SARS based on the information we knew from China. I've acknowledged publicly I think my biggest mistake was thinking it really was looking like SARS in China. We did some forecasting on how the Chinese seemed to be doing in controlling it, and we accurately forecasted that it would be done in Wuhan by early March. That was right, but the difficulty was we didn't see Iran coming. Once you saw this in Iran, you knew the game was over, and this was going to disseminate around the world.

They're all the same, but they're all different. When you look at some of the key parameters, as we talk about, with these diseases, which let you sort of predict how things are going to play out, some important numbers include the reproduction number of the disease, the number of new cases per old case. This virus turns out to be a real trickster, in that it's got what's called an overdistributed reproduction number, where many cases are dead ends but some individual cases make 40 secondary cases. You see that play out again and again, whether it's in nursing homes, on cruise ships or in restaurants. As you know, there's the single individual in Korea who infected 40 secondary cases and sparked a massive outbreak in the city of Daegu.

That makes it difficult. It also provides a potential vulnerability for the virus in terms of control, because once you get rid of those large gatherings that make super-spreading events difficult, the virus becomes much less transmissible. The initial case fatality that we saw coming out of China—that's deaths per case—was listed as 2.4%. Of course, deaths go up slowly with this thing, because people die in the ICU. The China case fatality I think at this point is 5% or 6%. We're at 7% in Canada.

As for what we know now, we've been helped a lot in this regard by data from Spain from last week, from a national seroprevalence study, where they were able to find both the recognized and the unrecognized infections. About 5% of the country of Spain has had this, with 27,000 deaths. Now we're able to go from a case fatality in Spain, which is deaths per recognized case, down to an infection fatality rate, which in Spain we now are pretty sure is about 1.2%, based on seroprevalence data.

The fact that Spain is at 5% prevalence 30,000 deaths in, with an infection fatality rate of 1%, makes me very concerned about some of Dr. Schabas's remarks in terms of moving towards herd immunity. We think that we'd hit herd immunity at 60% to 70% of Canadians infected. Seventy per cent of Canadians infected is 28 million people, and 1% of that is 280,000 Canadians dead. I would note that the failure to have mass mortality in Canada to date relates to the public health response.

I would also note that we can do this because we've shown around the country that we can control this disease without just letting it rip and pushing for herd immunity, as they're doing in Sweden. We've seen competence in British Columbia. We've seen tremendous competence in Atlantic Canada and on the Prairies. We can do this. We just need to get the job done.

Throwing your hands up and saying that we're going to follow Stockholm, Sweden, which is currently leading Europe in per capita mortality, is not the way to go, in my opinion.

5:20 p.m.

Liberal

Darren Fisher Liberal Dartmouth—Cole Harbour, NS

Thank you. I had other questions for you, and I think we've run out the clock—

5:20 p.m.

Professor of Epidemiology, University of Toronto, As an Individual

5:20 p.m.

Liberal

Darren Fisher Liberal Dartmouth—Cole Harbour, NS

—but I do want to say that this is excellent and very thoughtful testimony, and I want to thank you for that, Doctor.

5:20 p.m.

Professor of Epidemiology, University of Toronto, As an Individual

5:20 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Mr. Chair, I have a point of order.

I'm still somewhat shocked at the evidence I heard from Dr. Attaran about him potentially being discriminated against or having retribution threatened against him as a result of this testimony before the health committee. All of us, as members of this committee, have an interest in upholding the integrity of this committee and ensuring that all witnesses who come before us can give us the sincere, unvarnished benefit of their opinion, particularly when we're talking about science.

I would like to ask that this committee formally request that Dr. Attaran indicate to us full details of what has occurred by PHAC or Stats Canada, or whoever it was, to ensure that the integrity of this committee is upheld at all times.

5:20 p.m.

Liberal

The Chair Liberal Ron McKinnon

Thank you, Mr. Davies.

Under our current operating mandate, we don't have the authority to do that. We can certainly invite him to submit all of the evidence, all of the allegations he has, to us or to the Speaker of the House. We would be unable to deal with a matter of this kind in our current operating situation.

5:20 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Mr. Chair, if I might—

5:20 p.m.

Conservative

Robert Gordon Kitchen Conservative Souris—Moose Mountain, SK

Mr. Chair—

5:20 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

—I would vehemently dispute that. This committee is mandated to receive evidence. It's clearly in the consent order of the House of Commons. If we have evidence before us that witnesses are being pressured or intimidated against not giving evidence, that is a direct interference with the precise mandate of this committee.

On the record, I'm happy to ask Dr. Attaran to provide those details, but for the record, I want to state in the strongest terms possible that it is absolutely the prerogative and mandate of this committee to ensure that we uphold the integrity of our process. Any time we hear that a witness may have been intimidated, or harmed in any way, for simply accepting the invitation from us to come and give us the benefit of their testimony, it's absolutely part of the pith and substance of this committee, and I will pursue this matter fully once we get that information from Dr. Attaran.

5:20 p.m.

Liberal

The Chair Liberal Ron McKinnon

Thank you, Mr. Davies. Your point is well taken. I will take the matter under advisement and—

5:20 p.m.

Conservative

Robert Gordon Kitchen Conservative Souris—Moose Mountain, SK

Mr. Chair, I have a point of order.

5:20 p.m.

Liberal

The Chair Liberal Ron McKinnon

Dr. Kitchen, go ahead.

5:20 p.m.

Conservative

Robert Gordon Kitchen Conservative Souris—Moose Mountain, SK

Mr. Chair, I'm 100% behind what Mr. Davies said, but my point of order extends further than that. We as committee members are here to present and ask questions, to protect our witnesses as well as ourselves, and to make certain that we have that protection. If we do not have that as a committee, the questions and points that we may bring up can be held against us, and that's just not acceptable. How can we function as a committee if that's not the place?

May 20th, 2020 / 5:25 p.m.

Conservative

Matt Jeneroux Conservative Edmonton Riverbend, AB

Mr. Chair, just to add on to that, if you could point us in some direction as to why you don't think we have these powers to be able to do that in this committee....

I disagree with you. I agree with Mr. Davies that it's within the mandate of this committee to ask for that testimony.

If you can point us in that direction, please do. If you can't, then I suggest we allow Mr. Davies to proceed with his point of order.

5:25 p.m.

Liberal

The Chair Liberal Ron McKinnon

Your points are well taken. It should be pointed out that all testimony before this committee, when it's operating in official capacity, is privileged. We have parliamentary privilege. Any repercussions that follow from that would be a serious matter, but our mandate is solely to receive evidence.

We are explicitly allowed to move motions relating to the invitation and scheduling of witnesses. We do not have the authority at this time to undertake a motion to demand information about matters such as this, but I certainly would welcome Dr. Attaran's information if he should provide it.

I wonder if our clerk would like to give an opinion on this.

5:25 p.m.

Bloc

Luc Thériault Bloc Montcalm, QC

Mr. Chair, I would like to raise a point of order.

Professor Attaran seems to want to add a comment. Perhaps he could clarify what it is, which could help you deliberate further. I would be prepared to let him speak quickly, since I thought I saw him raise his hand. So I would like us to hear what he has to say. Then you could deliberate on that.

5:25 p.m.

Liberal

The Chair Liberal Ron McKinnon

Witnesses aren't able to participate in the committee on points of order, but as I said, I will welcome his information. I invite him to bring it to the committee, to send it to the committee.

The clerk will be looking into this matter and will come back to us at a later time with an opinion. In the interim, I will reserve judgment and suggest that we carry on with the testimony.

Mr. Thériault, please go ahead. You have six minutes.