Health Committee on May 27th, 2020

[Conrad Sauvé]

I think it's the extension of what we've been doing in Trenton in terms of returning Canadians on cruise ship lines. We've extended that to support the Public Health Agency. People who arrive here who don't have a clear plan for their quarantine, we're supporting them in that quarantine period. That's what this is about.

I don't have the exact number, but that's what we're doing, basically. It's a continuation of what we've been doing, in this case to make sure that these people are being quarantined for the full period.

[Len Webber, Conservative, Calgary Confederation, AB]

I see. It's for the individuals who were perhaps in tight spots such as cruise ships and such where there was quite of an appearance of COVID, people in distress, basically, coming back to Canada and being put into these Canadian Forces bases.

[Conrad Sauvé]

The cruise ship plan was the Canadian bases, and there were a number of them. That's what we did. There were about 1,200. Then following that, we're supporting—I don't have the exact number—I think eight airports. For a Canadian who comes back who does not have a clear plan, we will support that quarantine period as close as possible to the airport to avoid travel within the country.

[Len Webber, Conservative, Calgary Confederation, AB]

You provide the quarantine spaces in these four cities to accommodate individuals who do not have any other way to quarantine or self-isolate for 14 days. It's where you feed them as well and provide all the essential services.

Okay. Thank you for that.

[Conrad Sauvé]

That's right, exactly.

[Len Webber, Conservative, Calgary Confederation, AB]

I also want to ask you a question about the deployment of your mobile field hospitals. You mentioned that you had two field hospitals, one that went up in Vancouver and one in Montreal.

First of all, how many field hospitals does the Canadian Red Cross have at your disposal? Who decides where these field hospitals are to go?

[Conrad Sauvé]

I don't have the exact number, but we probably have two 80-bed field hospitals. We have a number of mobile units as well. These deployments have been done at the request of the health authorities in the province. In the case of B.C., it asked early on. We had done exercises. We had looked at the possibility that this could be used. The subregional health authority of Montreal west asked for the same thing. We have capacity on standby with the Canadian government as well for deploying in the north.

[Len Webber, Conservative, Calgary Confederation, AB]

The reason I ask is, in my riding of Calgary—Foothills, a hospital in Calgary Confederation, set up a temporary tent, quite a large structure, to accommodate COVID patients there to keep them away from the general population of the hospital. That was at quite a cost. If the Alberta Health Services had asked the Red Cross, would you have deployed one there as well?

[Conrad Sauvé]

Yes, but I think what I was talking about earlier is that we need to go back and look at what the actual use of all this equipment was. What's the best way to do this?

We couldn't have answered all the requests; there are number of tented structures that have been everywhere. We responded in the way we could with what we had. I think we need to go back with the health authorities and look again at what has been required, what's useful, and what we can keep and stock that will be useful for these situations.

[Len Webber, Conservative, Calgary Confederation, AB]

Thank you for that.

Dr. Tien, I have a quick question.

First of all, thank you for your service in the armed forces. We can't thank veterans enough for their service.

You talked a bit about point of care and sending lab tests to remote communities and doing lab tests and such. You talked a bit about sending deployment kits such as ventilators and personal protective equipment up to remote communities, I guess to temporarily ventilate patients up there, then send them back.

With respect to deploying a kit there on a permanent basis, such as to leave the patient in their community and to provide care there, is that an option, or do these patients need to be sent back to larger hospitals, which would again cause risk for others in these larger cities?

[Dr. Homer Tien]

I think it's important to realize that, for some of the communities that we're talking about for the surge, it wouldn't be just the equipment that would go, it would be the critical care paramedic who would go with the kit. They have very little infrastructure there. At some of these remote indigenous communities in northern Ontario, it's a nursing station with no in-patient facility. The model of care there would be to evacuate them as quickly as possible. If there were, say, six or seven community members, and they were waiting for the airlift out, at least we could leave some people there to keep those patients alive while awaiting transport.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Webber.

We will now go to Dr. Powlowski for five minutes.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

I have to thank Mr. Webber, because he set me up nicely for my question. I thank Dr. Tien as well.

I'll lob Dr. Tien a question, though I know the answer to it because we've talked about it before.

The problem in a lot of northern indigenous communities is that there is no infrastructure. Basically there's one solution to any real medical problem: if anyone's really sick, fly them out. They call Dr. Tien at Ornge and say, “Come and help us; we need to get somebody out of the community.”

We know that if COVID gets into northern indigenous communities, it's likely to be bad. It's likely to spread quickly given the lack of housing, the lack of water supply and the fact that for some reason people in the north seem unusually susceptible to respiratory tract infections like influenza. H1N1 hit those communities very hard.

If we were faced with multiple very sick people who were sick at the same time, does Ornge have the capacity to get a lot of people out quickly, or does it have too limited an airplane capacity to move a lot of people quickly? I know you have a solution, so I'd like to hear it.

[Dr. Homer Tien]

Obviously we have some capacity, but in planning for the COVID surge, we have to think beyond the normal influenza season, with its one or two patients, or even three patients, who need immediate evacuation because they're in severe respiratory distress.

One of our surge plans, apart from having the critical-care paramedics, is that we've liaised with the Canadian Armed Forces to see whether we could use a request for assistance, RFA. We could leverage one of their military transport propeller aircrafts, like the Hercules or even a C-17, one of the four-engine jets. We could drive our ambulances on board and and bring the surge response team with the land ambulance capability to these communities. The idea would be to drive to the nursing station, load the patients, provide critical ventilator care, fly back to the regional hospital, drive to the hospital and keep making runs. Because they have such a large capacity, we would be able to move a larger number of patients more quickly.

We did the initial fit tests with our ambulances on the military airframes. They have to work out certain very technical things like where the ambulance needs to sit, given the axle of the aircraft and the load and weight. What happens to any air circulation in the ambulance? Does it actually leave the ambulance and enter the aircraft? They're working out some of those details from a doctrinal point of view, but we've already done the fit tests. Hopefully there is no second wave, but if there is a second wave that requires this, hopefully we'll have this capability on board to off-load some of these communities rapidly.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

We've talked about field hospitals, and I know a lot of northern indigenous communities are interested in the idea of them. The Red Cross has already discussed that with us.

Dr. Tien, you suggested the idea of a minimal treatment centre. Could you explain what a minimal treatment centre is and the rationale for using it?

[Dr. Homer Tien]

I think it's very difficult for these communities to have field hospitals, at least as I know them from the military. We'd have an operating room, ventilators and ICU capacity for any prolonged period of time. These communities, even the largest of them, have maybe 3,000 to 5,000 people, so it would be hard to sustain field operations for a prolonged period of time.

I think they could have a fairly minimal set-up, with some sections of tentage, to provide primary-level care for patients with COVID so that they're separate from the rest of the community. It's basic nursing care, but with the idea that if they were developing respiratory distress, they'd be evacuated quickly. Those with relatively mild cases could be kept in the community, and then once COVID-negative, they could return back to their homes.

[The Chair, Liberal, Ron McKinnon]

Thank you.

Ms. Jansen, go ahead, please, for five minutes.

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

Thank you very much.

First of all, I want to quickly say thank you so much, Ms. Polsinelli, for your fantastic explanation of the difference between task-based care and person-centred care. That was very much appreciated. It's probably the best I've heard.

My question is for you, Dr. Tien. Have you seen the Nav Canada press release of May 5 that announced overnight air navigation services suspended at 18 airports across the country?

[Dr. Homer Tien]

I did hear about that, yes.

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

Would closures of this type affect your organization at all should they happen in your region?

[Dr. Homer Tien]

To date, my air-ops people have said not so much, so—

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

It would be no problem for you if ambulances could not stop at night in airports?

[Dr. Homer Tien]

Well, it would, but to my knowledge, because of that there hasn't been a cessation of service to my knowledge in Ontario, but—

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

Okay. It would affect you, though, if they had that kind of a closure.

[Dr. Homer Tien]

Absolutely. We're completely dependent on airports, so if an airport did shut down because of any reason—and there are many different reasons for a shutdown besides that reason—we would be affected. It would deeply affect our operations, particularly in the north.