Health Committee on Feb. 5th, 2020

[The Chair, Liberal, Ron McKinnon]

We will suspend for a few minutes and bring the video conference online.

Thanks again, all of you.

[The Chair, Liberal, Ron McKinnon]

Thank you, everyone.

By video conference, we have Ms. Avvy Go and Ms. Kennes Lin from Toronto. We also have Dr. de Villa from Toronto. Shortly, I believe, we will have Dr. Bonnie Henry from Vancouver. There is some delay at the airport.

I would ask the witnesses to give us a short statement. Keep it as brief as you can. Normally, we'd give you 10 minutes, but we are kind of constrained on time right now. If you could shorten it up, that would be great. We'll have the two groups that are here now give their statements. Hopefully, Dr. Henry will come along in time to give her statement in that time frame as well. We will adjust as needed to accommodate her.

With that, we'll start with the Chinese Canadian National Council for Social Justice. Please go ahead.

[Kennes Lin, Community Member, Chinese Canadian National Council for Social Justice]

I would like to thank you for the opportunity to address the Standing Committee on Health regarding Canada's response to the outbreak of the coronavirus. My name is Kennes Lin, and I represent the Chinese Canadian National Council for Social Justice. I am also co-chair of the Chinese Canadian National Council Toronto Chapter. With me is Avvy Go, the clinic director of the Chinese and Southeast Asian Legal Clinic.

Since the formation of the Chinese Canadian National Council, or CCNC, exactly 40 years ago, the organization has spoken out against racial discrimination against Chinese in Canada. Among other things, CCNC took the leadership role in the campaign to redress the Chinese head tax and exclusion act, which led to a parliamentary apology for the head tax payers and their families. Building on the legacy of CCNC, the Chinese Canadian National Council for Social Justice was launched in 2019 to educate, engage and advocate for equity and justice for all in Canada. Specifically for the Toronto chapter that I speak for, we are currently an organization of Chinese Canadians in the city of Toronto that promotes equity, social justice, inclusive civic participation and respect for diversity.

CCNC-SJ's mission for equity and justice has been especially important to me in the past week as co-chair of CCNCTO and personally as a Chinese Canadian living in Toronto. Since the announcement of the hospitalization of two individuals with the coronavirus in Toronto, for Chinese Canadians it not only meant the arrival of an outbreak of fear, which all Canadians have, of catching the new virus. This fear was also immediately layered on with the pandemic of fear of being singled out, blamed for, and suspected of transmitting the virus, all for simply being Chinese.

What makes the recent upswing of racism and xenophobia toward members of the Chinese Canadian community especially triggering is that it invokes our collective memory of similar mistreatment and discrimination we faced during the SARS pandemic in 2003: “The SARS epidemic in 2003 had serious health consequences for many in Canada, with 438 suspected cases and 44 deaths. But for Chinese and Southeast Asian communities in Canada, it was compounded by serious social and economic implications.”

Mainstream media constructed a media event out of SARS and fuelled public fear and panic, contributing to the racialization of SARS. When anti-Chinese presumptions circulated, Chinese and Southeast Asians already working in precarious working conditions lost their jobs and were left with no livelihood. When customers stayed away from Chinese businesses and restaurants, this led to an estimated 40% to 80% financial loss in Toronto's Chinatown. When many were assumed to be Chinese, they faced daily incidents of verbal harassment and physical violence.

Today, 17 years on from the SARS pandemic, I witness the unfolding of a similar rerun of anti-Chinese racism with the novel coronavirus outbreak. This past week, my organization received angry phone calls, messages and emails placing blame on the Chinese community for the coronavirus pandemic. This time, however, anti-Chinese racism is fuelled by the powerful and dangerous tool of social media. In the past week, a CTV journalist was fired for posting an Instagram selfie with a Chinese hairdresser wearing a mask, stating in the caption, “Hopefully ALL I got today was a haircut #CoronaOutbreak #Coronavirustoronto”. Still, in the past week, a video post was shared multiple times showing a customer walking into a Chinese restaurant named Wuhan Noodle with a caption reading, “The Wuhan virus has spread to Markham”, a city just north of Toronto with a large Chinese Canadian population. As the World Health Organization has declared the coronavirus outbreak a global health emergency, we can only expect more racist incidents.

I will now turn to Avvy Go to talk about her clinic's involvement during the SARS outbreak and our recommendations for the committee on how to address the rising xenophobia and racism.

[Avvy Go, Community Member, Chinese Canadian National Council for Social Justice]

Thank you.

As Kennes mentioned, I'm with the Chinese and Southeast Asian Legal Clinic, which is a community legal clinic that provides free legal services to low-income members of the Chinese and Southeast Asian communities.

During the SARS outbreak, our clinic saw first-hand how racism and xenophobia affected the Chinese Canadian community. For instance, we were contacted by tenants who were evicted simply because they were Chinese. There were clients coming to our clinic who lost their jobs because the Chinese restaurants where they were working were laying off people due to business downturn. We also heard from Chinese workers who were terminated or were told to stay home because of perceived fear from their non-Asian colleagues. As a result of that, many had to leave their job without any compensation. Some were not able to access EI payments because of their status. Many were working in a non-unionized setting. There were also the IRB—Immigration and Refugee Board—staff who insisted on wearing face masks during hearings concerning Chinese refugee claimants. Even an MPP from Brampton at that time suggested that SARS was caused by the federal immigration policy, as if the transmission of SARS should be blamed on immigrants.

Right now, with the coronavirus, we are already hearing similar stories. This is happening even in the legal profession. A legal clinic in Toronto is imposing a quarantine on a Chinese Canadian lawyer who just came back from China, even though he was nowhere near Wuhan and had no signs of having contracted the virus.

At the same time, we know that in Canada every year we have about 12,000 people hospitalized and 3,500 deaths because of influenza. No one has ever suggested that we should quarantine people just because they have the flu.

While Public Health Canada and the local public health organizations are working very hard to stop the spread of the coronavirus, we need all levels of government to take the lead to stem the virus of racism. We need the government to provide support not only to those who suffer physically due to the coronavirus but also to those who suffer economically as a result of racism.

We have a number of recommendations for this committee. Not all of them deal with health issues, but we would like this committee to bring them to the government's attention.

First of all, we are calling on the government to set up an emergency fund to assist workers and help them recover a share of wages lost as a result of coronavirus-induced job loss. It could be modelled on the wage earner protection program we have currently, which is reserved for employees of bankrupt businesses.

Second, we are suggesting that the government should consider setting up a fund to assist small businesses that are losing business as a result of lost business.

Third is a recommendation for the Public Health Agency of Canada and the provincial ministries of health. We are asking them to set aside funding for public education campaigns to provide accurate and consistent information about the coronavirus, in different languages, not just English and French. This kind of multi-language public service announcement must also be disseminated through social media, as well as first-language media.

Finally, the campaign to provide information about the virus must be accompanied by an anti-racism campaign. To that end, we are calling on public health to work with the office of the national anti-racism secretariat to combat racism and xenophobia arising from the coronavirus outbreak, and to provide immediate support through funding to Chinese Canadian community groups working on anti-racism. Also, it should develop some long-term sustainable funding to combat anti-Chinese racism and hate in Canada.

Thank you.

[The Chair, Liberal, Ron McKinnon]

Thank you very much.

We will go to Dr. Eileen de Villa, medical officer of health, from Toronto.

[Dr. Eileen de Villa, Medical Officer of Health, City of Toronto]

Thank you very much.

As you've just heard, I'm Dr. Eileen de Villa, medical officer of health for the City of Toronto. Thank you to the members of the committee for giving me this opportunity to address you this afternoon. I will keep my remarks very brief.

As you've heard, I'm the medical officer of health for the City of Toronto. This allows me the privilege of leading Toronto Public Health, which is Canada's largest local public health agency, looking after the almost three million people who reside in the city of Toronto.

I'm going to tell the committee a little bit about public health, as I'm not certain as to your familiarity with the field of public health. I think it's one of best-kept secrets we have.

When you look for textbook definitions of public health, what you'll often see is the description of public health as “the art and science of preventing disease, prolonging life and promoting health through the organized efforts of society.” It's an interesting definition, technically very correct, but I find it's not particularly explanatory.

When I talk to audiences about what public health is and what it does, I try to boil it down to its main objectives. There are three major objectives of public health: first, to improve the health status of the population; second, to reduce disparities in health status; and third, and perhaps most relevant in this case, to prepare for and respond effectively to outbreaks and emergencies. Those are the three major objectives of public health.

What's interesting is that in public health, if we're successful at achieving those three objectives, by definition we achieve a fourth objective, and that's enhancing the sustainability of our health care system.

That's a bit of a primer on public health and what we do.

The other way I like to characterize public health is to describe it as that area of practice which is, to my mind and in my case, a particular branch of medical practice that looks at the entire health of the population. It takes a population health approach and focuses on prevention, so as to help ensure that people start life healthy and stay that way for as long as possible.

It is premised on a system. It actually has to be a system in order to be effective as public health. It requires a great deal of expertise. It requires a broad range of skill sets, everything from technical medical knowledge and epidemiology to an understanding of behavioural science, sociology and, yes, politics. There are a broad range of skills that are required in order to be effective in terms of public health practice, and those skills need to be resident in the various levels of government. It is a co-operative and collaborative endeavour among the local, provincial and federal levels of government, and it engages a broad range of participants, many of whom are outside of the formal health system.

What I will comment on at this stage of the game is that when we look at the novel coronavirus outbreak that we're currently facing, it's through these kinds of events that you can see very tangibly from a public perspective the value of public health, particularly in achieving that third objective: preparing for and responding effectively to outbreaks and emergencies. I think you also see the relevance of that interplay and system perspective, that there is a value and a role for the federal government and for federal public health agencies. There is a value and a role—a significant role—for the provincial health agencies, and, of course, there is a value and a role for those of us who work at the local level of government.

With that, conscious of your time, I'm going to wrap up my remarks. I'm happy to take any questions that members of the committee may have.

[The Chair, Liberal, Ron McKinnon]

Thank you, Dr. de Villa.

We'll start a round of questions.

Dr. Henry may come online later. Unfortunately, it's not ideal for the questioners, but when she comes online, we will interrupt to hear her statement and take the questioning from there.

We'll start with Mr. Kitchen, for six minutes.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Thank you, Mr. Chair.

Doctor de Villa, Ms. Go and Ms. Lin, thank you very much for your presentations. I'm going to apologize to you for taking a second to do something procedurally, and then I'll get back to ask you a question.

Mr. Chair, I would like to put a notice of motion for the following two motions, to be discussed in public forum. The first is:

Pursuant to Standing Order 108(1)(a), that the committee order all documents, including briefing notes, memos, emails, text messages, and summaries of phone calls prepared for the Minister of Health, Minister of Transport, Minister of Public Safety, Minister of Foreign Affairs, and Minister of National Defence regarding the outbreak of the Coronavirus no later than February 28, 2020.

The second motion I'd like to put forward is this:

Pursuant to Standing Order 108(1)(a), that the committee order copies of all correspondence between the Government of Canada and provincial and territorial governments regarding the outbreak of the Coronavirus no later than February 28, 2020.

[The Chair, Liberal, Ron McKinnon]

Thank you.

Carry on with your questions.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Thank you very much

Sorry, ladies. I appreciate your time and your presentations. Your comments are very pertinent to the issue we talked about.

Doctor, I'm wondering if you can enlighten us or expand on the issue of the testing process that's before you. In the city of Toronto, as big as it is, you will have a huge concern about that, and obviously when we have people who are concerned about that.... Can you tell us about that testing process? How does it work provincially, the testing process that you do?

My next question about that is, because you're doing that provincially.... I do believe that the testing process is valid and reliable, but you then have to send that to Winnipeg. Can you explain to us that difference? Are you comfortable that you could actually do that without having to do the follow-through to Winnipeg?

[Dr. Eileen de Villa]

Thank you for the question.

I will do my very best to respond to it, not being a laboratory medicine specialist myself.

The short version of the story is that you have a new virus. This is a virus that was only identified about a month ago. In the world of lab medicine, and microbiology in particular, they're very precise. They're scientists. We have a test here in Ontario that's conducted by the provincial lab, the Public Health Ontario laboratory. The fact that the virus was identified only a month ago and that we have a test is a remarkable accomplishment in and of itself. That's not unique to us. There are other labs around the world that have this.

Effectively, what happens is that the tests are conducted on the patients here. The results go to the provincial lab. It gives us what's called a “presumptive confirmed” test because it's a first test. If the test indicates the presence of the virus, it's positive. Because we're talking about a newly identified virus, a second test needs to be conducted. It is a different test, but it also tests for the presence of the virus, and that test is done at the National Microbiology Laboratory in Winnipeg.

Because you have a new virus and a new entity, you need two tests in order to precisely identify and confirm that it is a positive test for this new coronavirus.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Thank you.

The Americans have basically come out saying that they will recognize testing only from the CDC. Are you aware of that?

[Dr. Eileen de Villa]

I'm not particularly familiar with what's happening in the U.S. laboratory system. I apologize for that.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

That's okay. I appreciate that.

I don't know if you're aware that the World Health Organization has asked for $675 million to assist them. That's a huge amount of money, obviously. We want to make certain that we're protecting countries that can't protect themselves, so we need that assistance.

I guess the question is this. Where would you see that money being utilized? Would it be possibly in testing procedures? Do you have any thoughts on that?

[Dr. Eileen de Villa]

Again, as I am not familiar with what circumstances WHO is seeking to address, it's difficult to comment on that.

However, as with many infectious diseases, often the best strategy is to strengthen the capacity of those other nations and other jurisdictions where the capacity doesn't exist. Infectious diseases don't respect geographic boundaries. The stronger we can make all the links in the chain, the better we are in terms of protecting not only ourselves but also everybody else around us.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Thank you.

Earlier today, we heard from the military on the evacuation of Canadians from China to Canada and how they will be brought into Trenton and then isolated and quarantined in that area. Has that been part of your discussion within the City of Toronto? Is that something that's actually being talked about? I'm wondering if you could elaborate on any of that for us.

[Dr. Eileen de Villa]

Certainly we've had some discussion around that. It's a matter of interest, being part of the public health response to the novel coronavirus situation. Again, since we are not a jurisdiction directly impacted by that, I can't tell you that we've had in-depth conversations on that.

Certainly we anticipate that some of the people who will be arriving in Trenton may be residents of Toronto. We're a large city with a large number of residents, and we would expect that some of them might eventually come our way, so we've certainly had some conversation.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Kitchen.

Mr. Thériault, you have the floor. You have six minutes.

[Luc Thériault, Bloc, Montcalm, QC]

Welcome, ladies. I will speak slowly.

[The Chair, Liberal, Ron McKinnon]

Oh, it's my mistake. It's the Liberals.

Ms. Sidhu, go ahead for six minutes.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you to all the panellists for answering our questions.

I represent Brampton South. Our city recently declared a health care emergency. Our only hospital is functioning at more than capacity. While the risk of coronavirus is low, is there any plan in place such that, if an outbreak happened...? A health emergency has already been declared. We have a population of 650,000 and only one hospital. What kind of plan is in place?

My question is for Dr. Eileen de Villa. You have served in the Peel area. We already have a shortage of health care services.

[Dr. Eileen de Villa]

Having been a medical officer of health for Peel region, I am quite familiar with the circumstances in Brampton and the challenges with respect to health care access.

With respect to how the situation is being managed, I would defer to my provincial colleagues. Suffice it to say that I am having a conversation.

To give you a little bit of a flavour, as I said, in public health responding to outbreaks and emergencies is part of our role. I can tell you that in Toronto, in particular, we have moved into what we call the incident management structure, which is a very standardized approach to responding to emergency-type situations, to ensure that we are bringing enough resources to bear.

One of the functions, as we seek to respond to an emergency using this structure, is what we call a planning function, looking forward, trying to imagine where the situation will be in a few days, rather than just focusing on the emergency in front of us right now.

One of the issues for the city of Toronto, which we have been actively discussing, is that right now, as you said, the risk is low, and you're quite right, but what if the circumstances change? How would we manage that? What sorts of health care facilities might we need in order to address that? We're having those conversations here in Toronto. I have raised them with our provincial partners and our hospital partners as well, outside of Toronto, at least through the member association.

I don't have all the answers for you, but I do know that there are active conversations happening on that. There are multiple solutions that could be put into play, and they're actively being discussed.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you.

Mr. Chair, I want to share my time with Tony Van Bynen.

[Tony Van Bynen, Liberal, Newmarket—Aurora, ON]

How much time do I have?

[The Chair, Liberal, Ron McKinnon]

You have three minutes.