Health Committee on Feb. 5th, 2020

[Luc Thériault, Bloc, Montcalm, QC]

Okay, that is much clearer now. As I understand it, these medical situations are peripheral to coronavirus infection. According to the evacuation plan, people will only stop in Vancouver if they need emergency medical care that has nothing to do with the coronavirus. Everyone leaving China will land at the base in Trenton.

Where repatriation is concerned, the numbers are going up. Based on what we have learned, 373 people have requested repatriation. As I understand it, a plane transporting 211 people will take off tomorrow.

Can you tell us what selection criteria are being used? I am not talking about visas or things like that. Instead, I'd like to know, for instance, if priority is being given to families. Might some not make it onto the flight because priority is being given to bringing home entire families? Will a family member who is symptomatic have to remain on site?

[The Chair, Liberal, Ron McKinnon]

Mr. Thériault, what is your question?

[Luc Thériault, Bloc, Montcalm, QC]

I would like details about repatriation, how you selected the 211 people, when the second flight will take place and what will be done with those waiting for the second flight.

[Tina Namiesniowski]

I think that question should be put to our foreign affairs colleagues. I know they chose and applied criteria. However, I don't know which criteria they used to choose the people on the first flight.

[The Chair, Liberal, Ron McKinnon]

Thank you.

Thank you, Mr. Thériault.

Mr. Davies, you have six minutes.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you to all of the witnesses for being here.

Yesterday, health officials in British Columbia announced a new presumed case of novel coronavirus. The patient was a woman in her 50s from the metro Vancouver area who had recently been in close contact with visitors from Wuhan. I think this would be the first instance of domestic transmission in Canada.

Does this possible case of secondary infection change your assessment of risk posed by the coronavirus to Canadians, and how do you plan to respond?

This is for either Ms. Namiesniowski or Dr. Tam.

[Dr. Theresa Tam]

I'll respond to that question.

Obviously, in British Columbia, the health officials and the local public health unit in charge of that particular investigation have been in very close contact with the Public Health Agency.

As I understand it, the potential transmission occurred inside a family setting. This is a household close-contact transmission setting, which is not unexpected. That does not mean that the virus was spread further. They will be doing their investigation as to exactly what the situation is.

As with any infectious disease, public health units are very equipped to do case and contact tracing and management, but it would not be unexpected to have limited person-to-person transmission in a closed-contact setting, and it does not change our risk assessment for Canada. The risk remains low.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

The World Health Organization's February 1 situation report on the novel coronavirus stated, “WHO is aware of possible transmission of 2019-nCoV from infected people before they developed symptoms.” An early study on asymptomatic transmission of the virus published last week in the New England Journal of Medicine also appeared to confirm that asymptomatic transmission is possible.

How does the existence of asymptomatic transmission change your approach to containing this virus, if at all?

[Dr. Theresa Tam]

We are aware of a very small number of case reports in which it's suspected that asymptomatic transmission may have occurred, but these have not been verified. In fact, with regard to the New England Journal study, there's now been a publication to say that it was incorrect and that this person was, in fact, symptomatic and had been taking some medication that suppressed his fever, for example. That's a very important fact to verify and correct. I'm very happy that German scientists and WHO have verified that.

We have heard other potential reports, which have not been substantiated. What we know is that it could possibly happen, but we think it would be rare and very unlikely that asymptomatic persons would be the key driver of an actual outbreak or epidemic. Of course, the evolving description of the patients has shown that they can have quite mild to more severe symptoms, so some of the recommendations right now are for people to, for example, monitor their symptoms very carefully, potentially reduce contact with others and, at the earliest moment they feel any kind of symptom, seek medical care. I think that is very important. It's really a droplet-spread disease. It's when someone's coughing most vigorously and they're more symptomatic that, we believe, this virus is transmitted.

[Don Davies, NDP, Vancouver Kingsway, BC]

Dr. Tam, you anticipated where I was going to go next. It seems likely that there are individuals who are infected with the coronavirus who are going undetected because they are presenting mild symptoms and they are, thus, not interacting with health systems yet.

If that's the case, can you give us an idea of what proportion of overall cases that might represent?

[Dr. Theresa Tam]

It's actually a very evolving proportion, because, as you can imagine, at the beginning of any outbreak, it is the people who have the most severe symptoms who present. Many of the teams in China are currently unpacking the mild symptoms that are the underside of the iceberg, if you like. The tip of the iceberg is the severe cases. Right now, just proportionately, approximately 20% of cases are considered serious. That means that 80% have some other symptomatology that is less serious. That is the fluctuating proportion based on current data.

[Don Davies, NDP, Vancouver Kingsway, BC]

To follow up on Mr. Powlowski's question, the United States has implemented emergency measures to temporarily deny entry to foreign nationals who have visited China in the 14 days prior to their arrival. Restrictions also apply to U.S. citizens who have been in China's Hubei province in the two weeks prior to their return to the U.S. Upon their return, those citizens will be subject to a mandatory quarantine of up to 14 days. They'll also undergo health screenings at selected ports of entry.

In light of your comment earlier that the time to contain is now—I think that was your wording—and that it's very important that we get a good grip now, shouldn't Canada be taking similar protective measures now, following the precautionary principle, to make sure we're doing everything we can to contain this virus at the earliest possible opportunity? If not, why not? Why aren't we doing that?

[Dr. Theresa Tam]

As the president of the agency just stated, the World Health Organization declared this “a public health emergency of international concern” and indicated that right now we are in the containment phase. The most effective piece of containment, of course, is at source, in China itself, where you're seeing some of the extraordinary measures that are being taken.

As you move further away from that epicentre, any other border measures are much less effective. Data on public health has shown that many of these are actually not effective at all. We are doing some of those and adding those layers, but each of those layers is not a complete barrier, if you like. We have provided travel health advice from a health perspective to indicate to travellers to avoid the province of Hubei and to limit non-essential travel to the rest of China. That advice is provided to travellers.

Of course, how you protect yourself when you're in China, I think, is very critical. The other aspect is that you're not going to get health care, particularly if you're stuck inside a quarantine zone. That's another reason for saying not to go to Hubei right now. Not necessarily for health reasons but for reasons of safety and security, Global Affairs says you shouldn't go to China.

I think that WHO advises against any kind of travel and trade restrictions, saying that they are inappropriate and could actually cause more harm than good in terms of our global effort to contain. I believe that Canada is taking a balanced and measured approach as it pertains to travel measures at this point.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Davies.

We have another panel getting sorted out on video conference, so we're between a rock and a hard place. We don't really have time for a normal round two.

May I propose to the committee that we repeat round one with three-minute time slots for everybody? Is that acceptable? Okay.

In that case, we will go to Mr. Webber for three minutes.

[Len Webber, Conservative, Calgary Confederation, AB]

Thanks, Mr. Chair.

Major-General, what is the quarantine capacity at CFB Trenton?

[MGen T. J. Cadieu]

Mr. Chair, in terms of the quarters, the accommodations we're using currently for returnees, the Yukon Lodge facility, which I referred to before, has a capacity of approximately 280 rooms. Those are single rooms with washrooms. What we're working out right now is dependent on the various demographics and family groupings of individuals who come back. That will reveal to us how many additional rooms we have for returnees that are coming in.

It could well exceed 300. We might be able to support the returnees not just from the first flight but from others coming in as well. That number is evolving as we understand the various demographics and groupings of those returnees.

[Len Webber, Conservative, Calgary Confederation, AB]

Great.

Have you thought of perhaps another facility, another CFB base, that you may use in the future?

[MGen T. J. Cadieu]

Absolutely. In addition to working through the planning alongside the Public Health Agency and the Canada Border Services Agency, we are continuously forward-planning, contingency-planning. In addition to having a strong understanding of the resources that are available in Trenton, we are conducting a stock-taking of all infrastructure and accommodations at Canadian Forces bases throughout Canada.

[Len Webber, Conservative, Calgary Confederation, AB]

You also mentioned that military police will not be part of the security at CFB Trenton for these quarantined individuals and that you'll have civilian police and security. Why?

[MGen T. J. Cadieu]

Mr. Chair, our military police are primarily mandated to look after the security of our Canadian Forces bases and our members and their dependants. Notwithstanding the support that we're going to be providing to CBSA and the Public Health Agency, that work will continue. It still needs to continue. In part, that is the reason why the Public Health Agency is working with provincial security services to look after the needs of the returnees.

[Len Webber, Conservative, Calgary Confederation, AB]

Thank you.

Is the aircraft being used—pardon my ignorance—a Canadian Forces aircraft or a commercial aircraft?

[MGen T. J. Cadieu]

It's a commercial aircraft, Mr. Chair. The first aircraft that's been contracted by Global Affairs Canada is a civilian Airbus 340.

[Len Webber, Conservative, Calgary Confederation, AB]

Okay. There's just one. One aircraft is going to be used. Will it return to China, then, to pick up the rest of the individuals?

[MGen T. J. Cadieu]

Mr. Chair, I think Global Affairs Canada is continuing to work through options right now. They're looking at a number of considerations. I don't think that determination has been made.

[Len Webber, Conservative, Calgary Confederation, AB]

Dr. Tam—