Health Committee on July 7th, 2020

[Jeff Latimer]

No, we don't have a national household survey, but I will let Karen speak to you about the surveys we are launching, if you like.

[Karen Mihorean]

Thank you for that question.

As we've already mentioned, and as Jeff mentioned in the opening remarks, we did develop a web panel that we use to follow about 7,000 Canadians. These are labour force rotate-outs, so they participate in our labour force survey. This is what we call our probabilistic sample, which we can generalize to the general population. We launch a new topic through our web panel. It is a household survey, done through an electronic questionnaire, and they are provided with the link to respond to the questions. About every four to five weeks we send a different theme, and all of these themes have been specifically related to various things related to COVID: job loss, behaviours they've taken to protect themselves or, as we mentioned before, mental health. We've asked questions around recovery and those sorts of things.

Then we also have our crowdsourcing, which is not a household survey. We are currently working with the Public Health Agency of Canada on a survey of about 25 to 30 questions to look at the unintended consequences of COVID. We're hoping to launch that survey sometime later in August. That survey will be, again, a probabilistic survey that we will be able to generalize to the population. We will have at least national, provincial and territorial estimates, and hopefully we will have them for the larger CMAs as well. I'm sorry I don't have the exact sample size for that survey.

[Matt Jeneroux, Conservative, Edmonton Riverbend, AB]

It would be great if we could have you back to explain some of the data that you get. I think that would be interesting.

My last question goes back to CIHI.

We saw that data was obviously lacking in the lead-up to COVID-19. What recommendations do you have to improve our data sharing regarding COVID-19, but also in any future pandemic or a second wave?

[Kathleen Morris]

I think creating the infrastructure to have more timely hospital data would be a critical piece to support public health surveillance. The hospital data is very rich, and it's a fabulous resource for both health system managers and researchers to follow patients over a long course of time. The piece that is missing in it is the quick and timely information on admission so that public health has that information as soon as a patient is hospitalized.

It's been challenging with COVID because people very often have very long lengths of stay, and getting the information only when the patient has left the hospital delays things for up to a month.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Jeneroux.

We go now to Dr. Jaczek. Dr. Jaczek, please go ahead for four minutes.

[Helena Jaczek, Liberal, Markham—Stouffville, ON]

Thank you very much. My questions will be directed to CIHI and StatsCan. As a number of my colleagues on this committee have said, the testimony from witnesses overall has been extremely critical of our existing datasets, the timeliness and so on. I am sure you are very aware of that.

Ms. Morris, you have obviously told us that the Public Health Agency of Canada, StatsCan and CIHI have very clearly articulated areas of responsibility for which they collect data. Mr. Latimer has made the comment that in fact there is really no identifier that links across these organizations so that a researcher can follow the data on a particular individual, although obviously with non-nominal data. They cannot link across easily. You have made a reference to data-sharing agreements.

Can you explain how a researcher might use those data-sharing agreements to facilitate an inquiry? Our witnesses earlier today made it very clear that in the United States there was a very easy way of following datasets and linking them. What do you see going forward? What exists now, and how could we improve?

[Kathleen Morris]

Thank you very much for the question.

Researchers are a big customer of CIHI. I spoke of 500 data requests. Many of those were from researchers looking for information to do modelling work to help predict the impacts of the pandemic on the health system as well as to model restarts in terms of beginning elective surgery and other procedures as things started to improve.

One of the things that's particularly helpful with the CIHI data is that it does come with an identifier, so we can follow patients across datasets in terms of the prescription drugs they've been prescribed, whether they are in long-term care, in hospital settings or, in some cases, in primary care. We can follow them across.

That's particularly helpful in looking at health system performance measures such as readmissions or repeat emergency department visits, and it's very helpful at following the complications that might happen over time. For example, with COVID, it would be very interesting to know whether there are any long-term health consequences for patients who test positive that we could follow over the course of their lifetimes.

However, you're correct that there are data gaps. Some of them relate to the timeliness of the data. The data that CIHI collects has been built to facilitate benchmarking across long-term care facilities, hospitals and health regions, and the benchmarking supports improved health system performance. The data is complete, it's comparable, it uses common standards, and it provides very good information on care, but things like readmissions or pain levels in long-term care or worsening pressure ulcers are all things that don't change from day to day, typically, and the improvement efforts are okay if you can provide that information on a quarterly basis or an annual basis.

[Helena Jaczek, Liberal, Markham—Stouffville, ON]

Ms. Morris, can PHAC use that identifier to link with their dataset?

[The Chair, Liberal, Ron McKinnon]

I'm sorry, Dr. Jaczek, but your time is up.

[Helena Jaczek, Liberal, Markham—Stouffville, ON]

Could I have a yes or a no?

[Kathleen Morris]

CIHI data could be linked to testing data, because I believe both of them have a unique identifier.

[The Chair, Liberal, Ron McKinnon]

The floor now goes to Mr. Desilets.

Mr. Desilets, you have the floor for two minutes.

[Luc Desilets, Bloc, Rivière-des-Mille-Îles, QC]

Thank you, Mr. Chair.

My first question goes to Mr. Flynn.

We have heard about the situation where Dr. Xiangguo Qiu, her husband, and a group of students were expelled from the National Microbiology Laboratory in Winnipeg.

How was the Royal Canadian Mounted Police called on to play a role in that situation?

[C/Supt Mark Flynn]

Thank you, Mr. Chair.

The RCMP can confirm they've had referrals with respect to activity at the Winnipeg lab. However, it would be inappropriate and could potentially impact an investigation if I were to speak to it with any detail here this afternoon.

[Luc Desilets, Bloc, Rivière-des-Mille-Îles, QC]

I can understand the situation perfectly.

Can you tell us whether Canada considers that the situation has anything to do with an espionage activity?

[C/Supt Mark Flynn]

As I stated, for me to speak at any level with respect to the investigation could jeopardize that situation.

[Luc Desilets, Bloc, Rivière-des-Mille-Îles, QC]

Okay, I understand. No problem.

What lesson should we take from the incident?

Is Canada too open to receiving foreign researchers and including them in our teams?

Can it be a simple screening error?

[C/Supt Mark Flynn]

In a general sense, without speaking about this incident, if you look at the history of crime, we have all types of individuals—Canadians, immigrants and foreign individuals—who are involved in significant crime in Canada. It's difficult to speak in generalities around this type of situation.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Desilets.

Thank you.

[Luc Desilets, Bloc, Rivière-des-Mille-Îles, QC]

Thank you.

[The Chair, Liberal, Ron McKinnon]

We now go to Mr. Davies.

Mr. Davies, please go ahead for two minutes.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

Mr. Latimer, at his appearance before this committee on April 14, Dr. Amir Attaran said the following:

Scientists need transparent data on the disease from every province to make mathematically and medically accurate disease models and forecasts. We're not there, because the provinces hold the data, and sharing it with the Public Health Agency of Canada is optional. They have no legal obligation to share. Then, even more foolishly, the Public Health Agency of Canada censors the data before it's disclosed to scientists, probably to avoid embarrassing certain provinces.

Can you confirm if PHAC has engaged in the practice of removing information from the provincial and territorial COVID-19 data disclosed to scientists through Statistics Canada?

[Jeff Latimer]

I cannot confirm, explain or comment on that. I have no idea what the Public Health Agency of Canada is doing. What I can tell you is that it's highly unlikely in the data they're sharing with us. The only thing we're doing is cleaning it for accuracy. We're not removing or hiding any of the data we put on our website.

[Don Davies, NDP, Vancouver Kingsway, BC]

Okay, thank you.

Mr. Jones, I just want to be clear on this: Can you confirm if there have been any successful cyber-breaches at Canadian research institutions working on COVID-19?

[Scott Jones]

Yes, we have had successful breaches. We've been looking to continue to reinforce other research institutions, including through proactive advice and guidance. One of the challenges, I think, that's mostly unknown is that research institutions tend to be what we would call more of a small or medium-sized organization, so we'd also refer them to not only the specific health sector guidance but also the pragmatic steps and advice on guidance that we've given for small and medium-sized organizations to look at.