Health Committee on March 11th, 2020

[Dr. Stephen Lucas]

I will contribute as well that we are working specifically with the Canadian Institute for Health Information to help strengthen that information, which will support the initiatives the minister spoke to.

[Len Webber, Conservative, Calgary Confederation, AB]

Excellent.

I do want to switch my questions over to the issue of Lyme disease.

Dr. Tam, I think every time you come to this committee I've asked you questions on Lyme disease because it is another passion of mine.

In the past you have always talked about the three pillars for Lyme disease: the surveillance, the education and awareness, and the guidelines and best practices, but—and I've often brought this up, Dr. Tam—there is no fourth pillar, the pillar I suggest there be, and that is support for those already suffering from Lyme disease. Lyme disease sufferers face many employment, financial, medical and mental health issues, and they feel abandoned, Dr. Tam.

What specifically will the minister be doing to ensure those suffering with Lyme disease are better taken care of?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

I'll start, and I'll see if Dr. Tam wants to add anything else.

As someone from northern Ontario—and I look to Dr. Powlowski again just because he was our ER doc at Thunder Bay Regional Health Sciences Centre—I will say, again, that Lyme disease is something that we are acutely aware of in many parts of the country, and it's obviously related to climate change, as we see ticks climb up into even more northern parts of our country, where they were not very common, if at all present, years before.

The investment of $20 million is for health-related climate change programs, most dedicated to Lyme disease, funding research on diagnosis and treatment. The treatment component is important—

[Len Webber, Conservative, Calgary Confederation, AB]

The treatment part of it is my concern, because many who feel abandoned—

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

—as is the research on treatment, because, of course, it is an area where there is still lots to learn about how to treat people who are struggling with Lyme disease. Educating Canadians about prevention is, obviously the best dollar you'll ever spend in health care. Then there's supporting the training of health professionals, screening and then of course monitoring the tick spread. In terms of care for people who are living with Lyme disease, obviously this is an ongoing challenge because it is such a lengthy illness for some.

Certainly I think we can all do more to ensure that our provincial and territorial counterparts are well aware of the kinds of supports people could have. Obviously the work that we're doing to try to ensure that people have better supports in terms of EI, and better supports in terms of other income measures, can go a long way in terms of the disease and how long people are off work when they are ill.

[Len Webber, Conservative, Calgary Confederation, AB]

Thank you, Minister.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Webber.

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

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

Madam Minister, your mandate letter says one of the things you're supposed to do is to raise the bar on openness and transparency. In light of this, I want to ask you some very specific questions about preparedness for COVID-19, and it's open to anyone on the panel to answer the question.

I want to get back to Don Davies' point about ventilators. That's one of my major concerns as well, but let me just set up the scenario.

Dr. Tam has already told us the numbers are 6%, but let's say 5% of people get a very serious disease, perhaps needing an ICU. If we had an epidemic of 1,000 cases in a place like Thunder Bay, that's well less than 1% of our population. It's not that many really, but still with 1,000 cases that equals 50 people who might need ICU or a ventilator.

Thunder Bay hospital has 22 ventilators, which are always full. If we intubate someone in the emergency room, there's always an issue of whether there is an open ventilator in ICU to look after them. Apparently, because of the Critical Care Services Ontario program, which was put into place under H1N1, there are some backup ventilators, but that's four ventilators. We have 50 new cases that we want to put on a ventilator, so what are we going to do to ensure that people who need a ventilator have a ventilator?

To Don Davies' point, there are something like 5,000 ventilators in Canada, but the thing you have to remember is that those are probably 5,000 fully occupied ventilators. What's going to happen when we need more ventilators? Are there provisions, and what provisions are in place to potentially rapidly respond to a requirement for more ventilators?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

Thank you very much, MP Powlowski.

The $500 million for provinces and territories that can be rapidly accessed is a big part of today's announcement. This isn't going to be an apply and wait for the results of your application. This is about a rapid cash infusion into provinces and territories so that they can have what they need immediately.

We're also working on a joint procurement of ventilators with provinces and territories, and we'll have more to say about that as that unfolds. I know my colleague Mr. Jeneroux mentioned the letter from the Prime Minister to the premiers, but I've been communicating with the ministers of health for a very long time. They have been indicating to us, on an evolving basis, what they might need.

Of course, we are prepared to do more. If there is an additional need for more supports and more measures we will do that. Of course, it will be up to the provinces and territories to tell us exactly what those measures are. We have a federal jurisdictional responsibility to ensure provinces and territories have what they need, but they also have to determine for themselves how they will deal with any surge.

Again, I think it's a good time to remind everyone that what we're hoping to do together collectively as a Canadian society is to flatten the curve and to make sure that we don't see a surge of activity. Having said that, should we see that surge, this is the primary importance of today's announcement.

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

Has any consideration been given to creating a rapid response unit or perhaps using the military DART program, if required? Maybe you get another 50 ventilators for Thunder Bay, but you need the personnel, space and backup for those ventilators.

Have we considered using DART or creating something similar to DART so that, if necessary, we could rapidly respond should there be an outbreak in one specific municipality or area?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

Again, it will be important to understand from the provinces and territories in live time as well as in planning what they specifically need.

Yes, I've had conversations with Minister Sajjan about the ability to tap into the capacity of the Canadian military should we need expertise, human resources or specific measures. They've already been very active in the repatriation process without hesitation. These are incredible professionals who work for us at CAF who have a variety of expertise and levels of engagement in health care, but we can rapidly deploy other allied professionals should we need to, and those conversations are ongoing.

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

My understanding is that about 15% to 20% of the cases are more serious. Again, a scenario in Thunder Bay, of 1,000 people, that's 150 to 200 people possibly requiring hospitalization. Thunder Bay Regional, like almost all hospitals in Ontario, is full to capacity. People who are admitted are waiting in the emergency room without beds. What are we going to do when we have to find beds for another 150 to 200 people?

Are we actively looking at finding alternative beds, alternative institutions, using hotels as they did in Washington, or in Thunder Bay, our former psychiatric hospital, if required to meet that surge capacity?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

The short answer is yes. Those conversations are ongoing with provinces and territories right now to determine what facilities they might anticipate needing in a worst-case scenario, in a severe surge, and how we can be of assistance in ensuring that we procure those spaces and support them as they set them up.

[The Chair, Liberal, Ron McKinnon]

Thank you, Dr. Powlowski.

Dr. Kitchen, you have five minutes.

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

Thank you, Mr. Chair.

Thank you, Minister, for being here today, as well as your supporting people with you. I appreciate them. Thank you for everything you've done.

Science as you mentioned is very important. The good thing about science is making sure the people who are providing that science have the proper qualifications to provide that science. They also often give us numbers. I'm a numbers person, and I like to see numbers. Minister, you talked about numbers of 30% to 70%.

How many tests for test kits do we have in Canada today?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

I will turn to our chief public health officer to answer questions around testing.

[Dr. Theresa Tam]

We have a federal-provincial-territorial network called the Canadian Public Health Laboratory Network. I always say that the capacity changes rapidly on an ongoing basis as we begin to ramp up that capacity. Obviously when we first started, it was an entirely new test. You had to test those few cases in the Winnipeg National Microbiology Lab. Now some jurisdictions don't have to send anything for validation. Ontario, Quebec, Alberta and British Columbia can all do their own testing.

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

I'm sorry for interrupting. The bottom line is the test, as we should know, is basically a swab deep down into the back of the nasal cavity. That test is being done, so that kit has to be there. How many of those kits do we have in Canada today?

[Dr. Theresa Tam]

That's also in the area of jurisdiction of the provinces and territories. What I have been able to gather is that right now—

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

What I'm hearing is that you don't know the number of tests we have today. Is that correct?

[Dr. Theresa Tam]

We have the capacity to do at least 2,400 a day. Ramping up, the estimate is that we can go to 16,000 a day.

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

Okay, perfect. Thank you for that.

If we have 16,000 tests that we could go to today, where are those tests made?

[Dr. Theresa Tam]

There are different components. Obviously, you have to take a swab, so there's a kit.

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

Right, but where is that kit made? Is it made in Canada, or is it made overseas?

[Dr. Theresa Tam]

There are different options, which is why creating that logistics group allows us to explore all options. Of course, the whole world wants all these things.