Health Committee on March 31st, 2020

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

Ms. Jeffrey, yes.

[The Chair, Liberal, Ron McKinnon]

Go ahead.

[Heather Jeffrey]

Given the situation we're facing right now, with travellers in all the countries of the world trying to get back at the same time and the consequent shrinking of airspace, the need to negotiate the entry and exit permits, as well as the local transit arrangements, it's simply not possible to charter flights back from everywhere all at the same time. The most effective and efficient way to move people is for people to use the commercial means at their disposal.

We have a wide variety of solutions. Each country is different. Each country has different regulations. Each country has a different distribution of Canadians inside the country and different local restrictions on movement. They require different forms. We have a wide variety of different means—

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

Thank you.

I have a second question. This would be for Ms. Namiesniowski.

Front-line health care workers have been reporting to me here in my constituency. They're very concerned about their safety and the way PPE is being rationed. I spoke to someone from an OR who said they were being asked to use masks between patients, and so forth. I also had someone who returned from overseas and had symptoms. That person phoned 811 and was told to just stay home and self-isolate, as opposed to getting tested.

I'm just wondering, how can we ensure best practices and ensure that proper safety protocols are being followed?

[The Chair, Liberal, Ron McKinnon]

I believe that's a question for Ms. Namiesniowski. Go ahead, Ms. Namiesniowski.

[Tina Namiesniowski]

Thank you very much, Mr. Chair.

From the point of view of the proper usage of PPE, there was guidance that was issued, developed from the work that was done through the FPT governance framework. There was guidance that was developed early for the appropriate use of PPE, which is continually re-examined to ensure that it remains current in the context of the science and its evolution. It's guidance that was adopted through the special advisory committee—

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

The guidance that the health care people were being given was to continue to wear their mask all day, if they could, to save on masks.

I have a third question. It's in regard to a statement made by the Canadian Association of Emergency Physicians. It was released on March 12. It highlighted the fact that Canadian hospitals don't have surge capacity to handle the pandemic. I wonder if you can explain, Ms. Namiesniowski, what measures were implemented to increase surge capacity.

[The Chair, Liberal, Ron McKinnon]

Ms. Namiesniowski, please go ahead.

[Tina Namiesniowski]

This is actually a question that I will turn to my colleague at Health Canada, who has been working on some of those issues.

[The Chair, Liberal, Ron McKinnon]

Mr. Lucas, please go ahead.

[Dr. Stephen Lucas]

In regard to surge capacity, we've been working with provinces and territories. They have been taking steps to rapidly bring on and relicense retired physicians and other health workers and to work with students. We're encouraging and supporting them to consider foreign-credentialled health workers and other health human resources who can help support efforts in that surge. We'll continue to work with them.

In addition, efforts have been taken to cancel elective surgeries and move patients out of hospitals and to other facilities to free up beds where possible. These steps have been taken across the country in addition to identifying other locations.

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

Thank you.

I have one more question.

There have been reports here of shortages of PPE in hospitals. Despite the assurances that they are well stocked, we actually have local doctors putting out messages on social media. We even have the chambers asking for donations and so on.

As Vancouver is one of the four designated airports for international flights, it puts a heavy burden on our providers who are seeing shortages. When can we see that hospitals will be fully stocked and remain that way?

[The Chair, Liberal, Ron McKinnon]

Is that a question for Mr. Lucas?

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

It could be.

[The Chair, Liberal, Ron McKinnon]

Mr. Lucas or Ms. Namiesniowski, please respond, if you wish.

[Dr. Stephen Lucas]

As has been noted, we are working in a combined effort with Public Services and Procurement Canada to proactively order and secure supplies, and to arrange transport for supplies, wherever we can find them in the world—masks, gloves, N95 masks and other essential goods. We are working to ensure that as they arrive in the coming days and weeks, they're distributed as efficiently as possible across the country. We will be doing that to enable that the urgent need be considered and allow provinces to address stocks to cover any surge and the ongoing need.

[The Chair, Liberal, Ron McKinnon]

I'm sorry, but the time is up.

We'll go now to Mr. Van Bynen.

Mr. Van Bynen is splitting his time with Dr. Jaczek. I will give Mr. Van Bynen two and a half minutes.

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

First of all, let me say thank you to everyone for their dedication and commitment to responding to this unprecedented global crisis not only in dealing with the health and safety of Canadians, but also in bringing them home especially when things change on a daily and hourly basis. I'm reminded of the words of Rudyard Kipling, who said that it's important if you can keep your head when all about you are losing theirs and blaming it on you.

Having said that, my question is for the deputy minister, Heather Jeffrey. Your team has been doing great work to help Canadians come home, and as you mentioned in your earlier comments, the reality is that it's not possible to facilitate everyone to come home. What advice is being given to those Canadians remaining abroad, and what services are being made available to them?

[Heather Jeffrey]

I think the unique demands of quarantines and lockdowns require a different approach, and we saw this with Canadians who were in Wuhan, and again those to whom we were providing consular services during the Diamond Princess quarantine in Japan. They require assistance in making the right contacts with local governments; they require support with interpretation sometimes in making themselves understood with foreign doctors; and they need to know where to reach out for help, and what kind of help is available to them.

We're providing instructions on preparedness, things that you can do, which are similar to what public health officials are telling Canadians here at home: to make sure that you have adequate supplies, that you have prescription medication you might require, that you are able to sustain yourself and that you have a local SIM card and a phone. There are a lot of very practical tips in our material.

Also, there is information on who you can reach out to at the embassy, the things that should cause you to reach out, for example, if you become ill or believe you might be sick. There is also information on the local restrictions and what will happen to you in different circumstances and on how to reach out to us 24-7.

Then if and when people are hospitalized or need medical care, it's about facilitating their communications with their families. It's about trying to make sure, even in environments where isolation and quarantine are necessary, that they can receive the essential goods and things they need. It's a different kind of consular service for someone who is required, by quarantine, to be at a distance, but we're equipping our missions to be able to provide those services in situ.

At this stage it's really about preparedness, just as it is here in Canada, to get through a few weeks of mandatory isolation until the quarantines are lifted around the world.

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

Great. Thank you.

Helena, I'll turn it over to you.

[The Chair, Liberal, Ron McKinnon]

Thank you.

Go ahead, Dr. Jaczek.

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

Okay. Thank you.

I think, as Tony has said, it really deserves re-emphasizing that we're all in this together and we need to collaborate and work together, each and every one of us, and we will get through it, of course.

My question is for Mr. Lucas from Health Canada.

It relates to the fact that while we're in the midst of this pandemic, of course life goes on, and people are sick with many other health issues. We're hearing about elective surgery here in Ontario being deferred.

I would like to hear from Health Canada how they are looking at the supply of prescription over-the-counter drugs and medical devices. Are there any supply disruptions? What does Health Canada do in the face of potential shortages?

Also, we've heard from south of the border about some of the potential therapies like chloroquine, hydroxychloroquine. I'm sure there are patients on Plaquenil for arthritis who are very anxious about shortages, so could you please address what Health Canada does?

[Dr. Stephen Lucas]

Certainly, I'm pleased to do that.

We have an ongoing challenge with drug shortages, exacerbated now given the pandemic situation and the impact on global supply chains.

To that end, we have a team dedicated to working on this. They work with a network of people in the provinces and territories—industry, distributors and patient groups—to make sure we have a line of sight as far in advance as possible on shortages. We are co-operating with regulators in the United States, Australia, Europe and other places to identify where there are potential disruptions in supply chains of active pharmaceutical ingredients and other key elements in producing needed medicines and medical equipment.

In addition, steps are taken to find substitutes and to allow for the importation of other products that can help address it with an ability, through interim orders, to look at alternative labelling requirements to ensure that the needed medicine can get to Canadians.

In addition we are working with manufacturers here in Canada on moving to producing pharmaceuticals if we need to. The powers provided last week through the bill will further enable that to help manage shortages and to have domestic production if we need to, to ensure that the needs of Canadians are met.

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

Could you address the Plaquenil situation, the potential shortages, specifically, of chloroquine and hydroxychloroquine, because of some therapeutic merit that is being touted?

[Dr. Stephen Lucas]

On that, we are working actively to secure additional supply and to look at opportunities to produce in Canada to augment it. Indeed, that's a global challenge we are working very actively to address.