Health Committee on Feb. 1st, 2021

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you.

During the last panel, Dr. Bogoch was talking about the issue of vaccine hesitancy. Unfortunately, vaccine hesitancy is a problem among some visible minority groups. Misinformation is spread easily on social media, and official public health information is not always available in the necessary languages.

Could you speak to how our public health agencies are combatting misinformation and vaccine hesitancy, especially among multicultural communities?

[Ian Culbert]

Front-line public health organizations have links to those communities established. They work with them on a regular basis, so we'll be getting allies into community centres or other venues.

It's hard to have large groups, so it's more one-on-one. However, the ability to connect directly with those populations is absolutely crucial, and will be as we go forward. They need to hear the message from someone who looks like them and represents their interests but also has sufficient background to be able to answer their questions.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you.

Dr. Evans, our government has provided over 17 million rapid tests to the provinces and territories. Ontario has received over six million of those tests, but according to updated numbers provided by the province's Ministry of Health on Monday, it had deployed only about one million of those tests. My community of Brampton has been one of the hardest hit and is home to many industrial and manufacturing hot spots. Do you think increased usage of the rapid tests would help to control outbreaks? Can you provide any explanation as to why the province has been so reluctant to use them?

[Dr. Timothy Evans]

I'd just like to clarify in answering your question that the COVID-19 immunity task force is not focusing on testing, either with antigens or with the real-time PCR, RT-PCR. However, I would say that the evidence from across countries is that where you have not only more aggressive or higher levels of testing but also much more timely determination of the results and follow-up of contacts, those countries are in a better position to control the epidemic

I think, again, in the spirit of learning, that Canada has a lot to learn with regard to how to manage testing systems such that they get to the populations where the problem is greatest and they're managed in such a way that you get timely results and can mobilize contact tracers in a way that mitigates the spread of infection. That being said, we need to look to our Atlantic provinces, where I think there's significant evidence of very good practice on that front thus far, and also take advantage of the way in which testing systems have been deployed in other countries.

[Sonia Sidhu, Liberal, Brampton South, ON]

I'm saying that because recently three Amazon facilities in Peel announced that they will be conducting their own rapid testing, which is helpful, as getting a test can often be a hassle and be confusing. Of course, not every company has the financial resources that Amazon does. Should the provincial government be deploying their tests to essential workplaces to help them control outbreaks?

[Dr. Timothy Evans]

My personal opinion on this is that getting more disseminated testing according to very clear public health standards is the only way to reach the levels of testing that are necessary to really mitigate the spread of infection.

[The Chair, Liberal, Ron McKinnon]

Thank you, Doctor.

Thank you, Ms. Sidhu.

Mr. Thériault, you may go ahead. You have six minutes.

[Luc Thériault, Bloc, Montcalm, QC]

Thank you, Mr. Chair.

I'd like to thank the witnesses for their statements.

In order to manage a health crisis of this magnitude, we have to ensure people continue to accept and follow the public health guidelines that are introduced. That means maintaining public trust. At the end of the summer, promising potential vaccines were announced, as were vaccines now authorized for use. Ever since, it seems to have become more of a challenge to maintain, or tighten up, the health restrictions in place. People became more lax, probably because of pandemic fatigue and the fact that their behaviours changed over the summer.

On one hand, according to the figures we have now, the government is claiming that everyone who wants to be vaccinated will be vaccinated by September 2021. On the other hand, the government has been anything but transparent about the timetable for vaccine deliveries or the terms of the arrangements. Is that the way to do things, Dr. Lexchin, if the goal is to maintain public trust in the authorities?

At the end of the day, all we know about the deals the government has signed is the quantity of vaccine doses. We know nothing about the price, the terms and conditions or the delivery schedule, and yet the government is asking us to believe that everyone will be vaccinated by September 2021.

What is your take on that?

[Dr. Joel Lexchin]

First of all, I think what we're dealing with is a lack of domestic capacity to produce vaccine, which leaves us vulnerable to what's going on in other countries.

We're seeing now threats, or moves, by the European Union to possibly restrict the export of vaccines from those countries.

Those are issues that we don't have any control over, nor do we really have the information to know what's going to be happening with delivery because we don't know anything about prices. Based on leaks from other countries, we know that there are differences in prices that have been negotiated.

For instance, the U.K. and Israel seem to have negotiated higher prices than the European Union, which may be affecting how quickly companies deliver to the European Union. We don't know the prices that Canada has paid.

This lack of information is a significant deterrent to being able to understand what our capacity is going to be to be able to vaccinate people over the coming months.

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Evans, have you done any modelling around the progress towards herd immunity, based on the government's vaccine projections? People have started to receive their vaccines, and perhaps everyone will be vaccinated by September 2021, but that still does not mean that we will have reached herd immunity. Has the task force done any modelling around herd immunity? When do you think we will reach herd immunity?

With so few people vaccinated to date, is it not essential to keep the health measures in place for a long time, or even strengthen them?

[Dr. Timothy Evans]

Thank you for your question. It's a very important one right now.

We don't have any models indicating when the reproduction number will drop below 1, at which point we will have reached herd immunity.

We are working on building those models. To that end, we are working with the people who are making certain projections right now. For instance, we are trying to find out the schedule for vaccine distribution. In the current context, that information is still very hard to obtain or predict.

As for your second question, it's highly important that the population follow all the public health measures as closely as possible over the next six months.

[Luc Thériault, Bloc, Montcalm, QC]

As long as we don't have those models, it would be risky to consider easing the health restrictions.

[Dr. Timothy Evans]

I think we need to be very careful. There are always things we can't predict.

If the number of infections were to drop for four, five or six weeks in a row, we could see policies and projections changing. For the time being, however, I think it's smart, even necessary, to keep all the public health measures in place.

[Luc Thériault, Bloc, Montcalm, QC]

We need to do more testing, then.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Thériault.

Mr. Davies, go ahead please for six minutes.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

Dr. Lexchin, I'm going to start with a couple of accountability questions and then, if I may, get into some substantive ones.

It's well known now that the federal government refuses to release a single word in a single contract that it has signed for the seven vaccine manufacturers that it has contracted with. Do you see any legitimate reason for the government's refusal to reveal to Canadians any details at all in these public contracts?

[Dr. Joel Lexchin]

I think the problem is that the vaccines are being treated as commercial products subject to commercial contracts. The vaccines are not a normal commercial good in the sense that computers might be. They're essential to health, and because they're essential to health, we need to understand the terms of the contracts so that everybody is aware of what the delivery schedule is going to be, the numbers and how quickly those doses are going to arrive.

I think Canada is just following what other countries have been doing or have done in terms of treating this as commercial goods, and I think that's a fundamental failure of the global community, not just Canada.

[Don Davies, NDP, Vancouver Kingsway, BC]

I'm going to get to that in a second, because that's a very important area, but we've been studying this subject for almost a year and we've had very few questions about the vaccine task force. You brought up this issue of conflicts of interest. I want to read to you something that was written about it just a few weeks ago:

An important issue in the medical arena is the ubiquity of conflicts of interest at play and how we consider this to be almost normal.... Public transparency of conflicts is not enough.... Independence is what is required for Canadians to gain trust in vaccine decisions. It is [therefore] mind-boggling, for example, that the task force decided that co-chair Mark Lievonen, who was the CEO of Sanofi Canada for 17 years (until 2016), who still owns shares in Sanofi, who is consulting with drug companies and who remains the director of two other drug companies, had no direct, material conflict of interest in assessing the Sanofi vaccine.

In your view, Dr. Lexchin, has the federal vaccine task force demonstrated sufficient independence and openness? What can you tell us about the way they've decided to conduct their activities essentially in secret?

[Dr. Joel Lexchin]

That's certainly a significant problem, that lack of transparency. One of the things we've been faced with over the entire period of the pandemic is that we need public trust in what is happening and what the health community and the government are doing in terms of trying to protect us from COVID-19, but without transparency in terms of what's happening on the task force, that trust is being eroded.

It can be done much differently. In Australia, for instance, back in April, the government in Australia funded a national COVID-19 clinical evidence task force to provide rapid evidence-based and continually updated advice on Australia's response to the COVID-19 pandemic. It set up an independent committee of four people to give advice over who should sit on this task force and release their conflicts of interest to this independent committee. The independent committee provided advice back to the Australian government saying, “No, this person shouldn't be sitting on the task force”, or, “Yes, this person is okay”. The Australian government has been following that advice, ensuring that when they get information from the task force, it's not tainted with possible conflicts of interest.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

I want to put two scenarios by you, Dr. Lexchin. From an epidemiological and public health infectious disease point of view, if we could immunize all seven billion humans in the next year versus not doing that, but rather, say, immunizing only a quarter of the world and doing the rest over the next 10 years, does that have any impact on the ability of this virus to mutate, or is it beneficial from a public health point of view to do one over the other?

[Dr. Joel Lexchin]

In my view, what we want is a global strategy for this, so that the most vulnerable people in all countries get immunized to decrease the rate of spread. One of the things we know is that the faster the virus spreads and the more people it infects, the higher the likelihood that it's going to mutate.

That's one of the reasons we're seeing mutations coming from countries like Brazil, South Africa, the U.K. and possibly the United States. These are places where the virus has spread very rapidly and is widespread.

If we concentrate our immunization efforts, as we seem to be doing, on the rich countries, and then go to the low and middle-income countries, we're ensuring the development of mutations. Some of those mutations may be resistant to vaccines.

Canada should show leadership. Canada can't do this alone, but it can certainly show other countries the right course. The right course is for Canada to support the COVID-19 technology pool, to give more support to COVAX and to announce when we're going to be donating our excess vaccines to other countries.

[Don Davies, NDP, Vancouver Kingsway, BC]

Did you not say that South Africa and India are calling on the WTO—

[The Chair, Liberal, Ron McKinnon]

I'm sorry, Mr. Davies. Your time is up.

I'd like to thank all the witnesses for sharing their time and expertise with us today. Your input is extremely well appreciated, and will be most helpful to our study. With that, I would invite the witnesses to withdraw, and we will carry on with a bit of business left over from Friday.

On Friday, we were considering a motion by Mr. Van Bynen. At the point where we moved to adjourn until now, we were perilously close to achieving a meeting of minds. Mr. Van Bynen's motion was to instruct the analysts to prepare a report on the mental health study. It was simply instructions to prepare a report. There was no mention of taking any committee time for considering the report.

Mr. Maguire submitted a motion to amend that to require that any consideration of such a report only be done during a constituency week.

I see hands up. I have Mr. Van Bynen up first, please go ahead.

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

Thank you, Mr. Chair.

Let me start by thanking my colleagues for proposing that we continue this debate today after we've heard from witnesses on our second topic under the current study. Hopefully, everyone has had some time to think about what I proposed last week. I hope we can get to an agreement and continue to be productive in our roles as members of this committee.

With respect to the standing committees, House of Commons Procedure and Practice, third edition, 2017, chapter 20, page 979, indicates that each committee:

is given the power to examine and enquire into all such matters as the House may refer to it, to report from time to time and to print an appendix to any report, after the signature of the Chair, containing such opinions or recommendations, dissenting from the report or supplementary to it, as may be proposed by committee members.

On Friday, January 29, I proposed to you, my colleagues, that we committee members instruct the analysts to prepare an interim report on the topic on the impact of COVID-19 on the mental health of Canadians, based on the four meetings held on this topic as part of our current study.

We were instructed by the House to look into the emerging situation facing Canadians in the light of the second wave of COVID-19, to hear from Canadians across the country on the impact this has had on our lives and to study the government's response to the coronavirus pandemic. As such, our committee agreed to a plan. Each party would submit four topics in the study, in order of priority. Each topic would be examined, in turn, by priority on the following rotation: Liberal, Conservative, Bloc and NDP. We determined by majority the number of meetings per topic, with a minimum of one and a maximum of four meetings. Each party would be entitled to an equal number of witnesses.

Now, this is a SparkNotes or a Coles Notes version of it, but I'm sure the clerk, the analysts, or the appropriate person would be more than happy to send an email to all members with a reminder on what was agreed upon in this plan.

If I remember correctly, it was Mr. Davies who suggested our committee move forward in such a manner and moved the motion that outlined our current plan. Maybe he's able to give us a better summary of it than I am.

I do know, however, at that time I said it was a reasonable approach, and I still believe that to be the case. However, I have since come to realize that interim reports, as part of our study, will help, not hinder, as it was suggested on Friday, our ability to effectively work as members of the health committee in the pandemic.

I will once again quote our favourite book, this time on page 991:

In order to carry out their roles effectively, committees must be able to convey their findings to the House. The Standing Orders provide standing committees with the power to report to the House from time to time, which is generally interpreted as being as often as they wish.

As the Standing Committee on Health in the middle of a pandemic, I see creating interim reports on each topic of this current study as our duty to the House to the task we've been given, to our colleagues and to Canadians.

I want to be very clear because, perhaps, I wasn't on Friday. I'm proposing the analysts produce an interim report on the topic we had just finished. I'm not proposing that we stall witnesses on vaccine delivery or the ministers in front of the committee next week. I'm not proposing that we interrupt, impede or delay any of the meetings on the topic of vaccines or future topics. I want to remind you that all parties submitted the topic of vaccines as a priority.

I'm not asking analysts to take any time away from their work in the meetings on the topic of vaccines, or any future topic, to write an interim report. On Friday I asked our analysts their thoughts on this. The answer was clear, and I quote:

I think writing an interim report would be very helpful. It would help the committee to focus on what they heard during those first four meetings, and it takes the study in some easier to consume bites. We're fine to go ahead and start to draft an interim report. If the committee wishes, each of the members could submit what they hope to be in the report. That could be submitted through the clerk.

House of Commons Procedure and Practice is clear on reports. It says they “may be short documents of less than one page in length or...more substantial and separately bound works.” That is on page 990 if anyone would like to check.

I see no problem in our being able to provide our requests and recommendations in writing through the clerk. I am also not asking us “to be wasting meetings deliberating things like punctuation on a report that's not material to getting tools to end this pandemic.” I'm confident in our analysts' ability to punctuate properly, as well as to dot the i's and cross the t's. To question our analysts' ability to properly punctuate is offensive, as is insinuating that documenting our work is not material to getting tools to end this pandemic when it very clearly is the opposite.

It's unacceptable that one year, 36 meetings, 198 witnesses and 63 submitted briefs since our first committee meeting relating to COVID-19 we have not yet reported our findings and recommendations to the House.

Mr. Chair, and colleagues, I'm once again seeking agreement on how to find a way for our analysts to produce an interim report. We just wrapped up the meetings on one topic. Let's have an interim report on that. Once we wrap up the next topic, let's have an interim report on that and so on.

This is a large study. It encompasses a variety of important topics for me, my constituents, you and yours. Let's make sure that the witnesses we bring in, their testimonies, their requests and the questions that we are asking are reflected and reported in a timely manner without impeding, interrupting or delaying the following topics. We're all professionals here, and I trust that we can work together to find a solution to move this forward.

Thank you, Mr. Chair.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Van Bynen.

Mr. Kelloway.