Health Committee on Feb. 19th, 2021

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

I'm just asking because we have the DG levels of most of PHAC here. Did PHAC advise the government to undertake the quarantine hotel measures, or did the government tell PHAC to make it so?

[Cindy Evans]

When we're looking at the prevention of the importation of COVID-19 cases, that would include the concerns we would have with respect to the influence of the variants and the increases in the variants—

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

So, quarantine hotels are more effective than the Calgary border pilot.

[The Chair, Liberal, Ron McKinnon]

Ms. Rempel Garner, I would remind you that appropriate courtesy and fairness should be displayed when questioning witnesses. I—

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

I also know when word salad is being given to me.

[The Chair, Liberal, Ron McKinnon]

Ms. Rempel Garner, I have the floor.

I request that you show respect and courtesy to the witnesses and let them answer your question.

Thank you.

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

I'm also trying to show respect to the Canadian public.

I am asking if PHAC advised the government on the quarantine hotel measures based on data that it was more effective than the Calgary border pilot measure, or if the government advised them to come up with a rationale for this directive.

[Cindy Evans]

What we can again reiterate is there is a need for a multi-layered approach with our public health measures. There is not one single measure that is going to work on its own. There's the combination of effective quarantine, for having the implementation of testing, and we've introduced pre-arrival testing as well as a requirement for testing on arrival, and it is the combination of measures that is going to help us bring the pandemic under control.

Thank you, Mr. Chair.

[The Chair, Liberal, Ron McKinnon]

Thank you, Ms. Rempel Garner.

We go now to Ms. Sidhu.

Ms. Sidhu, please go ahead. You have five minutes.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Mr. Chair.

Thank you to all the witnesses for being here today.

My first question is for the Public Health Agency.

The National Advisory Committee on Immunization has released updated new guidance for Canadians on COVID-19 vaccine efforts. Can you give a better sense of the work that goes into developing and releasing this guidance?

[Kimberly Elmslie]

I'd be happy to do that.

As Dr. Quach indicated, the National Advisory Committee on Immunization is a long-standing committee that has been providing advice to the Government of Canada, to the Public Health Agency, on the optimal use of vaccines in the population over many years. They do their work by looking at the science and evidence that is available and they are experts in their fields of immunology, pediatrics, infectious disease, behavioural science and economics. They consult with the public health consultative ethics group and their job is to, with all of that combined data and expertise, look at benefits to the Canadian public of particular approaches to vaccination.

We rely on that expertise, and we rely on the independence of the committee, to bring forward the guidance that provinces and territories take into account as they make their own decisions on how they will implement their vaccination programs.

The committee publishes statements, as you will have seen, on the COVID situation and they update those statements as more evidence comes to bear. They use systematic methods for the analysis of their data so it's always done according to international standards. They are one among a number of international committees called NITAGs, national immunization technical advisory groups, that work together and work independently as well to provide both global as well as domestic advice on optimal use of vaccines.

Their advice has stood the test of time in this country. We see the success of vaccination programs and we see the success of efforts to prevent vaccine-preventable diseases. We also see from NACI where more research is needed and where there are gaps in our efforts to ensure that our population is well protected from vaccine-preventable diseases.

Thank you.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Ms. Elmslie.

I noticed that racialized seniors have now been included on the guidance list as a priority for vaccination. Many seniors expressed concerns about being at risk. Would you be able to comment on what kind of data is being used to take this decision?

[Kimberly Elmslie]

Yes. NACI uses epidemiologic data. They look very carefully at the impact on population groups with respect to both the transmission of viruses, in this case SARS-CoV-2, and the impact on illness, particularly severe illness, hospitalization and death.

When they do their analysis of a population subgroup, they see that certain groups including racialized communities and seniors are disproportionately affected by COVID-19: more illness, more severe illness, more death. That feeds very strongly into the priorities they set. They are very concerned, as we are at the Public Health Agency, about equity in the rollout of vaccines across the country, so they put a special emphasis on using an equity framework to run their recommendations through to ensure they are not leaving communities or particular groups behind, especially those who are vulnerable. As we all know, when we are ensuring that vulnerable populations are protected from infectious diseases like COVID-19, we are protecting everyone; we are protecting communities.

Thank you.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you.

Dr. Szumski or Dr. Poliquin, on February 9, Health Canada approved extracting six doses from Pfizer's COVID-19 vaccine vials versus the previously approved five. Can you give us an understanding of how six doses instead of five will affect the spread at which we will get vaccine? Do you think it will impact the speed at which we will get the vaccines?

[Dr. Roman Szumski]

It doesn't have a material impact on the speed of delivery, but it does allow more efficient use of the available vaccine supply globally.

[The Chair, Liberal, Ron McKinnon]

Thank you.

We will go now to M. Thériault.

Mr. Thériault, you have the floor for two and a half minutes.

[Luc Thériault, Bloc, Montcalm, QC]

Dr. Szumski, in your response to Ms. Sidhu's question, you said that this doesn't affect the speed of vaccination, but it does affect its efficacy.

How does increasing the number of doses from five to six improve the vaccine's efficacy?

[Dr. Roman Szumski]

Mr. Chair, I have to clarify. It improves the global supply, ultimately.

By “efficiency” I was not referring to the performance of the vaccine. That has no change whatsoever with moving from five to six. What does change is that the amount of vaccine that can be provided from a given production lot becomes increased. Ultimately, the amount of supply available to all becomes enhanced. The amount of supply that's available to Canada remains what we have contracted—

[Luc Thériault, Bloc, Montcalm, QC]

You said, however, that having more doses available didn't increase the speed of vaccination. In my opinion, it would allow us to speed it up.

Having said that, how is it more effective if the people who need to administer the vaccine can't extract the doses?

The decision was made on February 9. In early February, Rick Hillier had said that the sixth dose couldn't be extracted 80% of the time and that, for some deliveries, it couldn't be extracted at all. In Quebec, it was one out of five times.

Aside from the fact that it's in our interest to have more vaccines and doses, how is it more effective or faster if there are practical difficulties in extracting all the doses? Why did you support this decision and change the parameters of a contract?

I understand that the contracts are the responsibility of Public Services and Procurement Canada. However, when it comes to public health and vaccine efficacy, real issues still exist. Are you compiling all of these issues at the Public Health Agency?

I would ask you to send your responses in writing to the committee, if the chair decides there isn't enough time.

[Dr. Roman Szumski]

Just quickly, Mr. Chair, if I may, the specific syringes that improve your chances of succeeding with the six doses are being distributed with the doses as they go out currently. Also, the extensive training that has been made available to the health professionals across the country will be instrumental in helping them achieve that goal.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Thériault.

We will go now to Mr. Davies.

Mr. Davies, you have two and a half minutes, please.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Mr. Chair.

Are there any discussions currently going on at the Public Health Agency of Canada on considering imposing restrictions on travel within Canada in order to prevent transmission of variants of concern between regions?

[Cindy Evans]

The jurisdiction for the federal government and for the Public Health Agency of Canada with respect to the Quarantine Act is only as it applies to our federal borders. From that perspective, any restrictions on interprovincial travel would be in the purview of the provinces and territories.

[Don Davies, NDP, Vancouver Kingsway, BC]

Has the Public Health Agency of Canada revised its public guidance on infection control and prevention in response to the emergence of variants of concern?

[Stephen Bent, Director General, Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada]

In the context of our overall guidance for public health measures, we continue to work with the provinces and territories to review our guidance in the context of variants. This includes instances where we should revise based on new evidence or research that's available. We're in the process now of continuing to review the issue of variants and to make changes to our guidance.