Health Committee on Feb. 19th, 2021

[John Barlow, Conservative, Foothills, AB]

Okay. Thank you.

What I'm hearing is that you have the data available.... Actually, I haven't heard that today, but PHAC and the Government of Canada—the Liberal government—apparently have the data to enforce border lockdowns and travel restrictions and to quarantine people in hotels. You have that data, but you don't have the data available such that we can tell Canadians when life can go back to normal and Canadian businesses can reopen and Canadians can go back to work. We don't have that data. Is that what you're saying?

[Dr. Guillaume Poliquin]

Mr. Chair, on this issue, data is not a fixed concept. We continue to learn more and to learn about this and add to our understanding of the transmission dynamics. The modelling that was released today demonstrates a number of different scenarios, including one where variants of concern with a 50% transmissibility increase are in play in Canada, and we see from that data that public health measures are a necessary component of achieving outbreak controls here in Canada.

[John Barlow, Conservative, Foothills, AB]

All right. I appreciate that, but this is having a very real impact on Canadians, and they need some answers.

I have a last question that I want to try to get out, Mr. Chair, if I have some time here. We've heard today I think some very different perspectives. If we have the most robust access to vaccines in the world, which we keep hearing—even though we don't actually have vaccines in hand, we keep hearing that we have access to them—then why are we now rationing those vaccines?

We've heard today that we may be extending the time between the first and second dose and even that maybe we won't need that second dose at all. Why is there such a change from the information we've heard over the last few weeks to what we're hearing today? Why is there that massive change? If we have all these vaccines, why are we rationing and then maybe instead of having two doses having only one?

[Kimberly Elmslie]

This is a matter of the evolution of the science. It's really as simple as that. We're learning more about the effectiveness of vaccines. We're learning more about the efficacy of one dose or two doses. This is all quite expected in the context of watching the population in its response to vaccines and watching vaccines as they interact with our population. To be quite clear, it is us as a globe learning through the science how to use vaccines most effectively. That's what this conversation is about.

When Moderna and Pfizer were authorized for use in Canada, they were authorized according to the clinical trial data that the companies brought to the regulator. Once the vaccine is in use in a population, as with all vaccines, you then look at effectiveness in the real world, and you start to understand whether or not the way the vaccine is being delivered in the population can be revised, and whether or not those adaptations that you might make are having significant public health benefits. If they are, then you can modify your use. If you see that things are moving in the wrong direction, again, you modify your use. It is squarely the evolution of science.

[The Chair, Liberal, Ron McKinnon]

Thank you.

We go now to Mr. Fisher.

Go ahead for five minutes, please.

[Darren Fisher, Liberal, Dartmouth—Cole Harbour, NS]

Thank you very much, Mr. Chair.

Ms. Elmslie, I want to thank you for hitting the nail on the head there. It's the evolution of science. That explains so much. From day one, this has been a rapidly evolving situation. I know that all of the people who are taking care of Canadians and watching over the health and safety of Canadians are constantly monitoring new data every day as it arrives.

I think we all agree, on this committee, that we have to do everything we can to protect Canadians from COVID, especially with these new variants. One new case of COVID is too many. I want to thank all the witnesses today for the work that you do, every day, because I suspect that you live this. You live this, and you have for probably a year.

You didn't get a chance to answer all the questions that were asked of you. Members are very tight with time. We have a lot of constraints on the time here and you didn't get a chance to answer all the questions you were asked. You specifically mentioned the importance of a multi-layered approach to controlling and preventing COVID-19.

Since I'm on with you, Ms. Elmslie, I wonder if you could elaborate on this multi-layered approach on how we need to take every step to make sure we ensure the safety of Canadians.

[Kimberly Elmslie]

This is something that I feel passionate about. I think we all, as public health professionals, feel passionate about this. When you're dealing with an epidemic or a pandemic, when you're dealing with a public health crisis, you need to use all the levers you have in order to interrupt transmission and to save lives. From that perspective, when we talk about a multi-layered approach, we talk about vaccines as part of our tool kit and we talk about public health measures. We've learned over time how effective those public health measures are, whether they be for the wild strain of the vaccine or for variants. We know, very clearly, that masking, physical distancing and washing hands—all of those public health measures—work. That's why they've become so important to our multi-layered response.

We also, of course, rely on Canadians and know that Canadians are sacrificing and doing so much to ensure that we are controlling the spread of this virus in all of its forms.

Public health is a team sport. We know that and we need to work in collaboration with the whole of society as we tackle this very complicated problem. We don't have all the answers and we don't pretend to. Nobody does. But what we're doing every day is getting more data, doing analysis and trying things out. Sometimes you take a risk and you try something out and then you collect data as you go to see whether or not your best-informed public health interventions are working. We're in that space right now. We've been in it since the beginning of this pandemic. We'll continue to be in it as we now roll out vaccines at the same time as we reinforce public health measures and work with Canadians in communities to ensure that they maintain confidence in the vaccines that are being provided and that they will access over the next short while, as the number of vaccines delivered to our country increases.

I'll stop there. I probably have been a little bit too impassioned. I feel very strongly that we use our levers, we adjust our levers, we use evidence and we apply evidence very effectively in Canada in order to deal with this devastating pandemic.

[Darren Fisher, Liberal, Dartmouth—Cole Harbour, NS]

I, for one, thank you very much and thank all the folks who do the work very similar to the work you do.

I also want to take a chance—if I could, Mr. Chair, I know my time is just about out—to thank the public health officials in the provinces and territories for working as a team, looking out for the health and safety of Canadians for a year now. It's absolutely incredible. Here in Nova Scotia we've had some pretty significant success as we've fought COVID. Of course, we've had to take some pretty serious public health moves. We've had buy-in from the community and Canadians have bought in, essentially, to a lot of the suggestions from their amazing public health officials across this country. I want to salute them all with my last 10 seconds.

Thank you so much, Mr. Chair.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Fisher.

Mr. Thériault, you have two and a half minutes.

[Luc Thériault, Bloc, Montcalm, QC]

Thank you, Mr. Chair.

I'd like to tell the witnesses that the answers they can give us in writing in the next few days will be just as important as the answers they can give us today. It's important that they understand our concerns.

Of all the people who are with us today, no one could have imagined on February 19, 2020, the narrative of the crisis we are experiencing. Nor could anyone have claimed to know that there would be so many questions about vaccine efficacy, since the possibility of creating a vaccine in such a short time wasn't even considered. So there are negative aspects and positive aspects. I'm going to talk about one of the negative aspects.

At one of the committee meetings, I had asked Dr. Tam whether, in hindsight, she felt that she should have recommended more quickly that the border—one of the longest in the world—be closed. She ultimately said yes. It's always important to be modest and humble when dealing with a crisis like this, unless you have the science to back it up. The Public Health Agency of Canada has a responsibility for border management as part of pandemic management, as well as a responsibility for consultation and advisory services.

This week, the land border was open. Quebec was concerned about the upcoming spring break and had asked for a tightening of the rules. For us in Quebec, the spring break was the determining factor in the spread of the virus.

Ms. Evans, have you documented the border crossing issues that have occurred this week, particularly at the Lacolle land border office? Have you corrected them?

[Cindy Evans]

There are now requirements for pre-departure testing for arrivals in Canada through our land borders. That came into force on February 15, specifically to the point the member has raised.

[Luc Thériault, Bloc, Montcalm, QC]

I hear there's fraud.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Thériault.

[Luc Thériault, Bloc, Montcalm, QC]

I see you don't seem to be aware of the problems that have occurred this week, Ms. Evans. We'll be able to share them with you.

Thank you.

[The Chair, Liberal, Ron McKinnon]

Thank you, Monsieur Thériault.

We will go now to Mr. Davies.

Mr. Davies, go ahead for two and a half minutes, please.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

Several provinces have recently eased COVID-19 control measures or are contemplating doing that despite the spread of variants of concern across Canada.

Does PHAC have a position on that? Is that a wise course of action for provinces, to be easing controls, when we're seeing the emergence and spread of variants of concern?

[Dr. Guillaume Poliquin]

Thank you, Mr. Chair.

That was a complex question. I will maybe speak to the modelling that was presented, and Mr. Bent may have some additional commentary.

We displayed modelling that shows that the introduction of variants is one factor that affects the epidemic curve. We see that different levels of maintenance or relaxation of public health measures do also have a potential impact on outbreak trajectory to control.

With that, I would like to turn to Mr. Bent in terms of the view moving forward.

[Stephen Bent]

Thank you.

Perhaps to build on the earlier comments of my colleague Ms. Elmslie, I will say that it's very much about a tool kit of measures. At the provincial and territorial level, they take a regional approach based on the incidence of COVID and the challenges that are being faced in specific communities.

In the context of going forward, I imagine that will continue as an approach, as we watch the surveillance related to rates of COVID-19, hospitalizations and other important surveillance measures that help inform decision-making at the provincial and territorial and local public health levels in terms of how to manage COVID-19.

[Don Davies, NDP, Vancouver Kingsway, BC]

Okay.

We know that one of the attributes of these variants of concern is greater transmissibility. Frankly, they're more infectious viruses. I'm wondering about the relationship between transmissibility and PPE advice. Does PHAC have any comments to make on how the variants may impact our PPE? We know that we had a great deal of problems with PPE in this country early on in this. I'm wondering if there is any guidance that Canadians need or should have about masking or any other precautions they can take in terms of PPE measures.

[Stephen Bent]

Beginning broadly, we know that the measures we have in place work. The research and evidence that we will build and continue to draw on will help inform how we provide advice to Canadians on how to adapt the measures we have in place.

In terms of masking, we continue to review our advice to Canadians. We recently did so. We continue to monitor work that is happening in other countries and in the research community. In the context of masking, we continue to advise that a non-medical mask with multiple layers, including a filter layer, remains a very good and useful approach to reduce the spread of COVID-19.

As I mentioned, we continue to monitor activities that are happening in other jurisdictions. Based on the evidence available to us today, our advice remains that in the context of variants of concern, the current masking advice remains appropriate.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

[The Chair, Liberal, Ron McKinnon]

That brings us to the end of round four. It also brings us very much past the two hours we had proposed for this meeting.

I'm wondering if it is the will of the committee to adjourn at this time.

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

I so move, Mr. Chair.

[The Chair, Liberal, Ron McKinnon]

It seems to be the will of the committee. Thank you, all.

To our witnesses, thank for being with us today and for biding with us through all of the delays earlier on. Thank you for your testimony.

Thank you, all. I'll see you next week.

The meeting is adjourned.