Health Committee on April 19th, 2021

[The Chair, Liberal, Ron McKinnon]

Thank you, Ms. Bisanz.

We'll go now to Don't Forget Students, Brandon Amyot, co-organizer.

Mr. Amyot, please go ahead for six minutes.

[Brandon Rhéal Amyot, Co-Organizer, Don't Forget Students]

[Witness spoke in Ojibwe and provided the following text:]

Aaniin kina wiya.

[Witness provided the following translation:]

Hello, everyone.

[English]

My name is Brandon Rhéal Amyot. I'm student at Lakehead University in Orillia and a co-organizer with the Don't Forget Students campaign. I am speaking to you from the territory of the Chippewa Tri-Council of Rama, Beausoleil and Georgina. These are lands under the Williams Treaties and the Dish With One Spoon wampum, long stewarded by the Anishinaabeg, the Haudenosaunee and the Wendat. I mention this not just because it's important to recognize the land, but because of the impact that the pandemic has had on indigenous peoples and, in particular, indigenous students and students of diverse communities.

Members, I speak to you today to raise a grave concern about the impact of the pandemic on post-secondary education, students and recent graduates. This pandemic has taken an immeasurable toll on our financial outlook, our job prospects, our quality of education and, most important, our mental health and community health.

In the past year, students and recent graduates have fought hard to get governments to listen and to act. At the beginning of the pandemic, we called for the CERB to be extended to students and recent graduates. After almost two months of advocacy, the Canada emergency student benefit was launched. This provided four months of relative stability and support for students and recent graduates, but hundreds of thousands of international students and recent graduates were not eligible, and recent graduates who are still in search of jobs and who were not eligible for CERB also could not access this program.

The other large program, the Canada student service grant, as you all know, did not end up rolling out and also did not equitably address the impact of the pandemic on students. In the end and to date, of the over $9 billion originally promised for aid to students through the pandemic, $3.2 billion remains unspent. If I'm to be frank, I feel that politics came before students and before responding to the impact this pandemic has had on us, the post-secondary system and our communities.

We're now 13 months into this pandemic, and I probably don't need to tell you that here in Ontario, where I live and attend university, new COVID-19 cases have hit an all-time high. This third wave is particularly impacting me and other young people across the province and across the country.

The toll this has had on my mental health is difficult to measure, and it's difficult to measure the impact it has had on our mental health for all of us post-secondary students, but research just this past November from the Ontario Confederation of University Faculty Associations and others paints a bleak picture—one that I'm living in. The lack of attention to post-secondary from all levels of government during the pandemic and the legacy of systemic underfunding have led to the pandemic being able to wreak havoc not only on our education, but on our lives.

Most recently, one of the casualties was Laurentian University. This is the product of mismanagement, systemic policy failures and underfunding, and it's not only billions of dollars lost in economic activity but a community ripped apart. These systemic issues are not unique to one school. They are present in this system across the country.

Students and recent graduates were barely making ends meet as it was, and we're barely making ends meet now. Despite the picture that is sometimes painted, we are not a homogenous group of recently graduated high-schoolers. Students are parents, caretakers and workers. Some of us, including me, are disabled and are struggling to cope. This is not an environment conducive to learning, and it is not an environment conducive to innovation.

Meanwhile, recent graduates and those about to graduate are facing one of the worst job markets in a generation and will be crushed under the weight of record high student debt and unreasonable payments. What possible justification is there for collecting student debt payments and interest during a pandemic? In the best of times, these payments are difficult to make. We have to find a better way, not just to get us through the COVID-19 pandemic, but to fully realize the potential of post-secondary education in this country as a part of a social, environmental and economic recovery.

In the short term, all funds that were originally allocated to students—and additional funds—need to be invested towards supporting us through the pandemic. This means relaunching the Canada emergency student benefit—or whatever you want to call it—in May and including international students in the eligibility. It means including all soon-to-be-graduating and recently graduated students in direct supports. It also means extending the moratorium on student loan debt and interest payments until at least the end of the pandemic, with commitments to significant student debt relief.

We have to think about the long term, and that means systemic investments in post-secondary students and education. It means expanding the Canada student service grant with a goal of returning to a fifty-fifty cost-sharing model. It means increasing funding to institutions, and it means creating a federal vision for a universal post-secondary system in collaboration with students, workers and academics.

With these measures, the government can begin to address the impact that the pandemic has had on students and our mental health and well-being, and the long-standing inequities and gaps within the post-secondary system.

In closing, I want to thank this committee for reaching out to hear from students, and I urge members to take action.

Meegwetch.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Amyot, and thank you to all the witnesses for your statements.

We will start our round of questions at this point with Mr. Maguire for six minutes.

[Larry Maguire, Conservative, Brandon—Souris, MB]

Thank you, Mr. Chair.

I want to first go to Dr. D'Angiulli, just to look at the best ways....

You talked about the delay in medical screenings and interventions. There are delays in all ages, I believe you said.

Can you give us your impression of how this compares with other countries? I guess that's one of the biggest issues I'd like to know about. With regard to the delay in medical screenings, you say there's help for teachers and that sort of thing in those areas in your presentation that you gave us today.

Can you elaborate on how that compares in Canada with other countries and what context they have for reopening?

[Amedeo D'Angiulli]

Canada is doing much better than countries like Italy, and this I can tell you from own experience. One of the things that Canada is doing very well is managing the online environment better than other countries.

However, we are, I would say, better and worse. It's a relative term. To be clear, we are lagging behind some of the Scandinavian countries, for example, and other countries like Australia and New Zealand.

The approach that most of the countries in the EU are taking, for example, is to enhance the online environment to give schools and parents more contact and to change the way that schools operate with the input of the students and parents. What they have done in Scandinavian countries is to reduce class sizes to have more one-to-one time, redefined spaces for physical activity and other things, which is critical right now, because play and socialization in young children, for example, is vital. You cannot replace it online.

My 3-year-old sits at a computer like a zombie. She doesn't really engage with the media. You need some form of engagement that is person to person.

We can do it. As a country, we have the ability and the skills. We have some of the best schools in the world. However, we are still not quite getting it.

Compared with other countries that don't have resources, of course, we are doing much, much better.

[Larry Maguire, Conservative, Brandon—Souris, MB]

Thank you.

You were talking about home-schooling and working from home—the change is a lot for many parents—and disabilities and the domestic violence.

Can you elaborate a bit on that and what needs to be done?

[Amedeo D'Angiulli]

Well—

[Larry Maguire, Conservative, Brandon—Souris, MB]

Talk about the disabilities as a specific case.

[Amedeo D'Angiulli]

With regard to disabilities, I think we need to have much more one-to-one tutoring and a lot of support for parents. Parents are really struggling.

I think we need to find ways to do that, to create a space for de-stressing for parents, who maybe are stuck in an apartment with children, and one of the children, or more, has challenges and needs to be helped.

[Larry Maguire, Conservative, Brandon—Souris, MB]

Ms. Bisanz, first of all, I just want to say, thank you for all of the work you're doing with your frontline efforts. We just can't say enough about the frontline workers and caregivers who have made the situation so much better than it could have been.

I'd just like to ask you a little bit about what you talked about, the social isolation and that sort of thing. I've heard some really devastating stories in meetings that I've had with seniors' advocates regarding the feeling of social isolation, as we just talked about, which many are experiencing during this pandemic. Being cognizant of the federal and provincial jurisdictions that we have to deal with, is there anything that we, as federal legislators, can push to combat this issue? What can we best help with?

[Christina Bisanz]

I appreciate that currently we are funded predominantly by the provincial governments and bound by the rules and regulations of the provinces. I think that looking at the challenges of social isolation is not something that's unique to COVID and the pandemic. This has been going on for a long time. I know that the federal government has had discussions about the development of a federal seniors strategy, as well as potentially looking at national long-term care regulations in a structure.

I think within that context we also need to be very realistic about addressing social isolation and loneliness on a pan-Canadian basis, and some of the ways in which the federal government can support the provinces, and then down to the actual frontline agencies, to address those challenges and concerns. Part of that is looking at ways we can reimagine housing structures and opportunities. Instead of rushing to build more long-term care facilities, for example, of 300 or more beds and towering facilities, can we not look at how we can address the housing strategies and work with Canada Mortgage and Housing to incentivize developers to start building different forms of product that enable seniors to age in place and do so in a way that promotes social engagement among them.

[Larry Maguire, Conservative, Brandon—Souris, MB]

I think that's a good point. A lot of our senior facilities are over 60 years old.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Maguire.

We go now to Mr. Van Bynen for six minutes, please.

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

Thank you, Mr. Chair, and thank you to all the witnesses who have taken the time to share their perspectives and to help inform this committee on the collateral impact of COVID.

My question is for Ms. Bisanz.

Hi, Christina. It's always good to hear from you, and thank you for being here today and for the work you do to support seniors and caregivers in York Region and in Simcoe County.

I've seen the positive impact of your important work over almost 10 years that we've worked together in the Newmarket council, and I appreciate your hard work in recruiting and engaging so many volunteers and your efforts to raise critical funding that you need to serve your community, like so many of the other non-profits.

You support a broad and diverse community, and firstly I'd appreciate hearing how COVID-19 has impacted the way you serve your clients and how you've adapted to continue your support.

[Christina Bisanz]

Thank you very much, MP Van Bynen.

The key change or impact that has occurred in our services has been the need to move to virtual programming, as opposed to in-person programming. Not unlike many other home and community support agencies, we pivoted very quickly to look at ways in which we could deliver social connectivity but using virtual means. By that I'm referring to both telephone and Internet communication and programming.

We also developed a number of activity packages through our adult day programs and dropped them off in a contactless way to many of our clients so that they had activities that would engage them in things such as crossword puzzles or recipes, things that they really could use to make them feel connected even though they were required to be physically isolated and sheltering at home.

The biggest thing is that shift to virtual programming, which we don't anticipate is going to go away any time soon. Even when whatever the date is that the pandemic is declared over, we know that our clients are going to continue to have hesitancy and fear about going out and being in larger groups again. We anticipate the need to continue to provide virtual programs and support our clients to do so through providing them with tablets and Internet connectivity. Providing them with technical support is going to become even more important because that's not something that typically a lot of older adults would have had access to or be comfortable using.

I can report that the response to our virtual programs has been overwhelming. It still doesn't replace the in-person contact, but it has been very well received because it is a lifeline by which people are able to know that they can connect on a daily basis or a couple of times a week. They can access physical activity. We do yoga and other physical activity exercises for them. They know they have that in terms of looking forward and that connection.

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

Thank you.

How many volunteers do you have to deliver the service?

[Christina Bisanz]

Before COVID, we had close to 500 volunteers. They truly are the heart and soul of the organization, because we wouldn't be able to deliver near the breadth of services that we do without them. Unfortunately, and particularly in the first wave of COVID, you'll recall that anyone over the age of 70 was advised to shelter at home and not go out. Our clients tend to skew to retired people in that age group, so unfortunately we had to ask a number of our volunteers just to hold off until it was safe for them to become involved again.

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

Thank you.

The Standards Council of Canada, the Health Standards Organization and the CSA group announced the launch of their process to create new national long-term care standards.

The new national standards will take into account lessons learned from COVID-19. We've heard a lot of that from you already, but based on your extensive experience in working with seniors, what would you recommend would be important considerations for this group to explore?

[Christina Bisanz]

Let me say this, if I may: As the experience from COVID and the tragic situation that affected so many frail elderly in long-term care homes has really highlighted, certainly for our organization, the time has come for us to stop questioning why people need to go into long-term care and instead focus on how we can help them to stay at home, in their own homes where they want to be.

Without doubt, there is a need for long-term care for very complex needs and conditions, but we also believe with better investment in home and community supports it is quite possible, quite feasible and better for people to be able to age in place and to have the choice to do so. Instead of solely investing in the creation of more institutionalized care, we need to start talking about how we enable people to exercise their choice to stay at home as long as possible.

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

Now if the federal government leads to a process to set out long-term care standards, how might those standards help to strengthen the home and community sectors?

[Christina Bisanz]

I think it needs to be seen as an end situation. Long-term care needs to include a consideration of home and community supports as well, so its not an either-or option but an “and”.

I think we need to look at those standards and at a way in which there could be better integration between long-term care and home and community supports. By that, I mean not just assuming, when somebody ages and has complex care needs or advanced dementia, that long-term facilities are the default. We need to look at how there could potentially be a way to support through both sectors those individuals who need the enhanced care but can still be involved and connected to their communities.

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

Thank you.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Van Bynen.

Mr. Thériault, you have the floor for six minutes.

[Luc Thériault, Bloc, Montcalm, QC]

Thank you very much, Mr. Chair.

I would like to thank all of the witnesses for their insightful testimony. Their contributions will surely help us to make important recommendations.

Dr. Champagne, thank you for your presentation, which was very clear. It was so clear that it is chilling. What you are telling us is that over the next 10 years, there will be a 10% increased risk of mortality.

There is no medical care without diagnoses. Still, when it comes to cancer, the diagnosis must come in time. Screening is therefore crucial in the fight against this disease. Yet, currently, patients who do not have COVID-19 are bearing the brunt of this pandemic, just as patients who do have COVID-19.

However, we weren't talking about it much, we weren't talking about it enough. If we want to find solutions, we still need to have a diagnosis and a clear picture of the reality. What we understand from your testimony is that the pandemic has had two effects in terms of costs. First, it requires additional, one-time costs to address the pandemic, but it will also cause further increases in system costs because of undue delays and postponements.

The underfunding was there before the first wave. We are in the third wave, and there is no guarantee that there will not be a fourth.

Are you concerned? What should be done?

[Dr. Martin Champagne]

I am very concerned.

Let's take the example of colon cancer—it always comes back to that example. If you have stage 1 disease, which is very localized, surgery will put an end to the episode. You have an 80% chance of cure, and after that, it's over.

However, if the disease has started to spread into the lymph nodes, which are like filters around the tumour, and the disease is now in stage 3, you will need additional chemotherapy for a period of about six months. There are costs associated with that, and there is certainly increased morbidity for patients, as they have to endure the effects of treatment. The chances of recovery will be less: at best, it will be 50% to 65%.

This means that a large number of patients, one-third to one-half of them, will eventually relapse and return to the health care system for other equally costly therapies that will require human resources. The physical resources exist, the hospitals exist. We can always imagine revamping hospitals, but we know that antineoplastic treatments, cancer treatments, cost tens of thousands of dollars per episode of care for a patient.

These are health care system costs that will be recurrent for many years. Relapse does not necessarily occur in the first few months after the initial diagnosis, it can occur, two years, three years, five years, or even 10 years later. This imposes a human burden on the patients, who will suffer more, but also on the entire health care system, which will necessarily have to make major investments in human and material resources.