Health Committee on April 30th, 2021

[Mike Kelloway, Liberal, Cape Breton—Canso, NS]

Thank you, Mr. Chair, and thank you, colleagues. Hello to you.

Thank you to the witnesses as well today.

Minister Hajdu, in the last week the COVID situation in my home province of Nova Scotia, which is also MP d'Entremont's home province, has been for me a great cause of concern. In just two weeks, we went from 42 active cases to 589 cases. The majority of those new cases were reported just this last week.

I have to tell you, though, and Canadians, that I am so proud of my constituents and all Nova Scotians who have been getting tested to identify and reduce the spread of the virus in our communities. In Nova Scotia we are also so lucky to have provincial leadership that has taken this pandemic seriously from the beginning. We are now in day three of our two-week province-wide shutdown. I know that Nova Scotians will do whatever it takes to get this virus out of our province once again. I want to thank you and the Prime Minister for your role in supporting provinces and territories as we fight this virus together.

My question is simply this: Can you tell us more about the direct supports our federal government has provided to provinces and territories as we fight this third wave?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

I can, MP Kelloway. I do want to congratulate Nova Scotia for their very rapid action on putting out cases of COVID-19. That's exactly what helps communities when provinces take quick action the way Nova Scotia has.

I have to say hello to Minister Delorey, who was the minister of health. I worked very closely with him, and he was really proactive. Hello as well to Minister Churchill, who is now working on the file, and of course Premier Rankin. Their leadership has been really a model not just for Canada but for the world. In fact, they have realized that they cannot allow community spread to continue, that the best marker of safety is less COVID, and that when there is less to no COVID is when you can actually see these outbreaks and you can see when cases are growing, so I just want to thank them.

As you know, MP Kelloway, we have been there for the Province of Nova Scotia as well as all other provinces and territories—for example, through the safe restart agreement, providing billions of dollars for preparing for resurgence. The testing that Nova Scotia is now becoming famous for as well—extensive testing; rapid testing; testing pilot programs; making sure that anyone who is experiencing illness or that a public health unit that needs to test contact has the capacity to do that—that is federal government funding. There are federal government tests, by the way, that we have provided free of charge to provinces and territories.

There's also data capacity. Data is a huge component in managing and tracking COVID-19. The ability to put together those webs of how people interact, who is coming in contact with whom, and really tracking how the virus is spreading has been essential. Of course, we supported provinces with that.

There's also all the PPE, MP Kelloway, that is being used in hospitals and community settings and health care settings across each province and territory. That's been purchased for provinces and territories by the federal government.

Then there are the additional supports—contact tracers, isolation centres and rapid tests, as you know. We continue to be there for provinces, including Nova Scotia, for whatever they need.

For me, what has really been very fulfilling, despite how challenging it has been, has been the personal relationships I have developed with other health ministers. Regardless of party, I might say, they know that the phone line is open. They all have my cellphone number. We speak on a regular basis about how things are going, what they need and where we can best support them at the federal level.

[Mike Kelloway, Liberal, Cape Breton—Canso, NS]

Thank you, Minister.

On Saturday, I think, it was quoted in the press that approximately 15,000 tests were completed in just one day. Comparatively speaking, I think that at this time last year, or maybe a little later, there were approximately 200, so the advancements we have made have been immense. Again, I can't thank you enough, and also the people of Nova Scotia. It's a real inspiration to see everyone come together to really stamp this out. I think this is overused, but it's apt to say that COVID-19 has changed our day-to-day lives, and yet we're finding innovative ways to adapt.

My question is around virtual care. How is the federal government supporting Canadians in expanding access to virtual care services? We're upping our game there, and I'm curious to get an answer to that question, particularly for the rural parts of my riding.

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

Thank you very much.

Through the chair, you're absolutely right. There are very few silver linings to COVID-19. Maybe that's just my perspective today.

One of the silver linings is that it really accelerated provinces' commitment to creating B-codes for virtual care and to empowering physicians across the country to use virtual care and be able to be compensated for providing virtual care. This a game-changer. It's a game-changer for places like Nova Scotia and my own home community or region of Thunder Bay—Superior North. I'm looking at Dr. Powlowski, who would have struggled to be able to provide care for patients in remote communities who maybe just wanted to talk to him to follow up. This is an ability, actually, for Canadians to get access to care. It obviously doesn't replace face-to-face care. I don't think anyone would expect it to, but it certainly can help get people access to primary care much more quickly.

Last May, we announced $240.5 million to support this work to enhance digital tools, such as secure messaging and digital video conferencing, for example, because confidentiality and privacy issues are very important in the context of health care.

We have signed seven bilateral agreements for virtual care with provinces and territories, including one with Nova Scotia. We have investments of over $98 million towards that.

Also, we immediately knew that this would create mental health stress for Canadians across the country, so we launched wellnesstogether.ca. This is a provision of a mental health service support for Canadians regardless of where they live that's available online through a variety of ways.

The neat thing is that Wellness Together is essentially reaching Canadians who, prior to this, maybe had a hard time reaching out for help, didn't have coverage for help or just hadn't thought about using mental health supports as a way to help with some dark moments in their life. I'm very thrilled to say that we'll be sustaining that investment over the next year.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Kelloway.

We will go now to Mr. Barlow. Mr. Barlow, please go ahead. You have five minutes.

[John Barlow, Conservative, Foothills, AB]

Thank you very much, Mr. Chair.

My first question is for Dr. Lucas.

Dr. Lucas, will the known traveller digital identity pilot project, which is included in budget 2021, be used to provide proof of COVID vaccinations for Canadians travelling abroad?

[Dr. Stephen Lucas]

Mr. Chair, I may direct that question to the president, Mr. Stewart. It is not a direct area for Health Canada.

[John Barlow, Conservative, Foothills, AB]

Go ahead, Mr. Stewart.

[Iain Stewart]

That is a Transport Canada investment, I believe, for border measure certification.

[John Barlow, Conservative, Foothills, AB]

Is Transport Canada not talking to Health Canada on this issue at all? Is this something none of you are aware of in terms of how that will be used or implemented?

No? Okay.

Minister, you had a number of scathing audits on your performance, and they continue to pile up. Your own department's internal report from September has shown a slow response to the pandemic. The external review panel's interim report outlines the failure in cancelling the pandemic early warning system before COVID. Certainly there is the Auditor General's report on the lack of pandemic preparedness, surveillance and border control measures. Most recently was the Auditor General's report pointing out gaps in the oversight on the natural health products.

Two weeks ago my colleague, Mr. Davies, asked if you accepted any responsibility for the failures outlined in the Auditor General's report. You avoided any accountability. Do you now accept some responsibility for the failures of the departments of which you are in charge?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

Mr. Chair, we've been very clear to accept all the recommendations of the Auditor General. Accepting the responsibility includes, for example, appointing independent investigators into what happened with GPHIN and making commitments to restoring the Global Public Health Intelligence Network.

This government has been clear that there is much to learn by this country. There is much to learn by every country. We will be very focused on those recommendations and indeed on ensuring that we have a world-class Public Health Agency of Canada and a world-class global pandemic response system going forward.

[John Barlow, Conservative, Foothills, AB]

I'll take that as a no. You won't take responsibility for some pretty significant failures in the departments of which you are—

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

Actually, Mr. Chair, I would prefer not to have words put in my mouth.

[John Barlow, Conservative, Foothills, AB]

I've asked you a question. You have answered the question. I am moving on.

The recent Auditor General's report concluded that “Health Canada did not ensure that natural health products offered...Canadians were safe, effective, and accurately represented”.

Maybe Dr. Stewart or Dr. Lucas would know the answer to this question. Do we know how many Canadians were harmed or had medical incidents as a result of adverse reactions to the natural health products in the past five years?

[Dr. Stephen Lucas]

Mr. Chair, in response to that, I don't have that information at hand. I could follow up.

What I would observe is that Health Canada, in its regulatory areas, including the natural health products area, does have a strong system of oversight on safety, efficacy and quality with the responses. Our response to the report of the Auditor General indicates we are taking further action to strengthen that, including working with patient groups, the industry and others to ensure that support and oversight are strong to protect Canadians.

[John Barlow, Conservative, Foothills, AB]

Thank you, Dr. Lucas.

The Food and Drugs Act and the regulations set out the reporting requirements of adverse reactions, which the department collects. Can you table with the committee the number of adverse reactions Canadians have had with natural health products over the past five years? Can you table that with the committee?

[Dr. Stephen Lucas]

Mr. Chair, as I indicated, Health Canada will follow up and provide the committee with our report on reported adverse reactions to natural health products.

[John Barlow, Conservative, Foothills, AB]

Thank you.

I'll go back to the minister. We've certainly had some evidence that the hotels used for hotel quarantines are now advertising that they are booking hotel quarantine stays well into September, now till the end of September 30, but the most recent order in council mandates that the quarantine hotels will expire on May 21.

Is it your intention to maintain the quarantine hotels into September and into the fall of next year? If it is, why?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

Mr. Chair, I will just say that we will follow the advice of the researchers and public health experts who are advising us on how best to manage the border. We will be prepared to continue to isolate Canadians returning from international travel for as long as the virus is presenting a threat to Canadians.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Barlow.

We will now go to Dr. Powlowski.

Dr. Powlowski, please go ahead for five minutes.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

I have a bit of a technical question. It would seem like Major-General Fortin might be the person to answer it, but this isn't really something he's been dealing with.

I know the government has agreed to deploy the army—at least, medical assistance teams—and the Red Cross to southern Ontario to help them deal with the large number of cases overwhelming the health care system there.

Question number one is this: What exactly are they going to do? My understanding is it's likely they have limited ICU capacity. I think the hospital in Kandahar had 10 to 20 ventilated beds. Certainly that's not going to make much of a difference in terms of stemming the number of people in ICUs. How are they going to be used?

Then the second thing is—and this is the important one for me—who determines what they're going to do?

Having been in contact with infectious disease doctors in Ontario in London, Oshawa, Markham and Stouffville, I know there are infectious disease people there who are eager to use the bamlanivimab that was purchased by our government is basically sitting on the shelves. They want to use it. They want to get it into people's arms. Exactly where the problem lies in doing this isn't totally clear, but one of the problems is having infusion sites. Certainly having tents with medics and/or nurses who could infuse them would certainly seem to me to be one way of addressing and trying to deal with the large number of people ending up in the hospital, when studies seem to indicate you need treat eight people as an outpatient to prevent one hospitalization. This is something we could be doing.

Now, who makes the decisions as to what those army units will doing? I kind of fear it isn't going to be as simple as the doctors asking the army for some help. It's going to be, well, the doctors have to talk to the hospital, which has to talk to the province, which has to talk to the science table, which has to talk to PHAC, and it will take months for any decision to be made. Who's going to make that decision as to what the army does?

One, what are they going to do? Two, who is going to determine what they can do? Three, how about using them to infuse monoclonals?

[MGen Dany Fortin]

Mr. Chair, I'm happy to provide some comments.

From past experience as commander of the joint task force Laser, the response for the pandemic last spring, I can say that the Canadian Armed Forces are prepared to support, at the request of provinces and territories, in a range of capacities and tasks that fit the profile of the capabilities we deploy. In this current case, given the pandemic and the way it's going, the way it's been and the way it's affected the CAF, as well as other activities, mobile medical assistance teams have been purpose-built to deal with the different requests.

As we have seen in supportive activities in northern Ontario, northern Manitoba and currently in Sunnybrook in Ontario, they're really there to bolster capacity and provide assistance at the request of the Government of Ontario. Maintaining a military chain of command, they provide assistance to support the needs of the local hospitals, local long-term care homes or what have you, as they see appropriate.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

In terms of a chain of command—because I'm in touch with these doctors—they have to then get the Ontario government in the Ministry of Health to then put in a specific request to the army to do a specific thing.

Again, I'm focused on.... If they want to use the tents, the medics and the nurses to infuse monoclonal antibodies, they first of all would have to go to the hospital, which would have to get the Ministry of Health to then ask the army to do something. There's no short circuit for this so that they can go directly to the army.

[MGen Dany Fortin]

Mr. Chair, I wouldn't be able to respond in great detail about what the CAF is doing in terms of technical support, but I can tell you that we have an omnibus RFA—request for assistance—and the current tasks fit the profile.

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

Perhaps, Deputy Lucas, you can add a few words about the treatment aspect.