Thank you very much, Mr. Chair.
Good morning, everyone.
I would like to begin by thanking all the members of the committee for giving me the opportunity to represent the Canadian Cardiovascular Society.
My name is Marc Ruel. I'm the chief of cardiac surgery and a cardiac surgeon at the Heart Institute in Ottawa. I'm also, incidentally, the president of the Canadian Cardiovascular Society, which is the national professional association that represents 2,500 cardiologists, cardiac surgeons and scientists across Canada.
I'm pleased today to have this opportunity to describe to you the realities that my colleagues and I are facing as we treat heart patients throughout the COVID-19 pandemic. As you know, this is a time that is very challenging for our resourcefulness. Among our concerns have been the priority sequencing for COVID-19 immunization and our country's ability to deliver essential cardiac care as the pandemic continues.
My colleagues and I oversee medical and procedural aspects of hospital cardiac care across the country. We have direct contact with COVID patients and their contacts every day as we serve as Canada's front line of defence in the pandemic. Our patients are the most severely ill: some who have pre-existing heart disease and then contract COVID-19, and some who develop cardiac complications as a result of COVID infection.
Along with the physicians and the health care and support workers who have direct contact with COVID patients are also the nurses, technologists, care aides and cleaners, and they need full protection from the virus. This has been recognized by the National Advisory Committee on Immunization, which identified health care workers as a priority population for immunization, given their essential role and their high potential for transition to those at high risk of severe COVID illness.
We applaud the recent acceleration of vaccination of vulnerable populations and the continued emphasis on preventive public health measures to reduce the spread of COVID-19. However, we have expressed our strong and persistent concern about the policy shift to a four-month delay in providing the second dose of vaccines—which is off-label for the Pfizer and Moderna messenger RNA vaccines—for frontline health care workers.
Incomplete vaccination of health care workers has translated into vaccination rates of essential health care workers of as low as 50%, depending on the region, as of today. There's recent data from The New England Journal of Medicine that demonstrates the profound effect of the timely administration of the second dose of the vaccine. One dose dropped rates of infection by about 30%, whereas the second dose dropped COVID infection rates by 98%. Let's remember that frontline health care workers do not have the option of not providing direct care in close contact with COVID-19 patients.
Other emerging data suggest that the delays for off-label use of mRNA vaccines lead to inadequate immunization and a paradoxical increase in the risk of variant spread. They also may exacerbate vaccine hesitancy due to infections after one dose, leading to lack of confidence in effectiveness among the population.
Outbreaks have already occurred in hospitals across Canada in this third wave. Most patient-facing health care workers and key support staff in many provinces are not fully vaccinated, and some of those with incomplete vaccination have become infected with the virus. We have seen examples of these in every centre. These outbreak situations and the general intensity of COVID-19 in hospitals not only puts patients and health care workers at risk for COVID, but also puts patients at risk from cardiac and other non-COVID disease conditions—indeed a dual threat. This has placed extreme strains on hospitals that were already heavily strained to deliver care prior to the pandemic.
Therefore, we fear that our public health organizations and governments have underestimated the negative impact of incomplete vaccination on health care workers and on the workforce as a whole, which has a direct negative effect on the health of Canadians from both COVID and non-COVID-related illnesses.
A related concern is an increase in vaccine hesitancy when infection occurs as a result of delayed dosing. Strict measures are needed to ensure the highest possible adherence to the vaccine with limited medically documented exemptions.
We all agree that vulnerable populations should be vaccinated as soon as possible, and that public health preventive measures are key even with vaccination, but again, protecting health care workers has the compounded benefit of protecting the public from both COVID and non-COVID illnesses and keeping hospitals less vulnerable to outbreaks. In a reality where we're now overwhelmed with COVID patients and what feels like an insurmountable backlog of critical non-COVID cardiac patients, every policy and practice improvement matters.
Based on the vaccine efficacy and increased risk, the Canadian Cardiovascular Society strongly recommends prioritizing the timely vaccination of our vulnerable populations and, by the same token, reclassifying high-volume patient-facing health care workers and key hospital support staff among those who should receive a second dose no more than two months after the first, also to ensure strict adherence to vaccination. These measures would enable the highest level of protection, so that health care workers can serve the public good to treat COVID and non-COVID-related illnesses, including cardiac disease.
Thank you for your attention.
I look forward to your questions.