Evidence of meeting #36 for Health in the 43rd Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was federal.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Christyne Tremblay  Deputy Clerk, Privy Council Office
Rob Stewart  Deputy Minister, Department of Public Safety and Emergency Preparedness
Asher Shalmon  Director of the International Relations Division, Ministry of Health of Israel
Clerk of the Committee  Mr. Jean-François Pagé
Bruce Macgregor  Chief Administrative Officer, Regional Municipality of York
Thao Pham  Deputy Secretary to the Cabinet, Operations, Privy Council Office
Jodie van Dieen  Counsel to the Clerk of the Privy Council and Assistant Deputy Minister, Privy Council Office Legal Services Sector, Privy Council Office
Martin Pavelka  Epidemiologist, Ministry of Health of the Slovak Republic
Isaac Bogoch  Physician and Scientist, Toronto General Hospital and University of Toronto, As an Individual
Vladimír Lengvarský  Minister of Health of the Slovak Republic
Peter Hotez  Professor and Dean, National School of Tropical Medicine, Baylor College of Medicine, As an Individual

11:05 a.m.

Liberal

The Chair Liberal Ron McKinnon

I call this meeting to order. Welcome to meeting number 36 of the House of Commons Standing Committee on Health. The committee is meeting today to study the emergency situation facing Canadians in light of the COVID-19 pandemic, specifically today examining Canada's national emergency response landscape.

I would like to welcome the witnesses. We have from the Privy Council Office, Ms. Christyne Tremblay, deputy clerk; Ms. Thao Pham, deputy secretary to the cabinet operations; and Ms. Jodi Van Dieen, counsel to clerk of the Privy Council and assistant deputy minister, Privy Council Office legal services sector. From the Department of Public Safety and Emergency Preparedness, we have Mr. Rob Stewart, deputy minister. From the Ministry of Health of Israel, hopefully we will have later on Dr. Asher Shalmon, director, international relations division. From the Regional Municipality of York, we have Mr. Bruce Macgregor, chief administrative officer.

I will invite the witnesses to make their opening statements. We will start with the Privy Council Office and Ms. Christyne Tremblay for six minutes.

11:05 a.m.

Christyne Tremblay Deputy Clerk, Privy Council Office

Thank you, Mr. Chair.

Good morning.

Thank you for the opportunity to appear before this committee to discuss the federal response to COVID-19 in the context of emergency management.

My name is Christyne Tremblay, and I am the deputy clerk of the Privy Council and associate secretary to the cabinet, and the deputy minister for Intergovernmental Affairs. I am joined today by my colleagues Thao Pham, deputy secretary to the cabinet for operations; Jodie van Dieen, assistant deputy minister of Privy Council Office legal services; and Rob Stewart, deputy minister of Public Safety and Emergency Preparedness.

The Government of Canada's efforts responding to the pandemic run the gamut from federal investments in public health such as testing and contact tracing or the purchase of personal protective equipment; to providing direct financial support to individual Canadians and businesses; ensuring adequate and reliable supply of therapeutics and medical supplies across the country; maintaining effective border measures to minimize the importation and spread of COVID-19 and its variants; and purchasing and distributing vaccines to the provinces and territories.

The federal government has also worked collaboratively with the provinces, territories and indigenous communities to manage the pandemic. Public Health measures are largely within provincial and territorial jurisdiction, and the federal government sought to ensure that they had the tools and resources to exercise their jurisdiction.

Federal funding to support Canadian workers and businesses provided the space for provinces and territories to enact public health measures in their jurisdictions, tailored to their specific circumstances.

Through the Safe Restart Agreement, the federal government provided nearly $20 billion to support the provinces and territories in their efforts to deal with the pandemic. A further $7.2 billion in pandemic support was provided for provinces, territories and indigenous communities, in recognition of the ongoing pressures COVID is putting on the health care systems.

The federal government also provides PPE, medical equipment and surge capacity support to the provinces and territories. This includes the provision of testing and contact tracing supports and mobile health units. The federal government has responded to more than 70 requests for assistance, including by deploying the Canadian Armed Forces to long-term care facilities, supporting vaccinations in remote First Nations communities, and most recently deploying nurses and medical assistance teams to Ontario hospitals. My colleague Rob Stewart is responsible for coordinating these responses to requests for assistance.

Additionally, the federal government has provided health care staff and equipment to the front lines and more rapid testing and support for contact tracing thanks to teams at Statistics Canada. We have also provided additional drugs and developed laboratory testing capacity within our federal labs. Through our partnership with the Canadian Red Cross, support has been provided to long-term care facilities in several provinces, and additional nurses and physicians were recently deployed to assist in Toronto.

The Privy Council Office has played a central role supporting the Prime Minister and Cabinet throughout the COVID-19 pandemic. This includes supporting the Cabinet Committee on the Federal Response to the Coronavirus Disease, or COVID-19, which has a mandate to ensure leadership, coordination and preparedness for the response to, and recovery from, COVID-19 across Canada. The committee has also played a coordination function, working with all federal departments participating in managing the pandemic.

We have also played a central convening and coordination function, working with departments and agencies horizontally across government on a wide array of COVID-related priorities as well as communications through our COVID communications hub. My colleague, Thao Pham, is very much involved in this work.

Our responsibilities for Intergovernmental Affairs has also meant that the Privy Council Office has been leading engagement with the provinces and territories, including supporting 30 first ministers meetings in the past 15 months, which have focused primarily on the response to the pandemic. The last meeting was held 10 days ago and every provincial and territorial premier was in attendance.

I understand the committee is interested in discussing the legislative tools that exist at the federal level to respond to emergencies like the current public health crisis the country finds itself in. Parliament has granted the government authority to deal with emergency situations and some of these authorities have already been employed in dealing with the pandemic. An example of this is the Quarantine Act, which has been used to implement restrictions at the international border, including mandatory testing and quarantine requirements for travellers.

The Emergencies Act also exists as one possible tool for dealing with emergencies on a national scale. There are four types of emergencies that can be declared under the act: public welfare emergency, public order emergency, international emergency, and war emergency. Pandemics such as the COVID-19 pandemic are considered a public welfare emergency. The act includes a specific definition of a national emergency as urgent, critical and temporary in endangering the lives, health and safety of Canadians that exceeds the capacity of the provinces and territories to deal with. Importantly—

11:15 a.m.

Liberal

The Chair Liberal Ron McKinnon

Could you wrap up, please?

11:15 a.m.

Deputy Clerk, Privy Council Office

Christyne Tremblay

Sure. I need one second.

Additionally, the federal government is obligated to consult with the provinces and territories prior to invoking the act. As such, a cabinet decision to invoke a national emergency under the act is a measure of last resort. The Prime Minister consulted with the premiers of the provinces and territories regarding the potential need for invoking the Emergencies Act. The consensus among premiers at that time was that it was not required.

11:15 a.m.

Conservative

Michelle Rempel Conservative Calgary Nose Hill, AB

Chair, I have a point of order regarding time for questions.

11:15 a.m.

Deputy Clerk, Privy Council Office

11:15 a.m.

Liberal

The Chair Liberal Ron McKinnon

Go ahead on your point of order.

11:15 a.m.

Conservative

Michelle Rempel Conservative Calgary Nose Hill, AB

I was just wanting to make sure that we had time for questions, because the witness was going over time.

11:15 a.m.

Liberal

The Chair Liberal Ron McKinnon

Thank you, and thank you, Ms. Tremblay.

We'll go now to Mr. Stewart.

Deputy Minister, I believe you have a statement as well. You have six minutes, please.

11:15 a.m.

Rob Stewart Deputy Minister, Department of Public Safety and Emergency Preparedness

I will save you time by only making a few short remarks.

Obviously, emergency management has been a very large feature of the landscape over the last year. If we go back in time, we had a snowstorm in Newfoundland and we had disruptions to critical rail infrastructure before the pandemic struck, so we have been busy.

I'm here today to talk to you about the structure of the federal government's response to emergencies and how we coordinate with the provinces, the tools we've used and the situations we've responded to.

I'm at your disposal. Thank you.

11:15 a.m.

Liberal

The Chair Liberal Ron McKinnon

Thank you, Mr. Stewart.

We'll go now to Dr. Shalmon, the director of the international relations division at the Ministry of Health of Israel.

Dr. Shalmon, welcome. You didn't have a chance to test your sound, so maybe you could say a few words to make sure the interpreters can hear you properly, and then we will carry on with your statement.

11:15 a.m.

Dr. Asher Shalmon Director of the International Relations Division, Ministry of Health of Israel

Good morning, Ottawa.

My name is Dr. Asher Shalmon. I'm the head of the international ministry of health of Israel and I'm delighted to be here with you.

Is it fine?

11:15 a.m.

Liberal

The Chair Liberal Ron McKinnon

Thank you. Hopefully we'll get the thumbs up from the interpreters.

Mr. Clerk, are we good?

May 10th, 2021 / 11:15 a.m.

The Clerk of the Committee Mr. Jean-François Pagé

Move your mike closer to your mouth, please.

Okay, Mr. Chair.

11:15 a.m.

Liberal

The Chair Liberal Ron McKinnon

Thank you, Mr. Clerk.

Dr. Asher, I invite you to make a statement of six minutes. When your six minutes is up, I'll show you the red card. Please do try to wrap up then. Thank you.

Go ahead, please, for six minutes.

11:15 a.m.

Director of the International Relations Division, Ministry of Health of Israel

Dr. Asher Shalmon

Thank you for inviting me. It's a pleasure to be here.

I was asked to speak about Israel's vaccination campaign, which is quite a successful one. We started early. On December 19, the Prime Minister and the Minister of Health were publicly vaccinated, and from the morning of the 20th we started to vaccinate widely all over the country.

We decided to go on a simple scheme, meaning that from the first day we vaccinated everybody who was age 60 and above, and medical personnel and first responders all over the country, with no subgrouping. Then, on a weekly basis, we dropped the age by five years, until at the point of week eight, the campaign was fully opened for the whole population over the age of 16.

We are now discussing when to start vaccinating teenagers. We have not yet authorized vaccine for ages 12 to 16, but we are working on it. I believe that at the end of next week, or the week after, that will be authorized in Israel and we'll be ready to start.

As you may know, Israel decided to take a single approach. We are using only Pfizer-BioNTech vaccines. We do have a clear deal with Pfizer regarding shipment dates and the exact terms of how the whole project is working. We were appealing to them, as we are running it as a national IT-driven operation where every case is fully registered not only with the national registry, but at the same time, registered by the recipient's HMO into their personal electronic medical record.

As I mentioned, the whole project was paperless. You had to pre-register for your appointment, although if you did not register, you had a good chance to be vaccinated anyhow.

At the peak of this vaccination program, we vaccinated more than 200,000 people a day. To remind you, we have 9.25 million residents here in the State of Israel. We vaccinate everybody here: citizens, temporary residents, diplomats and foreign workers. Even asylum seekers and illegal immigrants were fully vaccinated from the first day. As well, we vaccinated our diplomatic corps around the world. We hoped to have some bilateral agreement with countries and we understood that it could not work at the pace that we were looking for, so we basically vaccinated everybody by ourselves.

Compliance was good. I think the psychology of supply and demand in the beginning was a major issue for the public. People were queuing and were trying to get it sooner rather than later. Of course, it changed as this campaign moved on, and now we are putting a lot of emphasis on the last part of the population who are hesitant or against it. We do understand that a devoted anti-vaxxer will never be convinced, so we are putting our efforts into hesitant people and into some communities that were slow in terms of the numbers, such as the Bedouin in the Negev and some of the Orthodox communities, who we are pushing ahead to be vaccinated.

It's not obligatory. You have the right not to be vaccinated, although there are some crucial working places, such as the health sector, that expect everybody who gives crucial services to the public to be vaccinated. We do not have a legal framework to force it, but it's kind of an understanding that it is what we expect from our employees.

We issue what is known as a “vaccination certificate”, which is fully electronic; it's a bar code. You get it a week after the second dose.

At this point, I might add that we decided to stick to the manufacturer's protocol and to vaccinate everybody for the second dose on day 21.

The green pass is another document, which you are entitled to receive if you are COVID-recovered or fully vaccinated. That allows you into what are known as “green pass zones” in the country, mostly restaurants and bars. Gyms used to ask for it, but now, by law, gyms are open to everybody, including public swimming pools. Large cultural events and concerts, all of them, could operate under a green pass registry, meaning that they are allowed to have much larger gatherings of people than what is known as the “purple tag”, which is a standard COVID-19 restriction for general places like supermarkets, pharmacies, hospitals, and so on.

Just to sum up the numbers, more than 90% of our medical personnel are vaccinated. More than 90% of those 60 and above are vaccinated. If we look at the adult population of Israel, 80% of the population were all vaccinated with, at least a single dose or had recovered. Around 9% of our population was found by PCR test to be positive in terms of carrying COVID-19 at some point during the past year.

That's where we are. I would be very happy to answer questions. I guess there will be a few.

Thank you.

11:20 a.m.

Liberal

The Chair Liberal Ron McKinnon

Thank you, Dr. Shalmon.

Before we carry on to our next statement, Ms. Tremblay, I'm advised that your mike may not be properly selected. Could you check that?

While Ms. Tremblay does that, we will carry on with Mr. Bruce Macgregor, chief administrator officer for the Regional Municipality of York.

Mr. Macgregor, please go ahead for six minutes.

11:25 a.m.

Bruce Macgregor Chief Administrative Officer, Regional Municipality of York

Thank you, Mr. Chair. As a former soccer coach, I'm a little sensitive to yellow and red cards, so I hope you won't be using them.

I'm the CAO of York Region. There are nine cities and towns that extend north of the City of Toronto to Lake Simcoe that serve as home to over 1.2 million Canadians. We are an upper tier municipality and provide 14 core services to all of our communities, ranging from courts to policing, transit, water and wastewater, to name a few.

We also deliver public health services, as one of 34 public health units in Ontario, under the direction of Ontario's chief medical officer of health, as described under the Health Protection and Promotion Act. This is a model that differs from practices in other provinces.

Our public health responsibilities are also delivered through a community and health services department in an integrated model that also includes paramedics, social services, long term care and housing, all of which have a focus on the social determinants of health.

The perspective I'll provide you today is as the CAO of a large greater Toronto area municipality where our regional council also serves as the board of health.

York Region has a comprehensive emergency management and preparedness program that is tested annually as required by legislation. Through our emergency management program, threats are assessed annually using hazard identification and risk assessment. Since SARS in 2003 and H1N1 in 2013, pandemic risks have increased in priority and focus. Formalized business continuity planning is also part of our emergency preparedness, and is centred on maintaining critical services.

On January 23, 2020, our medical officer of health, Dr. Karim Kurji, activated the public health emergency operations centre to respond to the COVID-19 pandemic threat, one month before York Region recorded its first case. On March 17, 2020, York Region activated the regional emergency operations centre, and by March 23, York regional chair, Wayne Emmerson, had declared York Region's first ever state of emergency under the Emergency Management and Civil Protection Act.

Prior to, and throughout, the pandemic response, York Region and our nine local cities and towns have worked together very closely. Our local municipalities have been an added source of assistance during York Region's mass immunization efforts.

With public health embedded in our organization, we were able to redeploy approximately 1,000 staff from within our organization to support the public health response. Additional critical internal supports were immediately redirected to enable staff working remotely. We redirected procurement to rapidly acquire personal protective equipment, human resources to quickly hire required specialized staff for long-term care and public health, and communications to ensure updates were available through multiple communications channels.

Business continuity plans documenting essential services and functions with assigned priorities helped to quickly identify services that could be suspended or reduced to shift staff resources to support the COVID-19 response while ensuring that critical core services continued uninterrupted during the pandemic.

York Region has in place robust and well-tested incident management systems that will serve emergency response efforts well into the future. We've strengthened relationships with our local municipalities, community partners and elected officials, and forged new relations with experts from various fields, such as the Red Cross, St. John Ambulance, local physicians, hospitals and pharmacies, all of which will support our future decision-making.

What we have learned through forced digital transformation will not be lost, with efficiencies and opportunities incorporated into our new normal moving forward.

Provincial and federal funding programs have enabled many Canadians to refrain from going into workplaces while enabling business to receive support during shutdowns. Without this financial support, the pandemic outcomes would have been much worse with respect to community and workplace transmission. While most of York Region's population has access to consistent and reliable broadband technologies to support remote working, there are many rural parts of our communities that experience the ongoing challenges that persist in rural areas throughout Ontario and Canada. As we optimistically shift from the response phase of the pandemic and into recovery, individuals and businesses will continue to require provincial and federal assistance and supports, hopefully with a stronger commitment and component of funding critical public infrastructure.

Through the COVID-19 experience, York Region's state of preparedness is higher than ever before, and as we look ahead to the potential of recurring infectious diseases, it will become critical to remember this experience and guard against complacency. We're hopeful for progress in three specific areas, working together with our provincial and federal partners.

First is encouraging domestic production and he supply of personal protective equipment and vaccines; second is investing in broadband to support all Canadians in working and schooling from home; and third is ensuring consistent and clear communication among all levels of government to educate and inform the population we serve, as a vital component of any emergency response.

Thank you, Mr. Chair, for your time this morning and for the opportunity to share York Region perspectives shaped by our organizational emergency management and public health model and experience.

11:30 a.m.

Liberal

The Chair Liberal Ron McKinnon

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

We will start our questioning right now. We will start with Ms. Rempel Garner, please, for six minutes.

11:30 a.m.

Conservative

Michelle Rempel Conservative Calgary Nose Hill, AB

Thank you.

I'll start by issuing hearty congratulations to the Government of Israel on their vaccine rollout program. I'll then direct my questions to Ms. Tremblay.

Have any of the vaccine procurement contracts been sent to the law clerk, per the October 26 motion in the House of Commons?

11:30 a.m.

Deputy Clerk, Privy Council Office

Christyne Tremblay

I just want to mention that with respect to the motion, PCO, together with all the departments, is reviewing the documents. So far more than five series of documents have been communicated including thousands of pages—

11:30 a.m.

Conservative

Michelle Rempel Conservative Calgary Nose Hill, AB

Thank you. I don't have time for this.

Have the vaccine contracts been provided to the law clerk per the motion?

11:30 a.m.

Deputy Clerk, Privy Council Office

Christyne Tremblay

The contracts have not been sent yet.

Work with the pharmaceutical companies continues.

11:30 a.m.

Conservative

Michelle Rempel Conservative Calgary Nose Hill, AB

Has the government directed you to not send these documents to the law clerk?

11:30 a.m.

Deputy Clerk, Privy Council Office

Christyne Tremblay

These documents belong to the pharmaceutical companies. We are actively working with these companies—