Health Committee on May 21st, 2021

[Dr. Theresa Tam]

I think we are evaluating those policies right now.

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

Do you think not having some language on that by this point is harming Canadians because you're not providing them with some hope?

[Dr. Theresa Tam]

I do think that it's important to provide some hope. I think that the international arena is discussing this right now, and I do think that vaccines will play a role in facilitating travel.

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

Do you have any line of sight on when that might come out?

[The Chair, Liberal, Ron McKinnon]

Thank you, Ms. Rempel Garner.

We will go now to Ms. O'Connell for five minutes.

[Jennifer O'Connell, Liberal, Pickering—Uxbridge, ON]

Thank you, Mr. Chair.

I think conducting meetings and asking questions and actually allowing the answer isn't a sign of the patriarchy; it's actually doing our job as MPs to get the testimony from the witnesses we've asked to be here.

In that vein, it's interesting that the Conservatives talked about our never going to have vaccines until 2030, and then today they're saying that we have to get more vaccines or allow Canadians to take additional risks to go to the U.S. even though there are vaccines available in Canada right now. I believe it was yesterday that Canada surpassed the U.S. in first doses.

How appropriate would it be, if we're actually administering more first doses to Canadians than the U.S., to take supply away from another country when we have adequate supply here? I find that a bit odd.

I want to speak to the first-dose strategy. I have a number of questions. The first-dose strategy was also criticized by the Conservatives, which again is very confusing because you can't get a second dose until you have a first dose. Therefore, it makes a lot of sense to administer first doses, and again, we have surpassed the U.S. on this.

To Dr. Tam—or if there are others who would like to jump in, please do so—the real world data has looked very promising in terms of protection from first doses, although people are not 100% protected after a first dose. In real world data on first doses, as well as something I know the minister likes to talk a lot about, a community with less COVID is safer for everyone. If you have a lower risk, even with a first dose, that in fact makes your community safer because that spread is down.

Could you maybe speak to that piece of it and why it's important for Canadians to continue to get that first dose, and why it's so important that our momentum with vaccines and these doses is increasing and continuing?

[Dr. Theresa Tam]

Mr. Chair, maybe I'll start with the answer to that question.

I think the first-dose, fast strategy was taken up as a result of the National Advisory Committee on Immunization reviewing existing information on the COVID-19 vaccines, but also a wealth of knowledge —decades of experience—about vaccinology, immunology and how vaccines work. Together with mathematical modelling and other considerations, it meant that there was a consensus amongst chief medical officers of health in the provinces and territories to do this strategy.

I think it has paid off and has contributed to increasing population protection. More and more data is coming out, including from the United Kingdom, which shows that the first dose offers significant protection, particularly for serious outcomes, and that the duration of that protection does last.

We also have Canadian data, from Quebec and British Columbia, that I think will provide the world's first glimpse into just how good that first dose is even beyond the 12-week mark. It has been very encouraging.

If you can imagine, if you're doing mathematical modelling, covering twice as much of the population with an effective first dose provides significant benefit, but that doesn't mean you can forget the second dose. You have to come back fast with that second dose.

On that, I will just clarify that the National Advisory Committee on Immunization said “up to 16 weeks”. As the supplies improve, I think we will see that interval potentially being compressed more. I believe British Columbia has just come up yesterday with a 13-week interval now, given their supply management. I think you will see that interval being more compressed as we go along as well.

Just rest assured to Canadians that first doses do matter and they have worked and have prevented a lot of serious outcomes in Canada already.

[Jennifer O'Connell, Liberal, Pickering—Uxbridge, ON]

Thank you.

With the U.K. strategy of this first dose, we were confident....

I have a question for Dr. Tunis, but I'll have to come back to it.

[The Chair, Liberal, Ron McKinnon]

Just finish it up quickly.

[Jennifer O'Connell, Liberal, Pickering—Uxbridge, ON]

Okay.

Dr. Tunis, you spoke earlier in your testimony about AstraZeneca, and you were talking about the dosing interval.

For the average Canadian and putting it in regular-speak, you were talking about that effectiveness being extended or some studies showing that. Can you maybe explain that without some of the medical terms and actually explain what that means for the average Canadian who got the AstraZeneca dose?

[Dr. Matthew Tunis]

Yes, I can attempt that.

NACI has advised us that, based on what we know about the immune system, intervals that are longer can provide the immune system more time to generate a robust immune response. We have seen in some of the clinical trials, such as those for AstraZeneca, that a longer interval resulted in more protection and a better immune response. There have also now been some studies published showing similarly for the Pfizer vaccine that a longer interval can provide a stronger immune response.

These are all things that the committee continues to weigh out, as they look at the interval strategy. As Dr. Tam said, jurisdictions are now looking at whether they can revise their strategies as supply shifts. NACI has always said that an interval of up to 16 weeks could be used, based on their deep understanding of the immune system, immune responses and what we've seen historically from other vaccines—that more time can allow the immune system more time to generate a better response.

Thank you.

[The Chair, Liberal, Ron McKinnon]

Thank you, Ms. O'Connell.

That questioning went way over what I expected, so I will give Mr. Maguire a little extra time here.

I want to update the committee in response to Mr. Davies' point of order. My understanding is that there was a brief interval at the beginning of the meeting, about three to five minutes, when WebVU and ParlVU were not operating, but they have been operating since.

That's my information.

Mr. Maguire, please go ahead. I'll give you five minutes plus.

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

Thanks, Mr. Chair.

I want to direct a question to Mr. Stewart.

During the emergency debate and then in your last appearance before the committee, I raised the issue of rural Canadians not being able to send back their CoV-2 PCR test because of Purolator's lack of presence in small communities. Just this morning, our committee was notified that more than 17% of the tests have not arrived on time.

Since I raised this issue, have you identified any other companies that are going to fill this gap, yes or no?

[Iain Stewart]

Mr. Chair and honourable member, we've done a number of things as to timeliness to address the backlog you're talking about.

Number one, we tried to reduce the impact of it by moving.... The test is now a “day-8” test, so if there is a delay, it's less likely to impact travellers.

Number two, we have looked for alternate service providers, or enhancement of service providers, such as—

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

Is this still a Switch Health decision, or are there other companies helping Purolator do this now? That was my question.

[Iain Stewart]

Switch Health remains the service provider for many areas. They have been working with Purolator, but they have also worked in two ways: one is that they have tried to increase the level of service that Purolator is providing, such as with drop boxes; and two, they—

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

I'm sorry, Mr. Stewart. It was months ago that we raised this. I know that PCR tests are not being sent in on time, and it's clear that the system is still not working.

Are you telling the health committee here today that Health Canada has done absolutely nothing with the information provided to them months ago in regard to getting other people to help Purolator get these tests in on time?

[Iain Stewart]

Mr. Chair and honourable member, actually what I was trying to say was that they have started working with alternate service providers as well. For instance, I said they were trying to increase the service from Purolator, but they have also recruited other service providers—in fact, three other service providers—in this phase, such as Uber.

We are on it, and we're trying to improve the performance to ensure that Canadians get their tests.

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

Can you give us any kind of specific date—because they're still lapsing—for when this issue will be fixed, so that rural Canadians particularly don't have to wait days for their tests to be picked up and can stop leaving them outside in the elements while they're waiting to be picked up?

[Iain Stewart]

Part of the service delivery package is that we have drop boxes. As population becomes sparser, it's obviously more difficult to do door-to-door delivery, so the drop boxes will continue.

When you refer to their being left outside, perhaps you have a specific example that we could investigate.

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

Yes. I raised it a couple of months ago.

Can you please table with the committee, by next Wednesday, the contract that the Government of Canada signed with Switch Health?

[Iain Stewart]

Mr. Chair and honourable member, we have the deputy minister of Public Services and Procurement Canada with us. He may be better placed than I am to speak to your request, sir.

[Bill Matthews]

Thank you, Mr. Chair.

I have a couple of things to point out. Number one, we are pressuring Switch Health to improve service, because it is uneven. It's working well in some areas and less well in others.

Iain Stewart just mentioned a few improvements, but we continue to work with Switch Health to get better service, because we know—

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

Can you table the contract by next Wednesday?

[Bill Matthews]

Number two, I will look at the contract and see what can be tabled. I can't commit to next Wednesday, only because we would have to go through and agree upon redactions with the company. That typically involves review with legal, etc., so it often takes more than a few days.

I can take back the request and—