Health Committee on May 21st, 2021

[Iain Stewart]

Is that for a particular person?

Go ahead, Theresa.

[Dr. Theresa Tam]

Mr. Chair, vaccine confidence is extremely important. I think Canadians should know that between the regulator, the National Advisory Committee on Immunization and the provinces structuring the vaccine programs, thorough scientific data review as well as expert advice have been taken into account. Canadians should feel confident that we have effective and safe vaccines being provided. That is very important, for sure. When the advice comes out on the option of receiving the same vaccine for their second dose or a mixed-dose schedule, they should know that it has come from a thorough review.

[Chris d'Entremont, Conservative, West Nova, NS]

Okay.

Just quickly, Mr. Stewart, when you were updated on the information about Major-General Fortin, did they ask you not to mention it to Major-General Fortin? Or, did you have a discussion with him, from that March date to the day that you actually...the 13th?

[Iain Stewart]

I received no instruction about whom to talk to regarding that information, to be honest.

[Chris d'Entremont, Conservative, West Nova, NS]

Thank you.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. d'Entremont.

We'll go now to Mr. Van Bynen for five minutes, please.

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

Thank you, Mr. Chair.

Thanks to all of the witnesses for joining us today. This is quite a panel, and I appreciate your taking time off of your schedules to answer some questions today.

I'd like to start my questions with Dr. Tam.

We continuously said that, as we learn more about this virus, our approach will evolve, and, as we vaccinate more and more people from different priority groups and locations, I think it's fair to say that our knowledge about these vaccines evolves too.

I've heard of a few cases abroad where the antibodies were found in babies whose mothers received the vaccination while they were pregnant. I think this is certainly something to give us some hope.

I'm wondering if either nationally or internationally you have seen any of these cases. Are there are any studies about these situations, and if so, can you tell us about them?

[Dr. Theresa Tam]

As you indicated, we're studying the science as we go along. I think, based on other vaccines, it wouldn't be surprising that some antibodies could, for example, be passed on from the mother to the baby either through the womb or, indeed, through breast milk. These are being studied. Yes, I have heard of some of these accounts, and that evidence is being reviewed.

We have research on vaccination for women during pregnancy as well—persons who are pregnant—and we will look forward to some of that data. It is also important to emphasize that persons who are pregnant have an increased risk of COVID-19. The advice at this point in time is to offer persons who are pregnant the vaccine because of this increased risk, and it may provide some benefit to the baby, but that remains, I think, to be studied.

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

Thank you.

Still on the topic of priority groups, our approach across Canada was to identify specific groups and target them for early vaccination. Could you please share with the committee how impactful this decision might have been?

[Dr. Theresa Tam]

Mr. Chair, that decision has been very impactful, because COVID-19, of course, has a disproportionate impact on certain populations, including our most senior age groups as well as those in congregate-living settings such as long-term care, and then, of course, those at high risk of exposure to the virus such as health care workers.

I'll just point out that, in this third resurgence, the number of deaths—and we should take note of every death—is much smaller, whereas we would have expected that to be much higher. As the protection of the very effective vaccines have taken hold, long-term care facility cases and outbreaks have dramatically decreased. That was the first thing that we noticed about the vaccine program. Then the rates in the 80 years and older age group plummeted, really, at a very fast rate. That was another really good sign.

Vaccine effectiveness studies being carried out in Quebec and British Columbia indicate the effectiveness of even the first dose of vaccine. Health care worker cases have also dropped as a result of their being vaccinated as a priority group, so I do think that those prioritizations have had an impact.

First nation communities and the territories were prioritized and have had a really high vaccine uptake. I do think the vaccine has played a very key role in protecting those populations.

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

Thank you.

Throughout this entire study and even through our previous study, we heard from numerous witnesses about the importance of sharing health data across Canada. While we've mostly heard about this in the context of COVID-19, I think it's applicable to other health-related contexts.

Do you see a benefit in such a system, and if so, would it impact the efforts to prevent and to manage diseases across the country?

[Dr. Theresa Tam]

Mr. Chair, that is a very important question.

I think public health policy should be driven by data. We have had data presented, and it has to come from the local level up to the national level, so I do think we've seen data improve over time. This is the first pandemic where we're having case-by-case data reported nationally through the pan-Canadian health data strategy. With the safe restart agreements and the resources being provided to the provinces and territories, we have seen improvements in the data being gathered, including on race, indigeneity and occupation. That has improved, and that kind of improvement must be taken forward as we look to keep going and strengthening that data system.

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

Thank you, Dr. Tam.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Van Bynen.

We go now to Mr. Barlow, please, for five minutes.

[John Barlow, Conservative, Foothills, AB]

Thank you very much, Mr. Chair.

Just to go along with what Dr. Tam was saying about decisions on public health having to be based on data, Dr. Tam, what data shows that requiring a fully vaccinated international traveller to stay at a quarantine hotel is more effective in stopping the spread of COVID than quarantining at home? Is there some data that shows that hotel quarantining is more effective than quarantining at home?

[Dr. Theresa Tam]

We are very actively examining the policies related to fully vaccinated travellers, so that—.

[John Barlow, Conservative, Foothills, AB]

Right now, then, Dr. Tam, there is no data. Right now you've made a decision on hotel quarantines without data that shows that it is more effective than quarantining at home.

[Dr. Theresa Tam]

That policy will be evolving, because there haven't actually been that many fully vaccinated travellers. Canada is still in a very difficult situation with the third wave. Our domestic vaccination rate is still catching up and is accelerating, but I think part of the decision-making related to vaccinated travellers has to take into account the global as well as the domestic epidemiological situation. We're still learning about the reduction in transmission.

[John Barlow, Conservative, Foothills, AB]

I appreciate that, but it was a pretty yes or no question.

We've had the quarantine hotels for many months. Is there any data that shows, for any traveller, that the spread of COVID is controlled any better in a hotel quarantine situation than with quarantining at home?

[Dr. Theresa Tam]

The GAAs or accommodations are there so that we can wait for the PCR results. That's the primary rationale for doing this, and it has been effective, in that PCR-positive individuals are then referred to quarantine facilities.

From that perspective, it doesn't matter whether you're vaccinated or not; if you're positive and your PCR is positive, you will be quarantined for essential safety for the individual and for the population.

[John Barlow, Conservative, Foothills, AB]

I'm getting from that, Dr. Tam, that there is no data showing that controlling the spread of the virus is any better when quarantining at a hotel than when quarantining at home.

I want to change to the vaccinations on travel, to try to clarify some misinformation or miscommunication that has happened over the last week. This is either to the CBSA or Dr. Iain Stewart.

Are Canadians exempt from quarantining if they cross the land border to the United States, with appropriate documentation for the purpose of vaccination, and then immediately return?

[Iain Stewart]

You're referring to an exemption that was created for people who have something such as a specialized cancer and want to go to the Mayo Clinic. To do that, they get a letter from their physician saying that they need to go and get that medical treatment. On that basis, they can return, because they're ill and under treatment, free of quarantine.

I believe some people have used that provision and secured that exemption to go to get a vaccine. We have 23 million vaccines in the country right now, so I guess I would wonder why a physician would write a letter in that regard. It was intended for specialized medical treatment. We tried to clarify that, Mr. Chair, and honourable member.

[John Barlow, Conservative, Foothills, AB]

I don't know whether that clarification has worked very well, from the 24-hour differences between two messages.

The question is not even about going for special circumstances, Mr. Stewart. If a Canadian has a doctor's letter to go across the border to the United States to get vaccinated and return, are they exempt from quarantine?

[Iain Stewart]

I guess I would add that the United States government does not view that as a reason to enter their country. From our perspective, I would ask the physician involved, does it actually require that they leave the country to get what they can get at a drugstore?

[John Barlow, Conservative, Foothills, AB]

Mr. Stewart, the question is, yes or no, are they exempt from the quarantine? It's not whether the doctor has given them a note and whether he should have given them the note. The question is, if they have that note, regardless of how it came about, if they go down to the United States to get vaccinated and return, are they exempt from quarantine? Yes or no?