Thanks so much. I have never paid attention when given any yellow card before, so I don't know why I should start now.
Mr. Chair and honourable committee members, thanks for allowing me to address you. Before I start, I want to acknowledge that I'm currently speaking on what I believe to be the unceded ancestral territory of the Haudenosaunee, where my family home currently rests.
I'm a professor of medicine and infectious diseases at the University of Toronto, and I'm also a consultant in infectious diseases at Sinai Health and University Health Network. Prior to this pandemic, most of my academic work was focused on antimicrobial resistance, that is, drug resistant infections.
I currently co-chair, with Dr. Gerry Wright, a project to conceive of a national network to tackle antimicrobial resistance, or AMR, and support the anticipated—and I'll say, massively overdue—pan-Canadian AMR action plan.
This is my fourth such appearance before your Standing Committee on Health related to infectious diseases over the past four years, and I'm really quite honoured to be able to have this privilege of presenting to you again.
I want to cover two things: pandemic strategy and antimicrobial resistance.
Pandemics require strategy. Strategy should be based on the best available information and should be adaptive to new information. The pace of new information that we have received has been rather incredible and unprecedented. In my first and second HESA appearances, I highlighted for this committee the potential cost involved in preparing properly for an antimicrobial resistance pandemic. I think I quoted $100 million price tag at the time. Just imagine now only spending $100 million in exchange for properly preparing for a costly pandemic. My guess is, by the way, that this government still won't commit $100 million for an antimicrobial resistance pandemic.
If we consider Canada's performance to date regarding this pandemic, and with deference to my colleague who just spoke, I think my personal and, I would say, reasonable assessment is that it was not good, but it could have been worse. We've lost over 25,000 Canadians directly to COVID-19. The fact that we will see well over 10,000 COVID-19 deaths since January 1 will remain one of the most catastrophic and tragic failures of our nation.
However, the cost to Canadians in terms of quality of life, sickness and death from other illnesses, including mental illness, will be orders of magnitude greater than this for years to come, and it didn't have to be this way.
If you compare our response in outcomes with the U.S., most of Europe and, say, Brazil, we've done quite well. When I was a kid, when I came home with a grade that was below my parents' expectations, I always mentioned the classmates who did worse. I never made a comparison when I received an A, however.
Canada's first responsibility moving forward will have to be an honest assessment of our performance, and, indeed, the Auditor General is doing some of this work, but we need a more fulsome assessment of our performance. I would suggest that the time to start such a commission, perhaps titled “Why did Canada not get an A in COVID-19?”, is now.
The U.K. and Brazil are both holding similar such commissions. Apart from the obviously gripping theatre both have provided, they've offered insight into the flawed mindset of two governments that dramatically failed their electorate. The question that should be on the minds of all of you and indeed all Canadians is: Why have you failed to seek a maximum suppression strategy?
In November, I used the term “COVID-zero” publicly, but “Zero COVID”, “Canadian Shield Strategy” and “No More Waves” have all been monikers to a strategy I've affixed my name to. It's been abundantly clear that exponential growth has meant that living with COVID-19 was never an acceptable strategy, even though it was attempted. This would be true for any future pandemics.
Moving forward, Canadian governments should have a stated policy that says, “We will work to maximally contain and suppress any new infectious diseases throughout until the nature of that threat is fully understood.” This would have meant clear and consistent pan-Canadian communication, closing our borders sooner, reducing interprovincial and regional travel, making no assumptions on the nature of its transmission, protecting the most vulnerable members of our society with a focus on obtaining the data to demonstrate this protection, rapidly and transparently sharing this data, starting up clinical trials similar to what was done in the U.K., relying on the best available scientific evidence and stating, most importantly, that the primary goal of government and public health with infectious disease threats is not to protect the health care systems or the economies from the threat, but to protect the health of Canadians.
On May 28, 2021, we can start learning from this. Our government can make a commitment to maximum suppression of COVID-19. This does not mean locking down our society for the entire summer, but doing everything possible to continue to drive our cases down so that we'll be able to start the school year in full force, with an economy that can start working in full force.
Before I address AMR, I want to make one last point. It's very possible that in an upcoming school year we will be faced with an outbreak of a non-COVID infectious disease. It could be influenza or maybe another virus. In that situation, it would be important that we do not dismiss it. I have found myself at times dismissing other infectious diseases. Do we need a flu-zero approach? I doubt it. However, the famous and proudly Canadian overburdening of hospitals in winter is unquestionably due to respiratory viruses. We can and should do much to reimagine respiratory viruses.
That brings me, lastly, to antimicrobial resistance. I've spent most of my career tackling AMR. It has not gone away, and it won’t go away. Moving forward, the AMR pandemic, which is a much slower moving one than COVID, will continue to require close and careful attention. It is not going to come and go like the COVID-19 virus. It will endure and grow in nature.
This very committee has a responsibility to Canadians. It has failed in the past to address and push government on properly addressing this. We need to address AMR in Canada and globally in the same manner that we've been addressing COVID-19. Thank you.