Evidence of meeting #39 for Health in the 43rd Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was witnesses.
A recording is available from Parliament.
1:50 p.m.
Liberal
The Chair Liberal Ron McKinnon
Thank you, Mr. Thériault.
We'll go now to Mr. Davies.
Mr. Davies, officially you have six minutes, but everyone else took at least seven, so go ahead for seven minutes.
1:50 p.m.
NDP
Don Davies NDP Vancouver Kingsway, BC
Thank you, Mr. Chair.
Dr. Morris, you recently posted on your website the following: “I anticipate we will be hearing definitive word of a 'passport' from our political leaders in the coming weeks, in anticipation of a relaxation of quarantine restrictions. (I cannot imagine we can be seen as safe until the 3rd wave truly recedes in all provinces.)”
Now, some provinces, including my own in British Columbia, have just announced plans to open up and are starting to open up, while others, like Manitoba, are clearly in severe crisis.
In your view, is it prudent for us to be having some provinces reopen when others don't? Do we need national reopening guidelines?
1:50 p.m.
Professor and Physician, As an Individual
I've always felt that we need to, first and foremost, consider this pandemic to be a global pandemic, so we need to appreciate that Canadians won't be fully safe until everyone around the world is going to be safe. If we think of Canada and its borders, and everything within its borders, you have really two choices.
One is that you allow provinces to make their own decisions, but you protect the provinces from the strengths and weaknesses of the adjacent provinces where people travel to and from. At the moment, if you're bordering Manitoba, which has a pretty high case rate at present, and you're allowing travel from your province to and from Manitoba, then you are adopting much of the risk of the other province. I think it's really important that we not only consider international travel, but we consider interprovincial and regional travel in how we open up our economies and, more importantly, how we move forward.
It is important that we move forward, especially as we become more successful within Canada with meeting vaccination targets, but we have to be very aware that the threat won't go away until the threat internationally goes away.
1:55 p.m.
NDP
Don Davies NDP Vancouver Kingsway, BC
I'm going to turn to something you've written about AstraZeneca on our website. You wrote:
Some have argued—as the Ontario government just acceded—that patients can receive informed consent regarding the risk of VITT prior to getting a second dose of AZ. They are basing this on rather preliminary UK data; the same UK data that has consistently underestimated the 1st-dose VITT risk (starting off with 1:600K, then 1:250K, and is now down to 1:81K). They started off with a 1:1M 2nd-dose VITT risk, and now are quoting 1:600K risk after 15 cases. I am fairly certain the likelihood of risk is higher than this, but the magnitude is entirely uncertain.
What advice do you have, Dr. Morris, for Canadians who have received a first shot of the AstraZeneca vaccine and will reach the end of their four-month dose interval before trial data is available on vaccine mixing?
1:55 p.m.
Professor and Physician, As an Individual
There are a few things.
I do think it's really important that we appreciate how incomplete and tenuous the U.K. data is on AstraZeneca safety. Their MHRA, which reports on their Yellow Card system for vaccine safety, reported again last night our time, or early this morning, and the risk is now for AstraZeneca and VITT is one in 76,000, so it's been progressively increasing in frequency for first doses.
They're really early in their rollout for second doses, and I don't have much confidence in really understanding the risk to Canadians of a second-dose VITT from the AstraZeneca vaccine. It may turn out to be very safe, but we really don't know. In Canada we are fortunate enough to have adequate vaccine of the combination of Pfizer and Moderna for the very near future.
I know what I've been telling my loved ones and I'd be encouraging vaccine task forces as well at the federal level that we should be moving as quickly as possible to getting the mRNA vaccines in arms. They've proven to be exceedingly safe, and we should be affording people who rolled up their sleeve to get the AstraZeneca early on the same if not accelerated benefit as those who have held out for the mRNA vaccines.
1:55 p.m.
NDP
Don Davies NDP Vancouver Kingsway, BC
Thank you.
You recently co-signed an open letter in Maclean's, along with a group of leading Canadian physicians and researchers, calling for strict nationwide restrictions to control COVID-19. Your letter said, among other things, the following:
As much as we might wish otherwise, COVID-19 is not done with us yet. The consistent failure to learn from the experience of other jurisdictions and even worse, failure to learn from our own miscalculations, is a sad statement on Canada’s political leadership.
Could you provide this committee with an overview of best practices from other jurisdictions that you think could and should be applied to Canada?
1:55 p.m.
Professor and Physician, As an Individual
I think the simple answer to that, without going into too many details, is an intolerance of allowing cases to rise in any manner. As I kind of alluded to, if we're titrating our response to health care system capacity, what we're doing is allowing Canadians unnecessarily to become infected. We also have learned that pretty well everyone in society, especially government and the health care system, is not really good at titrating when there's exponential growth.
What we've seen in Manitoba, and to some degree in Alberta and Ontario, is that we've pulled the trigger on trying to control cases way too late. Everything's much easier when we try to keep cases as low as possible.
1:55 p.m.
NDP
Don Davies NDP Vancouver Kingsway, BC
Thank you.
This is just a quick question for Mr. Taillon.
Mr. Taillon, I presume you've read the anti-inflation board reference at the Supreme Court of Canada. Do you agree with me, sir, that it's quite clear from the Supreme Court that the peace, order and good government power gives the federal government paramount jurisdiction to legislate in all measures, and even to usurp provincial powers in the case of an emergency? Do you agree with the Supreme Court when they say that?
2 p.m.
Professor, Faculty of Law, Université Laval, As an Individual
A distinction needs to be made between this power and the opportunity to exercise it. The main thrust of my comment was to congratulate the government on its decision not to have exercised it and to have demonstrated just how unproductive and inadequate it would have been to do so under the circumstances. There were also several benefits to refraining from exercising this power. The federal authorities were also not prevented from implementing any standards, regulations or actions by not exercising the Emergencies Act. That's the first part of my response
The second is that the Constitution clearly provides exorbitant powers that are inconsistent with what federalism in its ideal form ought to be, but that can be exercised in certain circumstances. These include the power to act in an emergency, which is time limited and has serious consequences because it can be exercised with impunity towards the principles that are central to our system, like rights and freedoms and federalism.
These powers need to be exercised when necessary and useful,and when there are good reasons to do so. I believe that it was very wise to have paused and taken some time to think before moving in that direction. The good news is that did not have to take this extraordinary and exorbitant action, which should only be used in very limited circumstances.
2 p.m.
Liberal
The Chair Liberal Ron McKinnon
Thank you, Mr. Davies.
I'd like to thank all of the witnesses. We've burned up all of our time for this panel. Thank you for spending your time here today with us helping with our enquiries.
With that, we will suspend and bring in the next panel.
Thank you, everybody.
2:05 p.m.
Liberal
The Chair Liberal Ron McKinnon
I call this meeting back to order. We are resumed.
Welcome back to meeting number 39 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 examining today Canada's national emergency response landscape.
I'd like to welcome the witnesses.
As an individual, we have Dr. Colleen Flood, university research chair in health law and policy at the University of Ottawa. We also have Dr. Dean Knight, associate professor, faculty of Law, Victoria University of Wellington. From World Animal Protection, we have Michèle Hamers, wildlife campaign manager; Melissa Matlow, campaign director; and Scott Weese, professor.
I should point out that I have these magic cards. A yellow one indicates that your time is almost up, and the red one that your time is up. If you see the red card, please do try to wrap up. You don't have to stop instantly, but try to wrap up.
We will now invite the witnesses to give their statements, and we'll start with Dr. Knight for six minutes.
2:10 p.m.
Dr. Dean Knight Associate Professor, Faculty of Law, Victoria University of Wellington, As an Individual
Greetings. It's a pleasure to join the committee to share some of the experience and insights from Aotearoa, New Zealand. I think there has been understandable interest in the efficacy of New Zealand's response. We've only encountered just over 2,600 cases of the virus and only 26 deaths during the pandemic. And one-third of those diagnosed cases have been caught at the border before entering the community.
The virus was, if I can say, first stamped out in the community nearly a year ago, five months after it first infiltrated. Since then, there's been a handful of flare-ups largely arising from what we describe as “border breaches”, which have again been stamped out in what has become quite a sophisticated game of whack-a-mole. The last instance of community transmission was at the end of February this year.
In many respects, I think our current settings, the arc of the pandemic and thus the government response, have been quite different from Canada's and many other countries'.
However, to give you a sense of the nature of the regulation of the government response that has been deployed, I think that story is best told through a series of bubbles, which has been a very powerful metaphor in the New Zealand context. We started with what we described as our “household bubbles” from back in March 2020 nearly, where we had two months of aggressive and strict nationwide lockdown, stay-at-home directives and closure of premises other than those that were essential. That really broke the chain of transmission and allowed that shift from what was intended to be a mitigation or a suppression strategy to our current elimination strategy. That “go hard and go early” approach—which is how it was branded by the Prime Minister here—has probably been the main driver of New Zealand's success so far in combatting the virus. The achievement of that COVID-free community set the conditions for an ongoing elimination strategy where those re-emergent instances of the virus could continue to be stamped out, and that's been the focus.
After our household bubbles, where we were confined to our houses, we had a nationwide fortified bubble where ordinary day-to-day life largely resumed almost a year ago with most restrictions largely lifted. We have some ongoing restrictions, low-level measures such as a contact tracing system with QR codes, face coverings on some public transport and so forth.
Significantly, we had a fortified border fortress with a 14-day state-managed isolation and quarantine system, an escalating system of border testing, and management of incoming border flows through bookings, charges and pre-departure testing. It was very much trying to create an impenetrable border to protect the nation as a whole.
Within that, as I said, there were some flare-ups. I think of this in terms of resurgent localized bubbles where we had a handful of regional lockdowns, largely in Auckland, and other targeted measures to address the small number of flare-ups.
More recently, we've developed and moved to a transnational shared bubble where we've reopened our borders with Australia and a couple of other Pacific nations, allowing restriction-free travel. In order to do that, we've also harmonized our public health monitoring and measures across those countries.
Our hope is for a future popped bubble, if I can describe it like that, where there is a slow but steady vaccine rollout. We look forward to hopefully being able to fully open up our borders again and reintegrate with the world.
While we can see that success, the government regulatory response I don't think has always been smooth, stable and slick. The early days were characterized by a lack of preparedness for this type of virus, but a willingness to pragmatically innovate and respond.
Legally, the resort was to perhaps ill-fitting public health and civil defence tools, principally directive health orders issued by our senior medical officer of health, the director general of health, enforceable by the police. There was also heavy reliance on an extra-legal alert level framework as a communication tool, characteristic communication from our Prime Minister, ministers and director general in building a collective community trust in the government and the government's response.
I should note that there was one notable instance where the high court found that the government messaging overreached the underlying legal requirements, and I'm happy to talk about that some more if that's of interest.
After the lockdown was lifted, more COVID-specific, bespoke legislation was passed, which gave broad power to ministers to continue to issue directive health orders mandating public health measures and continuing police enforcement. The authority to do that was moved from the officials to the minister. I think of it in terms of belt and braces protections being overlaid on top of that.
Preservation of the right to contest any of the measures was, for example, inconsistent with the Bill of Rights Act's protections, such as freedom of movement and so forth, select committee scrutiny of orders and House confirmation of orders and other examples of checks and balances being grafted onto that power.
My final comment might be to say that the other notable feature has been a strong social licence in the community for these very aggressive measures. My analysis is that the legitimacy for that response has been catalyzed by the government maintaining and enhancing accountability through direct, face-to-face, reasoned explanation of the problem and the measures, openness and transparency—for example, all of the cabinet papers dealing with measures and so forth are publicly available—active scrutiny, continuing improvement and large doses of kindness.
Thank you.
2:15 p.m.
Liberal
The Chair Liberal Ron McKinnon
Thank you, Dr. Knight.
We will go now to World Animal Protection, and I believe Ms. Hamers will give the statement.
2:15 p.m.
Michèle Hamers Wildlife Campaign Manager, World Animal Protection
That will be Melissa Matlow. She will give the statement for us.
2:15 p.m.
Melissa Matlow Campaign Director, World Animal Protection
Thank you, Mr. Chair and committee members, for this opportunity to speak about a very important issue of pandemic prevention.
I am Melissa Matlow, the Canadian campaign director for World Animal Protection. We are an international animal welfare charity with offices in 14 countries and more than 300,000 supporters in Canada. We have general consultative status with the United Nations. We are members of the civil society 20 that is engaging the G20 and we have a formal working relationship with the World Organisation for Animal Health—the OIE.
Working together with environmental and infectious disease experts, we are encouraging the federal government to take a “one health, one welfare” approach to preventing pandemics through curbing the commercial trade in wild animals and products made from them, not only to prevent pandemics, but also to prevent animal suffering and biodiversity loss.
I should say that we are concerned about the growing legal commercial trade in wild animals that, in our opinion, is under regulated, unsustainable and presents disease risk. Our focus is on non-essential wildlife use such as exotic pets, entertainment and trinkets. It's not on subsistence community use.
It is widely acknowledged that wildlife markets, breeding farms and the trade supplying them played a significant role in the outbreaks of SARS and COVID-19.
In April, the one health tripartite—the World Health Organization, UNEP, and the OIE—issued emergency guidance that called on national authorities to suspend the trade in live-caught wild mammals for food or breeding. That guidance also stated that it was relevant for other wild animal uses.
Canada should adopt these recommendations immediately, but more transformative change is needed. Seventy-five percent of new or emerging infectious diseases originate in animals, mainly wildlife. These include MERS, avian flu, Ebola, SARS, HIV/AIDs, Nipah virus and monkeypox. I could go on, but I won't.
Recent reports by UNEP and the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services recognized the commercial wildlife trade as a key pandemic driver and animal welfare is at the root of it.
When a variety of different wild animals that wouldn’t normally encounter each other in nature are kept in close proximity in crowded, unsanitary and stressful conditions, it is the ideal environment for the emergence and spread of infectious diseases that can then be transmitted to humans. These conditions exist throughout the wildlife trade and studies show that the risk of transmitting diseases can increase significantly as animals are traded up the supply chain.
This is a global problem that requires a comprehensive global solution. Canada has an important role to play.
Our research shows that more than 1.8 million wild animals were imported into Canada between 2014 and 2019 and it would seem that the vast majority—93%—were not subject to any permits or pathogen screening. Animals are coming in for a wide variety of purposes, but there’s been a dramatic increase in the number imported to supply the exotic pet industry. We found that different federal government agencies regulate different aspects of the trade, with their own data collection systems and requirements. This is leaving gaps in important information like the names of species, the purpose of the trade, whether the animals were wild caught and the country that they come from. Once animals are brought into our country or if they are captive bred here, they are subject to a patchwork of inadequate domestic regulations. Nobody is tracking these animals.
Other countries are taking action on this issue. China has permanently banned the farming and consumption of many terrestrial wild animals and it is helping farmers transition to alternative livelihoods. In the U.S., the preventing future pandemics act, if passed, would prohibit the import and export of wildlife for human consumption and medicine. The Netherlands is fast-tracking their ban to end fur farming for good because COVID-19 is running like wildfire across mink farms. Germany has agreed to reduce the trade in wild animals for pets, ban the sale of wild-caught animals and set up a centralized trade register. Last month, Italy, which holds the G20 presidency, approved a ban on the trade of wild and exotic animals. Just a couple of days ago, Thailand announced its interest in being free of illegal wildlife trade.
We urge Canada to join these countries and do its part. Specifically, Canada should immediately adopt the guidance issued by the one health tripartite and prohibit the trade in live-caught wild mammals, promote a greater emphasis on pandemic prevention and address the key drivers of pandemics, particularly the commercial wildlife trade at the G20. It should urge the one health tripartite to present a list of wildlife species and conditions that present significant risks of transmitting zoonoses and guidelines for mitigating them. This was actually recommended at the G20 agriculture ministers meeting last year.
Here in Canada, to do our domestic part, we need to adopt a more preventative regulatory framework and improve our systems for collecting data and monitoring the trade. The federal government should work collaboratively with the provinces and territories to improve their regulations to significantly reduce the trade and improve enforcement through better coordination and resourcing across all agencies and jurisdictions.
Those are all my remarks, but I want to say that joining me today to help me answer your questions, I have two experts. Michèle Hamers is a professional biologist who works with our organization. She conducted our research on Canada's wildlife imports and is one of the leading experts in Canada on the exotic wildlife trade. Dr. Scott Weese has contributed his veterinary infectious disease expertise to our organization and this cause. He is the director of the University of Guelph's centre for public health and zoonosis, and is chief of infection control at the Ontario Veterinary College teaching hospital.
Thank you.
2:20 p.m.
Liberal
The Chair Liberal Ron McKinnon
Thank you, Ms. Matlow.
I see that Dr. Flood has been able to rejoin us, I believe from New Zealand, where we've been having some communications connection issues.
Before we start your statement, Doctor, I will ask you to speak for 10 seconds so we can get a sense of whether the interpreters can hear you well. Maybe tell us where you are and what the weather is like.
2:20 p.m.
Dr. Colleen Flood University Research Chair, Health Law and Policy, University of Ottawa, As an Individual
Well, I'm here in the top of the South Island, which is not too far from a little city called Nelson. Normally the weather is glorious, but it's actually pouring rain, so bummer. It's my son's ninth birthday today, so bummer again, because we were meant to be going to Laser Tec.
2:20 p.m.
Liberal
The Chair Liberal Ron McKinnon
Let's try. I'll invite you now to present a statement of up to six minutes.
I don't know if you saw the caveat. When I wave my cards, this yellow card means your time is imminent and the red card that your time is up. Try to wrap up when that happens, okay?
Please go ahead, for six minutes.
2:25 p.m.
University Research Chair, Health Law and Policy, University of Ottawa, As an Individual
Thanks very much. Six minutes is not really too much time to talk about how COVID has irrevocably changed our world.
I know you all are working so hard to try to unpack all of that, and I want to thank you for the work you're doing, first of all.
I want to make two points. The first is that the federal government needs to manage the border and coordinate with the provinces to restrict the potential for new variants of concern to enter Canada. The second point is that the federal government should launch a royal commission into the treatment of people in long-term care homes across Canada.
Those are the two things I want to talk about. I might not get to talk too much about the second claim, so perhaps I could pick that up in questions.
On managing the border, Canada's performance on COVID has been a very mixed bag overall. Smaller provinces, like New Brunswick, Nova Scotia, P.E.I. and Newfoundland, have aimed for zero COVID.
2:25 p.m.
Liberal
The Chair Liberal Ron McKinnon
I'm sorry, Doctor, we're getting popping noises. It's going to be hard for the interpreters.
Just maybe put the mike a little bit away from your mouth, but roughly above and kind of adjacent to it, if that's—
2:25 p.m.
University Research Chair, Health Law and Policy, University of Ottawa, As an Individual
I'm sorry about that.
2:25 p.m.
Liberal
2:25 p.m.
University Research Chair, Health Law and Policy, University of Ottawa, As an Individual
Okay.
Smaller provinces have aimed for zero COVID and attempted to eliminate community transmission and quickly manage any new outbreaks. This has involved tightly managing their respective borders to prevent new infections entering their safe or green zones.
If we look cross-nationally, the countries that have aimed for zero COVID—New Zealand, Australia, Singapore, South Korea, Iceland, Vietnam and so on—have been able to live comparatively normal lives over most of the year. Since we arrived in New Zealand in January, our son, who's just turning nine today, has been in school constantly with no masks and no social distancing, but with lots of play and social interactions. We go to dinner parties, movies and volleyball matches. This has been the case, as you've heard from Dr. Dean Knight, for over a year, with some brief windows of very short lockdowns to stamp out possible community spread.
Most Canadian provinces have not aimed for zero COVID, but instead have stated that their goal has been to reduce cases to a level where hospitals are not overwhelmed. By having this as a goal rather than trying to eliminate transmission, most Canadian provinces have thus accepted a certain level of death and disease, mostly in the elderly in long-term care institutions and those living in racialized and poor communities. In Canada around 25,000 people have died. If New Zealand had adopted Canada's policy instead of what it did, then 3,600 New Zealanders would have died instead of the 26 who actually did.
Canada's goal of “bending the curve”, as they describe it, has not worked on its own terms. The problem has been that as soon as the curve has bent—that is, there's been some improvement in infection numbers—provinces have rushed to reopen without a serious mitigation strategy in place, causing a new cycle of lockdowns and reopenings, prolonging pandemic suffering for Canadians. The federal government and the big Canadian provinces have pinned their hopes instead on vaccines. Fortunately, science has delivered on this. Canadians from coast to coast, despite many barriers, are rolling up their sleeves to get vaccinated.
As the vaccines roll out, there is the inevitable clamour to open up again. Restaurants and shops, schools and camps, universities and faith-based organizations, opening up the U.S. border for travel—everyone has a good reason that their particular group or venue should be able to open up now. But great caution is required. Canada has already lost so much physically, emotionally and economically that I don't think Canadians can afford or tolerate yet further cycles of lockdowns and reopenings for short-term political gain or because of a short-sighted economic outlook.
In this regard, I make a plea to the federal government to do a much better job than is presently being done of ensuring that new variants of concern do not enter Canada and undermine all the gains we have made in recent months with vaccinations, at least not until we are certain that vaccinated individuals are protected against them. We know that in parts of the world, such as Brazil, India and Iran, COVID-19 is still on a rampage, with no vaccine path in sight. We still do not have great science on the extent to which the vaccines will protect against the variants that are emerging.
Now, I realize that there's a lot of politics about border management and a lot of politics about fed-prov and who should be doing what, of course, but Canadians themselves are amazing. They are resilient. They are are getting out there. They're getting vaccinated. Soon, widespread vaccinations will drive transmission rates low. But once we largely have the forest fire of COVID under control through the miracle of vaccinations, imagine that we allow variants of concern into the country with the potential to evade immunity. To me, this is akin to the federal government permitting more small fires around the perimeter of the forest and hoping the forest rangers are not too tired to put them out.
In managing its border, Canada will not abandon its humanitarian and other values—and we can speak about that during the questions—but Canada should not permit those crossing land borders to circumvent any requirements for management at the border. All Canadians coming from countries or regions of concern where there are variants emerging must be required to enter through a managed border. If the science emerges—and I hope it comes quickly—to show that our available vaccines prevent transmission of variants of concern, then some of these requirements could be softened for returning Canadians or other travellers, with the recognition of vaccine passports and rapid testing. However, we need the science first.
I've run out of time to speak to my second point, but I hope we have some time to come back to it in questions. Thank you for your time. I'm sorry about this stupid headset that died.