Health Committee on June 7th, 2021

[The Chair, Liberal, Ron McKinnon]

I call this meeting to order.

Welcome, everyone, to meeting number 42 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.

I would like to welcome the witnesses. From the Canadian Association of Optometrists, we have Monsieur François Couillard, Dr. Michael Nelson and Laurèl Craib-Laurin. From the City of Windsor, we have Mayor Drew Dilkens. From the Region of Peel, we have Dr. Lawrence Loh, medical officer of health, public health, and Dr. Jennifer Loo, acting medical officer of health and chief executive officer, Algoma Public Health. Furthermore, we have Dr. Christopher Mackie, medical officer of health, Middlesex-London Health Unit. We also have, with UNITE HERE Canada, Michelle Travis, research director; Elisa Cardona, hospitality worker, Local 40; and Kiran Dhillon, hospitality worker, Local 40.

With that said, we will invite the witnesses to make a five-minute statement.

I will display a yellow card when your time is nearly up and a red card when your time is over. If you see the red card, you don't have to stop right away, but do try to wrap up quickly.

With that, I will invite the Canadian Association of Optometrists to begin. Go ahead, please, for five minutes.

[Dr. Michael Nelson, President, Canadian Association of Optometrists]

Thank you very much, Mr. Chair.

Good morning. Thank you to all the members of the House of Commons Standing Committee on Health, in particular Luc Thériault, the member for Montcalm, for the opportunity to present on behalf of the Canadian Association of Optometrists.

My name is Dr. Michael Nelson and I'm the president of the association. I'm also a practising optometrist in Winnipeg, Manitoba, and I'm joined by François Couillard, our CEO, and Laurèl Craib-Laurin, our senior manager of government and stakeholder relations.

The Canadian Association of Optometrists represents over 5,400 optometrists who serve as Canada's primary eye care doctors. Our experience during the COVID-19 pandemic has been to have an increase in patients complaining of a variety of vision problems. Canadians are realizing the importance of their vision and that they should not be taking it for granted. Optometrists are seeing higher rates of eye fatigue, increased incidence of dry eye disease and a growing rate of myopia. Conditions like diabetic retinopathy, which can lead to vision loss, have worsened as some Canadians have chosen to delay their routine eye exams.

The growing myopia rate is especially alarming for optometrists and should raise a flag for government. Last year, the World Health Organization's inaugural world report on vision included some startling findings. Listen to this: The rate of myopia is expected to rise from 28% in 2010 to 50% by 2050. This is very alarming as myopia increases the risk of glaucoma, retinal detachment and vision loss in adults. While heredity plays a large part in myopia, it is further exacerbated by what we have seen through the COVID-19 pandemic with more and more near and close time and not enough outdoor time. This is especially worrisome for children because of the increased screen time for school and recreational activities.

For those living with diabetic retinopathy, a condition that is particularly predominant in indigenous populations, the problems of accessing care during the pandemic have resulted in worsening eye health.

[François Couillard, Chief Executive Officer, Canadian Association of Optometrists]

There are some high-level policy issues regarding eye health that deserve the attention of the federal government, as they have major implications not only for the health of Canadians, but also for the economy and productivity of our nation.

A Deloitte Access Economics research paper released last month estimates the total cost of vision loss in Canada was $15.6 billion in 2019. That was before the COVID‑19 pandemic.

The lack of a coordinated primary health care system for eye health was particularly evident during the COVID‑19 pandemic, which significantly reduced the ability of optometrists to provide care to Canadians. Vision problems affect the majority of Canadians, with six out of 10 Canadians reporting having had a vision problem. Every year, nearly one million Canadians miss work or school, or have their performance affected by vision problems.

We would like to encourage the Standing Committee on Health to conduct a study on vision, once this pandemic is over.

For whatever reason, Canada's many health care systems do not recognize that our eyes deserve the same level of care as other parts of the body. There is an urgent need to prioritize eye health and access to appropriate vision care for all populations.

We have the opportunity to make eye health and vision care an integral part of health care delivery from birth. Seventy-five per cent of vision loss can be treated or prevented, which means that early detection and treatment can improve population health and help avoid more costly future interventions and treatments.

Thank you very much for your attention.

[The Chair, Liberal, Ron McKinnon]

Thank you.

We go now to City windy...oh, sorry, the City of Windsor, Mayor Dilkens.

Mayor Dilkens, go ahead, please, for five minutes.

[Drew Dilkens, Mayor, City of Windsor]

Thank you very much, Mr. Chair, and it is windy here from time to time today.

Thank you and members of the committee for the opportunity to appear today and make the case for border communities, not just Windsor but across the country, to gain access to surplus vaccines that have been offered by our neighbours in the United States.

In my community prior to the onset of the pandemic, the border between Windsor and Detroit was much like that between Ottawa and Gatineau, in the shadow of Parliament Hill.

Thousands of health care workers live in my community but cross to work every day in Detroit.

At the onset of the pandemic when Detroit was a hot spot for cases—in fact, among the worst in the United States—Canadian nurses crossed the border each day to support the health care system in southeast Michigan. It's no exaggeration to suggest that without Canadian health care workers, entire hospitals would have closed in Michigan, creating widespread problems. In fact, the United States State Department recognized this invaluable contribution, and the U.S. consul general came to Windsor. He and I handed out thank-you gift cards to doctors, nurses and pharmacists who were crossing at the Windsor-Detroit tunnel and the Ambassador Bridge.

That was April 2020.

When the vaccines began to be delivered, the City of Windsor stepped up to support all aspects of the process. Hundreds of city staff have been redeployed to support different mass vaccination clinics across Windsor. We set up a special call centre to help ensure the process was smooth and efficient.

It hasn't been without challenges, the largest of which relates to the mismatch between supply and demand.

In the beginning we had 12,000 seniors over 80 years old on our wait-list. Some had waited for six weeks for the phone call to book their first appointment.

I actually booked 180 of these appointments myself. When I called one 86-year-old, she broke down crying on the phone with joy. She hadn't left home for six weeks. She wouldn't even take out her recycling without bringing her phone for fear of missing the call that would set her on a path to, once again, hug her grandkids.

The problem is that the fear and uncertainty she felt in the beginning was only exacerbated after she received her first shot, because we told her to go home and wait for up to four months now for someone else to call and book the second appointment.

Members of the committee, we can and we must do better until everyone has been fully vaccinated. Today, multiple medical officials in Detroit and the State of Michigan have offered to provide us with surplus vaccines, many of which would otherwise expire and be thrown away because vaccine uptake is slowing just two kilometres away in Detroit.

Last week it was reported that the State of Michigan saw 35,000 doses hit the landfill, and I submit to this committee that those were doses that could have gone into the arms of Canadians.

I appreciate there are a host of issues that would need to be resolved in order to make this sort of international inoculation effort possible. I'm not here to minimize or trivialize the effort that's required to make this happen, but I am here to advocate for that effort to be sped up, because it would help get Canadians access to their second doses faster than would otherwise be the case.

The federal government's COVID-19 testing and screening expert advisory panel report released on May 28 specifically highlights that Canadians with only one dose are at a significant public health disadvantage. I appreciate that a pathway exists for Canadians to get fully vaccinated based on the supply procured at the national level, which is allocated to the province, but this process will take months to hit all eligible Canadians. Multiple offers for surplus vaccines have been made to Canadians from U.S. counterparts today.

An urgent dialogue is required with all respective parties on both sides of the border to find a way to make this happen.

Throughout this pandemic, governments at every level have found ways to move mountains to safeguard the health and safety of the public. Policy initiatives which would otherwise have taken years get resolved in a matter of days, and I commit to doing everything and anything in my power to create the conditions for success.

Last week the board of the Windsor-Detroit Tunnel Corporation voted to authorize the closure of the international tunnel for the purpose of hosting a vaccination clinic at the border line below the Detroit River. I established an online wait-list for Windsor-Essex residents who are ready to stand in line for U.S. surplus vaccines. As of today we have over 11,500 Canadians on that list.

Creative solutions have been found at the Carway crossing between Alberta and Montana, and I congratulate everyone involved on both sides of the border for the creativity employed to make the right thing happen there. Surplus vaccines from Montana are getting into the arms of waiting Canadians. I'm asking for that same type of creativity and effort to be [Technical difficulty—Editor] so that we can accomplish our shared binational goal to fully vaccinate our residents so that we can reunite families, reignite our economies, get people back to work, get businesses open, and reopen the world's longest undefended border.

But I need help and leadership from our federal government, and I'm here again asking for that today.

Thank you, and I look forward to the questions and discussions this morning.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mayor.

We go now to the Region of Peel and Dr. Lawrence Loh. Please go ahead, sir, for five minutes.

[Dr. Lawrence Loh, Medical Officer of Health, Public Health, Region of Peel]

Good morning. Thank you, members of the committee, for the opportunity to present today.

I will be focusing largely on my experience as a medical officer of health for the Region of Peel. I'm also honoured to be joined today by my colleagues, Dr. Chris Mackie, Middlesex-London Health Unit, and Dr. Jennifer Loo, medical officer of health for Algoma Public Health. They will be able to complement my observations with their own experiences from other areas of Ontario.

Peel Region is one of 34 public health units in Ontario. It serves 1.5 million people in the cities of Brampton and Mississauga and in the Town of Caledon. As many of you on the committee likely know, Peel Region has been one of the regions most impacted by COVID-19 in Canada, due to population factors such as a large proportion of essential workplaces as well as socio-demographic and economic diversity. We are also home to the country's busiest international airport, which has been a source for introduction of variants of concern into our community.

Throughout the pandemic, local public health efforts are supported through ongoing collaboration with federal and provincial partners, our local municipalities and community partners. Some specific examples of the support we have received in Peel from the federal government include $6.5 million in funding from the Public Health Agency of Canada to support voluntary isolation housing for residents who cannot self-isolate at home; $13.1 million in funding received through the reaching home program to make a meaningful impact on supporting some of our most vulnerable residents; and federal support for long-term care outbreak management from the Canadian Armed Forces to protect some of the most vulnerable seniors in our community.

We've greatly appreciated these and other supports we've received. We recognize there are other areas where collaboration can be strengthened.

In the short term, financial support from both the provincial and federal governments have aided our immediate pandemic efforts. In Peel, those efforts have entailed the redeployment of most of our staff, new hiring and suspension of most of our public health programs. We're grateful for this support.

However, looking to the longer term, the federal government could further assist Peel Public Health and public health units in Ontario by allocating public-health-specific funding in provincial transfers, as most health funding is traditionally used for health care provision. In addition, it could enhance the resources and governance of the Public Health Agency of Canada to better support a national response to infectious diseases, which would include the chief public health officer having the autonomy and authority to direct public health measures, including maintenance of international surveillance programs. It could also provide additional resources to address pre-existing, non-COVID public health crises such as the opioid epidemic, as well as those that will arise due to the delayed provision of public health services. We would be happy to expand upon key COVID issues faced by the public health sector during the question and answer session, as needed.

Another area for review would be outbreak management for first nations communities. My colleagues from Middlesex-London and Algoma who are with me on this call today have reported taking on a primary role at the local level in responding to what is a defined federal mandate. This may require supplementary support and resourcing.

The federal government can also support our pandemic response by enhancing travel and border control measures to further decrease the influx of variants of concern or interest from interprovincial and international destinations.

We support federal and provincial measures to restrict non-essential travel. To emphasize our level of concern, Peel regional council recently called for the suspension of all non-essential travel from interprovincial and international destinations to Toronto Pearson International Airport. As the international situation changes, prompt adjustments to travel restrictions should be implemented.

Dr. Loo will also speak to an additional point, regarding Algoma's experience with the land border. Their experience has underlined a desire for local input into any proposed restrictions that have an impact on our communities.

Parallel to this, it is also important to protect those who are vulnerable and impacted by restrictions. In Peel, this includes international students who arrive in Canada. Many of these individuals are targeted with marketing by unscrupulous landlords and are charged very high amounts to share inadequate living spaces during and after isolation. Support from the federal government could assist in providing arriving students with better information about their isolation options.

We also need to ensure that our workforce is protected. In Peel, an analysis of our large essential work sector found that 25% of work place outbreak cases had reported employees going to work even after symptom onset. Without proper sick leave, essential workers are often unable to isolate or stay home when ill or access vaccination in a timely manner. The previous enhancements to the Canada recovery sickness benefit and Ontario's new worker income protection benefit are steps in the right direction. However, further improvements could include minimizing interruption of individuals' income flow with timely release of funding and removing the the requirement to demonstrate a 50% loss of income prior to application. These changes would remove barriers and help to ensure that our workers can follow public health guidance when they're sick.

In Canada, public health is a shared responsibility between all levels of government. Coordination and collaboration are essential. Ensuring flexibility to meet local challenges is equally important. Moving forward support from multiple levels of government with local action is essential as we move out of the response and into recovery.

My colleagues and I are happy to answer any questions you may have.

[The Chair, Liberal, Ron McKinnon]

Thank you, Doctor.

We go now to UNITE HERE Canada.

Ms. Michelle Travis, go ahead, for five minutes, please.

[Michelle Travis, Research Director, Local 40, UNITE HERE Canada]

Hello. I would like to thank the committee for inviting us here today.

My name is Michelle Travis, and I'm the research director for UNITE HERE Local 40, the hospitality workers' union.

COVID-19 has had a devastating impact on the hotel workers who were put out of work by the pandemic. Nowhere is this more true than at the Pacific Gateway Hotel, which was taken over by the federal government under the Quarantine Act last year.

Shortly, you will hear from two workers who have been directly impacted by the takeover and are calling for government action.

The government is spending untold amounts of public money on a hotel that recently fired over 140 long-term workers, mostly women. There is no transparency on the terms of the federal takeover or how long it will last.. We have asked for a copy of the agreement between the government and the hotel, but the hotel says there is no contract.

Hard-hit workers deserve to know why the government repeatedly extends its time at, and subsidizes, a hotel that takes advantage of the pandemic to fire much of its staff. Workers should be allowed to return to their jobs as travel restrictions ease. Every day the government subsidizes this hotel more workers risk losing their jobs.

We are urging the government to state its end date at Pacific Gateway, share a copy of their agreement and to please move to another site.

Now I would like for you to hear from Elisa and Kiran.

Elisa.

[Elisa Cardona, Hospitality Worker, Local 40, UNITE HERE Canada]

Good morning. Thank you so much for your time.

My name is Elisa Cardona, and I worked full time for seven years as a hostess and server at the Pacific Gateway Hotel near Vancouver Airport.

When the government took over the hotel, they brought in the Red Cross. Some of us were displaced from restaurants, kitchen and housekeeping jobs.

The government has repeatedly extended its takeover of our hotel. We were told they would be out last May, then August, then November, then it got extended to March 30, 2020, and now it's been extended to the end of the summer of this year.

The hotel has used a federal takeover as an excuse to terminate me and 142 of my co-workers. That's over 70% of our staff.

Many of us were fired in the last two months and are women. I'm a single mom raising two children ages 12 and 14, and I have been worrying about my finances and money this past year. It has been incredibly stressful for me and my family. I expected to go back to my job when it was time.

We asked the hotel to allow us to return to our jobs after COVID-19 had passed and when the work becomes available again. They have refused the whole time.

The federal government is subsidizing a hotel using a temporary pandemic to fire and replace us for less. These have been good, family-supporting jobs. Why is the government allowing this to happen?

Prime Minister Trudeau promised us a feminist recovery, yet women are bearing the brunt of firings at Pacific Gateway on the government's watch. A human rights complaint has been filed against the hotel for sex and racial discrimination against women because their jobs have been disproportionately impacted.

How much has the government spent on this hotel while women like me are treated like we're disposable? After the latest round of mass hirings, we went on strike and remain on the picket line. What's happening at our hotel is not acceptable. The government can and should act. That's why we're asking the government to stop subsidizing the Pacific Gateway Hotel.

Thank you.

[Kiran Dhillon, Hospitality Worker, Local 40, UNITE HERE Canada]

Good morning, everyone.

My name is Kiran Dhillon. I worked as a room attendant cleaning hotel rooms at Pacific Gateway for 17 years until the pandemic hit.

I raised my children on this job. When the government took over our hotel as a quarantine site, they brought in the Red Cross. Other people were trained to do our jobs.

I was terminated last month along with many of my co-workers. The hotel fired 90% of housekeeping staff. Most of us are women who have been working there for decades. Women at Pacific Gateway are taking the brunt of job losses while the men's jobs are more likely to be protected.

We filed a human rights complaint on the basis of sex and racial discrimination because of how we have been treated. The hotel terminated 74% of its female staff. More of my co-workers could lose their jobs this summer if the government continues to use our hotel.

My co-workers and I want to know when will the government stop using Pacific Gateway and how will the government help women like me return to our jobs so that we aren't treated like we are second class.

People want to travel again. There's no reason why we should lose our jobs during a temporary pandemic.

Thank you so much.

[The Chair, Liberal, Ron McKinnon]

Thank you all.

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

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

I'll be directing my questions to Mayor Dilkens.

Before I do, I just want to say to Ms. Cardona and Ms. Dhillon that your testimony was shocking and should wake every member of this committee up. I can't believe you had to go through that. I reiterate calls for the government to scrap the non-scientific and discriminatory hotel quarantine program.

I am so sorry you have had to go through that. I'm in shock. It's ridiculous.

Mayor Dilkens, it's my understanding that prior to this meeting—about three minutes before the meeting—you got some correspondence from PHAC that said that if a U.S. pharmacist reached her hand across the border line to give a Canadian a dose that would otherwise go in the garbage, it would be considered importing the drug for sale and would need Health Canada approval. Is this correct?

[Drew Dilkens]

That's correct.

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

Has the federal government offered you any assistance in getting these doses into Canada?

[Drew Dilkens]

No, none whatsoever.

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

Would you say that they have been more focused on providing roadblocks to getting these doses into Canada?

[Drew Dilkens]

Every effort to find creative solutions to make this work has been thwarted.

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

Would you characterize the Canadian federal government as being, in fact, comfortable with 35,000 doses going in the garbage?

[Drew Dilkens]

It would appear that way.

We have 35,000 doses that hit the trash in the State of Michigan, two kilometres away from where I'm sitting at this very moment. These were doses that had been offered to us by pharmacists living in my community who work over there. They are just beside themselves thinking that this stuff is going into the landfill when there's such a demand here on our side of the border.

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

Would you characterize that as sort of the height of privilege, in terms of watching vaccine inequity around the world, with the Canadian federal government being content to let doses of Pfizer vaccine go in the garbage?

[Drew Dilkens]

I just think we can do better.

We have a pathway to do better. It's not like [Technical difficulty—Editor] the U.S. side, in every situation at all times. This is being offered to us and for some reason, our government is finding every way to say no to making this happen.

I'm looking for someone who will find one way to say yes. This is a sensible pathway. It's Pfizer vaccine that's manufactured at the same plant in Kalamazoo, Michigan. Let's just find a way to make this happen.

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

In front of this committee, the head of PHAC said that every Canadian currently has a pathway to a vaccine and then made this sort of glib comment about the Twitter account, Vaccine Hunters.

Would you characterize that as correct in your community right now? Does every resident in your community have a current pathway to, let's say, even a second dose of vaccine? Could anybody in your community go and get a second dose today in Windsor?

[Drew Dilkens]

No. If they could, I wouldn't be here. That's the problem. There's a supply and demand mismatch. This is a pathway to help make our situation better on this side of the border.

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

Do you think Health Canada and PHAC are just being obstinate? I don't understand why they're not helping you.

Could you shed some light on that? Are they just being obstructionist for the sake of being obstructionist, in their privilege?