Health Committee on June 7th, 2021

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

On the contract we were talking about earlier with Switch Health, are they currently legally obligated to ensure that samples collected via the online portal are collected under the supervision of a nurse?

[Iain Stewart]

It actually varies by jurisdiction. They are not required to collect the samples under the jurisdiction of a nurse. It varies by province. It may be an appropriate health care professional, and so on. It's different language in different provinces.

That said, of their workforce—this is from memory—about 1,029 are, in fact, nurses. I think there were 29 who are not nurses. After we found out that non-nurses were involved in supervision, even though it wasn't required under the province, we asked them to reassign those staff to other duties to ensure that appropriately trained medical teams were looking over the supervision.

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

I know this. I'm assuming it's the same in all provinces in Canada. The situation, which I've raised two or three times, with the incompetence being seen in the way these COVID tests are being picked up in rural Canada continues unabated at this point.

PHAC is very quick to call. There is a case that I had in one of my communities as of yesterday that you're familiar with, Mr. Stewart. PHAC was quite ready to call someone to make sure that they were still in quarantine as late as yesterday from that person's May 15 crossing back into Canada, when that young individual concerned had already been vaccinated twice—was fully vaccinated—coming from college in the U.S.

He's had two very negative tests in the last five days, again here in Canada, and he's still in quarantine. He doesn't know what he has to do. He's never been told. He doesn't want an apology that you've offered in response to this situation, and it's not yet been resolved for the future. Can someone contact him? How do you get a hold of regular people who are stuck in this dilemma? He needs to be contacted so that he knows how to get out of quarantine so he can go to work.

[Iain Stewart]

Thank you, sir.

First of all, I want to thank you for bringing the matter to my attention, honourable member. As you know, obviously we're very distressed at the situation that we've created for him. Second, we have in fact, in response, set up a change in procedure. Somebody in a similar circumstance now will be offered the opportunity to test locally, instead of continuing to wait in a situation of the nature you described.

Thank you, again, for bringing that to our attention.

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

He did his day-1 test, and it sat for six days. It was finally picked up after his constantly phoning every day. His day-8 test sat for another week before it was picked up. In fact, it never was picked up. He had to drive it 100 kilometres to Brandon to the COVID testing site. These are the kinds of things that people are faced with in rural Canada, and it's completely against the contract.

That's why I'm asking for information on these contracts, because this is incompetence. The major courier couldn't even find a local address in a small town in my area. Uber, which was put up as an alternative, doesn't exist in rural Canada. What are these people supposed to do with regard regard to the viability of those tests after they've been sitting for six to eight days?

[Iain Stewart]

They're supposed to phone Switch Health, and we've changed the operating procedure to make sure that what you just described doesn't happen again.

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

Believe me, they phone Switch Health every day.

[Iain Stewart]

No, effective today, we have changed it so that the situation will not recur.

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

Okay, I appreciate that, because it has been a huge dilemma in rural Canada, and particularly for many families in my area in southwest Manitoba.

I want to bring that to your attention again and I trust that someone will contact them today, these people in the past, to make sure that they know what to do to get out of quarantine.

[Iain Stewart]

Thank you.

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

Will that occur?

[Iain Stewart]

Yes.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Maguire.

We'll go now to Mr. Kelloway for five minutes.

[Mike Kelloway, Liberal, Cape Breton—Canso, NS]

Thank you, Mr. Chair. Hello to my colleagues; and again, thank you to the witnesses for being here.

My first question will be directed towards Dr. Tam.

Last week, Nova Scotia premier Iain Rankin and the chief medical health officer, Dr. Strang, announced that, beginning tomorrow, rotational workers with no symptoms, who have been fully vaccinated at least two weeks before arriving in Nova Scotia, will no longer need to self-isolate. The catch is that they must get tested on day 1 or day 2, again on day 5 or 6, and again on day 12, 13 or 14.

My understanding is that those who have one dose and are not coming from an exposure hot spot are required to self-isolate for 7 days after they have proof of two negative test results.

As we start looking at ways to safely reopen our national borders, what would you expect it could look like and what are your concerns around reopening, if any?

[Dr. Theresa Tam]

Of course, domestic borders are in the realms of provincial jurisdiction, but we are sharing this kind of discussion amongst chief medical officers of health. Even in regard to the international border, while it's in federal jurisdiction, one has to have these discussions with the provinces and territories particularly as it pertains as to whether Canada, in this domestic situation, has its third wave or resurgence under control. Also, we're discussing what it means to be vaccinated fully, those kinds of discussions.

We've also tabled the expert panel's report, not only to the ministers but also the deputy ministers and the special advisory committee. Those kinds of recommendations will be taken into account as the decisions are being made by the federal government on our border pathway forward.

I think some of the public health parameters, vaccine effectiveness information, as well as the other more operational considerations are sometimes quite similar between what the provinces have considered and what the federal government has to consider for the international border. With these elements, there are some parallels that one can draw.

[Mike Kelloway, Liberal, Cape Breton—Canso, NS]

Thank you, Dr. Tam.

Last week, NACI advised that Canadians are able to move forward in terms of mixing and matching doses and that all vaccines approved by Health Canada are safe and effective.

I believe in one of our earlier committee meetings with the folks from PHAC we learned that there were several international studies that were informing NACI's decision. We have Dr. Tunis here, as well as some folks from PHAC, so I'll open this question to you folks.

Can you tell the committee what the new recommendations say, and what are the main takeways from those international studies?

[Dr. Matthew Tunis]

I'll start with this. Last week, NACI recommended that either the AstraZeneca/Covishield COVID-19 vaccine or an mRNA vaccine may be offered for the subsequent dose in a series started with the AstraZeneca/Covishield COVID-19 vaccine and that the previous dose should be counted and the series need not be restarted.

NACI made this recommendation at the time, informed by several studies from the international landscape, one from Spain, one from the United Kingdom and one from Germany, all of which showed that when you provide an mRNA vaccine after an AstraZeneca vaccine, it is safe. There were actually multiple intervals studied—four weeks and also eight to twelve weeks. At any of those intervals studied, overall the mixed schedule was found to be safe.

They looked at immune response data from that study from Spain as well, which showed that you do, in fact, boost the immune response when the mRNA vaccine is provided after the AstraZeneca vaccine.

Since that time, there have been several studies that have also come out from Germany, looking at the immune response, that replicate that finding as well, that you get a good, strong boost to the immune response when you follow AstraZeneca vaccine with Pfizer.

That was underpinning NACI's recommendations. They had seen studies from multiple countries looking at multiple schedules, looking at safety and now also the immune response, that have demonstrated that this is a strategy that can be used. Provinces and territories are now looking at this and how they integrate that into their second dose approaches across the country.

Thank you.

[The Chair, Liberal, Ron McKinnon]

Excuse me, committee, we have the bells ringing for a vote in the House. I need unanimous consent to carry on for another 15 minutes. Do I have it?

[Some hon. members]

Agreed.

[The Chair, Liberal, Ron McKinnon]

Very well. Thank you.

Mr. Kelloway, carry on. You have 20 seconds left.

[Mike Kelloway, Liberal, Cape Breton—Canso, NS]

Well, I will either surrender my 20 seconds or give them to someone else, but use your discretion.

Thanks to the witnesses, again. It seems like we've been together for more than a year. Thank you for all the work you're doing. It's not easy and I know we all appreciate it and the people who work under you.

[The Chair, Liberal, Ron McKinnon]

Great.

Thank you, all.

Thank you, Mr. Kelloway. With the thank you, your time is actually now up.

We go now to Ms. Rempel Garner, please, for five minutes.

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

Thank you, Chair.

Dr. Lucas, picking up on a question that my colleague, Mr. Davies, asked you, can you confirm that no doses that have passed the manufacturer's labelled date of expiry have been administered in Canada?

[Dr. Stephen Lucas]

Yes, Mr. Chair, to the best of my knowledge, that's the case. As I had indicated, the AstraZeneca doses that were to have expired on May 31, subject to a request by AstraZeneca, which provided data to extend that expiry by a month, were reviewed and approved.

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

Sorry, so the doses that were originally set to expire on May 31 have been administered. You guys just changed the expiry date. Is that what you're saying?