Health Committee on Nov. 20th, 2020

[The Chair, Liberal, Ron McKinnon]

I call this meeting to order.

Welcome, everyone, to meeting number 7 of the House of Commons Standing Committee on Health. The committee is meeting again today to discuss the supplementary estimates (B) for 2020-21. I want to thank the witnesses for appearing again today.

We have as witnesses the Honourable Patty Hajdu, Minister of Health. We have, from the Department of Health, Deputy Minister Stephen Lucas and Les Linklater, federal lead for COVID-19 testing, contract tracing and data management strategies.

With us from the Public Health Agency of Canada are Dr. Theresa Tam, chief public health officer, and Iain Stewart, president.

From the Canadian Food Inspection Agency, we have Dr. Siddika Mithani, president.

From the Canadian Institutes of Health Research, we have Dr. Michael Strong, president.

Today's meeting is taking place in a hybrid format. I would like to start the meeting by providing you with some information following the motion that was adopted in the House on Wednesday, September 23, 2020.

The committee is now sitting in a hybrid format, meaning that members can participate either in person or by video conference. All members, regardless of their method of participation, will be counted for the purpose of quorum. The committee's power to sit is, however, limited by the priority use of House resources, which is determined by the whips. All questions must be decided by a recorded vote, unless the committee disposes of them with unanimous consent or on division. Finally, the committee may deliberate in camera, providing that it takes into account the potential risks to confidentiality inherent to such deliberation with remote participants.

The proceedings will be made available via the House of Commons website. Just so you are aware, the webcast will always show the person speaking, rather than the entirety of the committee.

To ensure an orderly meeting, I would like to outline a few rules to follow.

For those participating virtually, members and witnesses may speak in the official language of their choice. Interpretation services are available for this meeting. You have the choice at the bottom of your screen of either “Floor”, “English” or “French”.

Before speaking, click on the microphone icon to activate your own mike. When you are done speaking, please put your mike on mute to minimize any interference.

I will give a reminder that all comments by members and witnesses should be addressed through the chair. Should members need to request the floor outside of their designated time for questions, they should activate their mike and state that they have a point of order.

If a member wishes to intervene on a point of order that has been raised by another member, they should use the “raise hand” function. This will signal to the chair your interest in speaking and create a speakers list. In order to do so, you should click on “Participants” at the bottom of the screen. When the list pops up, you will see next to your name that you can click “raise hand”.

When speaking, please speak slowly and clearly.

Unless there are exceptional circumstances, the use of headsets with a boom microphone is mandatory for everyone participating remotely.

Should any technical challenges arise, please advise the chair or the clerk. Please note that we may then need to suspend for a few minutes as we need to ensure that all members are able to participate fully.

For those who are participating in person, proceed as you usually would when the whole committee is meeting in person in a committee room. Keep in mind the directives from the Board of Internal Economy regarding masking and health protocols.

Should you wish to get my attention, signal me with a hand gesture or, at an appropriate time, call out my name.

Should you wish to raise a point of order, wait for an appropriate time and indicate to me clearly that you wish to raise a point of order.

With regard to a speaking list, the committee clerk and I will do the best we can to maintain a consolidated order of speaking for all members, whether they are participating virtually or in person. In order to be fair to all committee members, the list of speakers will only be activated once the meeting has officially started and not upon admission to the room.

Having said that and gone through our housekeeping, I invite the Honourable Patty Hajdu, Minister of Health, to make an opening statement of 10 minutes, please.

[Patty Hajdu, Liberal, Minister of Health]

Thank you very much, Mr. Chair. I thank all the members for inviting me to appear before the HESA committee.

I will reiterate that I have a number of departmental officials joining me today, including Dr. Stephen Lucas, who is the deputy minister of Health Canada; Iain Stewart, who is the president of the Public Health Agency of Canada; Dr. Theresa Tam, who is Canada's chief public health officer; Dr. Mike Strong, who is the president of CIHR; Les Linklater, who is the federal lead for COVID-19 testing, contact tracing and data management strategies; and Dr. Siddika Mithani, president of the CFIA.

As per the request of interpretation, I'll keep my remarks in one language so that translation is easier for them.

I want to start at the beginning and reflect on how the COVID-19 pandemic has shaped and continues to shape our work.

Right now, we are seeing a troubling trend of resurgence in Canada. Cases of COVID-19 in our communities are rising at a concerning rate, one that is higher than it was during the spring peak, but Canada is better prepared. Our procurement of personal protective equipment is more secure, we have a higher testing capacity across the country, and we have a better understanding of the virus, thanks in great part to investments in research and science. We also have a better understanding of how to treat COVID-19. These things are helping to keep Canadians safer across the country during the second wave.

Because this is a new virus, we've made significant investments in Canadian research. This research has improved our understanding of COVID-19 and its impacts on Canadians, and indeed the international community. We've all learned that the path through this pandemic is anything but predictable or straightforward.

As we face a long winter, we continue to ask Canadians to follow public health guidelines so that we can get this virus under control, avoid further loss of life, prevent more economic hardship and buy us the time we need until we have a safe and viable vaccine here on our shores. This will continue to be our top priority in the months to come, both for our government and for my portfolio.

Mr. Chair, you will recall that the recent Speech from the Throne responds directly to the challenges posed by the pandemic. It also confirms my department's role at the centre of the response. I have to thank the hard-working people of Health Canada and the Public Health Agency of Canada, who have worked diligently to help the provinces and territories to increase their testing capacity and their ability to perform contact tracing and suppress outbreaks.

That work includes ensuring access to personal protective equipment, both by building our domestic capacity and by securing our supply chains. The work includes developing and deploying a vaccine strategy to ensure that we're ready when one is available.

The health response to COVID-19 is only part of the story. The pandemic has exposed a number of gaps in Canada's social systems, which we referred to in the Speech from the Throne. Again, my department continues to do important work to address these gaps and to support the provinces and territories in their role and responsibility to administer health care.

The pandemic has highlighted systemic problems in long-term care. As many Canadians and many of my colleagues here today have advocated, we are committed to working with the provinces and territories to set standards for long-term care for seniors who reside in long-term care homes. We are also working to improve access to family doctors and primary care teams, especially in rural and remote communities. We've been working with provinces and territories to improve access to virtual health care, which is a service that has proven essential to Canadians during the pandemic. For example, 530,000 Canadians have accessed the mental wellness portal to chat, text or meet over video with professionals. We'll continue to address the opioid overdose crisis, which has worsened during the pandemic. It is essential that Canadians be able to access mental health and substance use supports that they need during this time.

Finally, we will continue to take action and accelerate action towards a national universal pharmacare program. These priorities reflect a great deal of work that is already under way in the health portfolio. As we move into the fall and winter, we will tackle each of these issues with increased focus and vigour.

As the pandemic has evolved, so has our response. This is reflected in our budgetary needs. Throughout the health portfolio, we are seeking additional authorities for a variety of purposes related to COVID-19: medical research, federal investments through the safe restart agreement, drugs, medical devices, and virtual care, along with many other initiatives to help Canadians through these uncertain times.

Our government has taken swift, coordinated and unprecedented actions to protect the health and well-being of Canadians, to keep businesses afloat, to support Canadians through difficult times and to keep our economy running.

In true Canadian fashion, Canadians have stepped up. They have listened to public health advice. They have made sacrifices and they've shown resilience. However, we are not out of the woods just yet, and we cannot forget that this virus remains a threat to all of us. We need to stay vigilant. With infection rates climbing across the country, we all must do more together.

The world is working feverishly toward a long-term solution to defeat COVID-19. Until we reach that point, we must continue to persevere and to support each other, because together we will get through this.

[The Chair, Liberal, Ron McKinnon]

At this point, we will start our six minute-round with Mr. d'Entremont.

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

Thank you very much, Mr. Chair. Minister and staff, thank you so much for being with us today.

I want to get to something that you really didn't have in your remarks. It's the issue that's probably giving people the most hope for a better year coming up, which is the vaccine. We've asked a number of times, and we haven't necessarily received a clear answer on when you expect vaccines to be delivered to Canada.

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

You're absolutely right. The arrival of vaccines is the glimmer of hope that Canadians are looking toward in order to provide some alleviation of the challenges that we're all having around the world with COVID-19.

I'm so proud of Canada for the work we've done to procure vaccines through the expert advice of the vaccine task force. In fact, we have procured more vaccines per capita than any other country in the world. Two of the seven candidates, as you know, have shown very promising results so far and have applied to Health Canada for our rolling regulatory review.

We anticipate getting some doses, hopefully in quarter one of 2021, but that work is ongoing. There are a number of steps under way before we can begin to vaccinate Canadians. We are taking those steps, and we're working very closely with the manufacturers and with the provinces and territories to ensure that we have a vaccine strategy plan and that we can deploy those vaccines when they become approved.

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

Quarter one is a long period of time. It could happen in early January or it could happen in March. Do you have a better timeline on what that rollout will look like in the future—about which vaccines will be coming to us, which ones are showing the most promise, and those kinds of information?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

We do have, obviously, two vaccines that are showing the most promise, the Pfizer vaccine and the Moderna vaccine. Canada has purchased millions of doses of both, and both have applied to Health Canada for rolling regulatory approval. This is exciting news. The regulatory approval has been, as you know, accelerated to make sure that we can review data as the manufacturers provide it that so that we don't have to wait until the conclusion of the clinical trials.

All of that is good news. Of course, it would be irresponsible for me to give you a precise date, because much of that depends on the manufacturers' processes and the regulatory review process, but certainly we're optimistic that we should be able to see doses in Q1. We'll be working really hard with the manufacturers to hopefully see that success.

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

All right. Let's say the FDA in the United States actually approves something. How quickly could Canada approve something? We're inundated with information coming from the U.S. Of course, we're going to find out when they get theirs approved. When can we expect to get ours approved? Is our process that much longer?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

I can't comment on the American process. I don't know what the American process is. I will just say that the Canadian process is focused on two things. First of all is the safety of the vaccines, and obviously what every Canadian expects is that the regulators will do their due diligence to ensure that the vaccines are safe and that they're effective as per the manufacturers' claims.

We have doubled the capacity, if not more, of the regulatory department. We have teams of regulators for each vaccine that are ready to review that data, and in fact are reviewing a lot of the data already. As I said, these rolling reviews allow for regulators to review data as it arrives, as opposed to having it all at the conclusion of the clinical trials.

We're well positioned to be working with the manufacturers to review the data as they produce it.

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

All right.

We were hoping for quarter 1; that's where we're getting to at this point. While we're waiting for quarter 1, have you developed national guidelines surrounding who will get the vaccines first, as has been done in other countries?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

Yes, the National Advisory Council on Immunization, which is an independent body that provides advice to the Public Health Agency of Canada, has provided interim guidance based on very general information that we have right now about the vaccines and for whom they would be indicated for use. Certainly provinces and territories also, in some cases, have their own advisers around priority populations, and that work is under way.

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

Can you table that with the committee?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

I believe the guidance from NACI is public. I'll turn to my officials to see.

[Dr. Stephen Lucas, Deputy Minister, Department of Health]

Yes, indeed, it is public. The interim guidance was released on November 3. We can provide that to the committee through the chair.

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

Okay.

Have you developed a national strategy for how and where the vaccine will be deployed? Some provinces now seem to be getting a little ahead of the federal guidelines, or at least the federal rules. Where are those things going to be going?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

Each vaccine has its own unique properties and its own unique logistics requirements for how it's transported, how it's stored and how it's deployed. Yes, we're working through those strategies now, both on a federal level and also with provinces and territories to ensure that their plans take into account the requirements for the vaccines as we understand them now, and also to ensure that they have the capacity to appropriately distribute and store the vaccines. That work is under way right now.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. d'Entremont. We go now to Mr. Kelloway.

Mr. Kelloway, please go ahead. You have six minutes.

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

Thank you, Mr. Chair.

Thank you for joining us today, Minister. I want to extend a heartfelt thank you to you and the officials here with us today for your hard work protecting Canadians since the onset of this pandemic.

As you know and as many know, the J.A. Douglas McCurdy Airport in my riding has suffered greatly due to the COVID-19 pandemic. Many airports have.

While the Atlantic bubble has kept those of us in the Atlantic provinces safe, my constituents and many Canadians are looking for innovative solutions to the challenges airports in the Atlantic are facing because of the two-week isolation period caused by the pandemic. It's undeniable that international travel and mobility during the pandemic have contributed to the spread of COVID-19 in Canada, but we also know that these measures are causing strain on Canadians. Could you tell us about the strategies that the government is looking at to potentially reduce isolation periods for travellers entering Canada, or Canadians entering the Atlantic bubble, without compromising the health and safety of Canadians?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

Thank you very much. That's an excellent question.

I know that the 14-day quarantine, while protecting Canadians, also presents some real challenges for people, interprovincial travel being one of them in the case of the Atlantic bubble, but it's also travel across international borders, including the United States.

The 14-day quarantine, although difficult, has been an important tool to reduce the importation of the virus into Canada and into regions that have very low transmission. That is why we continue to enforce those border measures in Canada, especially at the international borders. We believe that changes to these measures need to be grounded in evidence and in research. That's why we've been working closely with Alberta on the feasibility of using a rigorous testing and monitoring program that combines testing and some limited isolation to understand how we can reduce that mandatory quarantine system in a safe way. I'm very pleased that Calgary International Airport and the Coutts land border crossing are the location of this pilot.

The work of Air Canada and WestJet, in partnership with universities, will provide additional evidence. I think that evidence will give Canada a very strong scientific basis to move forward on how we alleviate mandatory quarantine length.

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

Thank you, Minister.

I want to pivot a bit on vaccines. There has been lots of talk about them and we've had a question here today about them.

A lot of exciting developments have started to come up, and we're starting to feel a bit more optimistic about having a vaccine soon, perhaps in a couple of months, but we know that the provinces and territories are responsible. They are responsible for delivering health care, but the COVID vaccine is going to take a lot of logistical coordination and co-operation.

Can you tell us a bit more about the work being done to ensure that vaccines will be developed quickly and safely when the time comes? Additionally, I've heard from provinces like Ontario and Alberta that they are expecting certain numbers of vaccines. I work with a lot of vulnerable groups, Minister, in my riding. I'm wondering if this is also true for indigenous populations and other federally supported groups.

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

I think you're right. It's such exciting news for the world that there are vaccines that are starting to demonstrate high degrees of effectiveness. Of course, it's early days still, but we have one of the strongest vaccine portfolios in the world and, again, the vaccine task force has been guiding our way.

The members of the task force are volunteers on top of that. They come from all kinds of diverse backgrounds. That might include virology, the business sector or experts in the pharmaceutical sector. I think that blend of expertise has really been helpful for Canada.

As you know, we have been working closely with provincial and territorial partners on the issue of vaccines and how we will deploy them. Some of the vaccines have very challenging logistical considerations. We will be supporting provinces and territories to make sure they have in place what they need to store these vaccines and transport them safely.

While I know provinces are excited to get doses and talk about numbers, we are still in discussions right now with the provinces and territories about how we'll share the doses as they arrive. It's very important that we do this together, because we want it to be fair.

Of course, we've done this before with things like personal protective equipment and rapid tests. I have every confidence that we'll work out an agreement with provinces and territories that ensures that we can protect Canadians and that the federal government can protect the populations for which we have a responsibility.

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

Thank you, Minister.

Those are my questions for now, Chair.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Kelloway.

We go now to

Mr. Ste-Marie.

Mr. Ste-Marie, you have six minutes.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

Thank you, Mr. Chair.

Let me send greetings to your and to all the committee members, the support team and the interpreters in that room.

Let me also send greetings to you Madam Minister, Dr. Tam and all the other witnesses. My thanks to you for joining us in the meeting today.

My questions go to the Minister.

In an article by Hélène Buzzetti that appeared in Le Devoir, she quotes the words of Dr. Tam's deputy, Dr. Howard Njoo. Those words are:Provincial authorities are the most up to date on, and the most familiar with, the reality on the ground in Quebec.

I would like to ask the Minister whether she generally agrees with a statement like that.

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

I do agree, generally, with that statement. It's important that we understand, especially in the consideration, for example, of the public health measures that prevent provinces....

The provincial medical officers of health are often the closest to the ground. They understand their populations. They know oftentimes how to blend action with messaging in a way that's most appropriate for the people they serve.