Health Committee on Nov. 20th, 2020

[The Chair, Liberal, Ron McKinnon]

Over to you now, Mr. Ste-Marie, for two and a half minutes.

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

Thank you, Mr. Chair.

My first question goes to Dr. Tam.

Dr. Tam, I'd like your point of view as chief public health officer. Do you believe that, last winter, before the first wave of the pandemic, the public health system was underfunded to the point of fragility?

I am thinking specifically of the situation in the CHSLDs. If that is the case, did the underfunding that increased the fragility reduce the quality of the public health response to the pandemic?

[Dr. Theresa Tam, Chief Public Health Officer, Public Health Agency of Canada]

In terms of the health system and also, even more complicated, the long-term care system, which is funded both privately and publicly, this is actually in the purview of local and provincial jurisdictions. However, as the chief public health officer, I've been pointing out some of the systemic issues that were present in Canada prior to the pandemic. That includes health equity challenges for seniors and for other persons, including first nations, Inuit and Métis peoples, and women who are particularly impacted, the low-wage, often racialized populations. The health system itself, and access to the health system, is a challenge for a number of people.

The long-term care facility impacts were really the feature of the first wave. Absolutely everything needs to be done to improve capacity in that sector. From the public health system side, I think we have to do everything we can to improve the capacity of the public health system. Public health is very invisible when there isn't a pandemic. It represents a much smaller proportion of health care spending in the provinces—municipal level, which means it's actually quite a small system that's trying to do many things, including preventing the acute care system from being severely impacted by the pandemic.

I would certainly advocate, going forward, that we not forget the lessons learned from this pandemic. We need to keep the public health system going at all levels. This is not just at the federal level. The local level is where things happen. Long-term care for sure needs to be better supported.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Ste-Marie.

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

Thank you very much.

[The Chair, Liberal, Ron McKinnon]

I apologize; I missed Ms. Sidhu on the list earlier.

Ms. Sidhu, please go ahead for five minutes.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Mr. Chair.

Thank you, Minister and Dr. Tam, for being here today.

I'm grateful to all of the witnesses for appearing. All of you, along with the public service, have been working tirelessly since the beginning of the pandemic to keep us safe. Thank you.

Minister, we have spoken several times about how the pandemic is affecting my constituents in Brampton and Peel region. You were there as well. While I know that the government has provided support to Ontario, including sending in the Canadian Armed Forces and providing other resources, what is the current status of support being provided to Ontario when Peel is in the red zone?

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

Through the chair, thank you to the member for hosting me in Peel and Brampton. It feels like a lifetime ago, but it was just a couple of months ago. In fact, it was lovely to meet the chief medical officer of health of that region, Dr. Loh, who is working so hard to protect the residents of Peel.

Of course we're there for Peel region. We've been working very closely with Peel region to support and augment the response to the pandemic and the growth of cases in Peel. It includes supporting the ability to have a safe isolation centre, something that Dr. Loh said would be particularly useful. This will be, I think, an important addition to that region, which features oftentimes large multi-generational families in really crowded housing conditions. We know that one of the primary routes of infection is other family members. This self-isolation centre that the region will facilitate and that the federal government will fund will provide an opportunity for people who have been diagnosed with COVID-19 and/or their close contacts to remove themselves from the family household and thereby reduce the spread.

We are also there for Peel region supplying additional contact tracers. We'll be there for them as well with additional capacities as required. We continue those conversations.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Minister.

The provinces and territories—in this case, the Province of Ontario—provide long-term care. Given what we have seen in care homes across the country, there's a need to implement national standards for senior care to avoid another tragedy in the second wave.

Can you please tell the committee what work is happening to support our seniors in long-term care?

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

Thank you very much.

This is a tragedy that has happened through the first wave. We're seeing infections rise in long-term care homes during this wave. That's why we're all working so hard to protect the seniors and the vulnerable people in our communities. It's also why, during the safe restart agreement, we contributed $740 million to provinces and territories to augment their infection prevention and control measures. We know that many of the homes had additional needs to strengthen those protections and keep COVID-19 out of those facilities.

As you know, there were a number of other economic measures during the first wave, including wage subsidies, for example, to the most hard-hit front-line workers, which included home health care workers, through the provinces.

Through the Speech from the Throne, we made a commitment to create national long-term care standards that I think will be a legacy of this government in the years to come. No matter where a person lives, they deserve the right to age in dignity and safety. I think all provinces and territories agree. Creating national long-term care standards together will be an important way that we can protect seniors in the years to come.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you.

We know that testing is a very important part of stopping the spread of COVID-19. Canadians need access to testing regardless of where they live.

Can you expand on what the federal government is doing to help provinces and territories increase their testing capacity, as this is so necessary in outbreak areas such as my area of Brampton?

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

Thank you again for the question.

Over 10.6 million Canadians have been tested for COVID-19 to date. As you know, a large portion of the safe restart agreement was to help provinces and territories build their capacity to test Canadians.

Testing is one component of the strategy. Test, contact trace, and isolate is the way that we reduce the cases across the country. People obviously have to take actions themselves to reduce their mobility, but we know that this robust test, trace, isolate strategy is one of the ways that we can actually reduce the growth of cases as well.

In addition to the safe restart agreement, we've also been procuring and sending rapid tests to provinces and territories. In fact, over 4.6 million rapid tests have ben distributed to provinces and territories to date, and two million have gone to Ontario alone since early October. We've had rapid tests in the field in rural and remote communities for a very long time to support those communities to get access to test results very quickly. I'm thinking of indigenous communities in Ontario, for example, that have very vulnerable health care systems.

We've been there for provinces and territories. The good news is that we're starting to see testing numbers go up across the country as provinces and territories build their capacity to have a robust testing strategy.

[The Chair, Liberal, Ron McKinnon]

Thank you, Ms. Sidhu.

We now go back to the regular list.

Mr. Davies, please go ahead for two and a half minutes.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

Mr. Stewart, I understood you say that of all the contracts we've signed and the hundreds of millions of doses of vaccine that we may have procured, we will expect to receive only six million doses by March 31. Am I understanding that correctly?

[Iain Stewart]

All of the vaccines that are being used for COVID are novel. They're being invented for the first time for this purpose. The manufacturers are having to not only develop the vaccines and do the clinical trials, but also scale up the manufacturing of the vaccines. They start slowly and then they build.

All countries are interested in the very first vaccines. The companies are trying to distribute out to multiple countries at the same time. The amounts start out small and then they build over the course of the coming year.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

That's the explanation for it, but I still want to confirm that if we have vaccines that are approved by Health Canada, the maximum number of vaccines that will be available to Canadians by March 31 will be six million. Is that what you're saying?

[Iain Stewart]

Yes.

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

Could I add to that?

My understanding is that, of those two vaccine manufacturers.... There's nothing to say there might not be additional vaccines coming. Is that correct?

Iain, I shouldn't be questioning you, but just for clarity—

[Don Davies, NDP, Vancouver Kingsway, BC]

Minister, I have two and a half minutes, so if I may, my second question is to you.

We have sobering numbers that came out today. We have huge COVID spikes in Manitoba, Alberta and Saskatchewan. There are alarming spikes in Ontario, B.C. and Quebec. The transmission rate has been consistently over 1% since August. The national positivity rate is over 6%. Hospitalization rates are climbing across the country. We have a near crisis in Manitoba. The current projections put us at over 20,000 cases per day by January, and we have alarming outbreaks in long-term care homes and indigenous communities.

I remember that in the summer the curve was being flattened and Dr. Tam was talking about that. Clearly, we have had an incredible flare-up. What do you attribute that to? Why is Canada, at this point in November, in such a dire situation? What has caused that?

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

I'll give some overarching statements, but Dr. Tam would be best to respond.

The simple answer is mobility, as people move around. Of course, the more people move around and the more people resume their everyday lives, the more we have the risk of either contracting or passing on COVID, especially in communities where there is transmission at the community level.

Dr. Tam, perhaps you'd like to say a bit more.

[Dr. Theresa Tam]

Canada, as a country and everyone working together, did well to flatten the first wave. What happened was that over the summer, of course, public health measures were relaxed. There was an increased mixing of the population. Then, as the fall and winter seasons approached, we began to see an increase in numbers. A lot of it was in young adults, so a different population from the first wave.

A really key challenge was one of looking at human behaviour. Of course, young adults are going to work. It's not because they were being irresponsible necessarily; they are mixing more. However, there were also some social gatherings, which were driving the cases as reported by colleagues in the provinces and territories. Therefore, a lot of it could not be necessarily managed within a workplace or a long-term care facility. There were actual social gatherings, which included some important cultural events such as weddings, funerals and other things. I think that was what resulted in an acceleration in the younger population, which then spilled over into the higher-risk populations.

Some of the jurisdictions you're seeing, such as Manitoba, hardly had a first wave. I think, in some ways, people didn't quite believe this was perhaps going to happen and fatigue set in, so it was really difficult to get that type of momentum going again.

There are multiple different factors, but the long-drawn-out nature of the pandemic in areas that haven't experienced it is definitely challenging on the ground.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Davies.

We'll start our third round now, with Mr. Maguire.

Mr. Maguire, please go ahead. You have five minutes.

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

I want to go back to the previous question from Mr. Barlow and see if we could get tabled with the committee the service standards that were referenced in the interim order. Those are the ones for Health Canada approval.

[Dr. Stephen Lucas]

Mr. Chair, those service standards are available on the web and we'd be more than pleased to provide that information to the committee through you.

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

Thank you.

I also want to ask Deputy Minister Lucas about this: Yesterday, in Parliament, Liberal MP O'Connell thanked the Prime Minister for committing to national standards for long-term care.

We don't know anything about that, because there has been, to date, no information, other than a line in the throne speech. What we do know, though, is that 80% of the COVID deaths have been related to long-term care homes. Succinctly, has your department advised the government to develop national standards for managing the long-term care homes during this pandemic?