Health Committee on March 21st, 2022

[Mike Lake, Conservative, Edmonton—Wetaskiwin, AB]

We passed the motion back on December 11, 2020: “That, given that the alarming rate of suicide in Canada constitutes a national health crisis, the House call on the government to take immediate action, in collaboration with our provinces, to establish a national suicide prevention hotline”. It says “immediate action”. It has now been 465 days since that point in time. If we extrapolate from the numbers, that would be over 5,000 Canadian deaths by suicide since that time.

Why is it taking so long?

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

As you know, the concern has been that it must be hooked up to the most appropriate care. That is the work that CAMH is doing, and it's what we're hearing from the provinces and territories: When someone calls that, what support do they get? Is it possible...? As you know, Mike—

[Mike Lake, Conservative, Edmonton—Wetaskiwin, AB]

We already have a 24-7 line that the Government of Canada promotes on its website. We have a 988 line that's not in use right now but that could be used so that the 24-7 line is just readily available in people's minds. Certainly, there's work that needs to be done on the part of the stakeholders to make sure the capacity is there, but of course we have that line that exists already.

It's 465 days and 5,115 deaths at this point in time since we passed the unanimous consent motion. I'll note that in answers to questions, the first time I asked the question, on December 7, you said, “The CRTC is currently considering public input from consultations that concluded on September 1.” That wasn't actually the case, because at that point, the time frame had been extended. Your parliamentary secretary, who happens to be with us today, later pointed out, as you've just mentioned, that the time frame was extended to reopen the consultations: “the CRTC reopened the consultations to allow for new interventions in accessible formats, such as video.” That was to accommodate people with disabilities.

Now, in the last four or five years, on a repeated basis, including in two election campaigns, your party has declared that everything the government does will be undertaken through a disability lens. In fact, in the House of Commons, there was a big debate on accessibility prior to the 2019 election. I took part in that, as many of your colleagues did. That was a declaration made by your party.

We are now six months past the original September 1 deadline and still consulting, it seems, because the government didn't apply a disability lens to the suicide prevention hotline. Was that an oversight on the part of the government?

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

As you know, the CRTC is an arm's-length organization that we don't interfere with, but it seems that they have decided to reopen the consultation in order to put on that disability lens that is so important.

The other thing, Mike, is that some jurisdictions have their own number. This is about making sure that this is all coordinated.

[Mike Lake, Conservative, Edmonton—Wetaskiwin, AB]

To be clear, the Government of Canada, on its website, points to a 24-7 number that already exists and that you couldn't remember off the top of your head.

This is simply a proposal to direct Canadians who are in their darkest moment to an easy-to-remember 988 number that they can call to presumably get the same services that they would get if they could remember the number that already exists.

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

I think you and I know that suicide prevention is a life-cycle approach and that we actually need to do everything we can in terms of supporting people in mental health concerns throughout, whether it's wellness checks or whether it's all of the things that have had disastrous outcomes. We need to make sure we have a system that will work for Canadians and work in every part of the country—

[Mike Lake, Conservative, Edmonton—Wetaskiwin, AB]

But what—

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

Mike, when 911 came in, rural Canada was way, way behind, because they didn't have the capacity to actually be able to implement 911 at that time. We can't launch something if it won't be universal, and that's I think the work that CRTC is trying to do.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Lake.

Thank you, Minister.

That's a fascinating discussion, but we have to give other people a chance.

Next is Dr. Hanley, please, for five minutes.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you, Mr. Chair.

Thank you to both ministers and to the officials for appearing.

Minister Duclos, I'm really pleased that you could spend the time with us. The last time you were here, I asked about long-haul COVID or post-acute COVID. I'm glad to see that you already spoke to the importance of long COVID and the burden it is presenting to Canadians. I've certainly heard from constituents in Yukon with long COVID who are having some difficulty in accessing care or receiving a diagnosis. Health care provider knowledge in this area still appears to be quite limited and inconsistent.

I was wondering if you could describe what role you think the federal government should play in advancing progress and addressing the medical needs of and the support for patients with long-haul COVID and their families.

[Jean-Yves Duclos, Liberal, Québec, QC]

Thank you very much, Brendan.

I'm pleased to be able to have this discussion with you. Being a medical doctor and public health specialist, you know that in a pandemic there are eventually a lot more impacts than what we had thought earlier. One of these impacts is long COVID.

I mentioned earlier that the best estimate we have up to now is that between 10% and 30% of those infected with COVID will end up with long COVID. That means having up to 100 different symptoms affecting 10 different vital organs. A large number of these people have to either stop working or significantly reduce their hours of work. The estimate is that about 30% of those people affected need to stop working or stop studying; 70% of them need to reduce their hours of work or are absent. A large number—I think about 30%—will consult health care workers more than 10 times, so you see the impact on the health care system as well. All the human costs, the life costs and the tremendous economic costs obviously add up.

I would be glad to turn, if you want, to Dr. Michael Strong from CIHR. He's on the line and would be very pleased—and it would be very useful—to detail the type of research that CIHR is conducting to understand the nature and the impact of that other pandemic.

Dr. Strong, would you be able to do that?

[Dr. Michael Strong, President, Canadian Institutes of Health Research]

Yes, thank you very much, Minister, and thank you very much for the question.

As the minister has indicated, the consequences of COVID-19 for upwards of 30%, and higher in some populations, will be long-term. That is measured as greater than six months. No organ system is spared. The research that will be conducted going forward will be not only to develop the diagnostic criteria for some of these syndromes, so there can be clarity for the patient populations as to what needs to be treated, but also to clearly understand what the underlying basis of the disorders is.

It is not going to be the same for each target organ, as we look forward on this, so it's going to be complicated. These will be long-term studies that are internationally driven. CIHR will begin that process soon, through the commitments of the government for the $100 million for the long COVID research.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you.

Mr. Chair, if I may, I'll move on to Dr. Tam.

Dr. Tam, hello again and thank you for being with us today.

There has been a lot of talk from our colleagues, including in this meeting, on mandates and various public health measures and the lifting thereof. I would like to give you an opportunity to explain what we have learned and what we hope to learn from Canada's experience with vaccine mandates and passports.

How would we apply these learnings to either future waves or future viral threats?

[Dr. Theresa Tam]

Thank you very much for that question, Mr. Chair.

I think there is no denying that vaccines are extremely foundational to our response to COVID-19, and right now the National Advisory Committee on Immunization has provided recommendations, including up-to-date vaccination booster doses, particularly for the high-risk populations. I think it is really important that anyone for whom the booster is recommended and who is eligible get that at this point.

Increasing vaccination in the general population and in targeted ways requires a multipronged approach. I do think that when vaccine mandates were introduced by provincial and territorial governments, and also the federal government for its own area of rules and responsibility, they occurred at a time before omicron, when we saw extremely high vaccine effectiveness against both infection and severe outcomes. Omicron changed that picture, but we know there are certainly studies, including from Simon Fraser University, that show the initial impact, collectively, of the vaccine mandates that were implemented around mid-August, which saw an increase in coverage. But that's different in each jurisdiction, and I think that needs to be studied at a more granular level in terms of the impact of vaccine mandates.

Going forward, I think there is a movement, certainly in the provincial and territorial setting, to move from requirements to recommendations. That's going to be really all hands on deck yet again, using all kinds of techniques to improve vaccine confidence, providing the information that patients and individuals need, and that information has to be provided by credible sources, trusted by the community, including indigenous leaders and racialized communities and their leaderships.

I think there are multipronged ways in which we encourage, recommend and get people to get that additional dose. As the Minister of Health said, the number is not really very high. I am, though, encouraged that booster doses are quite high in the higher-risk populations, but I think in the 50-plus portion, we need to up our game on that coverage. I think all of this can be used—

[The Chair, Liberal, Sean Casey]

Can you wrap it up, Dr. Tam? We're a little past time.

[Dr. Theresa Tam]

Okay. All of this experience can be used, because vaccines are going to be useful in future pandemics. We can apply all of the experience of the last couple of years to future applications as well.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Tam.

We have Mrs. Goodridge, please, for five minutes.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Thank you, Mr. Chair.

To the Minister of Mental Health and Addictions, you repeated multiple times in your opening remarks that you're working to implement a safe supply of opioids. Can you provide any medical evidence that has been used to support these decisions?

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

Absolutely. We can show, really, the lives that have been saved, particularly now. We will be able, this week, to release what would have happened without safe supply or without safe consumption sites.

Also, Health Canada has approved diacetylmorphine as well. Fentanyl patches are being used at St. Paul's Hospital, in terms of overdose prevention sites. This is working.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Could you perhaps table any medical evidence that supports the use of safe supply?

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

Absolutely. I'm sure that CIHR and all.... This is saving lives, when you see what's happening. Even naloxone is not working for what is on the street. Because it's mixed with a benzodiazepine, it's a deadly cocktail that people are getting on the street. For people using drugs, there is no question that a safe supply is saving lives.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

In my home province of Alberta, they're actually doing a study right now on this very topic. Dr. Keith Humphreys, the chair of the Stanford-Lancet commission, which examined the North American opioid crisis, stated that there is no evidence that this approach will have positive outcomes and that there is significant long-standing evidence that the more opioids there are in the community, the more harm there is in the community.

I think that's very concerning.

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

Laila, I think it would be really good for you to talk to people like Petra from Moms Stop the Harm, in Edmonton. This is an organization of moms who have lost a loved one to a toxic drug supply. They are some of the most effective advocates for this, from all walks of life.

Also, to actually talk to some of the people using drugs, and the people who are—

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Thank you, Minister.

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

And 30,000 overdoses have been—