Health Committee on March 21st, 2022

[The Chair, Liberal, Sean Casey]

Thank you, Minister, and thank you, Mr. Barrett.

Dr. Powlowski, you have five minutes, please.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

If I may, I will direct my question to Dr. Tam.

Now, the progressive conservatives would like a date on which we're going to lift the mandates. I think they figure that we're going to base this on some arbitrary decision, like my mother's birthday, or maybe Mr. Duclos' wife's birthday, or Fidel Castro's birthday, or something like that.

[Michael Barrett, Conservative, Leeds—Grenville—Thousand Islands and Rideau Lakes, ON]

On a point of order, Chair, I'm wondering if Dr. Powlowski is speaking about provincial progressive conservatives, or progressive conservatives in a provincial legislature, because in the House of Commons, there's only one conservative party. That's the Conservative Party of Canada.

[The Chair, Liberal, Sean Casey]

I'm sorry for that interruption. Go ahead.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Well, we certainly realize that you're not progressive.

Mr. Barrett, to give him credit, wasn't asking for a date. He was asking us for benchmarks on which we're going to base our decisions. Now, I'm pretty sure we aren't making our decisions arbitrarily on when we're going to drop the mandates. I think it's obviously based on complicated things, on modelling. Even though I, too, have a Master's of Public Health, I don't even understand things like regression analyses and how they work.

I think the Canadian public wants, and I think we all want, the government to be basing its decision on something other than dumbing it down, because in Parliament, that's what we do: We dumb it down. But I don't think we want our policy decisions with respect to health and the pandemic to be dumbed down.

I'd like to give you an opportunity in a couple of minutes to explain it. I want you to explain it in a technical fashion, because I think that's what we base our decisions on. Some of us in this room are doctors. Feel free to maybe go over our heads in describing this. What is modelling, and when you're doing the modelling, what is it based on? Presumably it's case rates. Presumably it's based on hospital admissions and ICU admissions.

Just give us a bit of the hard science on this, please.

[Dr. Theresa Tam]

Thank you for that question.

Mr. Chair, as you and many who watch the media briefings or the press conferences will know, we've been providing modelling information on a regular basis. There are different types of models. There are ones that are longer-term, but only good for, let's say, a month's time frame, where we input, through surveillance and epidemiological data, some forecasting on the case trajectory but also on hospitalizations, as well as projections on mortality. Those are important if you are thinking about adjusting policies. Are the cases going up? How fast are they going up? Are they coming down and at what rate? What might the impacts be?

Our last modelling certainly would suggest that, with the lifting of provincial public health measures, there could be some resurgence, particularly in the context of a very highly transmissible variant. We are watching that very carefully right now, because the cases are plateauing as they are coming down. They may be at a point of resurgence. We do want to know that the hospitals are not being impacted as that resurgence occurs and feeds into some of the federal decisions.

We also have other types of models that are used for planning purposes. They input a number of variables that include vaccine uptake and vaccine effectiveness. They don't as yet include waning immunity, but all of those models tell us something about how we should strengthen booster doses and look forward to the timing of those and what might happen in terms of provision of those models in the slightly medium and longer term.

Vaccine effectiveness, uptake and all that is taken into account as well. Then there's the international epidemiology and, as many people have seen, there's a resurgence of cases in many areas of the world at the moment.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

When you are doing the modelling and making your decisions about things like mandates, the primary things you want to avoid are hospitalizations, deaths and ICU admissions. Is that what basically determines policy in terms of when you're going to bring an end to the mandates?

[The Chair, Liberal, Sean Casey]

Please give a short answer, if you can, Dr. Tam.

[Dr. Theresa Tam]

Absolutely, but policy-makers also need data on the effectiveness on reducing transmission and infection on top of severity and on top of trajectories on vaccine uptake as well and what difference a mandate might make.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Tam and Dr. Powlowski.

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

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you to our guests here today answering these difficult questions.

Through the chair, is the Minister of Mental Health and Addictions aware of the unregulated sale of cannabis on reserves, especially in Nova Scotia?

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

Of course, it would be Minister Hajdu who will deal with that through the first nations and Inuit health branch in terms of what they are trying to do to keep people well.

On first nations, it is about the first nations leadership having governance for themselves and often policing. If you have a concern about that, please let us know and we'll respond.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Great. Thank you, Minister, for that. I appreciate it.

Through you, Chair, to the Minister of Health, we've talked extensively about mandates here today. I'm curious to know.... There doesn't seem to be an answer about the mandated nature of a third shot for COVID. Is that in the works?

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

There are two angles to that. First is the connection between policy and vaccination status. Second is the value of vaccination status around a third dose.

If you want, we can turn to Dr. Tam for evidence on that.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

That's okay, sir. Thank you for that.

I have another question for you, sir. Prior to the pandemic, it was very clear that hospitals in Canada, both in my home province of Nova Scotia and certainly here in Ontario, functioned at between 90% and 130% capacity. We've heard previously from some witnesses here that the mandates will continue until hospitals are not affected.

You're an economist, sir. I wonder how that's mathematically possible.

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

I'm going to answer in French, because I express myself a little better in that language.

Of course, in no way are we aiming to return to a system in which people with COVID‑19 would not receive care.

I'd like to give you an example, however. In Quebec, a few weeks ago, because of the very high number of hospitalizations, the offload delay rate in the health care system was 80%. In other words, 80% of the usual operations were not possible because of the number of hospitalizations related to COVID‑19.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you, sir.

We've talked a lot about COVID and the effect it's had on our communities. We also know that measles is a very deadly and very contagious illness. Can Canadians expect childhood vaccines to be mandated in the future, sir?

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

That's an excellent question.

We might all benefit, including myself, possibly, from turning to the deputy minister or perhaps even Dr. Tam. Dr. Tam would be well equipped to answer that question around measles and vaccination strategy.

[Dr. Stephen Lucas]

It's over to you, Theresa.

[Dr. Theresa Tam]

Measles is a very contagious childhood disease, but the vaccines are very effective, to the extent that the elimination of measles is now a global priority. It is really important for people to keep up to date with the vaccination. It may have been delayed due to COVID itself, so it's really important to catch up. The provinces and territories are, in fact, responsible for any of those vaccine policies.

In Canada, there's no specific mandating of measles vaccination, but jurisdictions vary in their requirements. Some require the provision of measles vaccination status for school entry, for example, but that is not within the federal jurisdiction.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you for that, Dr. Tam.

I have one final question for the Minister of Health.

Sir, to be clear for Canadians—a simple answer of yes or no—is there a plan for ending federal mandates?

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

It depends what we mean by mandates. There are mask mandates, vaccination mandates, testing mandates....

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Sir, I mean just the federal ones.

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

There's a large range of policies and mandates. I would be dishonest, and I don't think you would appreciate it, if I were to give you a yes-or-no answer.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

I'm sorry, sir. Is there a plan for the ending of federal mandates? I guess that's the question.