Health Committee on March 23rd, 2022

[Majid Jowhari, Liberal, Richmond Hill, ON]

Thank you.

You pointed out four recommendations as you were providing your testimony. The first one was around long-term funding. I just want to go back to the government record over the last six or seven years. In 2017, I believe, we allocated $5 billion over 10 years, and in budget 2021, there was an allocation of about $100 million over two years specifically around innovative mental health intervention for populations disproportionately impacted by COVID-19.

In your statement, you also had a caveat about how we have to work with provinces on a jurisdictional basis to make sure that these funds are properly allocated. Can you expand on that, please?

[Margaret Eaton]

Yes. We were delighted that the federal government had identified, a few years ago, billions of dollars to support mental health; unfortunately, we don't really have much information about how that money was spent. We know that there is underspending on mental health, and when we look at investment in community mental health, we see it's even lower.

We were very excited to see the creation of a mental health transfer and the opportunity there to fund community mental health through the mental health transfer. We're very excited by the idea that there would be standards set around mental health, and that those standards would be tied to this mental health transfer to ensure that community mental health gets funded, but also to ensure that there is a standard of care across the country, so that if you live in Newfoundland, you're going to get the same quality of care that you would get in Ontario. That isn't the case right now.

We're very excited to see standards and to see a much higher investment, particularly targeted and [Technical difficulty—Editor], if you will, to mental health investment.

[Majid Jowhari, Liberal, Richmond Hill, ON]

You talked about community mental health organizations. I also noticed that you put a report out in March 2022 that talked about burnout for these community-based health organizations as it relates to mental health. Can you briefly brief us on the findings?

[The Chair, Liberal, Sean Casey]

If you could briefly brief us, that would be helpful. Thank you.

[Margaret Eaton]

When we spoke to our branches across the country, people talked about the fact that the demands for service had gone so high that there were waiting lists in most of the areas we were looking at. At CMHA Toronto, there was a 300% increase in demand for youth programs. At CMHA Edmonton, there was a 200% increase in calls just related to income support and employment needs.

What our CMHA workers found was that they were being asked to do things way beyond mental health. They were asked to help provide food. They were volunteering at vaccine clinics. They were doing everything they could to make sure their communities were healthy and cared for. Because our community mental health organizations are underfunded at the best of times, it just means that this incredible demand, with phones ringing off the hook, has led to burnout for a lot of our workers.

If we look at nurses who work for CMHA, we see that they are underpaid, compared to hospital-based or private nurses working in mental health care. We have underpaid, overworked health care workers in mental health, and we believe that things like investment in community health would go a long way to mitigate that.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Eaton.

Thank you, Mr. Jowhari.

Mr. Thériault, you have the floor for two and a half minutes.

[Luc Thériault, Bloc, Montcalm, QC]

Thank you, Mr. Chair.

Ms. Langlois and Ms. Lelièvre, what is your assessment of the position, if any, or the posture of the Canadian government on the issue that you have shared with us about the WTO? In other words, in the last two years, has the government walked the talk?

You also told us about the problems in relation to the supply chain and that the infrastructure was sometimes non-existent.

What more should the government do to make its contribution match your expectations?

[France-Isabelle Langlois]

Canada's position at the WTO is supposedly one of neutrality. However, according to Amnesty International, it is more of a blocking position. In actual fact, it does not help the temporary lifting of patents, which is really needed. There needs to be transparency in terms of revenue and other technologies, whether it's vaccines or any other product, to reach as many people as possible.

Also, as my colleague Ms. Lelièvre mentioned, it is not true that Canada is doing nothing. It is participating in the COVAX mechanism. It could participate more, but above all, it should keep its promises and play a leadership role on the international scene when it comes to deploying logistics. While we talk about lifting patents and almost exclusively about vaccines, the logistics are not being put in place in the countries that need them so that any treatment, including but not limited to vaccines, can be deployed and made accessible to the population. Education is needed to convince the population to use the vaccines or treatments that will be offered to them.

Ms. Lelièvre, would you like to add any comments?

[Colette Lelièvre]

May I add something, Mr. Chair?

[The Chair, Liberal, Sean Casey]

Yes, but please be brief.

[Colette Lelièvre]

Certainly.

Canada could also support the health systems of countries with which it works on international development. This would allow these countries to prepare for the equitable distribution of vaccines in their own countries. This means providing sufficient support for personnel to ensure that there is adequate delivery within the country. It also means ensuring that the cold chain is maintained.

Substantial support from the Canadian government could certainly help ensure that health systems have the capacity to respond quickly, if need be, when they are going to be able to receive vaccines or access treatments.

Thank you.

[The Chair, Liberal, Sean Casey]

Thank you.

Mr. Davies, you have two and a half minutes.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

Dr. Warshawsky, we know that vaccines wane. I've already mentioned European regulators stating that we can't boost our way out ad infinitum and that, potentially, boosting may cause tolerance—I think that's one of the terms they use—long-term. Assuming that the boosters wane over time, what's the long-term game plan after that?

[Dr. Bryna Warshawsky]

Currently, as you know, the manufacturers are including different variants in their vaccines. In the next few months, we may see different variants included. They're looking at the original strain, the wild-type strain, and potentially the omicron strain. That's the nearest strategy.

As mentioned, we're also looking at other types of vaccines. Mucosal vaccines, which are delivered in the nose or in the mouth, will potentially enhance the vaccine protection that we get from an injectable vaccine and provide more protection against infections.

This research is all ongoing. We need to take each wave as it comes and the epidemiology as it comes to see what products are available. NACI will then make its recommendations, keeping all of that information in mind.

[Don Davies, NDP, Vancouver Kingsway, BC]

What's the current state of knowledge about efficacy three months out, say, after a booster? I got my third booster in January. What would you expect my efficacy to be three months after that?

[Dr. Bryna Warshawsky]

That's a very good question.

With regard to infection, the booster gives you around 60% protection against infection, but over time, so about three months later, it will have fallen. Exactly what it will be, we don't know; it may be 40% or it may be 30%.

Most importantly, it's about severe disease. We are really vaccinating to prevent severe disease. That's the main goal. If you talk about promoting vaccines for people, it's about keeping—

[Don Davies, NDP, Vancouver Kingsway, BC]

I know that's why, Doctor, but how long would that last? In June, I'm six months out after being boosted. What is the efficacy of the vaccine to prevent me from serious illness at that point?

[Dr. Bryna Warshawsky]

We know that once you're boosted, you get into the high nineties in terms of protection against severe disease. We know that, for the most part, it seems to last a number of months, but we don't have data for months and months and months.

With regard to three months out, for the most part the studies are still showing good protection, mostly 70% or higher, and many still in the eighties and nineties, but we need to go out longer to see what the protection for the longer term will be.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thanks.

Dr. Kalyan, perhaps I can give you the last word on—

[The Chair, Liberal, Sean Casey]

Mr. Davies, you're out of time. I'm very sorry.

[Don Davies, NDP, Vancouver Kingsway, BC]

That's okay. Thanks, Mr. Chair.

[The Chair, Liberal, Sean Casey]

We're trying to get a sprint to the finish to get the last two rounds in.

Dr. Ellis, you have the floor for five minutes.

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

Thank you, Mr. Chair. I appreciate that.

Ms. Eaton, we did delve a bit into the mental health issues associated with the stress of COVID and the mandates and lockdowns, etc. We talked about the chronic stress that Canadians are under. One of my questions is related.

If the government had a plan going forward with respect to federal mandates, do you think that would go some distance to alleviating the stress that Canadians are feeling chronically at the current time, and leadership?

[Margaret Eaton]

Sorry, just to clarify, if the federal government...?

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

If they had a plan, or communicated a plan to Canadians with respect to federal mandates, do you think that would go a long way toward alleviating stress? Or am I off base there?