Evidence of meeting #14 for Health in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was pharmacies.
A recording is available from Parliament.
Associate Professor of Medicine, University of Toronto, Staff Physician in Infectious Diseases, Toronto General Hospital, As an Individual
Vaccines are extremely safe and effective.
Conservative
Mike Lake Conservative Edmonton—Wetaskiwin, AB
Okay.
You talked about masks. We live in a real world where some jurisdictions are removing mask mandates, and some people just don't want to wear masks and they're not going to.
Setting aside masks, as you're very clear on the science around masks, and many experts are, what other things can people do to stay safe in their homes? When they're indoors, what other advice would you have beyond just masks?
Associate Professor of Medicine, University of Toronto, Staff Physician in Infectious Diseases, Toronto General Hospital, As an Individual
Going back to my last statement, I would say that the vast majority of people in medicine and science would say that the vaccines are safe and effective; and you have a small but very vocal group suggesting otherwise.
Getting to your more recent question, masks, of course, are helpful, but we have other tools that are also very helpful in creating safer indoor spaces.
Rapid testing, and rapid testing before going into an indoor space, is very helpful. Creating better ventilation in indoor spaces is also a helpful tool. Vaccination, of course, while not perfect in reducing the risk of infection, does lower one's risk infection, just not to the same extent as it did with earlier variants.
Those are all helpful tools to create a safer indoor space. These are multi-layered tools. No one tool is perfect, but when you add them all up, you have a synergistic effect.
Conservative
Mike Lake Conservative Edmonton—Wetaskiwin, AB
I'm going to try to get the most out of my time here.
Moving to testing and therapeutics, if you test and you test positive faster, it sounds as though the therapeutics have more effect, obviously, if you take them sooner. In a theoretical world where everybody testing positive tests positive right away, would everyone benefit from a therapeutic?
Associate Professor of Medicine, University of Toronto, Staff Physician in Infectious Diseases, Toronto General Hospital, As an Individual
No. It really is the highest risk at this point in time. That's key, getting the high-risk individuals timely access to those therapeutics.
Conservative
Mike Lake Conservative Edmonton—Wetaskiwin, AB
I think there are lots of misconceptions around testing. How accurate are the rapid tests now?
Associate Professor of Medicine, University of Toronto, Staff Physician in Infectious Diseases, Toronto General Hospital, As an Individual
It's hard to give a number, because the rapid tests answer the question, “Am I contagious?” and not “Am I infected?” They answer the question, “Am I contagious right now with COVID-19?”
They're actually very good at addressing that question. You might be a positive case but not contagious to others because you haven't built up enough virus in your system, and your rapid test will be negative. Again, the test answers the question, “Am I transmissible to other people?” It's very good at doing that.
Conservative
Mike Lake Conservative Edmonton—Wetaskiwin, AB
Is it accurate to say that the thing that registers on the test is the same thing that makes you contagious to people? Is that a simple way of thinking about it?
Associate Professor of Medicine, University of Toronto, Staff Physician in Infectious Diseases, Toronto General Hospital, As an Individual
Sure. We'll go with that.
Conservative
Mike Lake Conservative Edmonton—Wetaskiwin, AB
Thank you. I'm now a medical expert.
Is there a value to serological testing right now?
Associate Professor of Medicine, University of Toronto, Staff Physician in Infectious Diseases, Toronto General Hospital, As an Individual
You can ask 20 people and get 20 different answers.
I'm a little disappointed in serology. I think it does have some utility, but it has less utility than we thought. It's really good more in epidemiologic studies, looking at the burden of COVID in different communities and how that changes with time. It's less helpful—not not helpful, just less helpful—with meaningful clinical decisions.
Liberal
The Chair Liberal Sean Casey
Thank you, Dr. Bogoch and Mr. Lake.
Next we have Ms. Sidhu, please, for five minutes.
Liberal
Sonia Sidhu Liberal Brampton South, ON
Thank you, Chair.
Thank you to all the witnesses.
My question is for the Neighbourhood Pharmacy Association and Ms. Hanna.
For several years pharmacists have been advocating for an increased role as primary care providers, including having prescribing authority for certain conditions and medications in some remote communities. Pharmacists may already be the closest resource primary care provider. How do you see this playing a role in addressing the human resources concern in the health care system? What do you see?
Chief Executive Officer, Neighbourhood Pharmacy Association of Canada
Thanks for the question.
We think it's incredibly important. As we talked about before, there are many backlogs in the system, whether in primary care, public health or immunization. As pharmacies expand their role in primary care, by prescribing whether it's for common or minor ailments.... The majority of the provinces across Canada are already prescribing for these. There are a couple provinces that are still lagging in terms of pharmacists' ability to prescribe for some of the common ailments. We're talking about things like allergic rhinitis. We're talking about things like diaper rash or cold sores, or uncomplicated bladder infections. Pharmacists are prescribing for these things in many provinces, but still a number of provinces do not give pharmacists the ability to prescribe.
Given that authority, we'll be able to help distribute the burden of care among the many providers we have in the system. If somebody's experiencing symptoms of some of these common conditions on a weekend or in an evening, they may be going to the emergency room for that. Is that the best use of our health system resources? Likely not. It's much more costly, and they can be much better dedicated to somebody with more severe concerns.
Liberal
Sonia Sidhu Liberal Brampton South, ON
Thank you.
My next question is for Dr. Bogoch.
Dr. Bogoch, could you speak to the importance of waste-water surveillance in monitoring the spread of COVID-19? What trends are we seeing in waste water in recent weeks?
Associate Professor of Medicine, University of Toronto, Staff Physician in Infectious Diseases, Toronto General Hospital, As an Individual
Thank you. That's a great question.
The waste-water surveillance is an extremely helpful tool, especially when we don't have access to widespread community testing. It gives us an early signal as to where COVID-19 might be on the rise, or actually on the decline—although unfortunately we are seeing it on the rise in many jurisdictions. It's a way to look at early signals for COVID changes over time, plus tracking the geography of where those changes are occurring.
It's proven to be an extraordinarily helpful tool, not just here in Canada, but elsewhere in the world.
Liberal
Sonia Sidhu Liberal Brampton South, ON
Thank you.
The next question is for Dr. Falcone.
Dr. Falcone, you said that we need forward thinking, an efficient infrastructure and a standardized protocol for chronic disease. Can you elaborate on that?
Director, Post-COVID-19 Research Clinic, Montreal Clinical Research Institute, Attending Physician, Infectious Diseases, Centre Hospitalier de l'Université de Montréal, As an Individual
Yes. I think that when it comes to really understanding complex diseases, we really need to arm ourselves with objective data, which is often what is lacking in these types of circumstances for the diagnosis, and then eventually for the management of these patients.
Having a structure where we have several centres involved, where we could not only harmonize our data collection, but also pool it together or integrate it would be a lot more powerful at getting at meaningful tools like diagnostic biomarkers and potentially therapeutic targets that we could put into clinical trials.
Liberal
Liberal
Sonia Sidhu Liberal Brampton South, ON
Thank you.
My next question is for Dr. Edmonds.
Dr. Edmonds, in 2021, the federal government expanded caregiver benefits through the EI program. Could you share with this committee the specific impact you saw over the last year as a result of this measure?
Executive Vice-President, Mission, Research and Advocacy, Canadian Cancer Society
I'd like to turn to my colleague to answer that one.
Vice-President, Advocacy, Canadian Cancer Society
Thank you for your question.
The Canadian Cancer Society pays close attention to the supports that are available for caregivers, as well as for people living with cancer. We are focusing our attention now on the need to increase the employment insurance sickness benefit.
I'd like to take the opportunity to thank the government right now, as well as all parties around the table, for supporting the extension of the employment insurance sickness benefit.
We're also taking time to pay attention to the needs of caregivers in a time when their loved one has passed away. This current government has also given additional supports for grief and bereavement.
While I know I haven't answered your question specifically, I will get back to you with a better answer. Those are two measures of supports that we have seen over the last short while that will have a long-lasting and positive impact on people living with cancer and their family members.
Thank you.
Liberal
The Chair Liberal Sean Casey
Thank you, Ms. Masotti, and Ms. Sidhu.
Colleagues, we have now reached the 6:30 eastern time, so I'm going to ask whether it is the will of the committee to now adjourn. While we're determining whether that is the will of the committee, I will ask the witnesses to hold tight. We want to give you a proper goodbye if this is goodbye.
Is it the will of the committee to adjourn the meeting at this point?
I'm hearing from the clerk that we have a consensus in the room.
Before we adjourn, there are two things.
First of all, to the Bloc Québécois and to the Conservatives, could you suggest some more witnesses to us for the COVID study? We're running low on the witnesses from those two parties.