Health Committee on May 2nd, 2022

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Garon.

Next is Mr. Davies, please, for two and a half minutes.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Mr. Chair.

Dr. Tam, last week WHO Director General Tedros Adhanom Ghebreyesus said the following at a press conference:

As many countries reduce testing, WHO is receiving less and less information about transmission and sequencing.

This makes us increasingly blind to patterns of transmission and evolution.

But this virus won’t go away just because countries stop looking for it.

It’s still spreading, it’s still changing, and it’s still killing....

When it comes to a deadly virus, ignorance is not bliss.

WHO continues to call on all countries to maintain surveillance.

Dr. Tam, given that many provinces and territories scaled back access to PCR testing after the emergence of omicron, do you believe that Canada currently has a sufficiently robust system in place to monitor COVID-19 activity and the emergence of new variants of concern?

[Dr. Theresa Tam]

Thank you for the question.

I think, yes, the number of tests—and by that, I mean PCR tests—being done around the country has been reduced, but of course rapid tests have come into play. We don't have samples from those rapid tests in order to look for variants or sequencing, but there are quite a lot of samples being done every day from which we can do sequencing.

We are still sequencing at quite a high rate—at a rate at which we can detect more rare variants—but we need to keep this up. Of course, at the wastewater surveillance, we can actually, on top of doing viral copies, use metagenomics to look at variants in the wastewater.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Dr. Tam.

Dr. Tam, you touched on this a bit in my last round. I'm curious about whether the protection offered by mRNA vaccine third-dose boosters is waning at a rate similar to second doses.

[Dr. Theresa Tam]

We of course have to observe this over time, because many people got boosted more recently. What we're seeing is that third doses do increase protection against infection or symptomatic disease and, therefore, transmission, but that does decline over time. We're just trying to plot to see how fast that waning occurs. We need a bit more time, but it does decline so you can still potentially get infected.

The vaccine effectiveness against severe disease was boosted to very high levels of over 90%. Even over time that just gradually decreases, so we need more time to figure out the duration of protection. It does seem to be quite good at the moment, but we'll certainly provide further updates as time goes on.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Tam and Mr. Davies.

Next we have Ms. Goodridge, please, for five minutes.

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

Thank you, Mr. Chair.

Thank you to all of the witnesses. It is wonderful to have you appearing before committee.

One of the biggest questions I frequently get in my constituency office, in my beautiful riding of Fort McMurray—Cold Lake, are questions as to when we are going to see mask and vaccine mandates for the federally regulated sectors removed. I know we've had many people ask questions about what the targets are, but I'm wondering what you think I should be telling my constituents when they call and ask those questions.

[Dr. Harpreet S. Kochhar]

As I mentioned earlier, for the federal vaccine mandate, for example, the Treasury Board of Canada is responsible for the policy on vaccinations for the public service. Again, all the elements of the policy and other public health aspects are being reviewed by them. This is all based on science and advice—

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

That's fantastic for the public servants, but for me in my riding, being a northern riding, we basically have to fly to get just about anywhere. There are requirements by the federal government and PHAC that require proof of vaccination.

For people who want to go to a funeral in Toronto, if they're not vaccinated, they can't go. They're really curious to know when you are going to update this, because no other allied country is requiring people to be vaccinated to travel within their own country. Are there any targets in place for that?

[Dr. Harpreet S. Kochhar]

What I can say is that we are continuously evaluating the epidemiology, the vaccination coverage and what other public health layers can provide the protection. This is an active conversation that we are having in terms of the public health advice as we move forward, so that particularly science-based decisions can be made on that.

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

That's fantastic, but just so you are all aware—and I'm going to share this—it is more than 3,600 kilometres to get from Fort McMurray or Cold Lake to Toronto. I'm going to use Toronto as an example because you are aware of that. I have numerous constituents who contact me because they want to go.... They're not typically from those communities. They're from somewhere else. Unfortunately, they'll have parents who get sick and they need to get on a plane, but because of the rules of this government, they can't go visit their parents in their dying days.

I'm asking for some compassion and understanding. Many people in rural and isolated communities have different needs from those in urban centres. They can't just get in a car and quickly get there. This is really impacting the lives of everyday Canadians in communities like my riding, and all across northern Canada.

Can you do anything special to make sure that this is being considered?

[Dr. Harpreet S. Kochhar]

My heart goes out to those communities who are unable to attend to the family and other aspects of their daily life. We are committed to providing that advice to get to the point where we can have an appropriate decision, based on the public health guidance, as well as the ability to still protect the population from the transmission of COVID-19. We continue to work towards that goal.

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

Could you, at the very minimum then, perhaps look at simplifying the process for people who have medical exemptions, who have been exempted by doctors, physicians? I have one constituent who is a nurse and has an anaphylactic allergy to vaccinations. The process that was required to be able to get on a plane was so onerous and time-consuming, she almost missed her father's funeral. This is someone who has served us as a nurse on the front lines throughout the entire pandemic.

These mandates are completely heartless. Can you at least look at something to perhaps provide more clarity for those with medical exemptions?

[Dr. Harpreet S. Kochhar]

Again, we continue to work with our colleagues, with Transport Canada, which has the mandate also in terms of domestic flights. We continue to provide that kind of advice so that the decision can be taken to appropriately support and assist any of those situations.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Goodridge and Dr. Kochhar.

Next we're going to go to Dr. Hanley for five minutes.

Go ahead, please.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you, Mr. Chair.

Is Dr. Njoo still with us? Yes.

Dr. Njoo, just to perhaps mix it up a bit and change the theme, I'm just wondering what, to your mind, are some of the infectious disease priorities that may have suffered as a result of our necessary focus on the pandemic over the last two years. Also, how is the agency looking to address some of the backlog of work in some priority areas of infectious disease?

[Dr. Howard Njoo, Deputy Chief Public Health Officer and Interim Vice President, Infectious Diseases Programs Branch, Public Health Agency of Canada]

Thank you very much for the question, Mr. Hanley.

I can say yes. It's not just for infectious diseases. There have been many what I would call unintended consequences and a lot of collateral damage obviously as a result of the COVID-19 pandemic in terms of people accessing health services for other infectious diseases as well as obviously for a whole host of what I would say are non-communicable diseases—mental health, etc. We all know that. The opioid crisis is also obviously a very important priority.

For infectious diseases, I would say that the ones that have probably suffered the most, which we need to get back on track, are the ones that I think are unduly, disproportionately affecting vulnerable populations, those who are marginalized, who are racialized and who are not able to have the same resources to deal with certain infectious diseases as are perhaps many of us who are more fortunate.

For example, I would point out tuberculosis. Certainly the burden has been borne unduly by, for example, indigenous populations especially in the north and by the Inuit. We continue to work with them, but obviously in terms of the effort, we have had to take away from those scarce resources to deal with COVID-19, and addressing something like tuberculosis is certainly something we need to get back on track.

There are also what I would call the sexually transmitted, blood-borne infections, such as HIV/AIDS. The global pandemic that's been long lasting certainly isn't going away, and we need to get back to addressing HIV and all the other sexually transmitted, blood-borne infections.

Finally, I would say that another priority, which we're making headway on but which is certainly something we need to pay much more attention to in the future, is antimicrobial resistance. COVID-19 is the current very real pandemic, but I would say that may become a slower-moving pandemic if we don't pay attention. You can see even the WHO has listed it among its top 10 threats as being something that's going to affect us down the road. Can you imagine living in a pre-antibiotic era, if that were to return to Canada, in which we were not able to use antimicrobials, antibiotics, in a way that we're so used to doing at the present time?

Just in a nutshell, those are some of the infectious disease issues we're looking at. Of course I could go on and on. There are also things like climate change and how climate change is affecting infectious diseases in terms of the spread and distribution of vectors. Lyme disease and others certainly have a much wider range now, and more Canadians are being affected because of climate change.

You can see that there is a wide scope, and we intend to start addressing other infectious disease threats in addition to dealing with COVID-19 at the present time.

Thank you.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you very much.

I'm glad you mentioned antimicrobial resistance, because it's certainly something we cannot turn our attention away from.

This is a question for, perhaps, Ms. Evans.

I notice that in budget 2022 the agency has been designated over $400 million related to surveillance and risk assessment. Given that this is Emergency Preparedness Week, I wonder if you could talk about how this funding might help to strengthen surveillance with a view to managing and responding to and preparing for potential future phases of this pandemic but also, equally as important, potentially other infectious disease threats and pandemics, as quickly as you can.

Thank you.

[Cindy Evans, Vice-President, Emergency Management Branch, Public Health Agency of Canada]

Thank you for the question.

You've referenced, certainly, the funding in budget 2022, which will cover a broad range of activities. We are quite pleased with respect to some of the steps we'll be taking in terms of the early warning systems we have, and we will be advancing a number of the issues that were raised in that external panel report.

Certainly more broadly within the agency, as has also been raised, there is an interest in having more integrated risk assessment. That's some work we will be able to advance through those investments that have been articulated. As well, we will be looking broadly and horizontally across our surveillance programs to further advance those.

Thank you.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Hanley and Ms. Evans.

Colleagues, we have now completed two full rounds of questions. I'm advised that there are some members who have other obligations they are anxious to get to, so we're in a situation where we have three options.

We can entertain a motion to adjourn now, or we can agree to continue on as we do have the room. We do have the administrative support.

A third option that you may not have considered is to continue on with what's called a reduced quorum. For those who absolutely have to leave, they can, with the assurance of knowing that we're operating under the rules of a reduced quorum, which prevents any motions from being presented except for a motion to adjourn.

I'd be interested in taking the pulse of the room as to whether you wish to wrap, to continue or to continue under a reduced quorum. We do have the resources, but we have people with scheduling challenges.

Go ahead, Mr. Barrett.

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

Thanks, Mr. Chair.

If there were unanimous consent for a reduced quorum to be in effect, I think that would satisfy the issues of Conservative members.

[The Chair, Liberal, Sean Casey]

Do we have agreement to continue for one further round of questions with a reduced quorum?

I have Mr. Davies.

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Chair, before I can answer that, I'd like to get some shape around what we're talking about. The committee would go until when...? The Bloc and I have only ourselves here. We'd like to have other people to....

[The Chair, Liberal, Sean Casey]

My understanding is that we have support until as late as 6:30. I would suggest that we simply complete one more round of questions. That would be 24 minutes from now, if everyone stays on time.

[Don Davies, NDP, Vancouver Kingsway, BC]

How is that divided? Do you mean that each party gets six minutes?