Health Committee on June 13th, 2022

[Dr. Eric Arts]

I'll take the first stab at that, if nobody minds.

You're right. We can't estimate the actual percentage. Right now all we have to go by is waste-water surveillance to estimate the rates in the population at this point. I would suspect, from modelling data, that it probably is close to 30% of the population who have been infected now.

I don't think the percentage is the important point. It is the severity of the cases that we see and the number, in the end. I say this because we can all agree that if 10 million people were infected, then the impact on society would be quite devastating. I don't like to be a doomsayer; I'm always on the side of someone who says, I think it's not as bad as we all think it is. But in particular, I look at severe cardiovascular events and also these cognitive impairments. That, to me, is the gravest concern. We struggle already in our health care system in dealing with dementia, Alzheimer's and Parkinson's. I think that's where the difficulties lie.

The last point I'll make is that I had it. I'm not one, as well, to acknowledge symptoms, but I was out for at least a month and a half, and that was with delta. That was prior to my ability to get vaccinated; it was too early for me. It took me quite a long time to recover, and I still have some minor effects. Now, is it debilitating? No, not for me. I had to do a pretty busy work schedule. But if it is mild, in my case I can see how it could be more severe in others. That's anecdotal.

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

Thanks.

I want to get one more question in, namely, whether either the vaccine or the treatments reduce the incidence.

Either Dr. Falcone or Dr. Arts have said that, no, there isn't a correlation, meaning that people who have more severe COVID are more likely to have long COVID.

I'm not sure which of you mentioned a recent study from Harvard and the University of Pennsylvania finding that 40% of people on ventilators had a cognitive decline. Again, anecdotally if nothing else, certainly among the general population you're not getting anywhere near as much as 40%. Is there not some inclination that there is a correlation? Certainly the English found it. But now in more recent studies, isn't part of the problem that we don't know the denominator in mild COVID as to what percentage of the population have had it, whereas we do know the denominator with severe COVID, because we know who's been in the hospital and who's been in the ICU?

[The Chair, Liberal, Sean Casey]

Give a brief response, if possible. Dr. Powlowski has used up all of his time posing the question.

[Some hon. members]

Oh, oh!

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

Let me ask Dr. Falcone, since I'm [Inaudible—Editor].

[Some hon. members]

Oh, oh!

[The Chair, Liberal, Sean Casey]

Answer succinctly, please.

[Dr. Emilia Liana Falcone]

I agree. The fact that we don't know the denominator makes it very hard to estimate the prevalence, but even if it's a couple of per cent, with such a large denominator, it's potentially a huge number of individuals.

[The Chair, Liberal, Sean Casey]

Thank you very much, Dr. Falcone.

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

[Jean-Denis Garon, Bloc, Mirabel, QC]

Thank you, Mr. Chair.

I'll try to be briefer than my colleague Mr. Powlowski.

There has been a lot of discussion today about the research findings, and it was very interesting. I'd like to talk a little bit about research funding.

Dr. Falcone, has the COVID‑19 crisis changed the way we think about clinical research?

Should we change the way we fund clinical research, so that we are better able to respond quickly to public health crises as serious as the one we've experienced?

[Dr. Emilia Liana Falcone]

I think the research response has still been good in the context of this pandemic. However, we have seen that COVID‑19 was very surprising. It only surprises us. Sometimes you need to be open to slightly new hypotheses, which may not be based on the same preliminary data.

It is with this in mind that some funds could be earmarked for projects that have a slightly higher level of risk but can be very profitable, especially in a context where you need to mobilize quickly.

[Jean-Denis Garon, Bloc, Mirabel, QC]

If I understand correctly, you are talking about special funds that would be used in extremely serious and urgent situations. A number of criteria would allow funds to be released very quickly. This process could run in parallel with regular research funding.

To better understand, I would like to know what mechanism would be implemented to fund this clinical research.

[Dr. Emilia Liana Falcone]

It could be a somewhat parallel mechanism.

[Jean-Denis Garon, Bloc, Mirabel, QC]

The next question will be my last, since I have only about a minute left.

Earlier we talked about the denominator and the prevalence.

Should we be concerned in the long‑term about the impact of long COVID‑19 on the workforce? In Quebec, for example, we are facing a labour shortage. There are also pressures in hospitals, and this is linked to inadequate funding of the health care system, particularly by the federal government.

Do you have the same concerns in this regard?

[Dr. Emilia Liana Falcone]

Yes, I also have concerns, especially with long COVID‑19 because the duration can be quite variable. The symptoms can persist for months, or even years. In our clinic, we see people who, more than two years after having an acute infection, are still suffering from sequelae and are unable to return to work.

[Jean-Denis Garon, Bloc, Mirabel, QC]

Thank you very much.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Garon.

The last round of questions is going to Mr. Davies, please, for two and a half minutes.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

I'm not sure who is the right person to ask this of, so it's for whomever feels they can answer. Is long COVID impacted by the particular variant? Is it linked at all to, let's say, the omicron versus the delta variant or any previous version?

[Dr. Eric Arts]

It's going to be very difficult to assess in past clinical studies, because too many people did not have the information on what strain they were infected with. However, we do know, based on time periods, the likelihood of your being infected with one type of variant versus the other, so those assessments can be made. Yes, there are large cohort studies that could be used to assess that information, although they create a bit of an epidemiological study nightmare, but I think some things will work out in understanding that better.

One thing we do know is that omicron, for example, and delta were pretty distinct variants in terms of their population size and when they occurred, so that we have pretty understandable data, but those—

[Don Davies, NDP, Vancouver Kingsway, BC]

I'm sorry, I'm going to stop you there. I think I have the answer.

I want to give the last word to Ms. Goulding. I think it's so important that we hear from patients, particularly when we're dealing with a new phenomenon.

The last word goes to you, Ms. Goulding. What would you like the federal government to know first and foremost and what thoughts would you like to leave us with, as you are a representative of many people suffering from long COVID across the country?

[Susie Goulding]

I think it's important to recognize that the pandemic isn't over. It's not nearly over. With all the new waves and variants, long COVID continues. More people are joining our groups. When is this going to end? I think it's really urgent to understand the fast nature of how we need to get on top of this while we can. It's just compiling. The numbers are growing. This is an urgent situation that needs to be brought to the top of the criteria. People are really suffering here.

We don't want to see this happening to more people. We need to understand what is happening. We need to help our researchers, again, funding their efforts in perhaps different ways from what we're used to. It's very frustrating for researchers to get their studies up and running and then there are setbacks in terms of getting their budgets or whatever needs to get going. Everything is just taking such a long time to get rolling. We just really need to get on top of this.

Canada really lagged in recognizing this. The first recognition of long COVID was in July of 2021 with Dr. Tam's announcement that there was such an outcome. I think we really need to step up on this illness. Other countries have made significant contributions to dealing with the necessary issues and supporting with funds. Billions of dollars in the States have been allotted to research and funding for long COVID.

As well, recognizing it as a disability would give people access. I think that's a critical thing. People are really suffering. They can't go back to work. They don't have access to food or to the basic necessities of life. I think that's something you need to rectify right away.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you for sharing that.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Goulding.

Colleagues, stand by. I'm going to thank the witnesses, and then we have a bit of committee business that we need to deal with before we wrap up.

To our witnesses, today you had the full experience. You had a late start because of votes. We had technical difficulties. We had a debate on a motion in the middle of the meeting. Thank you for hanging in there. Thank you for staying with us.

Ms. Goulding, we wish you good health and thank you for your advocacy.

Dr. O'Brien, Dr. Arts and Dr. Falcone, thank you so much for the patient and professional way you've handled all of the events today. Thank you so much for the work you do in taking on this global pandemic and ensuring that we're able to move forward with the expertise you contribute to it all. Thank you so much for being with us.

Colleagues, you have received a budget for the children's health study. It's an estimate of $22,000. That budget is not at all cast in stone, but it's something we need to approve. It takes into account the possibility that we will have witnesses come here to testify before us, as well as the cost of sending headsets and the like. I would be pleased to entertain a motion to adopt the budget on the children's health study.

[Don Davies, NDP, Vancouver Kingsway, BC]

I so move.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Davies. Is there any debate?

(Motion agreed to)

Is it the will of the committee to adjourn the meeting?