Health Committee on April 20th, 2023

[Adam van Koeverden, Liberal, Milton, ON]

Thank you, Mr. Chair.

It's good to see you, Nate.

Seeing that you probably had a longer answer to that previous question, I'll give you an opportunity to provide that now before Marcus and I share our time.

[Nathaniel Erskine-Smith, Liberal, Beaches—East York, ON]

I appreciate it, Adam.

One, on the independent side of the equation, I would leave it as I answered.

On the second piece, though—and I think Don correctly assessed this—there are two core parts to this. I would have said that the review is ancillary even to the pandemic prevention and preparedness plan and the obligation to table that in Parliament. That's the architecture that we're really talking about here. There are details in what should or shouldn't be in the plan. There are amendments, I have no doubt, that ought to be made to add things, to remove things and to adjust language. That's, I think, the core focus.

On the review side, delete it if it's a problem. That was ancillary to the core focus here. If Matt has a problem with it or if others.... Don obviously has articulated a sensible challenge with it. Remove it, or in your wisdom, make it a stronger review.

I think that can very easily be dealt with. Let's focus on the nuts and bolts of this, which is the obligation to table a plan and the obligation to appoint a coordinator who is going to be responsible for the plan, and then really let's make sure the language is right for what ought to be in the plan.

[Adam van Koeverden, Liberal, Milton, ON]

Thanks, Nate.

I want to commend you on your willingness to come here and work collaboratively. You know as well as anyone—better than most, I'd say—that the House of Commons works best when we collaborate and work together. I think everybody in this room and certainly everybody in Parliament, and most people in Canada, believe in accountability, believe in preparedness and believe that we've learned some lessons through the pandemic and that we'd be best served as a country to learn from some of those.

Again, I commend you for coming here to express the willingness to work together, to collaborate and to change the bill if necessary.

I know that Marcus has a couple of good questions, so I'll leave it to Marcus, now.

Thanks, Nate.

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

Thanks, Adam.

I really want to commend you, Nate, for having the cojones to take this on. This has been the number one issue facing our government for the last three years, and also the number one issue facing all Canadians for the past three years. You certainly chose the biggest topic you could have chosen for a PMB.

Our review of what happened with the pandemic and our plans to try to do better next time are really important for our government, but I think—and I think you realize—you have a really uphill battle doing this as a PMB and getting this passed.

I wonder what your thinking is in terms of where we go from this. Do you think this will become the basis for government legislation? Where do we go as a committee? Do we go straight...? I'm wrestling with what we do with this. Do we go line by line, clause by clause now, or should we be calling in witnesses? Where do you see this going?

[Nathaniel Erskine-Smith, Liberal, Beaches—East York, ON]

I really appreciate the question, Marcus. I would say there is an opportunity for this bill to become law by virtue of the timing of it, because I won this arcane lottery, as far as it goes.

Matt Jeneroux, by the way, knows more than anyone about the ability to get a private member's bill passed. I was happy to help with that effort. I'm hoping I get a little help in return.

On the question of what to do as a committee, I think it's, very simply, to get the review question out of the way. Delete that section, as Don said. I think that's a pretty fair way forward. It's causing consternation across the aisle. Just get rid of it, because that's not the principle focus of this thing. You can make it an independent review and away you go, but otherwise, bracket that off, delete it, get rid of it and let's focus on the nuts and bolts of it.

Otherwise, yes, bring in experts. I sent Sean a list of them. Bring in experts. They will disagree with some portions. They'll have better language for other sections, but go through the obligations in the plan, and if anything's missing, add it. If particular language is a problem, change it. Make sure that there's a strong, fulsome obligation on the government of what ought to be in that plan when they table it in Parliament every three to five years. You can have the debate about three to five years, as far as it goes.

I think that's where the focus of the conversation should be. We're putting in place a framework for not just this government but all future governments. What ought to be in it to make sure that you don't have those conversations that you all had with PHAC and others in the wake of the pandemic, and that we're having them before the next pandemic?

What are the answers to core questions around preparedness? What are core answers to questions around prevention, and how do we make sure these questions are being answered in a very proactive way?

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

Again, I want to thank you, Nate, for doing this. We certainly have to start on this task. I think you've started us on this. Where it goes I'm not sure, but I really thank you for having done all your hard work.

[Nathaniel Erskine-Smith, Liberal, Beaches—East York, ON]

Thanks, Marcus.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Powlowski.

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

[Luc Thériault, Bloc, Montcalm, QC]

I'm going to provide a quick clarification, to put it on the record. I'm not saying that a one health approach isn't crucial. As you said in your preamble, it's a critical approach to preventing pandemic risk. I believe that as well. Having said that, I was referring to a study that is currently being done on children's health, but which has only been funded for two years. These people will soon be tabling their results. If this is a crucial approach, why not fund it for the long term? That's the point I was making earlier.

On the other hand, you say that we should drop the idea of an independent investigation into what went wrong despite all the measures that were already in place. However, that is a prerequisite, in my opinion.

Since Mr. Powlowski touted your freedom of thought, I'll ask you: do you support an independent, public inquiry?

[Nathaniel Erskine-Smith, Liberal, Beaches—East York, ON]

I would support an independent process, of course. That's an easy one.

The fact, though, is that an independent process isn't a necessary prerequisite to putting a plan like this in place. Of course, we should have lessons learned and they should inform ongoing efforts, but there have been so many reviews. I've mentioned a few reports already, both from international institutions and from other countries that have taken undertaken reviews. There is so much already available for us to learn from. We need a piece of legislation with an accountability architecture in place very much like this to ensure that we have an obligation on the government to table plans in a public-facing way and update plans on a going-forward basis.

I don't think either one presupposes the other. Let's have an independent review. Let's also pass this legislation to ensure that there is pandemic prevention and preparedness accountability to Parliament.

[Luc Thériault, Bloc, Montcalm, QC]

There have been several failures with respect to quarantines, border management, the National Strategic Emergency Stockpile, and the Global Public Health Intelligence Network. There were also measures that some would call antithetical to freedom: vaccine passports for everyone on all transportation under federal jurisdiction, mandatory vaccinations for all federal employees without which they could not access employment insurance, and I could go on.

You would want us to skip over the findings of such an investigation, which might determine why our response to the pandemic didn't work when everything was in place to handle it well, other than the fact that it fell on us because we didn't believe it would cross continents.

[Nathaniel Erskine-Smith, Liberal, Beaches—East York, ON]

Why would one have to gloss over any conclusions? It makes no sense. The bill doesn't ask for them to gloss over any conclusions. The bill says that these factors have to be considered in a plan. Whatever conclusion an independent review comes to or any other review for that matter, this sets an architecture in place that can encapsulate that learning. This doesn't make a decision to say this should have happened or that should have happened and presuppose a review.

[Luc Thériault, Bloc, Montcalm, QC]

Is it because this accountability architecture does not currently exist?

[The Chair, Liberal, Sean Casey]

I am sorry, but your time is up.

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

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

I'm not going to belabour the point because, Nate, you've been very forthright. I want to thank you for that.

I just have to state again that what this country needs and what I think is required for public confidence is that there be a transparent, independent and comprehensive review of Canada's COVID-19 response. Nothing less than that will suffice. That's why the NDP has called for such an inquiry under the Inquiries Act.

We already have legislation that sets up a process for such an inquiry. It establishes an independent chair. It would empower the inquiry to subpoena witnesses, order the production of documents and hold evidence in public and under oath. It allows them to retain appropriate experts, including counsel and technical experts, to advise them.

To me, that's far beyond the scope of this bill. That's why only excising that part of the bill is acceptable.

I want to end on a positive. I think that the work you've done on the pandemic prevention and preparedness plan is superb.

You have other things to look at. You have requiring a plan to look at protection of vulnerable and marginalized populations, working conditions of essential workers, the availability and management of relevant stockpiles and protective equipment, and manufacturing capacity in Canada with respect to any product relevant to pandemic preparedness, including vaccines and PPE. It calls for us to look at antimicrobial resistance; disturbed habitats that could contribute to pandemic risk such as deforestation, encroachment on wildlife habitats etc.; measures to look at the impact of live animal markets; and the importance of global biodiversity. It calls on us to look at global health equity, co-operating with international organizations and even transport routes of pathogens.

I think it's a really comprehensive plan you've put forward. I'm going to support the second half of the bill. I'm curious to hear from other witnesses, if there are any.

I just want to tell you that I think you've done an excellent job in identifying the factors that ought to be looked at. If COVID taught us one thing, it's that PHAC was not able to deliver the mandate it was given. We would be remiss as parliamentarians if we didn't recognize that and come up with a new way of holding them accountable to make sure that, when the next pandemic comes—and I'm told it's not a matter of if but when—we are not caught flat-footed and that we learn from the lessons of COVID. I think the second half of your bill does that, Nate, so thank you.

[Nathaniel Erskine-Smith, Liberal, Beaches—East York, ON]

Thanks, Don.

Let me say I would also be remiss, because it's 4/20, if I didn't say that it's been great to work with you previously. I look forward to delivering on this with you together at the health committee.

[The Chair, Liberal, Sean Casey]

Thank you.

We'll go back over to the Conservatives.

Dr. Kitchen, you have five minutes.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Thank you, Mr. Chair.

Nate, again, thank you for being here and presenting to us. It is appreciated.

Further to what Don has talked about, when I look at the second part of it.... We'll go to that second part as opposed to the first part. I think that's what Canadians want.

Number one is that, as I look at this, I see that you're pointing out things that I believe are already in place. That's part of why I brought up what I did in my first line of questioning. They are already in place. You are identifying that and making it such that, although the assumptions of Canadians are that PHAC would provide that information to the government, it appears that some of it may not have been provided. This basically puts that in place to say that it has to be done. It has to be done in this kind of time frame with that preparedness plan. That part, I think, is a good thing.

As we move forward, obviously, there are parts of it.... For example, if we were to look at paragraphs 4(2)(f) and 4(2)(g), basically what they indicate is that we need to be on top of things. Perhaps what this will do is create the re-existence of GPHIN, which was the global public health intelligence network that was in place until 2019 and was then shut down. One of the things that we found out during COVID, when we first saw this on our table in 2020, was that this wasn't in place to monitor these aspects. These are things that I think are of value in there.

I'm just wondering about your thoughts along those lines.

Did you have any discussions with any particular people in dealing with, for example, the GPHIN, as you approached the legislation?

[Nathaniel Erskine-Smith, Liberal, Beaches—East York, ON]

I didn't have specific discussions with that organization, no. However, I take your point that we do need, and the bill specifically speaks to the need, to emphasize and describe the state of the research in relation to infectious disease prevention and preparedness, but also the establishment and interlinking of surveillance systems inside and outside of Canada, which is critical for early-stage assessment of risk and making sure we're able to respond quickly to ensure that it doesn't turn into a pandemic in many cases.

It's a good organization to have attend as a witness, frankly. I would just say, if you are able to.... I know it's always tough with private members' business, but if you are able to set aside a few meetings for witnesses, I think it will really help. Once you bracket out the review portion, which I know has been causing more consternation and focus, to Ms. Goodridge's point, I think if we really focus in on the contents of the plan and make sure we tighten up the language there—and experts will be able to help with that—we'll be in good shape going forward.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Thank you.

Ultimately, as we've heard around the table, I think everyone here truly understands that SARS wasn't the first. H1N1 was a scare that sort of petered out. COVID-19 came along and woke people up, and many people will say there's another one just around the corner.

The idea is to have in place legislation to make certain that, first, we're ahead of the game. Second, we're on top of it when it's there, and third, we're prepared for something coming down in the future. It doesn't matter which government it is, whether it's the present government or future governments or those, as has been indicated, a hundred years down the road. These need to be in place, so that we have done the right steps and can make certain that the wording is done appropriately such that people will not find ways to evade it and work around that.

Would you agree with that?

[Nathaniel Erskine-Smith, Liberal, Beaches—East York, ON]

I think everything depends now on getting that language right in terms of what the contents of the plan ought to be, and then you guys will have to decide if it's between three and five years, in terms of the tabling of the plan.

I just want to emphasize, I suppose, the wording of the plan. I'll use an example. The United Nations Environment Programme lists seven key disease drivers. Climate change is one, as an example, but two of them are actually more fraught. One is travel, the fact that we move around the world as freely as we do. That is a pandemic risk. Another is the increased demand for animal protein, because as Brendan Hanley mentioned, the challenge of AMR is just one example, but there is a greater pandemic risk in other countries that don't take biosecurity as seriously as we do. If there are unhealthy animals, it can lead to unhealthy humans and a real challenge on the pandemic side.

I do think we want to talk about managing risks. It's not about eliminating activities. It is about managing the risks and reducing the risks associated with those activities in a thoughtful way. If you guys can take that same thoughtful approach at each provision and say, “We understand what Nate's getting at, but here's a better way of phrasing it, while maintaining the core idea of managing and reducing risk,” I think we'll be in a good place.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Erskine-Smith.

The last series of questions for today will come from Ms. Sidhu for five minutes.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Mr. Chair.

Thank you, Nate, for the update of this bill and thank you for your sincere efforts.

My question is this. What is the role of surveillance and early warning systems in pandemic prevention in your view? How can this be improved through research and technology?

[Nathaniel Erskine-Smith, Liberal, Beaches—East York, ON]

I don't have a great answer, in some ways, other than I know that early surveillance is absolutely essential and technology as part of that is absolutely essential. We need to make sure governments—our government and all governments around the world working together—are taking this as seriously as they can. That's really what this legislation is about. The establishment and interlinking of surveillance systems for infectious diseases is highlighted as a factor that needs to be included in the plan. I think that's an essential part of any preparedness and prevention plan, but the details will have to be worked out by those who are experts at PHAC and in the government, going forward.

[Sonia Sidhu, Liberal, Brampton South, ON]

I'll go to my next question. During the pandemic, we saw the key importance of our medical officers of health in different regions across the country. How can provincial, municipal and regional governments best be engaged when it comes to the legislation and pandemic prevention and preparedness?