Procedure and House Affairs Committee on Dec. 10th, 2020

[Daniel Blaikie, NDP, Elmwood—Transcona, MB]

As a public health expert, you know, I'm sure, and I'm seeking some of your wisdom, about the extent to which people's behaviour can depart from public health orders. That can happen when people choose not to respect those orders. It can also be the case that, despite reassurances that a process is safe, people still feel a lot of fear or anxiety and decide not to trust that, preferring to stay home.

That's relevant, obviously, in the case of an election, because if we do have one during the pandemic, I think there is some concern that, even despite reassurances that it's a safe process, people may elect not to vote because they just don't have that level of confidence. If an election were held during the pandemic, do you think a significant number of people may choose not to vote for fear of contracting COVID-19, even if all the procedures were safe?

[Dr. David Williams]

Again, our key from the get-go has always been communication and public education. If they were assured by Elections Canada and then were to ask for input from their local medical officer of health to deal with questions, to persuade them that it is safe and to deal with all their apprehensions, that would be good. Where it is in the vaccination program would also be a big factor; the timing has to be considered in that as well. A number of factors play in there.

[Daniel Blaikie, NDP, Elmwood—Transcona, MB]

One of the things that has changed since we began this study is the promise of a vaccine rolling out in 2021. Obviously, on top of the work and the strain already in the health care system in trying to treat people who have contracted COVID-19, now there's the logistical challenge of trying to administer the vaccine.

Where do you think the space and the capacity are within the health system right now to do the kind of training on public health measures that would be required for an election? I'm thinking particularly of long-term care facilities. It's going to take somebody's time, somebody who has health care expertise, either to help patients directly with the vote or to train people who normally volunteer there or who are non-medical staff who work there.

Where do you see the capacity in the health system right now in order to be able to do what it takes to effectively deliver a safe election in the pandemic to all Canadians, including those in long-term care and in indigenous communities and people living with disabilities who face additional barriers? Where do we find that capacity in the system right now when we consider that treatment and vaccine rollout are making incredible demands on the current system?

[Dr. David Williams]

One of the challenges we have in Ontario, and one of the benefits we have in Ontario, is that we moved very quickly from the get-go to an all-health approach. As a result, it's not just coming from my desk, but from all the tables, involving all our deputy ministers, our minister, as well as our assistant deputy ministers. All the different portfolios, including the minister of long-term care and minister of seniors for retirement homes, congregate under another ministry, so we have an all-wide government approach.

We have whole committees, set up by the secretary of the cabinet, which have all the deputy ministers. There are various sectors of staff throughout the whole Ontario public service who can give advice and direction, including intergovernmental affairs. It doesn't all depend on public health people or hospital staff to do that kind of training. We've been trying to improve the knowledge base, guidelines and directions accordingly.

That's where you have to do the advance training, as I said in my opening comments, to ensure the people involved have received all the adequate training well ahead of time, and it is not left to the health system to do that, because these are well-known processes in place.

It's just a matter of documenting, scrutinizing, and putting your checklists in place, so every setting has done what they're supposed to do at the right time in the right way to assure us and the public that it's all in place. That's the advance timing and training.

[The Chair, Liberal, Ruby Sahota]

Thank you.

Next we have Mr. Tochor, for five minutes.

[Corey Tochor, Conservative, Saskatoon—University, SK]

Thank you very much, and to Dr. Williams, thank you for the good work you're doing in Ontario on behalf of Ontario residents.

I represent a riding in Saskatoon, and I know chief medical officers are very busy individuals.

I'd like to hear a bit about a typical day. What time does your day start? I bring this up to understand how busy you are, and how a snap election might affect the important work you're doing in Ontario.

[Dr. David Williams]

My day starts at 4:30. We have our first teleconference at seven o'clock. We have teleconferences and meetings from seven o'clock. That's why this one was juxtaposed, double-booked with two or three others, so I'm taking the time out now. A lot of it is communication. It goes then until six or seven. We sometimes have some follow-up calls and phone calls in the evening. We then review the data, sometimes late at night. At night we get to look at some emails by staff, receiving some things at 2 a.m. We're trying to follow some things on that. It is busy, and there are many people involved.

[Corey Tochor, Conservative, Saskatoon—University, SK]

I'm very grateful for the good work you're doing. I apologize if we invited you to this committee and you're double-booked. You could be on another call that could actually save lives out there or communicating the rollout plan for the vaccine in your province. We all want this to end, and hopefully, you're not going to be staying up until past two every night for the foreseeable future.

If there was an election, though, another thing you'd have to do today would be to go vote, perhaps, if the voting day was today. It's another way you would be removed from the important work you're doing.

If there was a snap election, what role should you have in consulting with the Chief Electoral Officer of Canada, coming from a province where you probably know the best about what's going on. What role do you think you should have in consulting with him?

[Dr. David Williams]

I assume the officer would access us through the Pan-Canadian Public Health Network Special Advisory Committee, and Dr. Theresa Tam, to give us updates, and to deal with some things. We may have the same questions from all the provinces and territories. We would cover those as effectively and efficiently as possible. Communications and updates could flow on that basis. Specific issues could be brought forward.

We'd look to our internal government affairs office to connect up, as well, to make sure that we were consistent with our communications. There may be times when we would have to have special ones if there were some unique challenges that were deemed to be handled in Ontario as distinct and different from the rest of the provinces and territories. It would be a bit iterative, but using the time as effectively and efficiently as possible is important.

[Corey Tochor, Conservative, Saskatoon—University, SK]

So the structure would flow up to Health Canada—your input, your concerns—and then Health Canada would interact, if I'm hearing you right. Is that the role you see yourself in?

[Dr. David Williams]

That's correct. Health Canada could filter our concerns, and make sure we have the best and most efficient use of time with communications going out accordingly.

[Corey Tochor, Conservative, Saskatoon—University, SK]

I'd like to get into the challenges of rolling out a vaccination program during a snap election. You'd be fighting for communication and awareness with the public, as candidates would be trying to do the same thing.

What are some of the challenges you think would happen for the vaccine rollout if a snap election were called?

[Dr. David Williams]

People would have some questions in the midst of the process. Who had been vaccinated at that time? Who has evidence or proof of two vaccinations? What is the time period to have immunity? Would they have the same detailed limitation to get access...?

These are all things we're trying to address now. Even if you have been vaccinated adequately, do you have to go through the same scrutiny to get into a long-term care home? These different points are going to be an evolving question we have to ask ourselves. Even if you've been vaccinated, we are finding some people may be swabbed and still positive. They may not be getting sick, but they may be transmitting. There's much to be determined.

[Corey Tochor, Conservative, Saskatoon—University, SK]

Elections Canada employees should have the vaccine before we have an election. That seems to make sense. If they are going to be interacting with the public, would that be a smart health policy, that people administering the election have the vaccine so we're not spreading it?

[Dr. David Williams]

I wouldn't say they're on our top priority list that we put out by our national advisory committee and by our federal group. Right now, they would not be in the top tranche in that group. They still have their other methods of protection such as masking, distancing, getting tested and all that kind of stuff.

Whether they are volunteers or members of other groups, we would have to get some further direction. That depends if we're in the first quarter of 2021, second quarter or third quarter. It's all a matter of when we can do that, but they would not be on our list at this moment of top-priority individuals, because we want to decrease morbidity and mortality at this time.

[Corey Tochor, Conservative, Saskatoon—University, SK]

Thank you for your time. I'll cede the floor, but I want to say thank you for, on your busy day with so many things going on, spending an hour with us. There are probably much more important things you could be doing that would hopefully save some more lives in Ontario. Thank you for all of your long hours. I apologize that we're taking you away from that important work.

[Dr. David Williams]

Thank you. If you have to get me out of trouble with General Hillier, I'll let you know.

[The Chair, Liberal, Ruby Sahota]

We will do our best.

Ms. Petitpas Taylor.

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Thank you so much, Madam Chair.

I will be sharing my time with MP Turnbull.

I also want to add my voice in thanking Dr. Williams and all of the public health officials for the tremendous work that you've been doing over the past year. We are really, truly grateful.

My line of question is going to be very similar to Mr. Tochor's.

In the area of jurisdiction, during your opening remarks, you indicated that Ontario has 34 public health units. You have indicated that their role and responsibility is the public health in their specific jurisdiction.

I'm wondering, with respect to that, what their role would be in the midst of an election with respect to providing public health guidance to Elections Canada. We recognize there is a variation across the country when it comes to COVID-19 cases, and we're just trying to wrap our head around the issue of jurisdiction and who would provide that public health information to Elections Canada.

As committee members, we've had a lot of discussions with respect to that and would like to get your take on that.

[Dr. David Williams]

Our approach would be to have our general standards nationally. We'd roll those out so that all 34 would have the same messaging coming from my table or from the province. Then, for each health unit, the medical officer of health would have to deal with any outbreaks or concerns in various activities within the elections process, whether it's campaigning or in the selection of sites, and see if there were any issues where the medical officer of health could override that and give out directions to say, "We need to alter it this way and this way" under the umbrella of what we say in Ontario. Then you can go more granular if there's something unique in their respective jurisdictions.

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

When you say they could override it, who ultimately has the power to override such decisions?

[Dr. David Williams]

They have an umbrella. They can enhance above that, but they can't go below that. They can't say they'll do less than what the province allows. They can say, "In this setting here, because of, for example, access with certain first nations community groups coming in to an urban area, we may want to have some stipulations to protect them or to ensure there are things in place there". They can always make it more protective as long as there's evidence and scientific data to support that step.

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

During your testimony, you also indicated that staff, volunteers and family members must undergo testing before they can enter long-term care homes. Would you agree that it would be better to promote alternative voting methods, as opposed to people going into long-term care facilities to provide residents with other voting options? I'm making reference to either mail-in ballots or phone-in ballots.

[Dr. David Williams]

I would certainly support that.

As I said, an essential visitor, who knows the individual, could bring a ballot in, make sure they fill it out and then take it and mail it on their behalf. There are many methods I would prefer rather than having voting take place right in the long-term care home.

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Thank you so much, Dr. Williams.