Indigenous and Northern Affairs Committee on Oct. 27th, 2020

[Marc Miller, Liberal, Ville-Marie—Le Sud-Ouest—Île-des-Soeurs, QC]

We stay in touch with community health networks, nursing stations and local leadership. The general issue you raise is that lack of connectivity is a barrier to the effective deployment of our resources. This is even more the case with respect to transportation sustainability, which you mentioned in your question to the Minister of Northern Affairs. These are huge challenges, but not insurmountable.

Certainly, more investment in infrastructure is needed. It is difficult to do major construction in times of pandemic, but this is one of the issues that constantly comes up, not only in remote areas, but also in communities near Toronto and Brantford, such as Six Nations, which do not have the same Internet access as a neighbouring community.

So it's a problem that's pretty much across the country. This very often means that it is a problem experienced by indigenous communities.

[Sylvie Bérubé, Bloc, Abitibi—Baie-James—Nunavik—Eeyou, QC]

Let me go back to Internet access again.

You are well aware that municipalities, and even cities in regions, such as those in the Abitibi-Baie-James-Nunavik-Eeyou riding, have problems with Internet access. Imagine the situation in the Far North of Quebec and in Nunavik. We are told that funds are given to the communities, among other things. However, there is still this problem of Internet access.

What do you plan to do in the second wave of the pandemic?

[Marc Miller, Liberal, Ville-Marie—Le Sud-Ouest—Île-des-Soeurs, QC]

We recognize that students learning at home must use electronic equipment. They certainly cannot do so without access to the Internet. It's a challenge even in the most modern homes, so imagine what it's like in the scenario you just mentioned.

With respect to Nunavik, we need to talk about the commitment we have in common with the Quebec government. It is a shared responsibility.

[The Chair, Liberal, Bob Bratina]

We're out of time.

[Marc Miller, Liberal, Ville-Marie—Le Sud-Ouest—Île-des-Soeurs, QC]

It is a challenge, but it is not insurmountable.

[The Chair, Liberal, Bob Bratina]

Thank you very much.

Ms. Blaney, you have two and a half minutes. Please go ahead.

[Rachel Blaney, NDP, North Island—Powell River, BC]

Thank you, Chair.

My question is for Minister Miller. Minister Bennett, if you have anything to add afterwards, that would be fantastic.

I have a question about stockpiles and delivery of PPE for indigenous communities. In the very beginning, of course, that was a bit of a problem across the country. I'm just wondering at this point if every indigenous community has what they need to manage the current reality and to be prepared for an outbreak if one happens.

[Marc Miller, Liberal, Ville-Marie—Le Sud-Ouest—Île-des-Soeurs, QC]

I would say that, when it comes to British Columbia, this work is done principally through FNHA, but as for the general question, we have been moving in real time in terms of our stockpile to a turnaround time of 24 hours. Now FNIHB and the resources that we have at our disposal serve essentially the health care and the essential service community inside indigenous communities. Our response time has improved to a 24-hour turnaround.

Clearly at the beginning, we saw some confusion across Canada with respect to how, when and where PPE was being used and deployed, and conversations as to need. Obviously, the clear message to us that we had to take action on was that we had to increase our communication with communities to see, first and foremost, what the protocol was for PPE. Very simple things become quite complex and intricate, particularly in a northern remote scenario, like donning and doffing, which has become a commonplace expression now. There was also proper use of PPE and how and when it's used in conjunction with testing.

I would leave the remaining portion of this question to Dr. Gideon.

Could you just add a bit, Val?

[Valerie Gideon]

As the minister said, it was about clarifying where provinces were unable to provide supply, because the provinces and territories are still the primary provider of PPE for all health care workers in a province. However, some provinces experienced shortages early on, so we were able to step in. We have not had a shortage in terms of the supply that's been available to us. We continue to message out and encourage people to submit requests and plan in advance, and we will ship three months' supply, for instance, to remote and isolated communities, not one month's supply. We have an online management system for all of our PPE, which has expedited the process of ordering and confirming receipt of PPE even at a community level. Those are some of the measures we've put in place.

We expanded the reach of our PPE supply, noting some of the shortages to treatment centres and friendship centres. We have also negotiated some collaborative agreements with some provinces, like Ontario, where we have agreed that we will provide PPE in certain cases, and the Ontario government will provide it in others, just to make sure that that clarification is there.

[The Chair, Liberal, Bob Bratina]

Thank you.

[Valerie Gideon]

We've also provided funding to communities so they can purchase their own PPE for other workers in the communities who they would like to ensure are protected.

[The Chair, Liberal, Bob Bratina]

Thanks so much.

We go to a five-minute round now.

Cathy McLeod, you're up for five minutes. Please go ahead.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Thank you.

I have a number of questions, both for Minister Bennett and Minister Miller. Thank you all for coming here tonight as we kick off this COVID study in the new session of Parliament, which I think is certainly very important.

These are quick questions, and I'm hoping to get in a number of them.

We talk about 70 of the GeneXpert machines having been deployed. Are there more on order, or is that the limit of the machines that we have?

[Marc Miller, Liberal, Ville-Marie—Le Sud-Ouest—Île-des-Soeurs, QC]

I believe there are more, but Val can answer that.

[Valerie Gideon]

Yes, that's correct. We're continuing to work with the National Microbiology Laboratory of the Public Health Agency of Canada to continue to deploy GeneXpert machines near or in indigenous communities and northern communities, as well as other methods of rapid testing or point-of-care testing that become available.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

I would really appreciate it if we could have a list of where they're deployed currently and how many have been ordered.

My next question is for Minister Bennett.

You are responsible, as you indicated in your comments, in terms of the COVID response in modern treaty and self-governing first nations. Are there any barriers in terms of the deployment of these particular machines to the communities that you're supporting in their response? Has the focus really been on the ones that Indigenous Services is supporting?

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

We have, in terms of the stockpiles, all the things that actually have been managed by the provinces that.... To be truthful, Cathy, at the beginning, some of the self-governing nations, modern treaty nations, didn't really know where to go, and that was what we had to clear up right at the beginning. They could go to the province, and if the province didn't have it, we would back that up—as we will with vaccines. That will be the same thing. But in terms of—

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Some of these GeneXpert machines might be deployed right now in those communities that you're focusing on.

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

We will look at the list, but certainly in terms of some of the land claims, like Nunavut or the people we consider part of modern treaties and self-governing nations, yes, we will.... Again, where there was a need, the machine was sent.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

We all know that staff tend to often fly into these communities, and I can give you a real-life example. I keep in contact with former staff. They have their tests when they go in, and they take care of their communities. Sometimes they're allowed to see patients, but they're self-isolating, with the exception of seeing patients. It is now taking 14 days—or it has, in the past, been taking 14 days—for them to even get a response.

My first question is, has there been transmission from health care workers flying into communities, who are quasi-taking care of patients but quarantining? Certainly, as you might imagine, waiting 14 days for a result is not best practice in terms of a health care worker going into a vulnerable community. I'll leave you with that.

[Marc Miller, Liberal, Ville-Marie—Le Sud-Ouest—Île-des-Soeurs, QC]

Just as an update to your prior question, MP McLeod, we actually have 77 GeneXpert machines that are deployed.

What I would say is that one of the lessons we learned from H1N1 is that we didn't want nursing staff or people going in and out on an emergency basis from communities. They themselves become vectors, particularly in situations where they're obviously in there to care and to help. This is why we have quite an elaborate protocol, whether it is isolating before they go in or other methods, to accommodate any specific scenarios. This has been a huge logistical challenge, which has included charters as well. We're conscious of this.

In terms of specific examples of nurses themselves becoming vectors, I suspect you mean that they were not themselves infected solely and then prevented...but were infected and then spread.... I would defer to Val or Dr. Wong to answer that, but, based on all the briefings I've received, it has been exceedingly rare.

[Dr. Tom Wong, Chief Medical Officer of Public Health, First Nations and Inuit Health Branch, Department of Indigenous Services]

There have been no such cases at all in terms of nurses flying into the communities, because of the very intensive, elaborate procedures that they have to go through.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Is it still the case...? Again, I know of some very specific examples in the north where staff have a test when they fly in, and then provide care and wait weeks for the results of that particular test. Is that something you're aware of that is still happening frequently?

[The Chair, Liberal, Bob Bratina]

Answer very briefly.

[Marc Miller, Liberal, Ville-Marie—Le Sud-Ouest—Île-des-Soeurs, QC]

I can't speak to your examples without seeing the specific facts, MP McLeod.