Industry Committee on Feb. 25th, 2021

[Dr. Gary Kobinger, Professor, Université Laval, As an Individual]

Thank you, Madam Chair.

My name is Gary Kobinger. I'm a professor in infectious diseases at Université Laval and former chief of the special pathogen program at the national lab in Winnipeg. My expertise sits on the development of diagnostic tests, vaccines and therapeutics against emerging and re-emerging pathogens as well as outbreak responses on the ground in Africa, Southeast Asia and the Middle East.

From 2003 to 2005 I contributed to the development of the first mice model of SARS and one of the first reports on the ferret and macaque models. In parallel, I communicated some of the first reports on the stability of SARS in the environment and opportunity for contactless transmission from droplets. I'm here today to share my expertise and perspective on these subjects as applied to SARS-CoV-2, the causative agent of COVID.

As a scientist and as a Canadian, I have seen unfold the emergence and spread of SARS-CoV-2 worldwide within a few months. I have witnessed, like most of us, many extraordinary achievements and some missed opportunities. I'm here to highlight some of these successes and missed opportunities, because they are where we can learn and focus our efforts to improve our response in order to save lives tomorrow, next month and in the years to come.

In six to 12 months we will look behind, and surely we will be able to say that we made it through okay. We could have done better, as we can always improve. All things considered, we did make it through okay. But make no mistake: Not all of us will make it through at all. For the families and friends of the ones who will die, it will mean dramatic losses of loved ones, changing families and friendships forever. For the most vulnerable, it will be even more dramatic. The numbers will be higher. These are the people we must protect first.

Canada and the provinces and territories have done great with regard to diagnostic services. We must acknowledge the contribution and leadership of PHAC, including Dr. Theresa Tam and Dr. Matt Gilmour, who worked countless hours on decentralizing the diagnostic of COVID to provinces, which in turn expanded to hospitals. We saw the sharing of PPE within and between provinces and territories when PPE became more difficult to find than precious stones. We saw protective vaccines being developed within timelines never seen before in the history of vaccination, and unexpected alliances between big pharma and academia, such as Oxford and AstraZeneca, and big pharma and not-for-profits, such as Merck and IAVI.

We also saw missed opportunities. Currently, the reality is that over one year into this epidemic, only about 6% of the world population has limited access to vaccinations. Most countries, including Canada, delayed too long before imposing travel restrictions to delay the growing seeding of COVID spread throughout the country. More dramatically, the usage of masks at the population level was delayed for months while hard data strongly indicated their benefit in reducing spread, reducing exposure doses, and protecting from infection and severe disease and death. Even in March 2020, some within the federal government were aware of such data and were warned that the first major mistake in emergency response is to not adapt to rapidly growing science to protect policies and politics rather than public health.

Canada was well advised to sign multiple contracts with major pharma above the number of doses required. Unfortunately, it failed to act timely from January to February in 2020 and develop and implement strategies to build vaccine development and manufacturing within Canadian borders. This did not come up in January and February but months later, in July and beyond. As with masks, how many lives could have been saved through a more prompt reaction? We will be able to calculate soon. Each life lost will be one too many.

We were at least three teams with experience in bringing experimental vaccines against infectious diseases to the clinic in Canada. One finally received federal funding in late August 2020 to initiate their clinical development. This was Medicago. The others are also present here with my Ontario colleague.

Canada's solution now is largely sitting with the NRC. The NRC is managing the vaccine task force and managing funding to six promising vaccines. The NRC itself has never brought a human vaccine to licensure, to my knowledge. A federal department, the NRC, with approval from another federal department, Health Canada, is proposing to produce vaccines for the country's citizens—a model that exists only in authoritarian regimes or in communist countries. It's a ticking bomb that may well blow unless some other unexplained strategy is deployed.

My group, with a vaccine strategy that we have shown works against Zika and recently MERS, which is another coronavirus, with a COVID vaccine ready to progress through the clinic since mid-February 2020, a vaccine that showed protection levels similar to a commercial mRNA vaccine in animals, that vaccine received $1 million, and we are very thankful. Despite the great data in preclinical studies, there was nothing more—zero.

Now, let's be serious. Nobody on this planet can bring a vaccine through any clinical study in humans with $1 million, so we can ask whether this $1 million was well spent considering the lack of follow-up support. How many more like this in Canada also used funding and then were left behind? How far could my group and others be today if we had had early support like in the U.K., the U.S. or other countries?

I'm here to answer your questions with my best effort. Right now I will say this. Variants are emerging and the next pandemic is lurking upon us. This is not a fear argument; it is just a simple truth, and we must do better and invest for tomorrow and the future, because we can and so we must.

With my own hands I have decontaminated and prepared for burial the bodies of fathers and children, mothers and babies, all deceased from the Ebola virus disease in places without many resources.

We are very lucky here in Canada with all our resources. We can work together irrespective of gender, race, political party affiliation or religious belief. We are so very lucky to live in this amazing and wonderful country where we can recognize our gaps, where we can do better and hand in hand meet the most daunting challenges with the most innovative solutions.

Thank you.

[The Chair, Liberal, Sherry Romanado]

Thank you very much.

We'll now go to our round of questions. Again, please respect the time, as we're going to try to get at least one tour in before our two witnesses have to leave.

We will start with MP Dreeshen.

You have the floor for six minutes.

[Earl Dreeshen, Conservative, Red Deer—Mountain View, AB]

Thank you very much, Madam Chair.

Because of the fact that we're going to lose a couple of the really important witnesses here, I'm going to try to change my questions somewhat so that maybe we can get some answers later, as they could send these answers to the chair.

Dr. Nemer, you mentioned how behavioural scientists were part of the mix as far as advisers are concerned. Behavioural scientists basically look at how people are going to respond to things such as lockdowns and so on, whereas it's the mental health people who I think are really important in this issue. As the last speaker just mentioned, we have lost so much faith, and we have seen so many drastic things happening in the last number of months that I think, really, we have to be concerned about it.

We talk about international counterparts. Last week we were at 38th, and we are now 58th as far as vaccine deployment is concerned, yet we continually hear how things are just going very well. Well, they aren't going very well.

The other aspect that comes into the science discussion is, why are we not fast-tracking vaccines that have already been approved in the United Kingdom or the U.S. We talk about having to wait for Health Canada to do their due diligence. We speak about how this is an international dilemma. How are we going to manage that?

[Dr. Mona Nemer]

Thank you very much.

Madam Chair, I expect that you want me to answer, but I just want to mention that I have rearranged my schedule, and I'll be able to be with you until 12:30, an additional 30 minutes.

In terms of mental health and our behavioural scientists, we had biomedical and clinical scientists as well who were very aware and concerned about the mental health issues from the get-go. The reality is the management of this entire pandemic was an exercise in risk management between infection, between mental health, between keeping people at home, etc.

[Earl Dreeshen, Conservative, Red Deer—Mountain View, AB]

On that particular point, what information, advice or studies did you or your office provide the government to suggest that quarantining travellers in a hotel would be the safest option available rather than the system that we had before whereby travellers quarantined at home under supervision?

[Dr. Mona Nemer]

When government asks us for evidence, they don't ask us for policy options, so we provide the science. In this case, it would be the science around the transmission of the disease, how long the virus stays in you, how long people can be contagious and so on.

The policy options and the decisions are entirely up to the government.

[Earl Dreeshen, Conservative, Red Deer—Mountain View, AB]

I agree that is the key issue right here. We have a difference between natural science and political science. Of course, no one who is a scientist is going to say that there's a 100% chance, and then, of course, that's when the political scientists jump in to say, “Hey, we'll maybe be able to deal with this in this particular way.”

I want to come back to another issue, recommendation 3 of your special task force on long-term care. The report said, “Ensure sufficient resources required to safely care for residents within LTC homes”, including personal protective equipment and testing for long-term care staff and residents. I think we've seen how difficult and frustrating this has been. I know no one who hasn't seen somebody pass away or had issues where mental health has really caused them such grief.

What response did you get from the government on the recommendations for long-term care? Did you speak to the government at all about the report?

[Dr. Mona Nemer]

Madam Chair, our report on long-term care was, like other recommendations, sent to the government officials both on the political side and the bureaucratic side, but it was also made available to everyone on our website.

The situation of long-term care is one that distresses me a great deal. I think it distresses all Canadians. Unfortunately, in this particular instance we had to rely on the provinces really to implement those measures in the long-term care homes, or in the cases where there was private care, there had to be discussions between the operators and the provinces I understand as well.

To the question as to whether we could have done better in the second wave knowing what we knew about the virus, I think, yes, we could have done much better. We had the tools to do it with the testing, and we didn't have any shortages of PPE as well.

[Earl Dreeshen, Conservative, Red Deer—Mountain View, AB]

Of course, with that recommendation 3, that was what you were trying to tell the federal government. They have been laying this at the feet of the provinces, as I understand.

In the short time I have, on the international acknowledgement of vaccines, what is the reason that we are holding them up at this point in time when they've been accepted in other parts of the world?

[Dr. Mona Nemer]

Again, we have a regulator, and I'm actually quite proud that, unlike other countries, we don't interfere with the regulators as they do their jobs. My understanding, and this is a question best posed—

[The Chair, Liberal, Sherry Romanado]

Would you quickly just finish that thought, Dr. Nemer, and then we'll go to the next questioner.

[Dr. Mona Nemer]

It's a question best asked of Health Canada, but my understanding is it's not only the vaccine itself; it's also where it's produced that needs to be qualified. The vaccines that we're getting are not coming from the same place as those going to the U.S. and the U.K., among others.

[The Chair, Liberal, Sherry Romanado]

Thank you very much, Dr. Nemer.

We will now go to MP Jowhari.

You have the floor for six minutes.

[Majid Jowhari, Liberal, Richmond Hill, ON]

Thank you, Madam Chair, and thank you to all the witnesses.

Madam Chair, I'll be sharing my time with MP Ehsassi, and I ask you to keep the time. I'm going to try to stick to my three minutes.

Let me start with Madam Nemer.

In your opening remarks you talked about the focus over the last year being on advice on COVID-19. You specifically talk about the number of initiatives that you've spearheaded, starting with the multidisciplinary advisory group that has met over 40 times since March 10. You talked about the formation of the CanCOVID network, with over 3,000 members, and you touched on international partnerships you had a lot of conversations with and your recommendation for the formation of the vaccine task force. I want to focus my question on the latter two.

Specifically, can you talk about the role that you played and how involved you are? You continue to be on the vaccine task force. Specifically on the international partnerships, is there one international partner that stood out the most, that you had the most collaboration with?

Thank you.

[Dr. Mona Nemer]

Thank you very much.

I recommended the creation of the vaccine task force because very early on it was clear that a lot of vaccine development was under way. Actually, at some point, there were over 200 vaccines at different stages of development. There was no data on any vaccine development, certainly not things about their efficacy in human and even animal models until the summer. From my conversations with my counterparts internationally, it was clear that we were going to be running into a situation of shortages—the entire globe wants these vaccines—and it was unclear which ones were going to work. Even those countries that could produce vaccines didn't know which platforms would be available.

It was very important that we start putting in place a group that could give independent advice. Otherwise the government would have to basically rely on the private sector and others basically lobbying to get funds and lobbying to sell their products. I thought that maybe this was a situation where the scientific advice would be very helpful to the country.

I was very involved with the task force. As I said, I went to all the meetings, especially the ones where they studied and we had actually the scientists from the companies and from Canadian labs as well. We signed confidentiality agreements to be able to look at those data and make informed decisions.

I would say the countries that have similar vaccine task forces were the U.K. and—a little bit differently, perhaps—the U.S. with their Operation Warp Speed. Australia also had a vaccine task force. Eventually France also put in place a vaccine task force, as did other countries as well.

I think it was the right thing to do and the right model.

[Majid Jowhari, Liberal, Richmond Hill, ON]

Thank you.

I yield the rest of my time to MP Ehsassi.

[Ali Ehsassi, Liberal, Willowdale, ON]

Thank you, MP Jowhari.

I will follow up with a question for Dr. Nemer.

Speaking of the similarities in approaches, would you agree with me that the portfolio approach that Canada adopted was very similar to the approach that was adopted by the U.S., the U.K., Australia, New Zealand and France?

[Dr. Mona Nemer]

The portfolio approach adopted by Canada, which aimed basically to de-risk in case of all these unknowns, ended up being very similar to those of these countries, in the sense that we bet on different technologies, and we saw that. Nobody could predict that mRNA would work. I was the first to be skeptical of it, although I did my Ph.D. in RNA synthesis. Thanks to the nanoparticles, however, and all these developments coming together, it's been just incredible.

We didn't know whether we would be able to have vaccines for SARS-CoV-2 at all, whether adenovirus would work, whether protein subunits would work, which companies were going to be successful. Companies well established in vaccines, like Merck, have actually not been the first out the door, and small, innovative companies and others beat them to the home run.

[Ali Ehsassi, Liberal, Willowdale, ON]

You did state in your opening remarks that we aggressively moved forward and that, as early as March and April, we had invested in vaccine development and the development of therapeutics. However, you did say, and I quote, that these are “not trivial undertakings”.

Could you explain to us what those timelines are in terms of developing these things and elaborate on that particular point for the benefit of our members?

[Dr. Mona Nemer]

Perhaps to be very succinct, historically, if one developed a vaccine or a therapeutic within 10 years, it was a great thing to happen. Developing a vaccine in the space of a year, and not only developing it but actually mass producing it to the stage that you can vaccinate at the level that we are seeing right now, is unprecedented.

[The Chair, Liberal, Sherry Romanado]

Thank you very much. I'm sorry, but you're out of time.

Mr. Lemire, we now go to you for six minutes.

[Sébastien Lemire, Bloc, Abitibi—Témiscamingue, QC]

Thank you, Madam Chair.

Again, thank you to the interpreters for their hard work today.

My question is for Dr. Kobinger.

As we fight against COVID-19 and think about the future, it is incumbent upon countries, now more than ever, to better prepare for the spread of a virus. As you pointed out, the next pandemic is lurking upon us.

Would you say Canada's model for fulfilling its role and meeting its objectives was effective or was it more of a missed opportunity, to use your words?

Given your experience, describe for us, if you would, what a successful model looks like.

[Dr. Gary Kobinger]

Thank you for your question.

We can always do better. In Canada's response to a public health crisis, an important area for improvement is the lack of independence and political neutrality of advisory committees across the country.

Dr. Nemer has done a fantastic job when it comes to networking and collaboration. She was able to move mountains with the science behind her. Nevertheless, the work is directly tied to the government. That's clear from the statement that was read, which was approved by the government in advance. There's nothing wrong with that. It's just that the independence that helps encourage the sharing of scientific breakthroughs is lacking. The political dimension prevents the advisory committees from simply making recommendations and communicating them clearly to the public; the government in power decides which of the recommended policies to put forward, public health or otherwise.

[Sébastien Lemire, Bloc, Abitibi—Témiscamingue, QC]

Dr. Nemer just said that Canada's approach or efforts were comparable to Great Britain's. What are your thoughts on that?

[Dr. Gary Kobinger]

There are a number of similarities and differences. Great Britain opted to deploy all its efforts from the outset. In mid-February, it held a meeting in Geneva and invited a handful of international representatives, including myself. From the get-go, Great Britain decided to provide maximum support to three initiatives, one being the AstraZeneca vaccine, which is in production and has been approved in more than 50 countries to date. The vaccine is a real success story, and I think part of that success is attributable to the development model: an academic lab with high-tech facilities and equipment and a major pharmaceutical company joining forces backed by the British government. That's where our approach and Great Britain's diverge.