National Defence Committee on Nov. 20th, 2020

[MGen Dany Fortin]

In the spring there was a global shortage of protective equipment, both medical and non-medical grade equipment. We certainly utilized the stock that was at our disposal for the tasks at the long-term care facilities. We also had equipment distributed for additional potential tasks. It was very clear that we took every step to ensure that members were prepared, had the right PPE and were trained in its use before going into long-term care facilities. As I previously mentioned, we worked very closely with the Public Health Agency of Canada and PSPC to maintain the stock and to continue to acquire the appropriate stock.

I know that Admiral Patterson has further details on the distribution. She can certainly touch on the issue of expiry dates.

[RAdm Rebecca Patterson]

One thing we know is that when medical equipment has gone beyond the recommended usage date, it does not necessarily mean that the equipment is no longer protective or of value. However, due to the global shortage of medical-grade personal protective equipment, along with the fact that there literally was nothing on the shelf—it was right up there with the toilet paper run—and the fact that there were incredibly difficult challenges in moving this product around the world, it certainly was very important that we carefully reviewed what was available to us. While there were certainly items that had hit their “use-by” date, the surgeon general, rather than just moving forward and using them, determined that these were required to go back and be retested. Using Canadian standard testing, through the assistant deputy minister of materiel, it was determined that the gloves that were linked to this “beyond their use-by date” were, in fact, still of quality and still useable. Therefore, they were recertified for a period of up to an additional year, and therefore, no expired equipment was used with our personnel.

Second, with respect to the comment concerning a shortage, please keep in mind that this was a particularly urgent situation and some of our most vulnerable citizens were dying of COVID. What happened globally is that as our personnel went out the door with their equipment, we also shared it with the people we worked with in the different provinces, and vice versa. The intent was always to make sure that everybody was fully protected and had the equipment, the training and resources necessary to provide the care that was required for our citizens.

[The Chair, Liberal, Karen McCrimmon]

All right. Thank you very much.

Madam Vandenbeld.

[Anita Vandenbeld, Liberal, Ottawa West—Nepean, ON]

Thank you very much.

I would like to echo the thoughts of all of my colleagues here today. I want to thank you very, very much for your service, particularly now, at a time of crisis, and through you, to all serving Canadian Armed Forces members.

General Fortin, you mentioned in your opening remarks the extent to which the Canadian Armed Forces were prepared, had contingency plans and were ready for this crisis. Many Canadians are very aware of the work in long-term care. You also spoke about ships and aircraft. I wonder if you could talk about some of the things that may not be as well-known to Canadians, such as the delivery of PPE to Latin America, or why we would have had the ships at the ready. Could you talk a little bit about that, as well?

[MGen Dany Fortin]

As you will recall, we didn't know the type of environment we were getting ourselves into, as COVID-19 took on global pandemic proportions. As a result, the word of order in the Canadian Armed Forces was that we are and would remain the force of last resort. We didn't know what might be coming at us, in terms of the defence of Canada and to protect Canadians. What we did know is that there might be a need for forces across the country to do a wide range of tasks, as I explained earlier. I think I can safely say for a number of my colleagues that we did not anticipate having to deploy in such big numbers to long-term care facilities. We certainly were of the impression that we might need to help in a logistics capability in various scenarios. That would include transporting PPE to remote areas in Canada. That would also include, perhaps, power generation with ships at the given localities that are accessible by sea. We can think of a number of scenarios in which those assets of the Canadian Armed Forces could help.

With regard to helping—and you're particularly referring to UN-OCHA requests—Canada provided support, as detailed by Major General Cadieu earlier this week, and it was well appreciated by the UN and by those countries.

[Anita Vandenbeld, Liberal, Ottawa West—Nepean, ON]

Thank you.

This question is more for Commanders Mialkowski and Carpentier and Admiral Patterson, and it is specifically about when you went into the long-term care homes. My understanding is that there were certain criteria that enabled you to determine whether those homes were then “green”, meaning that the transition had happened to the point that you were actually able to leave those homes. Could you explain in a little more detail what those criteria were and how you were able to determine that? Could you also speak a little more about the transition to the work that the Red Cross is now undertaking?

[MGen Dany Fortin]

Madam Chair, I will ask General Mialkowski first to answer.

[BGen Conrad Mialkowski]

In the Ontario context, when we looked at transitioning from any long-term care home, there was a set of criteria that we built in concert with the Province of Ontario. It was, in fact, based on four separate criteria.

The first one was sort of the master criterion, and that was that the Ministry of Health and the Ministry of Long-Term Care agreed that it was time for the Canadian Forces to transition out and either be reassigned to another facility or, if the overall situation had improved to a point that we were no longer required, we would withdraw those forces from the request for assistance.

The second criterion was that the facility itself had the capacity to deal with the number of residents, and among those residents, the patients with COVID, through their own means and no longer required that assistance from our medical teams in support.

The third criterion goes to infection prevention and control, or IPAC, such that the IPAC control procedures were not only educated and in place, but also that the effect of having proper IPAC procedures—as determined by the competent civilian medical authority responsible for that facility—could be guaranteed as functioning and in place, and that we agreed, the Canadian Armed Forces and that competent medical authority and the Ministry of Long-Term Care and the Ministry of Health, that this essential element of our transition was there.

Finally, it was an assessment, not only by the management of the long-term care facility but also by the province in the form of the Ministries of Health and Long-Term Care. At the point of our transition, Ontario had implemented oversight from local hospital networks that were connected to a long-term care facility, and they assessed that the staffing had met both the required degree of competency and, most importantly, the numbers to be able to take care of the residents inside those homes.

Throughout that collaborative effort, we would do a daily review at the local level in the home itself with our teams and a daily review between the provincial emergency operations centre and the Ontario incident management system for COVID-19. We had weekly reviews as to how the overall situation was improving. That was finalized in an exchange of letters at my level with the deputy solicitor general of Ontario, because that individual was the one responsible to Minister Jones, the solicitor general of Ontario, to manage the request for assistance throughout.

Perhaps I can pass this to my colleague in Quebec to describe the events there.

[BGen Gervais Carpentier]

I don't want to repeat the different criteria that need to be evaluated to make the transition, which my colleague has just listed. I just want to reiterate the importance of the links that have been established with the centres. These criteria were first evaluated by the centres' managers and our senior military representative in the field.

In Quebec, an agreement has been reached with the regional public health department, namely the Centres intégrés de santé et de services sociaux, or CISSS, and the Centres intégrés universitaires de santé et de services sociaux, or CIUSSS, and then with the ministry of health and social services. Once there's an agreement with the ministry on the joint assessment of the situation, we could proceed with the transition, with the authority of my supervisor in Ottawa.

I'd like to mention that we've served in 47 CHSLDs. The situation has improved significantly during our mandate. The situation was different in the 25 CHSLDs where we went first than in the 22 CHSLDs where we provided assistance afterwards, as the first wave was winding down. There was an improvement in the situation and our civilian partners were able to continue to carry out their functions in these centres.

I will end by talking about the Red Cross, whose members arrived after we left. They offered help in other centres with slightly different teams. We worked with them at different stages. The first stage was pre-deployment training, which was mandated by the ministry of health and social services and offered by the Red Cross.

In preparation for their mandate, there have been discussions at my level with the provincial director. At the tactical level, we worked with our commanders and health experts in the field to share our experience, observations and best practices.

[The Chair, Liberal, Karen McCrimmon]

Thank you very much.

I think that's the end of the question rotation.

I want to thank our witnesses for giving us their time.

Also, to all of the committee members, there were some excellent questions today. Thank you for making good use of our witnesses' time.

The meeting is adjourned.