National Defence Committee on Nov. 27th, 2020

[Dr. Carole Estabrooks]

Thank you.

As many as 30% of PSWs and care aides were working more than one job pre-pandemic. About 70% of that group were working for financial reasons, and many of them couldn't make a decent wage. Wages in Canada pre-pandemic ranged from $12 an hour to about $22 or $24. You can't raise a family on $12 an hour. That condition was there although we didn't know it. Some of us knew it because we had samples from certain provinces that told us that, but we as a country really had no idea that this was going on.

The impact was that they were working multiple jobs and, specifically with regard to the pandemic, the more places you work and the more you travel, the more likely you are to spread the disease. It's not through any fault of your own; it's just the more traffic and the more exposure you have, the more it happens. We have put these “one work site” policies in place in many jurisdictions and they have helped, but they are fraught with unintended consequences.

For chains with perhaps 14 homes that are used to moving their staff around to cover shortages, which all of a sudden can't do that, we have seen some really catastrophic shortages and some loosening of the conditions around that policy to accommodate for that. However, the core issue is that if you don't pay a workforce that delivers 90% of the direct care a living wage and you don't make it possible for them to have full-time employment with sick benefits and vacation benefits, then you're going to have both a dispersion through different homes and issues with respect to workers' commitment to the organization they work for. There is a whole trickle-down effect.

I'm not suggesting that on a permanent basis we might want to put a one work site policy in place. The reason people are working more than one job shouldn't be that they can't make a living wage or get sick benefits.

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

Thank you. I really appreciate that.

Colonel Malcolm, first of all, I'd like to thank you and of course Major Martin for your service. I'm the lucky MP who represents the 19 Wing Comox. It's amazing. I know how hard you work and how dedicated you are, not only to our work internationally but here in Canada obviously.

I'm just curious as to whether you could answer two questions for me. One of them has to do with the process once the military is called in. How does that roll out? How do you make an assessment of what's happening and respond to it? Of course, you know the military did provide a report. I'm just wondering if you could give us a few recommendations with respect to how we could prevent this from happening again in the future.

[Col Scott Malcolm]

Madam Chair, thanks for the opportunity to answer these questions. I'll cover the first one, and then we'll turn the floor to Major Martin, who will be able to speak to the lessons learned, bearing in mind that what we saw there was a snapshot in time, so she will share some of her observations from that moment.

With respect to how the provinces make a request, I will clarify that, as a health services member, it's outside my lane on how that specifically occurs. The process, very generally, occurs through the regional joint task forces, and I know that you've had some of the regional joint task force commanders speak in the past.

In very broad terms, the requests are coordinated from a request from the province itself based on the assessments done by the provincial emergency operations centres in discussions with the regional joint task force commanders. Then a request is sent up through the Minister of Public Safety that comes across to the Minister of National Defence. Based on the requests of the chief of the defence staff, we'll have a look at the availability of forces. Speaking specifically to health services, they would come to the surgeon general to reply as to whether we have forces available to meet those requirements. We would provide the response back to the chief of the defence staff, and then the planning staff would look at our overall ability to respond to that need.

Turning to your second question, I'll turn the floor to Major Martin to speak to the lessons observed in her time working in the long-term care facilities in Ontario.

[Major Karoline Martin, Officer Commanding Standards Coy, Chief Standards Officer, Canadian Forces Health Services Training Centre, Department of National Defence]

Thank you for the question.

A few themes arose out of the report on our observations, certainly echoing what has been said by other witnesses. Staffing was a huge concern. When we arrived, many of the facilities had as little as 20% staffing, irrespective of what their nursing ratios were pre-pandemic. That made a huge impact on the outcomes of patients.

Second was infection prevention and control and really having that situational awareness of who was positive and who was negative. There were delays with having the results. Sometimes there was a lag of a week or up to 10 days, so by the time you got your results, you no longer had a good situational awareness of where the outbreak was. Also, the IPAC stream has centralized and/or standardized IPAC protocols. We within the CAF had a central IPAC member who provided us that advice, but IPAC was very different among each of the facilities in terms of donning, doffing, what the standard was for PPE, etc.

Finally, there's training. I think when you are looking at a degradation within the health status of a large population, having individuals who are trained in that acute care is paramount.

[The Chair, Liberal, Karen McCrimmon]

Thank you very much for that.

Go ahead, Madam Gallant, please.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Thank you, Madam Chair.

My questions are for Colonel Malcolm.

First of all, what vaccine safeguard protocols are in place for soldiers who receive an experimental vaccine?

[Col Scott Malcolm]

Madam Chair, to date there have been no experimental vaccines, to my knowledge, that have been used on Canadian Armed Forces personnel, nor is there any intent to use any experimental vaccines on our Canadian Armed Forces personnel.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Who is responsible for providing financial compensation for soldiers who suffer adverse reactions to a vaccine or this vaccine?

[Col Scott Malcolm]

Madam Chair, I'm unaware of any claims by serving or former serving CAF members against the use of an experimental vaccine. As I mentioned, to my knowledge there has never been an experimental vaccine used on our force. Therefore, I couldn't comment as to what the compensatory mechanism would be for that.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

We did see, with an anti-malarial drug, that our soldiers were among the first in Canada to be dispensed that. It has been quite an uphill battle ensuring that this required inoculation has been adequately compensated for in the instances where they had bad reactions.

Will the government confirm that no military insurance policy will be voided for soldiers who take this COVID vaccine administered by the military?

[Col Scott Malcolm]

Madam Chair, it would be outside my authorities to make a determination on that, regrettably. It's not a decision that would rest within health services.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Through you, again, Madam Chair, on whose shoulders would that responsibility lie?

[Col Scott Malcolm]

Madam Chair, regrettably, within my current position as deputy surgeon general, I wouldn't have the answer to that question. I'm not responsible for the insurance plans of our members. I honestly couldn't suggest right now who within the department would be in a position to answer that question.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Thank you.

Once the vaccine is available, it doesn't make a whole lot of sense to vaccinate soldiers but not their families. When can military families expect to receive a safe vaccine?

[Col Scott Malcolm]

Madam Chair, with respect to the prioritization of the impending COVID-19 vaccines, those prioritizations will first be made at the cabinet level based on expert advice, including from the national advisory committee on immunization. It will be based on those priorities, at which time it will be determined when our Canadian Armed Forces members will be vaccinated. Also prioritized among those, along with all other Canadians, will be the families of our military members.

Thank you.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

For the next roto to Latvia, what are the current COVID precautions being taken for soldiers who are headed there?

[Col Scott Malcolm]

For our troops deploying to Latvia, and for all of our troops deploying, measures are being taken to ensure that our members are not bringing disease into the country nor impacting those being deployed. Those folks are being quarantined in advance of their departure.

We have also been conducting operational testing on our members being deployed overseas to ensure that they are not, as we've termed it, “asymptomatic”, which means being infected with COVID-19 but not demonstrating any symptoms.

Then, of course, the Canadian Armed Forces has led the way in implementing very robust public health measures, including physical distancing, the use of masks, diligent handwashing and also strong recommendations for folks to have the influenza vaccine prior to their deployment, just to eliminate one other type of infection that could impact operations.

[The Chair, Liberal, Karen McCrimmon]

Thank you very much.

Mr. Robillard, you have the floor.

[Yves Robillard, Liberal, Marc-Aurèle-Fortin, QC]

Thank you, Madam Chair.

Good afternoon to the witnesses.

My first question is for Carole Estabrooks.

Dr. Estabrooks, I'd first of all like to congratulate you on your recent appointment to the Royal Society of Canada.

Because of your expertise in this area, I'd like to hear your views on the role of women and visible minorities in long-term care facilities, particularly as personal support workers or nurses.

[Terry Dowdall, Conservative, Simcoe—Grey, ON]

I have a point of order, Madam Chair.

I'm hearing both languages at the same time.

[The Chair, Liberal, Karen McCrimmon]

Thank you. Let's look into that.

Can we try it again, Monsieur Robillard?

[Yves Robillard, Liberal, Marc-Aurèle-Fortin, QC]

Do I start all over?

[The Chair, Liberal, Karen McCrimmon]

Madam Estabrooks, I think the question was directed to you.

Were you able to hear the question?

[Dr. Carole Estabrooks]

No. I only heard about half of it.

[The Chair, Liberal, Karen McCrimmon]

Then yes, please start all over again.

Thank you.