Public Accounts Committee on April 5th, 2022

[The Chair, Conservative, John Williamson]

I call this meeting to order.

Welcome to meeting number 13 of the House of Commons Standing Committee on Public Accounts.

Pursuant to Standing Order 108, the committee is meeting today on “Report 15: Enforcement of Quarantine and COVID-19 Testing Orders—Public Health Agency of Canada”.

Today's meeting is taking place in a hybrid format, pursuant to the House order of November 25, 2021. Members are attending in person in the room and remotely using the Zoom application.

Given the directive of the Board of Internal Economy on March 10, 2022, all those attending the meeting in person must wear a mask, except when members are seated at their place during parliamentary proceedings.

To ensure an orderly meeting, I would like to outline a few rules for the witnesses and members to follow.

Before speaking, please wait until I recognize you by name. If you're on the video conference, please click on the microphone icon to unmute yourself. When you aren't speaking, your microphone should be on mute.

Interpretation is available. Those on Zoom have the choice at the bottom of their screen of either floor, English or French audio. Those in the room can use the earpiece and select the desired channel.

As a reminder, all comments should be addressed through the chair.

Honourable members, if you're participating in person and would like to speak, please raise your hand. If you're participating remotely using the Zoom application, please use the “raise hand” feature. The committee clerk and I will do our best to maintain the order of speaking. Thank you for your patience and understanding.

In accordance with our routine motion, I am informing the committee that all witnesses have completed the required connection tests in advance of the meeting.

I'd now like to welcome our witnesses.

From the Office of the Auditor General, we have Karen Hogan, Auditor General of Canada, and Carol McCalla, principal.

From the Public Health Agency of Canada, we have Dr. Harpreet Kochhar, president; Brigitte Diogo, vice-president, health security and regional operations branch; and Jennifer Lutfallah, assistant vice-president, border measures operations, health security and regional operations branch.

Witnesses will each have five minutes to make their opening statements.

Ms. Hogan, you have the floor for five minutes, please.

[Karen Hogan, Auditor General of Canada, Office of the Auditor General]

Mr. Chair, thank you for this opportunity to discuss our report on the enforcement of quarantine and COVID-19 testing orders by the Public Health Agency of Canada, which was tabled in the House of Commons on December 9, 2021.

I would like to acknowledge that this hearing is taking place on the traditional unceded territory of the Algonquin Anishinabe people.

Joining me today is Carol McCalla, the principal who was responsible for the audit.

This is our second audit of the border control measures that were used to limit the spread of COVID-19. This time, we found that the Public Health Agency of Canada had improved its ability to check whether travellers complied with mandatory quarantine orders. With the move to collect travellers' contact information electronically in late 2020, the agency was better able to follow up to determine if travellers quarantined as required.

Nonetheless, between January and June 2021, the agency was still unable to confirm whether 37% of travellers complied with quarantine requirements. While this is a decrease from the 66% reported in our previous audit, it is not a success story. Thirty-seven per cent of travellers is still a large number of people to lose track of.

In addition, the agency did not know what happened in most cases where individuals suspected of non-compliance were referred to law enforcement as a priority for follow-up. In any public health emergency, the agency needs quality information to know whether its approaches are effective and what adjustments may be needed to manage the situation.

We also found that the Public Health Agency of Canada did not adequately administer two new border control measures introduced in early 2021 to respond to the risk of variants entering Canada. Incoming travellers were required to take a COVID-19 test on arrival, followed by a second test eight days later.

We found that the agency was either missing or unable to match 30% of test results to travellers between February and June of 2021. Even more concerning was that the agency never contacted more than 1,000 travellers who tested positive to inform them of their test results and related isolation requirements.

The second additional border measure we examined was the requirement that travellers flying into Canada stay at a government‑authorized hotel while waiting for the results of their COVID‑19 test. At the time of our audit, the agency had records to verify hotel stays for only 25% of these travellers. Again, because of gaps and duplications in the way traveller information was collected, the agency wasn't efficiently administering quarantine requirements.

In setting up the border measures, the agency conducted a gender‑based analysis plus assessment that covered age, language and digital literacy of travellers subject to quarantine orders. We found that only some of the recommendations from that analysis had been implemented. For example, anti‑bias training for quarantine officers wasn't in place by the end of our audit. Overall, it was unclear how the agency used the gender‑based analysis plus to mitigate potential negative impacts of quarantine measures on diverse groups.

Lastly, we found that the agency's ability to ticket people for not complying with quarantine orders varied across the provinces and territories. Almost all the tickets were issued to travellers who refused to quarantine at a government‑authorized hotel after they had landed at two of the four international airports that were open. Few or no tickets were issued to travellers arriving at the other two airports, or in any of the other provinces or territories.

At the end of our audit, the agency still didn't have a plan to improve its enforcement capability across the country. The Public Health Agency of Canada accepted our recommendations and prepared an action plan to address them.

Mr. Chair, this concludes my opening remarks. We would be pleased to answer the committee's questions. Thank you.

[The Chair, Conservative, John Williamson]

Thank you very much.

Turning to the president of the Public Health Agency of Canada, Dr. Kochhar, you have the floor for five minutes, please.

[Dr. Harpreet S. Kochhar, President, Public Health Agency of Canada]

Thank you, Mr. Chair.

Thank you for the opportunity to talk about the work that the Public Health Agency of Canada is undertaking in response to the audit of enforcement of quarantine and COVID-19 testing orders.

Joining me today are Ms. Brigitte Diogo, vice-president of the health security and regional operations branch, and Ms. Jennifer Lutfallah, vice-president of border measures operations at the health security and regional operations branch.

Since the beginning of the pandemic, the Public Health Agency of Canada has directed the implementation of border restrictions and border control measures to help prevent travellers from spreading the virus that causes COVID-19 in Canada. While our approach has evolved, our guidance and advice continue to be based on the latest available science, epidemiology and expert opinion. The agency, however, accepts both of the Office of the Auditor General's recommendations as outlined in the audit report. The work is already under way to address them.

As you are aware, the Auditor General's audit covered the period of July 1, 2020, to June 30, 2021. Since that time, the Public Health Agency of Canada has developed an action plan to address the audit recommendations. I will take a minute to highlight the key components of the plan.

The agency will continue to engage with its provincial and territorial counterparts to ensure maximum collaboration when following up with travellers. In particular, we will continue to focus on those who have tested positive.

We're renewing our efforts to engage law enforcement partners and working to identify barriers to reporting as well as some interim and possible long-term solutions that will increase reporting on referral outcomes. For example, we are providing an option for police to report if a visit is not completed, so that the Public Health Agency can assess how many referrals have or have not been actioned, and focusing law enforcement referrals on high and urgent priorities only.

The agency is working with testing providers to develop innovative solutions to better reconcile traveller data provided to the Public Health Agency with test result data in the near term, while also developing requirements for an improved end-to-end system to enhance automated tracking and improve overall data quality. For example, to mitigate unmatched test results due to errors or inconsistencies in data submitted by travellers, the Public Health Agency worked closely with CBSA and testing providers to improve the completeness and quality of data fields used for matching.

I must mention, Mr. Chair, that within just over four months of the launch of the Canada border testing program in February 2021, on-arrival and post-arrival test completion increased by 20%, to 95% and 82% respectively. This was a direct result of efforts by the agency, in conjunction with testing providers, to address the barriers to test completion, such as reducing virtual appointment wait times and ensuring that materials were available in a diverse set of languages. We're also looking at how we can improve and streamline methods for assessing data quality internally.

We are also implementing GBA+ considerations to mitigate any potential adverse impacts that existing and future programs have on diverse or vulnerable groups.

Throughout the pandemic, the Public Health Agency has developed and implemented mitigations to identify disparate impacts of border measures on vulnerable groups, such as providing tailored accommodation where possible and making amendments to orders in council to create exemptions for several cohorts of potentially vulnerable travellers.

Finally, we are updating plans for administering and enforcing emergency orders in future outbreaks. This work will include incorporating lessons.

Some of the work I have just outlined has already begun, and some will begin as the pandemic winds down.

As I mentioned, the Public Health Agency of Canada agrees with both of the recommendations made in the Auditor General's report. However, I would like to note that by focusing only on select metrics—for example, the record of stay for travellers who stayed at government-authorized hotels—the report's findings do not account for all the layers of the compliance and enforcement program and how they work together. Together, these layers work to reduce the risk and limit the spread of COVID-19 by travellers.

We'll also review recommendations from other audits, evaluations and lessons learned. This information will help inform our planning process so that the agency is in a better position to respond to any future global health events.

While Canada began a phased approach to easing border measures in July 2021 for fully vaccinated travellers, the agency took quick action at our borders in November 2021 to mitigate travel‑related importation of the Omicron variant, through enhanced testing and quarantine requirements and travel restrictions.

The situation at our borders is fluid. We'll continue to develop our measures when and where necessary to protect the health and safety of all Canadians.

Thank you, Mr. Chair.

[The Chair, Conservative, John Williamson]

Thank you very much, Doctor.

We'll begin our first round and I'll turn now to the official opposition.

Mr. Lawrence, you have the floor for six minutes.

[Philip Lawrence, Conservative, Northumberland—Peterborough South, ON]

Thank you, Mr. Chair.

I'll just start with a little statement here. In accordance with the report from the Auditor General, “The objective of this audit was to determine whether the Public Health Agency of Canada administered quarantine requirements for incoming travellers to limit the introduction and spread of the virus that causes COVID-19 and its variants....”

Ms. Hogan, your scope surrounded what restrictions were put in at the border. It is clear that the controls were not as effective as they could have been for slowing the spread and reducing the transmission of COVID-19. However, my line of questioning is actually going to be focusing on the scope of the audit. I have some questions with respect to that. Many of the questions will be put to the Auditor General.

Ms. Hogan, I'm concerned that, despite numerous media reports, your scope did not include the numerous terrible conditions and the civil liberties that were violated within the quarantine hotels and under the enforcement procedures. I would cite the article by Christopher Nardi in the National Post from December 7, 2021, in which he cited evidence of individuals complaining about going hungry and living in dirty clothes.

Also, and even more troubling, there were multiple allegations of sexual misconduct, both within the quarantine hotel system and at compliance checks. I'll quote the Canadian Press article from the National Post on February 24, 2021, which cited police saying, “The accused informed the victim that they were in violation of the quarantine order and demanded that a fine be paid in cash. When the victim declined to pay, she was sexually assaulted by the accused.”

Moreover, I'll quote the Canadian Press article on CTV News on March 10, 2021, which read, “Operators have been telling single women not to tell people of their location and...in some cases there are no locks on the doors within those quarantine facilities”.

Ms. Hogan, given these blatant civil liberty violations, why did you not include the operation of the quarantine facilities, the enforcement checks and the potential abuses of Canadian civil liberties within the scope of your audit?

[Karen Hogan]

I will ask Ms. McCalla to add to this with a little more detail.

Part of our work included looking at the security measures that the Public Health Agency had in place to monitor the quarantine facility and the government-authorized hotels. During the scope of our audit, we were aware of one issue that had been investigated in rather detailed fashion, I believe, by the agency, and measures were being taken to address it.

I am going to see if Carol wants to add a bit more flavour to that response.

[Carol McCalla, Principal, Office of the Auditor General]

Thank you.

We looked at the security measures that the Public Health Agency of Canada required of the quarantine hotels that it had approved to receive incoming air travellers, as well as the arrangements that were put in place at its quarantine hotels. We saw that in both cases the agency had established the security requirements for these hotels and put in place measures to verify that they were in place and functioning as intended.

Following an incident at one of these hotels, the agency had conducted a review of its security procedures and put in place recommendations to improve the security. During the course of our audit, we saw that the agency was working to institute that across its quarantine hotels.

[Philip Lawrence, Conservative, Northumberland—Peterborough South, ON]

Thank you for those responses, but my concern is that it doesn't appear as though.... Although there may have been policies put in place, at the end of the day it's the results that matter, and the impact.

How many people in the media or otherwise who reported a complaint did you interview? How many members of the general population—not just government officials—did you interview to see what the experience was truly like at the enforcement checks and quarantine hotels?

[Carol McCalla]

We didn't interview members of the public or travellers who had stayed at quarantine hotels. We contacted different agencies that were involved in setting these up—for example, hotel organizations—and they talked about the situations they saw at the hotels that were put in place and the extent to which they were consulted in those measures.

[Philip Lawrence, Conservative, Northumberland—Peterborough South, ON]

As I think you might have mentioned in your statement, it's clear that vulnerable populations, such as women, BIPOC individuals and members of the LGBTQ2+ community, might have been disproportionately impacted by the misconduct of government officials. To what extent did you review and analyze and apply a GBA+ analysis to the impact on vulnerable populations of the quarantine hotels and enforcement checks?

[Karen Hogan]

During our analysis, when we looked at what the Public Health Agency had done for gender-based analysis plus, we saw they had collected information but really not used that information or analyzed it to see whether or not adjustments needed to be made.

One of the other recommendations we saw that came out of their own analysis and hadn't been implemented was the bias training for many officials. As you know, training and awareness are the first key places to start in order to drive a change here. We saw that certain measures hadn't been applied and we weren't sure why.

[The Chair, Conservative, John Williamson]

Thank you very much.

We'll turn now to Ms. Yip. You have the floor for six minutes.

[Jean Yip, Liberal, Scarborough—Agincourt, ON]

Thank you, Chair. I appreciate the witnesses for coming in today and for their work done on this important study.

I remember that at the time the quarantine hotel stays were introduced, there was a lot of reporting on who just walked on by without quarantining and those who were compliant. There was an inconsistency and, in the public's eye, an unfairness, and there were even worries about border measures not being strong or effective enough to prevent the spread of COVID-19.

Dr. Kochhar, can you provide some examples to give us a sense of the breadth of the programs that PHAC had to establish in the implementation of the emergency travel and border measures during this pandemic?

[Dr. Harpreet S. Kochhar]

Mr. Chair, I would say PHAC was able to rapidly mobilize, adapt and respond to the evolving COVID-19 situation, including administering an unprecedented border and quarantine measures program.

There are a few examples. The agency established the program to follow up with travellers required to quarantine following March 2020. The agency was able to establish a Quarantine Act compliance verification program, which made over four million live agent phone calls, sent 13 million promotional emails, made 6.5 million robocalls, and also conducted in-person compliance checks, which were directed at 540,000 travellers.

In addition, Mr. Chair, we also established a compassionate exemption program. This allows travellers who would otherwise be prohibited from entering Canada to attend funerals and provide care or support to critically ill persons. We established that program and processed over 64,000 applications.

We also had the Canada border testing program, which we talked about, through which we were doing surveillance to see how many travellers were coming in. This was launched in February 2021. We did 4.38 million on-arrival and post-arrival tests, and we analyzed them so we could successfully detect and isolate infected travellers. Then, as of August 2021, we moved on to mandatory random testing.

Now, in addition, Mr. Chair, we continually expanded and enhanced Canada's ability to limit importation by establishing emergency travel and border measures under different acts. The Quarantine Act designated quarantine facilities and data monitoring.

I must mention the ArriveCAN app, which is an application to capture the key public health information of travellers. As of August 2020, over 80% of weekly travellers entering Canada had started to use that digitally. Now, those actions were really conflated to the point where we could mitigate travel-related importation, specifically in November of the omicron variant, through our enhanced testing and quarantine requirements and travel restrictions.

On top of everything, all of these measures, including the testing program, allowed us to really concentrate on identifying any variant of concern by genomic sequencing in our laboratory. This involved a whole array of things.

I could go on, but I think that captures what we did in the Public Health Agency to support that.

[Jean Yip, Liberal, Scarborough—Agincourt, ON]

Thank you.

I would like you to expand on that. In terms of the recommendations from the audit, what changes were made and also, as you just said, what lessons were learned to better combat the January omicron surge?

[Dr. Harpreet S. Kochhar]

I will turn to my colleague Brigitte on this one, because, as I mentioned, there were some very specific aspects that were put in place in respect of the omicron wave that hit us in November. Brigitte will probably be better able to explain and articulate them as they were rolled out.

[Brigitte Diogo, Vice-President, Health Security and Regional Operations Branch, Public Health Agency of Canada]

Thank you.

Indeed, in November 2021, when omicron came to light, the agency worked diligently to take some concrete actions. One of the first actions was to impose country-specific measures. Those required enhanced screening at the border, including the requirement for travellers from particular countries to go to the designated quarantine facilities.

The government also looked at increasing testing at the border, so there was a significant ramping up in the testing on arrival to determine which travellers were positive and required to go into quarantine. I would say that in doing so, we also had to ramp up our compliance and our follow-up activities in response to omicron.

[Jean Yip, Liberal, Scarborough—Agincourt, ON]

Do you feel that PHAC is better prepared to deal with the BA.2 variant and other future variants, especially with the random testing and removal of molecular testing?

[Dr. Harpreet S. Kochhar]

Let me start by mentioning that we have had experience over the last year and a bit in looking at testing at the border, looking at an extensive testing regime and shifting ourselves to mandatory random testing. This mandatory random testing is one of the key components that has allowed us to really focus on one aspect. We haven't had an opportunity to test everyone, but we can use a random sample based on an algorithm that was developed by the CBSA. It is based on travel history and the epidemiology of the country the traveller is coming from. That allows us an insight into the positivity rate of importation through travellers and into identifying any variant of concern. In the testing we do, any positive is 100% sequenced for genomic analysis. That's why we're able to identify things very early.

[The Chair, Conservative, John Williamson]

Thank you, Doctor. I suspect we'll probably come back to that issue.

I'm turning now to Madame Sinclair-Desgagné.

Ms. Sinclair‑Desgagné, you have six minutes.

[Nathalie Sinclair-Desgagné, Bloc, Terrebonne, QC]

Thank you, Mr. Chair.

I want to thank all the witnesses here today. I also want to congratulate the Auditor General for reaching an agreement and ending the strike in the audit services group.

I want to begin by providing a brief context for the role that the government played in its delayed response that facilitated the spread of the virus.

There has been the damning observation that the government has been consistently slow to take the necessary steps to slow the spread of the virus. Here is the first example that came to us that outraged people deeply.

It was the mayor of Montreal, Ms. Valerie Plante, who, faced with the absence of any border control, had to send city people to try to delay the arrival of travellers at one of Canada's busiest airports, Montreal-Trudeau International Airport. Absolutely nothing was done and the federal government just waited.

On March 15, 2020, the mayor called Montreal's airport a sieve and deployed about 60 employees from Montreal's public health department to offer travellers clearer guidelines on health measures. This is the first finding.

Then the government established a 14‑day quarantine, and that was fine. However, this is where I think the Public Health Agency of Canada could have made a bigger contribution.

Canada has always lagged behind. After several months of the pandemic, and given the evolution of knowledge, many countries, particularly in Europe, were now imposing a 6‑ or 7‑day quarantine, while Canada's was still 14 days. After almost a year of the pandemic, science was telling us that things had already evolved. In these countries, there was a test on the first day, and another one after a week. If both tests were negative, the traveller was free, whereas in Canada, we still had the old measures and were extremely cautious. The Public Health Agency of Canada had not transmitted the data or, alternatively, the government had decided simply to do nothing about it.

I experienced this situation very personally. My father and uncle, on day 10 and day 12 of their quarantine respectively, were unable to say goodbye to my grandfather. This could have been avoided. The Public Health Agency of Canada could have done a much better job of monitoring and putting better practices in place.

There have been improvements, and I thank the Office of the Auditor General for conducting a number of studies on controls and so on. Even in the measurements, there was a lot of progress to be made and we were still lagging behind. This is unacceptable for a country as developed as ours.

On that basis, my question is this, Ms. Hogan. In your opinion, could the data and information collected during these quarantine and screening programs have helped to correct or improve the measures decreed by the government?

[Karen Hogan]

First of all, I am pleased to report that we have reached an agreement and all employees are back in the office as of yesterday. We will now enter a period of healing and I am very much looking forward to a new normal that will allow us to better support the work of Parliament.

You are right that the requirements were clear. However, the department had not done a good job of monitoring and control. It did not gather the necessary data to demonstrate that the requirements were effectively limiting the spread.

We observed improved practices for contacting travellers. However, the agency did not learn lessons and automate the process to improve data collection. As a result, there was insufficient data to determine whether the measures were effective and whether they needed to be adjusted during the pandemic.

[Nathalie Sinclair-Desgagné, Bloc, Terrebonne, QC]

Madam Auditor General, it's still interesting to learn that at this point.

I would now like to get a clarification regarding the 8,061 travellers who arrived in Canada and tested positive. Were 14% of them contacted by the agency or were 14% of them not contacted by the agency?

[Karen Hogan]

Are you talking about individuals who tested positive?