Transport Committee on Dec. 10th, 2020

[Dr. Zain Chagla]

Yes. Absolutely. On the 0.7%, some of it was related to people who were positive, who were non-infectious but still shedding, who went on a flight and got back to Canada, and who probably got infected in their place of origin, in that sense. Some who were caught there were actually infectious. Yes, that 0.3% got caught a little bit later. These people were incubating on that flight, were negative when they showed up, but after a couple of days back in Canada tested positive.

Yes, there is a part that's missed, which is why you do have to institute some period. Again, with day seven, if you're going to catch most of them, that's probably a much more tolerant period for everyone else. Plus, you're going to catch people who might even be symptomatic day nine or 10, because we know they start shedding on day seven in that sense too.

[Taylor Bachrach, NDP, Skeena—Bulkley Valley, BC]

Right. Okay.

I'd like to shift a little bit to the cost of rolling out these rapid tests across airports in Canada. I'd like to know from Dr. Chagla, Dr. Bogoch or perhaps even Mr. Taylor, if we were to cover a percentage of international flights, whether we have some sense of the investment that would be required to roll this out in the way in which the major airlines would like to see it implemented.

[Dr. Isaac Bogoch]

I could take a quick stab at that.

I think the important thing to consider here is what we have available now, but that's rapidly evolving too, like inexpensive, easy to use, rapid screening tests. They're not diagnostic tests; they're screening tests. They are cheap, easy, point-of-care tests.

Are they going to be perfect? Of course not. We're talking about adding another layer of protection, and obviously, when purchased in bulk, it seems it would be a very feasible thing to do. That doesn't exist just yet, but it will shortly.

[Taylor Bachrach, NDP, Skeena—Bulkley Valley, BC]

Do you have any sense around the cost? My understanding is that what's being called for is something that will reduce or even eliminate the requirement for a quarantine.

Dr. Chagla is talking about reducing the quarantine from 14 to seven days. That doesn't eliminate the inconvenience of quarantine altogether. I'm just wondering if it's worth this investment, because we have scarce resources and we want to invest them in the areas where we can have the best impact on reducing transmission and addressing the overall pandemic.

Is it worth investing, as a country, if we can only get the quarantine down to seven days?

[Dr. Isaac Bogoch]

I'd mention two quick points. First, we're talking about pre-travel testing and post-travel testing. We're now talking about post-travel testing, just to clarify things. Second, we don't necessarily need rapid diagnostic tests for that. You can use conventional diagnostic tests and bring people into a conventional diagnostic testing centre to do that.

It would be very helpful to have a health economist look at it, and look at the cost-effectiveness and cost savings of having people potentially out of the workforce, or whatever inefficiencies you have by working from home over a 14-day period of time versus a seven-day period of time.

That's an answerable question, and it could be done; however, I can't do that on the back of an envelope here though.

[Taylor Bachrach, NDP, Skeena—Bulkley Valley, BC]

I appreciate that.

Dr. Bogoch, your point around international vaccination, global vaccination, really interested me. You mentioned Covax. What have Canada's funding levels been for Covax, if you know, over the past decade or so? Have we been adequately funding that agency to ensure that countries with more scarce financial resources than ours are able to vaccinate effectively?

[Dr. Isaac Bogoch]

Certainly Canada has been very good on the international front, but Covax is interesting, because it was just...I was going to use the words “cobbled together”, but those are probably not the most appropriate terms. It's through an alliance with the WHO and Gavi, which is a big international vaccine institute. The whole point was to gather a bunch of countries together to get buying power for COVID-19 vaccinations, so that they weren't muscled out of this by high-income countries.

I think it's going to be successful. It's clear that they're going to be later on. Lower-income countries and low middle income countries will be vaccinated, certainly not any time soon, but they will get access to vaccines. Many countries, including Canada, have paid into this. I'm very happy we're supporting it.

[The Chair, Liberal, Vance Badawey]

Thank you, Dr. Bogoch, and thank you, Mr. Bachrach.

We're now going to move to our second round.

For the Conservatives, we have Mr. Shipley, followed by Mr. Sidhu for the Liberals, for five minutes each. Then we will have Mr. Barsalou-Duval from the Bloc Québécois and Mr. Bachrach from the NDP, for two and a half minutes each.

Mr. Shipley, the floor is yours for five minutes.

[Doug Shipley, Conservative, Barrie—Springwater—Oro-Medonte, ON]

Thank you, Mr. Chair.

Our committee has been talking a lot about the impacts of COVID on the aviation sector. There have been a lot of questions so far about rapid testing.

I'm going to key in more on the vaccine aspect of it, because to get the airlines and aviation sector back to normal—which is an interesting word being bantered around these days—we need to deal with the pandemic itself and that's obviously through the vaccine, we hope.

Dr. Bogoch, I'm going to be asking you many questions, and I have to admit I'm looking forward to having a discussion with you.

Dr. Bogoch, you've become a bit of a COVID star in the news media. I knew I'd make you smile there a bit. You're almost a bit of a COVID celebrity, and I'm sure you're lots of people recognize you, because I definitely do.

I watch the news a lot. I'm a bit of a news junkie, and I definitely knew the name right off the top, and was looking forward to talking to you. You've done a great job over the last many months. You've kept a lot of people informed.

Once people have successfully had both vaccines—when I say both, the ones we're getting right now that require two doses—will they be able to travel without quarantine restrictions?

[Dr. Isaac Bogoch]

That's a great point. The short answer is I don't know. I just don't know, because we don't actually know yet about.... What we do know about these vaccines is that to date if someone gets the vaccine they're much less likely to have symptomatic COVID-19, significantly less likely to get symptomatic COVID-19.

Some people still get COVID-19 with the vaccines, but it's likely—I have to be careful with my words—that even if you do get COVID-19 with the vaccines, you're probably going to have a less severe course of illness. But you still can get infected and you can still transmit it to others.

I would imagine that the quarantine would be lifted when significant proportions of the Canadian population are vaccinated, such that if someone did introduce a case, it would not start tearing through communities like we're seeing it do now.

That's the best I can do for now. As we understand more about how this vaccine impacts transmission and infection, which we'll learn more about very closely over the coming months, I think I'll be able to have a much better answer for you.

[Doug Shipley, Conservative, Barrie—Springwater—Oro-Medonte, ON]

All right. Thank you very much.

You actually led right into my second line of questioning on the vaccine. What kind of vaccine adoption rate do you think the general public would need to have before you could see a significant impact on the COVID infection rates?

[Dr. Isaac Bogoch]

I think we're going to see a significant impact way earlier than what people think. If we get through our nasty level one group, which is indigenous populations, those who live or reside in long-term care facilities and front-line health care providers, we're going to alleviate so much death from COVID-19.

We know that long-term care facilities account for about 80% of the deaths in the country. By protecting them, we are obviously helping to save lives, but we're also taking a tremendous pressure off our health care system, which has tremendous ripple effects and benefits for everybody else.

There are a lot of benefits that we'll get early on when they're rolled out, so perhaps by February. Interestingly, even after the first dose of those vaccines, we are starting to see evidence that you have some pretty significant protection against getting this infection. It's not as good as two doses, but it's certainly a lot better than nothing, so we might see some early benefits with this.

Really, we want to have an uptake of about 60% to 70% of the Canadian population to really have something close to what we would call herd immunity, where if the virus were introduced, it would not start spreading through the community very easily.

[Doug Shipley, Conservative, Barrie—Springwater—Oro-Medonte, ON]

I like your quote about how alleviating death is good. I definitely agree with that one, Doctor.

I have another couple of questions about the vaccine. I know that it has been rolled out. It's coming out next week here in Canada, and that's great news. We're all looking forward to that. There is nothing negative about that at all.

I know that they have started it in the U.K. a bit ahead of us, and I know there have been a couple of glitches. I'm hearing from a few of my constituents about allergic reactions. Do you have any concerns about these allergic reactions? I have no concerns at all about the vaccine. I'll be one of the first in line to get it when it's our turn, but have any concerns been raised to you due to the couple of reactions that seem to be getting a lot of publicity right now?

[Dr. Isaac Bogoch]

Yes, I'm not surprised that it's getting a lot of publicity, because the world is watching closely. I'm not really concerned about these allergic reactions. We just have to be open, honest and transparent about what we know and what we don't know.

We're going to see some things like this happen. We know that the two people who had allergic reactions both carry EpiPens and have severe allergies to certain things. We have to learn more about this, but in the end, I think, we pivot to where it looks like people who have severe allergic reactions to any component of the vaccine will not be eligible for vaccination. That's kind of obvious, and that's a smart thing to do.

Also, of course, we know there are other vaccines in the pipeline, whereby people who might have an allergy to components of this vaccine will be able to use other vaccines that are not too far behind. We might hear from the Moderna vaccine very shortly here in Canada as well.

Yes, it's a small bump on the road, but by no means is this catastrophic. I think we're going to see the rollout of the Pfizer vaccine and other vaccines in Canada.

[The Chair, Liberal, Vance Badawey]

Thank you, Dr. Bogoch.

Thank you, Mr. Shipley.

We're now going to the Liberal Party, with Mr. Sidhu for five minutes.

Mani, the floor is yours.

[Maninder Sidhu, Liberal, Brampton East, ON]

Thank you, Mr. Chair, and thank you to all our witnesses for being with us today.

I want to take a moment to say thank you to all of our health care professionals who are working day and night.

Dr. Bogoch, it's nice to see you again. In your opening remarks, you provided some great insights, and I really appreciate your clarity. My wife and I watch you on the news. As Mr. Shipley was saying, it's just awesome.

Would you personally feel safe travelling by air for non-essential reasons? If not, what would need to change before you did? I know you mentioned professionally....

[Dr. Isaac Bogoch]

Yes, I certainly would. I wouldn't do it now because the public health guidance is to stay at home. I think the fundamental principle is to adhere to federal, provincial and local public health guidance, so I certainly would mention that, but if I had to travel, I would, and I wouldn't have an issue with it.

I know what to do to stay safe. I would make sure that I have a mask on and that my family has masks on. I would be very careful in getting to the airport and working my way through the airport and the various junctures along the way where there is potential for crowding. I have confidence in the filtration systems, the systems on the airplane. I'd keep my hands clean. I'd have situational awareness to make sure I didn't get too crowded. I'd get off the plane in a careful manner as well.

I would personally have no issues with travelling, but I can appreciate that the general public does have some concerns. I think that perhaps with some educational campaigns and also by decreasing the COVID rates in the community through a variety of mechanisms—vaccines included, but also through strong public health measures—we can certainly boost transportation and instill greater confidence in people's travelling.

[Maninder Sidhu, Liberal, Brampton East, ON]

Thank you for that.

Dr. Chagla, you provided information in regard to air exchanges and mentioned that flights are relatively safe. You also spoke about international flights.

Would you personally feel safe travelling by air? Would you say the risk increases on longer flights, for example, a 12-hour to 16-hour flight versus shorter flights?

[Dr. Zain Chagla]

That's a good question.

Again, as Dr. Bogoch said, I would be happy to fly at this point, recognizing the other features. The biggest risk factor to flying right now is your destination, particularly knowing what's happening in other parts of the world, rather than necessarily the flight experience and being mindful of the other parts.

That Department of Defense study was interesting because it kept talking about fluorescent particles and that measurement, the filtration and the amount of time they stayed in the air to a detectable quantity. It was about six minutes or two air exchanges.

If you take that on a probability map then, yes, the longer you're on a flight and beside someone who is actively infectious, the longer you may start seeing that exposure. As their burden and their shedding keeps going and going, the air exchanges keep going and going.

The DoD study suggested 54 hours beside a contagious person. I think it is probably dependent on the viral load of the person, the context, how close you are to them, if they're masked or not masked and that type of thing. Certainly, there is a dose relationship. Shorter flights are probably less risky than longer flights where you just have more particle exposure, even with the air exchanges.

[Maninder Sidhu, Liberal, Brampton East, ON]

Thank you for that, Dr. Chagla.

Mr. Taylor, did you want to weigh in here?

[Patrick Taylor]

Yes. I'm delighted to be more specific.

I recently took a 13-hour flight from Germany to Mexico and felt completely comfortable in the aircraft. The crew were incredibly well disciplined in enforcing the masking and, as best they could, social distancing. The hygiene of the aircraft was excellent. Obviously, knowing the industry intimately, the protocols that are now in place and implemented by the airlines helped to reduce the risk for all travellers.

However, as my two colleagues have said, the risk exists based on exposure, on concentration and a luck factor of how many people on that particular flight are infected. Many factors determine how high the level of risk is on a particular journey.

[Maninder Sidhu, Liberal, Brampton East, ON]

Thank you.

Very quickly, Dr. Bogoch, you briefly mentioned quarantine for international travellers. Would you recommend Canada shorten its mandatory quarantine period?

[Dr. Isaac Bogoch]

If we had good data demonstrating a negative test on arrival and a negative test at seven days, we are going to have very few slip through the cracks. I think it would be completely reasonable.

[The Chair, Liberal, Vance Badawey]

Thank you, Dr. Bogoch.

Thank you, Mr. Sidhu.

We're now going to move to the Bloc Québécois with Mr. Barsalou-Duval for two and a half minutes.

The floor is yours.

[Xavier Barsalou-Duval, Bloc, Pierre-Boucher—Les Patriotes—Verchères, QC]

Thank you, Mr. Chair.

Dr. Chagla, if I understand correctly, you were involved in the tests conducted in the pilot project in Calgary. There is a pilot project in Toronto and another one was announced for Montreal three days ago.

Are you able to explain to me the difference between the pilot projects in those three cities?