Health committee  I would like to take this opportunity to thank all the witnesses for their very comprehensive and interesting presentations. I am very grateful to them. I have a very simple question for Dr. MacDonald. It is perhaps a little naive. I wonder about it very often; I assure you it’s true. Have we reached the endemic stage of the pandemic in Quebec and Canada? After each wave, we are told that we have.

Health committee  I've been asked this many times and it's not simple. We would love it if it became endemic, didn't mutate further, and moved to being a “meek and mild” virus. It hasn't quite gotten to meek and mild. We still have people dying from omicron. We still have people being hospitalized with omicron.

Health committee  Dr. MacDonald, if you had taught me, I might have wanted to become a doctor. Let’s say the virus becomes endemic. The debate about preventive measures, masks and so on, always comes up. We hear one thing and its opposite.

Health committee  I want to be a real infectious disease physician, now. Listen, mask-wearing is not that hard, folks. In a number of countries in the world, even pre-COVID, people were wearing masks all the time. Masks really decrease respiratory viral infection transmission—influenza, parainfluenza, RSV and COVID.

Health committee  Great.

Health committee  You were really part of the last people still operating and serving Canadians, so thank you for that. I'm also going to concentrate my questions on you, Dr. MacDonald. It's really good to see you. You gave a real tour de force in five minutes. I can't believe how much you covered that is left to unpack. One area in which we know we have lost ground is getting adults their third dose or, in some cases, their fourth dose.

Health committee  I'm sorry; I could talk for hours on this.

Health committee  I have a couple of quick points that I hope with make this more understandable. It's complex. One of the problems in South Africa is that over 80% of people have had COVID. They do not see the value of having the vaccine, even though we know that in having had COVID, particularly omicron, you are not protected should we get another variant that looks like delta.

Health committee  Sure. Again, Canada was kind of a middle of the road. We did not shut our schools as completely as a number of other countries did, but we already have evidence that this still had a negative impact on the development of children, on their reading and writing skills. I think we will not know the full impact of the negative pieces that went with this for probably a decade or two.

Health committee  Dr. MacDonald, it's a bit of a hot-button topic, but we're talking about vaccines and adverse events, and certainly again those are going to be in our “lessons learned”, I think. Given the complex reporting requirements for adverse vaccine events, how do we then begin to unpackage what we know has happened?

Health committee  Thanks, Dr. MacDonald. That folds nicely into the next thing we will begin to look at. Certainly it's likely we would invite you back, if you would have us, so to speak, but we're going to start a children's study.

Health committee  Let me stick to a couple of points, and I need to give full disclosure here. I was a founding member of the Global Advisory Committee on Vaccine Safety with the World Health Organization, so this is something that I've been very involved with for more than 25 years. There is something we did not do well, and we know that communication is key.

Health committee  I probably would have left, but that's just me. I'm not a very patient person. Thank you very much for your great understanding. Dr. MacDonald, you talked a bit about the concept of vaccine hesitancy. Could you characterize your thoughts on how Canada did, as a country, with respect to vaccine hesitancy?

Health committee  I can answer that wearing several different hats, my provincial hat, my Public Health Agency of Canada consultant hat, and also my WHO consultant hat. Relatively speaking, Canada, depending on which province you were in, did brilliantly well or did not. We had quite a range across our country.

Health committee  There are two things I would raise in regard to that. Number one is that the whole emphasis that I tried to put forward is that we really need to be teaching people how to do critical thinking, so they can understand when people are speaking to them whether or not they are using the techniques that we know sell misinformation and disinformation.