Thank you very much, Mr. Chair.
Certainly, it's a privilege to be the very first witness, a double privilege. I have a very short deck. I'm going to go through the deck very quickly. I'm going to ask Dr. Matthew Gilmour, who is the head of our laboratory, NML in Winnipeg, to add to that. Those are basically the messages I have.
I'd like to start by conveying three key messages to you. The first key message is that our knowledge is rapidly evolving when it comes to the Zika virus. Many of the recommendations and activities that we're doing currently will likely change as the knowledge increases. The second key message is that the risk to Canadians living in Canada is low at this point in time. The third key message is that based on some of the science we have, we are certainly taking, and I think the globe is taking, a precautionary approach in terms of how we deal with the Zika virus.
Page 2 of the deck talks a bit about the virus, a bit about how it's transmitted. One of the key messages there is that only 20% to 25% of the people who are infected with the virus actually get symptoms. This virus has been around for a long time. It has been around in Africa and Asia since 1947 or 1950, but despite that, we don't know a lot about it, mostly because very few people actually got sick and very few people were hospitalized. It was one of those things that just happened and we didn't even look for it.
The current outbreak of the virus in the Americas is a little bit different, but the vast majority of the genome is the same. It's in a family of viruses, which I'm sure you've heard of, like dengue, yellow fever, and West Nile virus. West Nile virus is the virus that is in Canada, which makes some of the diagnostics a little bit difficult to do.
As I mentioned, there's very limited knowledge. We're learning more and more. You've seen reports of microcephaly and Guillain-Barré syndrome and that knowledge is gradually building. The diagnostics, and Dr. Gilmour will talk to those in a second, are extremely important. A key point here, though, is that there is no treatment. There is no vaccine for this virus and much research is needed.
The next slide is on the risk to Canadians. You've seen in the media that since the huge outbreak in the last several years, over 50 countries worldwide currently have a local circulation or outbreak of this virus and over 30 countries in the Americas at this time.
What's key to us, given that the risk to Canadians, as I mentioned, who live in Canada is very low, is the travelling public. You'll note from the slide that over three million Canadians travel every year to the countries currently affected in the Americas. As of March 7 there have been 20 confirmed cases of Zika in Canada. These are laboratory confirmed and these are all people who have acquired their infection outside the country. The key population that we're worried about is pregnant women and most of the remarks I'll make in the next little while are focused on them.
The next slide is Zika and pregnancy. Brazil, as you're aware, is reporting a serious spike in birth defects known as microcephaly, which is an abnormal head size associated with incomplete brain development. Along with microcephaly, there are other neurodevelopment changes that have been noted as well. This has not been proven yet and that's some of the difficulty.
There is an association of this virus. You've probably seen in the media reports of 5,000 or 6,000 new cases or reported cases of microcephaly. There's some evidence to suggest that those started before the Zika virus was actually in Brazil and there are only a few hundred that have been linked to the Zika virus. I emphasize linked. We will never have proof of this. You can't give a pregnant woman the virus just to see what's going on. They will always be observational studies, but that evidence is gradually building.
We do have evidence of the virus present in fetuses, in placentas. But does it cause the defect or does it just happen to be there? That's what is unknown.
We have special precautions with pregnant women specifically targeted. As you've seen in our travel health notices, we're advising pregnant women who are considering travelling to those countries to reconsider their travel and defer their travel at this time until the outbreak is over. If they must go, they should practice very careful mosquito avoidance techniques.
The other thing that's also new is sexual transmission. Prior to this outbreak, it was exceedingly rare, one or two cases reported globally. You've probably seen in the media a few more cases of sexual transmission. The virus seems to exist in semen. Our knowledge so far is up to about two weeks and there have been a few cases of men who have gone to these countries, become infected with the virus, and given it to women through sexual contact when they come back.
On slide 5 I'm going to talk a bit about our domestic response. Key to us is surveillance. We're monitoring the outbreak, compiling a national picture to find out what's going on, and we're certainly meeting our obligations under international health regulations.
We're a signatory to the International Health Regulations with the WHO. We're not obligated to the IHR to report on all cases of Zika that are acquired outside the country, but we are obligated if anyone acquires Zika inside Canada, or if it's associated with a birth defect.
We've been producing a lot of guidance, such as travel health notices, which I've alluded to. We have a public health notice going to the general public. We have CATMAT, the Committee to Advise on Tropical Medicine and Travel, a group of experts we've put together. They've been in existence for many years. They have produced a series of travel guides and put them on our website.
We also have laboratory testing and recommendations for Zika virus, which Dr. Gilmour will talk about in a second. You're probably aware that there's a 21-day deferral period in place for blood, cell tissue, and organ donations. My colleagues from Canadian Blood Services will speak to that in a minute.
Slide 6 talks about the diagnostic testing support, and I wanted to let you know that we have had the virus in Canada since 2013. It was isolated from a traveller who acquired it in Thailand in 2013. We kept a sample of it in our laboratory, which gave us a jump-start on the diagnostic tests for the virus. The virus was 99% identical.
Matt, do you want to add a few comments about our diagnostic support?
Yes, I'd be glad to, Dr. Taylor.
First, thank you for having me in from Winnipeg. It is certainly a busy time at the National Microbiology Lab right now, because we're offering first and foremost all the diagnostic testing services for Zika virus within the country.
We're offering two different types of tests. One is a molecular test. It's a rapid test. As Canadians return from endemic areas or areas where Zika is transmitting, if they've recently come back and they're recently symptomatic, we have a test that very quickly and definitively confirms if they do have the virus. It's detecting if they still have the virus circulating within their blood or within other tissues. It's an easy test.
The other test we have is called serology, and that's a test to see if someone has been exposed to the virus in the past. It's testing someone's own immune system to see if they have produced antibodies to the virus. Unfortunately, that test is not as rapid as the molecular suites, because we're trying to detect a past infection. It could take weeks to confirm a case.
Right now, we're lucky to have both of those within our menu of testing. It's coming through collaboration with our colleagues in the States at the CDC, through having had this 2013 isolate that came through a traveller who went to Thailand.
As you expect for the NML, one of the reasons we're there is that cases of infectious disease occur in Canada and there's not a chance to diagnose them locally within a hospital or provincial public health lab, as was the case with this return traveller from Thailand who had returned with symptoms of dengue. It wasn't dengue. It was something else, so they called on the NML. The specimens came to us in 2013, and we confirmed that this was the first travel-associated case of Zika. As Dr. Taylor said, it gave us that leg-up to start doing the work and to start offering and developing some of those diagnostics.
Right now, we're offering the diagnostic testing for all the provincial public health labs. In the background we've started to do research. Some is applied research on developing new tests. Some is evaluating commercial assays. If we can get those put into place, then we can disseminate the testing capacity into provincial labs so it's not all coming into Winnipeg.
We're also beginning other research studies, such as small animal models, because if one wanted to test antivirals or candidate vaccines, you'd want to start in small animals. Other models...such as in mosquitoes. We have an entomology lab where we can start doing testing to see if the mosquitoes that are in Canada can carry this virus. We have math modellers, tele-epidemiologists, and mathematical geographers who can model if the mosquitoes that are present in Brazil and Central America have a possibility of coming to Canada and also bringing the disease to Canada.
Again, we have a variety of research means to interrogate the likelihood, which is low, of this coming to Canada and sustaining in Canada. We have research on the go to develop these animal models, which will lead to possible therapeutics, whether an antiviral or a vaccine.
That's some of the work at the NML right now.
Thanks, Matt. That's great. Also within the federal family we're coordinating across several departments, we're working with the provinces and territories, and we're also engaging with the international community.
We're communicating—and this is engaging the provinces—regularly with all of our colleagues across the country, consulting experts, providing the latest information, and assembling the guidance, as I mentioned. I'm talking to the chief medical officers of health almost daily. There's a lot of angst across the land in terms of how best to report, what happens, etc. We're going on an ongoing basis. We've connected with front-line practitioners, specifically the Society of Obstetricians and Gynaecologists, the college of family practice, the pediatric society, etc.
As you can imagine, pregnant women who may be infected or are concerned they're infected have a very difficult decision to make. The CEO of the Society of Obstetricians and Gynaecologists of Canada—I've talked to her several times—says she thinks that lot of women will be deciding to terminate their pregnancies, and whether they have a positive lab or not, a lot of women are having a very difficult decision. If they aren't symptomatic and it is based on serology or antibodies, it's a very difficult test to interpret, so we're working very closely with front-line practitioners to assist them with that.
I've mentioned several federal departments. We're also connecting with Sport Canada; the Canadian Olympic Committee, specifically Dr. Bob McCormack, who is the chief medical officer of the Olympic Committee; and the Canadian Paralympic Committee to assist them in terms of making their decisions for their athletes.
Internationally, we're working with WHO, and also PAHO. Since this is in the Americas, PAHO is our main contact. We've been working very closely with them. As I mentioned earlier we're reporting cases to the International Health Regulations, to WHO, so they're aware of what's going on in Canada. The WHO has been looking for $56 million across the federal departments. We're looking at how we can best meet some of those needs.
In terms of how we can assist, some of the work the laboratory is doing.... We're considering assisting CARPHA, the Caribbean Public Health Agency. We've worked closely with CARPHA for many years now. In essence, it's several Caribbean countries that have come together to form one overarching organization to support them. We're looking at how best to support them.
I will stop there and pass it on to my colleagues.
Thank you very much to committee members. At Canadian Blood Services we welcome this opportunity.
I'll very briefly tell you about Canadian Blood Services to give you some context on the issue of the Zika virus. As members of the committee know, we're an arm’s-length organization within the larger health care system, supporting transfusion and transplantation medicine across the country. We are regulated by Health Canada under the Food and Drugs Act, but we are funded by the provinces and territories and the ministers of health across the country, who serve as the corporate members of Canadian Blood Services.
Our mandate is to manage the national supply of blood, blood products, stem cells, and related services for all the provinces and territories except Quebec, which has its own agency, Héma-Québec. We also manage for Canadians the national public umbilical cord blood bank. We're involved in the procurement of a variety of plasma-derived drugs for the country. We also lead an integrated interprovincial and national system for organ donation and transplantation. We look forward to talking to the committee about that at another opportunity.
We are dedicated as an organization to providing value to Canadians by improving the health outcomes of patients who depend on transfusion and transplantation by enhancing health system performance and by optimizing costs of the health system. We are an integrated pan-Canadian service delivery model, national in scope, with an infrastructure and governance model that makes us a unique part of the health fabric in this country.
I won't go into any detail with respect to Zika virus—for background, you've heard from colleagues at the Public Health Agency—other than to say that we do have a responsibility for mitigating risks to the blood supply for all viruses. Certainly Dr. Taylor referred to West Nile virus as a similar virus that emerged quite a number of years ago. At that time, we took very rapid and proactive steps to protect the blood supply against West Nile virus. Here we now face the same situation with respect to Zika virus.
What do we know about Zika virus and risks to the blood supply globally, and in particular in Canada? The transmission of Zika virus through blood transfusion was not entirely clear in the early evolution of this. More recently, there have been a couple of cases in Brazil that have strongly suggested that transfusion of blood products is indeed a route through which the virus can be spread.
One important point—certainly Dr. Devine can expand on this should committee members have questions—is that there is no licenced screening test we can put into the blood system today for Zika virus. Unlike the tests we have for West Nile, HIV, hepatitis B, and hepatitis C, there is no screening test that we can routinely do on blood donors. Blood system operators like Canadian Blood Services, in countries where Zika virus is not widely present, have had to resort to the policy of deferring as blood donors the people who have travelled to areas where Zika virus is present.
As the situation emerged, we began to see cases in Brazil in the middle of 2015; subsequently in Colombia, Mexico, Guatemala, El Salvador, Venezuela, and Paraguay by November; and in Puerto Rico by December. By January it was emerging in other parts of the Carribean.
At Canadian Blood Services, we immediately determined, given the frequency of travel of Canadians to this part of the world, that we needed to take some rapid and precautionary measures to protect the blood supply. We consulted with our international scientific and research advisory committee, a group of experts in the field of transfusion-transmitted diseases. We consulted with colleagues at Héma-Québec. We've been in regular conversation with both the Public Health Agency and Health Canada.
I echo what Dr. Taylor said, that we all recognized that the risk was small. Even if we didn't put anything in the way of a deferral policy in place, the likelihood of a transmission through blood transfusion in Canada was very low.
Nonetheless, and in keeping with the precautionary principle that underscores decision-making at Canadian Blood Services, on January 28 of this year we announced our intention to implement a formal risk-based decision-making policy with respect to Zika virus for the blood supply no later than one week after that announcement on February 5. At the time, on January 28, we publicly asked Canadians who had recently travelled to Zika-risk areas to postpone donating blood for a month until we had time to complete a comprehensive risk assessment and determine an appropriate deferral policy for the country.
Dr. Devine and her team of experts immediately began a rigorous risk-based decision-making process. It was primarily focused on ensuring the safety of the blood supply balanced with the security of the blood supply—meaning ensuring that we had enough blood to meet the needs of patients across the country.
We used all available scientific information to understand the nature of the risk and the data on travel behaviour of our donors. We developed a sophisticated risk model based on assumptions, predictions, and experience both with Zika virus as a known pathogen and similar viruses such as dengue virus.
On February 5 of this year we implemented a deferral policy of 21 days following exposure to Zika-risk areas. Héma-Québec introduced the same deferral policy. That 21-day deferral policy is based on several important criteria: an estimated risk of infection through a unit of blood in the Canadian blood system; available information on the duration of illness and residency of time of virus in the blood stream; the need for a deferral time period that aligned with our computer system so that we could implement it rapidly and effectively; the need for a simple approach that did not require changing every time another country reported Zika virus presence; a calculated impact on sufficiency of supply so we wouldn't lose more donors than could meet the needs of Canadian patients; and most importantly, the introduction of proportionate risk so as to have the right balance of safety and security of supply.
It was known to us at the time that the U.S. Food and Drug Administration was contemplating a 28-day deferral policy, as were several other countries where Zika virus may have been of concern. This concept of a 28-day deferral policy was based on calculations done by an organization in the United States known as the AABB, or the American Association of Blood Banks. Dr. Devine and I have served on the board of that organization. Their committee did two risk assessments: one for 14 days and one for 28 days. They did not do a risk calculation for 21 days. Those two time frames, 14 days and 28 days, were selected because they had been used for deferral policies for other viruses.
Their data showed that a 14-day deferral policy is likely too short from a risk mitigation point of view, so they ended up recommending a 28-day deferral policy. FDA followed this advice from the AABB, and that has become the policy in the United States.
Our risk modelling included a detailed calculation, including the 21-day deferral policy. Our data will show, as does Héma-Québec's, that the risk of a unit of blood being infected with Zika virus and entering the blood supply in Canada with our 21-day deferral policy in place is one in 38 million. The risk using a 28-day deferral policy would be one in 380 million. As context for committee members, the combined risk of HIV, or hepatitis B, or hepatitis C entering the blood supply in Canada today in the face of sophisticated screening tests is about one in 3.8 million. We're confident that our 21-day deferral policy significantly reduces the risk of Zika virus proportionate to other risks we manage.
The region of travel that we have chosen is intentionally very wide. In other words donors who have travelled outside of North America and Europe will be deferred for their 21-day period.
As was mentioned, there are also considerations with respect to donors for cells, tissues, and organs. As I mentioned in my opening remarks, in addition to managing the blood system we are also responsible for managing the stem cell network for Canada and the public umbilical cord blood bank. We are also involved in supporting organ donation and transplantation across the country. We are confident that the risk calculations applied to blood donors will be equally applicable to adult stem cell donors.
Health Canada has indeed provided guidance for cells, tissues, and organ organizations that aligns with our 21-day deferral policy that Canadian Blood Services and Héma-Québec now have in place. While we don't screen organ donors directly—that is done by other provincial organizations—we do believe the advice related to organ donor management provided by Health Canada and the Canadian Transplant Society is appropriate.
Like the Public Health Agency of Canada, we're involved in active monitoring of this evolving situation. We remain in contact with numerous partner organizations, including blood system operators around the globe, provincial and federal public health agencies, and many other organizations managing this entity.
As a closing point, I would like to leave committee members with an understanding of one other technology that, while not available imminently in Canada, is a technology that we at Canadian Blood Services believe is incredibly important from a risk management and risk mitigation point of view. It is a technology known as pathogen inactivation technology. Sitting beside me is one of the world's leading experts in that. She will be happy to answer committee questions.
It is a technology whereby we don't rely on testing for agents in the blood supply but actually depend on technologies to kill or inactivate the pathogens prior to transmission. That technology is not yet licensed and available in Canada, but Canadian Blood Services is on record and working with a clinical trial and the regulator to get licensing of the technology to further enhance the safety of the blood system.
In closing, Mr. Chair, Canadian Blood Services can assure Canadians that we have taken swift and decisive action to mitigate the risk of Zika virus from entering the blood supply in Canada. Canadian patients can continue to depend on us to manage a safe and secure system. We are confident that our rigorous, risk-based decision-making processes have resulted in an appropriate policy for Canada, given what we know about Zika virus today.
Thank you very much.
Thank you, Mr. Chair, and thank you to the panel. I appreciate your information.
Way back in February of this year, when I first heard about the Zika virus, it was almost like panic struck the media when the World Health Organization declared the Zika virus outbreak a public health emergency of international concern. Of course, I compared it to Ebola, or something that's very concerning. However, you say that the risk to Canadians is low.
I look at the symptoms, which are things like skin rashes, fever, muscle and joint pain, and headaches. The symptoms are mild and they last for about two to seven days. Most people recover from the infection without complications. The hospitalization rates are low. I'm pleased to hear that, and the fact that it's not comparable to Ebola or hepatitis, or whatever.
You mentioned there are about three million Canadians who travel to these infected countries, and we have 20 confirmed cases now. Are any of these confirmed cases pregnant women? That's the big risk right there. These pregnant women have the issue of deformation of their child.
Is it contagious other than through mosquitoes and through blood? Can you sneeze and give it to somebody else?
I have a question for our Canadian Blood Services doctors. Because of the symptoms and the fact that people fully recover from this, do you feel it's excessive that you're deferring blood, organs, and tissues? People are dying on tables waiting for these organs and tissues, and you're going to turn away a potential organ from someone who may have travelled to that area.
Is there a way for you to test these organs and tissues first, before deferring them? Have you had any cases of deferral of organs and tissues?
There's a whole pile of questions I've asked you
Just on procedure, Mr. Chair, if I don't use up my seven minutes, can I pass them on to my colleagues?
I hear three questions and they're all excellent.
In terms of pregnant women, as Matt said, we're doing all of the testing in Canada right now, both for the presence of the active virus in the blood and for antibodies towards the virus. The latter test is tough to interpret. It's very difficult to interpret, and we're suggesting that the doctor be aware of that and that they have a good conversation with their patient, either before or after that test.
Oftentimes, we don't know whether the sample is coming from a pregnant woman or not. We're aware of one in Canada at this time. There may be more, but we're not aware of them. Obviously, for confidentiality reasons, we're not indicating where this person is. It would be much too easy to identify them. But that's all we're aware of.
We expect the numbers will increase. Given the three million travellers, we expect we'll see a lot more people who are positive for that, hopefully not pregnant women but we'll see a lot more.
Regarding your question about whether it's contagious, no, you can't sneeze and that. The methods of transmission are limited to—and this is our scientific knowledge now—those two mosquito types.... The virus is in the mosquitoes, and they'd have to bite a person who is uninfected and inject that into them. There's also sexual transmission through semen. The virus is in the semen of a man who's been infected, and it lasts for up to two weeks after the infection onset. Rarely, as my colleagues were saying, there are a couple of cases involving blood transfusion in Brazil.
I'll pass that over to you.
I'll take your question about deferral, whether the deferral period of 21 days is too long and whether we are having a greater impact on the other side, which is the availability of tissues, organs, and blood products for Canadians.
We have put the 21-day deferral in place as a precautionary measure. As we learn more about the Zika virus and understand more about how it behaves in infected people and what the risk really is, we will keep looking at the deferral period to understand whether it's too much. What we feel right now is that it is the appropriate place for us to start, because we are lacking a lot of detail.
In terms of the availability of organs, we are not aware of any case of an organ donor travelling in a Zika-risk area and then becoming a problem for deferral potential.
The other thing that comes in with organ donation is that there is always physician choice. Because of the rarity of organs and the length of the wait list in the country, there is more latitude for being an organ donor than there is for being a blood donor.
On the stem cell front, we are aware of one case in which we had a stem cell donor who was lined up for a recipient, and the donor had a Mexican holiday planned and was not prepared to reschedule. Fortunately, the transplant centre had multiple match donors who could have donated to the patient, so the patient is getting the transplant anyway, even though the donor has elected not to change the Mexican holiday plans.
You're right. With the amniotic fluid it's collected through amniocentesis. That's obviously a bit of an invasive procedure, so that's not a specimen that we've been receiving commonly at the NML. Odds on, the vast majority have been blood specimens, so it's people who are interrogating soon after their return from these countries to see if they are viremic, to see if the virus is still circulating within their body, or again, there's the alternative test with the serologic approach.
We actually have a two-pronged approach where we can fairly rapidly see if someone has a particular class of antibody that would be raised against a viral infection. The problem with that test is that it could equally be detecting something like dengue fever, or West Nile virus, or yellow fever. For these other viruses that are in the same class and are transmitted by the same mosquito, this initial test is really just saying, “You've had a past viral infection.” That's where we have to move on to a second round of serologic testing, a confirmatory test, where we're directly interrogating patients' blood to see if they have the antibodies to Zika. That's where the timelines come into play a bit. That, again, is why, very early on, we put the message out about being transparent about some of the test limitations that we have. There's not really a test limitation on Zika. It's just a test limitation for detecting some of these types of viral infections, including dengue, etc.
If someone is worried that they had Zika, but they're well, if they want the test, we can offer it. But again, it may not be an answer that comes quickly, within the same week. It may come weeks down the line because of the multitude of testing approaches that may be required. We're extremely cognizant of the decisions that patients might be making based upon these test results, again to possibly terminate their pregnancy or not. That's why we've been trying to be as transparent as we can with the limitations and the state of the art of the tests that we have right now, so that people can make this informed decision for themselves.
That's an excellent question.
Whenever one of these events happens, we do a risk assessment, so we look at the organism, look at transmission models, look at the outcomes, look at if there are ways to prevent it, if there is a vaccine. We look at all of those things and do a risk assessment and come up with what the risk is to Canadians. Granted, the definition of “low” versus “very low” is relatively subjective with that one, but in this case we don't have the virus in Canada. The mosquito vector doesn't exist in Canada. The only way they could infect, which we've just learned, is through sexual transmission. That's relatively new. Initially we didn't know that. Initially we didn't know about blood, because that is relatively new as well, so the estimate was that the risk to Canadians in Canada is very low.
Those risk assessments are updated on a ongoing basis, so we're looking at constantly updating. If new information comes in, research results come in, our scientists look at it again and look at our assessment and say, “Do we need to change that? Has the risk changed or not?” This is exactly the same thing we did throughout the Ebola outbreak, which is why we saw different measures for Ebola. When our assessment came it was still low, but we were watching this and acting.
It's an excellent question that gets into the core of what the agency does on an ongoing basis—constantly doing risk assessments and constantly monitoring that.
I'd like to. Thank you for that question.
I'm going to make a general comment, and then Dr. Devine can provide a little bit more of the specifics. I think it is important for committee members to appreciate that the clinical decision-making to support an organ donation or a stem cell transplant is very different from the clinical decision-making to give somebody a transfusion.
We collect close to a million units of blood a year. About 1.5 million transfusion events happen in Canada every year, and if a physician needs to choose a unit of blood, typically there's a large selection to choose from, so we can easily defer 3% of the blood donors and still meet the needs of all the transfusion patients.
For stem cell donors and patients, and certainly for organ transplant patients and donors, there's a very different relationship. Getting the organ is a life-saving event and often it's the only organ available, and if the patient doesn't get it, he or she might well die from the underlying disease. The whole notions of risk-based decision-making and clinical decision-making are very different.
I'll let Dr. Devine clarify again the situation with the stem cell donor, but if an organ donor who may have travelled to one of the Zika-risk countries comes back to Canada and is, unfortunately, killed in a motor vehicle accident within that 21-day window, the physician will make a clinical decision as to whether that organ is potentially going to save a life at the risk and very low likelihood of transmitting Zika, probably in the order of one in three million or four million.
The set of risk-based decisions for organs and stem cells is very different from that for blood, and it is based purely on the availability of the resource to match the patient's needs. Again, I think we'll clarify for the committee the specifics on that stem cell case.
I'll certainly answer on behalf of Canadian Blood Services.
Our decision to act and act quickly was based purely on the precautionary principle and actually, you asked that question earlier, Mr. Davies. I want to reinforce that we decided to act even in the absence of evidence because the whole precautionary principle says the absence of evidence is not evidence of absence.
Even though we didn't know that it could be transmitted through blood transfusion, we felt that a broad-brush safety measure deferring anyone who may have travelled to those areas for a 21-day period was an appropriate thing to do.
In terms of what additional resources my organization would need to further enhance the safety of the blood supply, one thing I have to credit governments in Canada, particularly the provincial and territorial governments.... When Canadian Blood Services was established in 1998 on the heels of the tainted blood scandal and the failures of our predecessor organization, one of the most important risk-mitigating strategies governments gave us was the capacity to act in the name of safety without asking governments for additional money.
Canadian Blood Services has a contingency fund, meaning we could implement any test or any measure at any cost to protect the blood supply without asking government for permission to fund it. We have a prefunded contingency fund in the amount of $40 million that allows us to act in the name of safety.
That is perhaps the most powerful resource that this organization has. Unfortunately, we acquired it because of the lessons learned from the tainted blood scandal, but to the credit of governments, both federal and provincial governments, when Canadian Blood Services was established, we were given the resource and capacity to act in the name of safety without fiscal restraints or constraints. That's perhaps the single greatest assurance we can give Canadians, that we do that when necessary.
I'd like to echo Dr. Sher's comments. This is a great opportunity to speak to you and to have media present to speak to Canadians and reassure them that for the vast majority of Canadians this is a very low risk.
The message I'd like to leave you with is, again, that this is not going to be the last one and wasn't the first. These are going to require a global response for a whole variety of reasons. Just as the agency cannot act alone but needs many government departments, Canada cannot act alone. We've been working very closely with all of our colleagues across the world.
I think Ebola illustrated that very well. We were lucky with the Ebola. We had a vaccine that we had developed and it was ready to go. We don't have that for Zika. If we had one for Zika, this would be a much different story. It's going to take a while. There are technologies, some in Canada, that can make rapid production of vaccines possible, but doing so requires huge resources, and it has to be on a global stage.
I think that's the last message I would leave: it requires a global response. In the next little while, as I mentioned at the outset, our advice is going to change, because the science will evolve almost on a daily basis, and the advice and recommendations will change.
Thank you again for the opportunity to be the first two witnesses at your—
Just to throw another angle on it, I think the committee is master of its own business. We can do whatever we want, so we can certainly issue a report if we want. Customarily, a briefing is very different from a study and a report. We received a briefing today. That was a briefing for us as members of this committee. I didn't anticipate a report would come out of it.
Generally, when we say we want a briefing, it's to receive a briefing. When we undertake a study, generally it's to study in depth, hear from a variety of perspectives, and issue a report. The reason I think that distinction might be helpful....
I have two concerns about issuing a report based on today. Number one is that we did not have a comprehensive series of witnesses. We had two government agencies. Typically, in a study that results in a report you have a wide variety of witnesses from a wide variety of perspectives. Maybe there are epidemiologists or people working in disease control that would take issue with what was heard today. I don't know, but maybe that's the case.
Second, I'm really concerned because much of what I heard today mirrors what I heard on Friday, which is that the information on this is changing—and we heard it here—daily, maybe even weekly. By the time we write our report and get our recommendations, for all I know the gestation period for the virus in semen could be found to be.... As I said, I heard 62 days, and 14 days here today, so I'd be very concerned about this committee putting out a report based on one day of testimony from two government agencies without testing information on something that we know is a highly labile, fast-changing subject.
Now, we could write a report with that in mind—
I am mindful that our analyst suggested getting—I was repelled at the deadline, but maybe it's not a bad idea—us to fire in as many witnesses as possible to her by the end of this week so that she can at least get started.
The Chair: Yes.
Mr. Don Davies: The other thing I was going to mention is that, as Bryan mentioned—he's right—you typically start off a study by hearing from the department. The departmental officials will brief you in your first meeting, and then you start your other meetings. I'm thinking of having six meetings of nothing but witnesses, because Darshan is correct; it goes quickly when you have just two organizations per hour.
Sometimes, Mr. Chairman, you may choose to schedule a two-hour meeting with just a couple of witnesses if you wanted to delve in for longer. That can happen as well, if you so choose.
I'm thinking of one meeting for the briefing from the department and six meetings of witnesses, which would be 24 witnesses. We can always cut that down, depending on the witnesses. Maybe we can just fire in to the analyst our witness list at least by Friday, as a first swath. I wouldn't limit anybody. I would suggest that—
An hon. member: You need at least one meeting for the report.
Mr. Don Davies: We need to have at least one meeting—usually two—for the report that comes afterward.