I call this meeting to order.
I'd like to welcome everybody to meeting number nine of the House of Commons Standing Committee on Health.
Pursuant to the order of reference of Tuesday, March 24, the committee is meeting for a briefing on the government's response to the COVID-19 pandemic. Today's meeting is taking place exclusively by teleconference and the audio feed of our proceedings is made available via the House of Commons website.
I'd like to note parenthetically that this is the first time ever a House of Commons committee has met virtually, and while the meeting today is purely audio, members of the House of Commons technical staff are working diligently to deliver a quality video conferencing solution, which hopefully will be available to us for our meeting next week.
I'd like to thank the technicians and all the people who are working so hard to make this happen on short notice.
In order to facilitate the work of our interpreters and to assure an orderly meeting, I would like to outline a few rules to follow.
First, before speaking, please wait until I recognize you by name. When I recognize someone by name, the operator will turn on the audio of that person; however, this may take a few seconds. During the questions and answers, I ask that members identify the witness to whom they are addressing their questions rather than simply directing their questions to the entirety of the panel. This will allow me to recognize the witness and give them the floor. All comments by members and witnesses should be addressed through the chair.
I should add that when I recognize a witness to respond to a question, if other witnesses wish to respond to the question, they should dial *1 to let the moderator know that. Should members want to request the floor outside of the designated time for questions, please dial *1 and the moderator will signal this to the chair as well. Hopefully, unless there are technical issues, we won't need to do that because it will interrupt the questions and/or answers.
When speaking, please speak slowly and clearly and avoid using the speakerphone. I also ask that members and witnesses speak in the language that they have chosen for the meeting, so whatever line you have dialed in on. If you have dialed in on the English line, speak only English. If you have dialed in on the French line, speak only French. If you have dialed in on the main floor line, you can speak in either language.
Should any technical challenges arise, in particular in relation to interpretation, please dial one to signal this to the chair and the technical team will work to resolve the issue. Please note that we may need to suspend during these times as we need to ensure that all members are able to participate fully.
During this meeting we will follow the same rules that usually apply to opening statements and the questioning of witnesses during our regular meetings. Each witness will have 10 minutes for an opening statement, followed by the usual rounds of questions from members.
Before we carry on, since this is a purely audio meeting and we can't see who is in the room, I'd like to acknowledge who is in the room in the public portion of this meeting.
I am Ron McKinnon, the chair. We have our clerk, Mr. Jacques, and our analysts, Karin Phillips and Sonya Norris.
From the Conservative Party we have Matt Jeneroux, Dr. Robert Kitchen, Len Webber, Tamara Jansen, and Pierre Paul-Hus. From the Bloc we have Mr. Thériault and Mr. Champoux. From the NDP we have Mr. Davies. From the Liberals we have Mr. Van Bynen, Ms. Sonia Sidhu, Dr. Powlowski, Mr. Kelloway, Mr. Fisher and Dr. Jaczek.
As witnesses we have, from the Public Health Agency of Canada, Ms. Tina Namiesniowski and Ms. Cindy Evans. From Health Canada we have deputy minister Stephen Lucas. From the CBSA we have Mr. John Ossowski and Mr. Denis Vinette. From Global Affairs we have Heather Jeffrey.
Each group has a 10-minute opening statement. We'll start with the Public Health Agency of Canada. I recognize Ms. Namiesniowski to deliver a 10-minute statement.
Thank you for the opportunity to update the committee on the Public Health Agency of Canada's efforts to respond to the novel coronavirus pandemic in Canada. I will give you a short overview of the situational update. As of this morning there were 719,758 confirmed cases globally, and 33,693 deaths worldwide. Cases are being reported from 197 countries and jurisdictions and from aboard international conveyances. The United States of America now has the greatest number of cases relative to the overall outbreak. As of March 30, they had 164,610 cases, and that number will be greater as of today. They are reporting 10,781 total deaths. As you're aware, things continue to evolve rapidly in terms of the spread of the illness and response efforts both globally and here in Canada. As of noon today, we have tested 236,000 Canadians and have 7,708 confirmed cases and 89 deaths. The situation in Canada is evolving daily.
In terms of the overall Canadian response, since we are seeing a daily increase in cases both globally and here in Canada, the risk to Canadians is considered high. We are already seeing a significant impact on our health care system as facilities are activating their pandemic plans and moving forward aggressively with preparations. Our health system is adjusting on an ongoing basis to respond to the situations, working alongside provincial, territorial and municipal counterparts. We at the federal level are continuing to monitor the situation and are working extremely closely with our provincial and territorial partners. In that context, as I think many of you know, we do have formal governance in place at the federal/provincial/territorial level, which includes the special advisory committee that is co-chaired by Dr. Tam and which is at the centre of the public health response from a pan-Canadian perspective.
Dr. Tam could not be here this afternoon because as we speak she's actually meeting with her provincial/territorial colleagues. Federally we are also continuing to adapt our border and travel measures as the Canadian and global situation evolves. We want to make sure that individuals, as they enter Canada, know and have the information they need to protect themselves as well as fellow Canadians. I can speak generally to some of these measures, and I'm sure my colleague, the president of the Canada Border Services Agency, will touch on some of these as well.
As you may know, as of March 21, Canada and the U.S. agreed to temporarily restrict all non-essential travel across the Canada-U.S. land border for 30 days. This timeline may be extended as needed. There is an exemption for workers who are essential for the movement of goods and people. Those include healthy workers in the transportation sector, for example, who move goods and people across the border on a continuous basis. The Government of Canada has also closed its border to people who are not citizens or permanent residents of Canada, and there are few exemptions to this rule. In addition, as of March 25 at midnight Canada implemented another emergency order under the Quarantine Act, which means that any person who enters Canada by air, sea or land must now mandatorily isolate or quarantine for 14 days.
Prior to that, this measure was being undertaken on a voluntary basis. Quarantine facilities have been identified to prevent the spread of COVID-19 and are being used to lodge symptomatic people who do not have private transportation or who are unable to get to their own dwelling to isolate since no symptomatic person is being allowed to move forward within Canada upon their arrival using any means of public transportation. The Government of Canada is also working very closely with provincial and territorial partners to promote the appropriate use of personal protective equipment, to identify areas of priority, and to collaborate on procurement of that equipment and other medical supplies such as ventilators. The government is working hard and exploring all avenues to secure supplies.
On March 27, the announced $137 million dollars of procurement of medical supplies, which will include an immediate purchase of 20 in-stock ventilators and a purchase order for 500 more. This also includes options to continue to buy additional ventilators. In addition, the procurement will also include an immediate purchase of 55 million surgical masks and a conditional purchase of test kits currently going through approval for certification, which has implicated our National Microbiology Lab.
The also announced an investment of at least $50 million from the NGen supercluster. This investment will support the development of products and equipment that are in high demand for health care workers. These are in addition to previous announcements made earlier towards the purchase of personal protective equipment and other necessary medical supplies.
We and other representatives of the federal government are working very closely with Innovation, Science and Economic Development Canada, as well as with colleagues at Public Services and Procurement Canada, to identify domestic manufacturers, to look to see how we can accelerate domestic production and to safely accelerate regulatory review and time frames to make sure that equipment is ready and available for our front-line health care workers.
I think it is true to say that in the context of this crisis, we've seen many individuals come forward in the manufacturing sector to aid Canada. We've been amazed by the responses we've received and are working around the clock to triage and assess opportunities. We've had vast numbers of offers of direct support from businesses, and we've also had some offers, through various organizations, to provide donations to Canada.
In addition to personal protective equipment, as I mentioned earlier, there has been a focus on testing within Canada. We are working hard, collectively across the country, with all jurisdictions, to advance testing. The National Microbiology Lab continues to support provinces and territories needing assistance with testing and other reference services.
Finally, Canada is also participating in the context of research and development investments. We're participating in the World Health Organization's solidarity trial, which is a multi-country clinical study looking at potential drug treatments for COVID-19, as but one example.
As you will see and hear on a regular basis, Canada is very much focused on advancing an approach that is looking to flatten the epidemic curve in Canada. As part of that, there are measures in place across the country that are focused on having individuals socially distance themselves from each other, stay at home to the extent possible, avoid crowded places and practise all of the good respiratory hygiene that Dr. Tam has talked about since the start of the development of COVID-19 globally.
From the Public Health Agency's perspective, we are very focused on continuing to support all efforts throughout the country to do just that. As Dr. Tam talks about constantly, the time is now to double down on our efforts and really work in a concerted way to do everything that is possible to flatten the epidemic curve.
The time has come for all Canadians to do what's necessary to help us get through this pandemic. I think everybody recognizes that these are difficult times for everyone who is experiencing this crisis worldwide, and there is no exception; the same holds true within Canada.
I will just conclude by saying that as the situation continues to evolve and as PHAC's response continues to evolve to adapt to the situation, we remain committed to providing updates and information as it becomes available. We're pleased to be here this afternoon. We'll do our utmost to answer any questions that any of the members of the committee may have.
Thank you, Mr. Chair.
Thank you, Mr. Chair. Thank you for the opportunity to speak to the committee today about Health Canada's role in the government's response to COVID-19.
I'll just start by echoing the comments that President Namiesniowski concluded with in terms of the critical importance of us all working together, and all Canadians, to support the effort now. Certainly Health Canada and all of our staff across the country are fully dedicated to this effort.
The COVID-19 pandemic is unlike anything we have seen in recent history. I can assure you that Health Canada is taking all the measures we can to protect the health and safety of Canadians. Health Canada plays a vital role in the government's response as the regulator of health products. Core to our regulatory mandate is the review of health products for safety, quality and efficacy. During this critical period, it is very important to get drugs and medical supplies quickly to the front lines. We are focused on expediting the review and approval of drugs and devices to address COVID-19, while continuing to ensure that these products are safe and effective for Canadians. We're using all the tools in our tool kit.
Last week, the government welcomed the passage of amendments to the Food and Drugs Act and the Patent Act, to streamline processes and provide the government with additional powers to help prevent and mitigate shortages of drugs and medical devices, to seek additional information from companies to confirm that products are safe for Canadians, as well as to make, use or sell a patented invention, such as a medication or a ventilator, that is needed to respond to the pandemic. These amendments help position us to adapt quickly. Our goal is to ensure that Canada is prepared for whatever challenges come our way in the coming days and weeks.
Another critical regulatory tool we have is the use of interim orders. An interim order is one of the fastest mechanisms available to the Government of Canada to help make health products available to address large-scale public health emergencies such as the one we are experiencing now. Earlier this month, the approved an interim order to allow quicker, more flexible approval of the importation and sale of medical devices necessary for Canada's response to COVID-19. This order made two new diagnostic tests immediately available to Canadian laboratories, and we continue to approve additional tests.
Despite all these efforts, we anticipate there will be shortages of health products, given global demand. Health Canada is working proactively to identify and mitigate the impact of drug and medical device shortages on Canadians and health care professionals during our ongoing work to combat COVID-19. We have stepped up our surveillance efforts and, as I have mentioned, have adopted new, more agile, rapid processes to help ensure that Canadians have access to the drugs and medical devices they need.
We've increased the frequency of our engagement with industry, provinces and territories, health care and patient groups, and international partners. We're doing this work to have signal identification and coordination of key mitigation efforts as early as possible.
As the president of the Public Health Agency mentioned, we're using all of the tools at our disposal to expedite the supply of safe and effective personal protective equipment. Protecting our front-line workers, those who care for the sick and keep our communities running, is one of our top priorities. Health care workers need a reliable supply of appropriate PPE to do their job safely. To that end, we're expediting approval of licence applications related to PPE products, sanitizers and disinfectants, and facilitating expedited access through the interim measures I noted. This work is critical to ensure that Canada is able to benefit from the latest advancements and to support both our domestic production that President Namiesniowski noted, as well as supplies coming in from wherever we can get them abroad.
As we know, no jurisdiction is immune to the threat and impact of COVID-19 and no individual government can respond alone. Co-operation and collaboration are critical to our response and have been part of our work from the start with provinces and territories, as well as with health care professionals, patient groups and industry. The and I, as well as Dr. Tam and President Namiesniowski, speak with our counterparts at the provincial and territorial levels very frequently, and certainly our deputies and officials do every day. This is critical for us to ensure coordinated efforts and regular communication.
In this context, we're working to understand the assets and potential pressure points on the health care system and to mobilize resources to support provinces and territories wherever possible.
We're using data and modelling to help understand the progression of the COVID-19 pandemic and where we can expect the pressure points.
As you may be aware, all the case data we have now is made available publicly through daily epidemiological reports on the Covid.ca site and through a Statistics Canada portal where the detailed data was made available to researchers yesterday.
Another key area for collaboration with provinces and territories is in the area of digital health.
Right now we are asking Canadians to stay at home as much as possible and to practice physical distancing. For many, this means they may have to access medical professionals and social supports in alternative ways.
Provinces have been mounting tools, and we're working with them to augment them. We recently launched an online health assessment tool for Canadians who are experiencing symptoms of COVID-19. It complements those already available in some provinces and territories and helps users determine whether they need medical attention or testing.
We're also developing, and plan to launch, an online mental health support that provides comprehensive psychosocial support to Canadians as they manage through this exceptionally stressful time, working with a variety of resources.
Finally, I would like to speak briefly about Health Canada's role in protecting the health of federal employees in the workplace.
Through our public service occupational health program and in collaboration with the chief human resources officer for the Government of Canada, we have advised federal departments on how to manage the risk of COVID-19 in the workplace. We have provided advice for a wide variety of work settings and have developed targeted advice for specific workplaces, including for the agents of the Canada Border Services Agency on the front line. This is critical to ensure they are protected as they perform their functions in helping Canadians and all of us combat the disease.
In conclusion, at Health Canada we're committed to doing everything we can to protect the health and well-being of Canadians, from people in communities to health care workers to federal public servants. The magnitude of this responsibility has never been clearer and the imperative for action now has never been stronger. We are working around the clock to help protect the health and safety of Canadians.
Good afternoon, Mr. Chair and members of the committee. Thank you for the invitation to participate in today's proceedings and for providing me with the opportunity to discuss with you the important work being done by the Canada Border Services Agency in the midst of this global health crisis. Also participating in the call is my vice-president of our travellers program, Mr. Denis Vinette, who has been leading the measures at all ports of entry with respect to the traveller stream.
Mr. Chair, I'd like to begin by saying I'm very proud of the men and women at the CBSA, who are working tirelessly both on the front lines and behind the scenes to help contain the spread of COVID-19 while keeping essential goods flowing to Canadians. The health and safety of our workforce is paramount and we continue to work closely with Health Canada, the unions and our employees to ensure they are protected.
You are all aware that the situation has evolved rapidly and we continue to adapt our operational posture to respond. As the outlined in presentations before the House of Commons and the Senate last week, the CBSA has a dual mandate to protect the safety and security of Canadians while facilitating trade and commerce at the border. In the face of COVID-19, I can assure the committee that we are working hard on both fronts.
From a safety and security perspective, the Government of Canada has put in place a number of enhanced border measures to help mitigate and contain the spread of the virus. These measures, which began on January 22, have resulted in a dramatic decrease on the inbound flow of travellers to the country. As a result of the prohibition of foreign nationals, including United States nationals, from entering Canada by air, land, rail and marine for non-essential or discretionary purposes, we have seen an overall decline of travellers by 79% in all modes, including air, since the prohibitions came into force, and 94% when compared with the same period last year.
Regardless of how and where they arrive, all travellers are being assessed upon their arrival into Canada. Travellers who are deemed to be symptomatic are provided with surgical masks and information on mandatory self-isolation by the CBSA, and are required to complete the contact tracing form. They are then directly referred to a Public Health Agency of Canada officer for assessment and follow up.
As Minister mentioned, Transport Canada has also increased the responsibilities of air carriers flying into Canada. Air carriers are required to conduct a health check of every traveller at the gate prior to boarding, and must ask the traveller if they are exhibiting a fever, coughing or difficulty breathing. If a traveller is symptomatic, air carriers must also ask the traveller if they have been denied boarding in the past 14 days due to a medical reason related to COVID-19. Travellers answering affirmative to either of these questions, or if they refuse to answer the questions, will be denied boarding by the air carrier, which will then advise the CBSA. Travellers who have a medical certificate stating that the symptoms are not related to COVID-19 will be exempted.
The CBSA now informs travellers that it is mandatory to self-isolate for 14 days upon entry into Canada. The CBSA also has measures in place to assist the Public Health Agency of Canada in its efforts to monitor and enforce compliance of the mandatory self-isolation orders, through contact tracing for all travellers arriving in Canada in land and air mode and through temporary lookouts in our systems.
The contact tracing form captures basic biographical data and contact information for the passenger while in Canada. Once completed it is provided to the Public Health Agency of Canada, which determines when and how to share this information with provincial authorities and/or law enforcement. Mandatory contact tracing applies to all travellers by land or air.
The CBSA also creates temporary lookouts in its system to support Public Health Agency efforts to ensure that asymptomatic travellers comply with directions on self-isolation following entry into Canada, and that symptomatic travellers who are issued a quarantine order under the Quarantine Act comply with those orders. The temporary lookout measures are already in effect.
Lookouts will not be issued on all asymptomatic travellers, but rather on those the CBSA believes may not have respected the requirement to self-isolate and have given indications that they may be unwilling to comply. The CBSA will notify the Public Health Agency every time it encounters an individual who it believes has failed to comply with the order to self-isolate. The lookout information will be maintained for a period of 14 days. The CBSA will share that information with United States Customs and Border Protection.
The CBSA will support compliance with the Public Health Agency travel and public health order issued under the Quarantine Act, including providing information at the border.
Turning to our facilitation mandate, I also want to assure the committee that the CBSA understands the critical nature of ensuring that essential goods and services, food, medicines and workers continue to be able to move across the border.
Let me be clear that while we have seen a reduction in truck traffic, overall the supply chains for Canadian industry and businesses remain intact. In fact, 114,032 truck drivers have been permitted to enter Canada since restrictions took effect on March 21. This is why there are important exemptions to the recent travel restrictions that were put in place. Whether it be first responders, truck drivers or workers supporting the agricultural and transportation sectors, these are some among us who are providing the essential services necessary to keep Canada's engines running.
To this end, I recently wrote to the secretary general of the World Customs Organization on March 17 to—
The scale and scope of the COVID-19 pandemic is unprecedented for us and is probably the most complex consular emergency we've had to manage, in that it's limited not just to one country or region but has global impact, including here at home at our headquarters.
We are providing consular assistance to Canadians in all countries of the world simultaneously, and at the same time we've had to redesign how we work in order to keep our own staff abroad, and their families, safe and healthy.
Since we last met, Global Affairs has been working around the clock to facilitate the safe return home of thousands of Canadian travellers who found themselves stranded because of the sudden imposition of border measures to prevent further COVID-19 spread.
Our efforts have included coordinating flights and logistics for air travel and the travel by air, sea and road that's required in order to reach those flights. We've been operationalizing constantly changing global travel advisories and travel information updates. We have stood up a new COVID-19 emergency loan program abroad and we are continuing to provide our normal emergency consular services while coping with the additional caseload related to COVID-19.
In the last 10 days, we have facilitated 42 flights back home from 29 countries, enabling thousands of Canadians to return, and we have flights planned for an additional 20 destinations in the coming days, including flights later this week from India and Pakistan.
At the same time, we're contributing to the government-wide efforts to keep essential goods and services that Canadians depend on moving across borders, preparing for the future by sustaining our international alliances, sustaining global supply chains and responding to urgent calls for assistance from the international community.
Information is critical for good decision-making. To this end, we have issued an official global travel advisory for Canadians to avoid all non-essential travel abroad and to avoid all travel by cruise ship.
Hundreds of updates have been made in real time to our country-specific travel advice to help Canadians make well-informed decisions and be aware of border closures and restrictions.
We continue to urge all Canadians outside of Canada to register with the “registration of Canadians abroad” service so they can receive important updates and check the entry and exit requirements of the countries through which they might need to transit. In addition, Canadians in need of emergency consular assistance can contact our 24-7 emergency watch and response centre by email or by phone.
We know that in many regions there are still Canadians trying to get home. We are continuing to work with other governments, local authorities and commercial airlines to find new options. In countries where commercial flight options are no longer available, we've been facilitating access to special flights and we have worked with domestic authorities to unlock restrictions on domestic movement that have been imposed due to local quarantines.
We continue to monitor cruise ships still afloat with Canadian passengers and crew. We have updated this committee in the past on our efforts with the Diamond Princess and the Grand Princess, and we are continuing to work around the clock to ensure the safe passage of citizens back home from the ships that remain at sea.
In the past week we have had successful repatriations from ships docked in Brazil, Argentina, South Africa and Chile, and we are working right now with our international partners to secure the passage of the Zaandam and Rotterdam through the Panama Canal and to assist with disembarkation once they make their way to Florida.
We have dramatically increased the number of Global Affairs Canada staff in our emergency watch and response centre to respond to the high volumes of calls and emails that we're receiving from Canadians abroad. After a peak of around 10,000 calls and emails a day, in the last few days we have been receiving an average of 5,000 calls and emails. We've been increasing staff to respond to demand and have been able to keep wait times over the last four or five days to around two minutes.
As part of our consular efforts we've put in place the COVID-19 emergency loan program for Canadians who have no source of funds available to return home or to sustain them while they are forced to remain abroad. This is an emergency repayable loan that helps either to facilitate their return to Canada or to cover their basic essential needs. To date approximately 500 loans, totalling $1.4 million, have been approved, and we are prioritizing pending applications that are required for urgent flights.
Despite the challenging circumstances, all of our Canadian diplomatic missions abroad remain open, and we are providing full consular and emergency services to Canadians even as we take the necessary precautions to protect the health and safety of our staff, their families and visitors to our missions.
Of course, we have to respect the guidance and rules imposed by local health authorities. We have adapted our service delivery models to local conditions and constraints on accessibility.
While we continue to make extraordinary efforts to assist travellers in returning, as has made clear, with mounting restrictions abroad it is becoming increasingly difficult to bring Canadian travellers back home. To that end, we have developed a new page with advice for Canadians who are remaining outside of Canada on their safety and security. Having learned from our experiences in China, Japan, Italy, and other lockdown situations, we've provided new guidance to all of our missions on the unique demands of quarantine situations and on the kinds of services we need to provide in those circumstances.
We're also continuing to work with external stakeholders to try to address emerging challenges, for example, by encouraging travel insurance providers to continue to support Canadians impacted by COVID-19, especially those who are unable to return to Canada through no fault of their own, by renewing or extending insurance policies.
In conclusion, since the beginning of this crisis we've been focused on trying to take concrete actions to ensure that Canadians remain healthy and safe so that we can assist those who are affected and repatriate those we can. The situation has evolved over the past two months from our response to quarantines in specific regions, countries and aboard specific ships to what is a global consular effort in mobilizing the resources of our entire department and our mission network in every country as well as here at home. We are going to continue to rely on our dedicated and professional staff to respond to these new challenges and to serve Canadians in the best way we can.
Thank you, Mr. Chair.
Thank you, Ms. Jeffrey.
Before we go on, when I mentioned the list of participants in the meeting, I failed to mention, I believe, Ms. Jenica Atwin of the Green Party. My apologies.
We'll go now to questions from the committee. I will point out that we will follow the regular rounds of questions according to our routine motions. I believe we will have enough time for three rounds.
We will start with Mr. Jeneroux.
The Chair: Go ahead for six minutes, please.
This is just to highlight the problems we've had. At the beginning of this committee it took us 13 minutes to get this off the ground, and now another couple of minutes here to get to the questions. I certainly believe we should look at extending it so that we get more than three rounds in.
To begin my questions, because I have limited time, I want to first thank our front-line workers and essential service workers, and everyone who is doing their part to contain COVID-19. As cases continue to mount, I would imagine hospitals are starting to prepare for an influx of cases.
Not to be too critical of the government's work, but there's no doubt that some of the measures were implemented much too late. Canadians are asking whether the government is prepared for the next surge.
I'll provide some examples. On January 29, many members in the House of Commons asked for Canada's borders to be closed in high-risk areas. The government implemented this measure only on March 16. On March 9 members again pushed the government to enact the Quarantine Act and to enforce mandatory quarantine for incoming travellers. It wasn't until March 25 that the government rushed an announcement that mandatory quarantine would be enforced—again, weeks too late. On March 23 our colleagues called on the government to cover 75% of wages following the government's announcement that it would cover only 10%. Then on March 27 the government backtracked and increased the wage subsidy to 75%.
This is all on top of how, on February 4, the government sent 16—
Again, Mr. Chair, thanks for the time. There are obviously some hiccups that we're working on here. I certainly hope they make those adjustments at the end of this meeting so we all get our quality time from all members of the committee.
First, I want to again thank our front-line workers, essential service workers and everyone who is doing their part to contain COVID-19. As cases continue to mount, I would imagine hospitals are starting to prepare for an influx of cases. Not to be too critical of the government's work, there is no doubt that some measures were implemented too late and Canadians are asking questions about whether the government is prepared for the next surge. I'll provide some examples.
On January 29, many members of the House of Commons asked for borders to be closed to high-risk areas. The government implemented this measure only on March 16.
On March 9, members again pushed the government to enact the Quarantine Act and enforce mandatory quarantine for incoming travellers. It wasn't until March 5 that the government rushed an announcement that mandatory quarantine would be enforced.
On March 23, our colleagues called on the government to cover 75% of wages following the government's announcement that it—
In the context of the work that is being done at the federal level as well as with the provinces and territories, we've been working for weeks in the context of ensuring that Canada is prepared and equipped to deal with the impact of what may transpire in Canada as a result of having COVID-19 within our borders.
In relation to the questions, I will start, Mr. Chair, and then ask my colleague, the deputy minister of Health Canada, to also speak to the work that's being done at Health Canada in terms of some of the questions that are being asked.
As everyone knows, in the context of the Canadian system, front-line health care services are provided by the provinces and territories. We work with them very closely in turn, and we are working with them very closely, to ensure that they have the kinds of supplies and equipment that will be necessary at a local level to respond to the crisis.
Regarding the question as to whether we will have the same thing happening all across the country at the same time, based on what is transpiring across the country, there are differences that can be seen from an epidemiological perspective. At this point things are different in different jurisdictions, and even within jurisdictions things are different depending on where you may be within any particular jurisdiction. Our expectation is that it will continue in the same way it has in relation to other countries that are experiencing the same crisis.
In response to the questions asked about the availability of beds, and hospitals converting and making more room available, and whether or not there are additional steps being taken to add capacity at a local level, from the conversations that are taking place with all of our provincial and territorial partners, all jurisdictions are definitely planning and taking steps to ensure there's a level of readiness. Each jurisdiction has a plan that's in place, and they're in the process of actually implementing their plans.
My colleague, the deputy minister of health, could also speak about some of the work that we're doing to ensure there is a level of transparency around what is happening at a jurisdictional level to ensure that we are able to support, where necessary, the efforts of the provinces and territories.
Mr. Chair, I will stop there and ask my colleague Mr. Lucas if he has anything he would like to add.
I'll describe the process for the air mode so that people can understand the continuum here.
First of all, the air carriers are being asked to prevent anyone who is symptomatic from getting on the flight. During the flight, if somebody is identified as becoming symptomatic, they're identified before the plane lands in Canada so that we can segregate them immediately upon arrival. Those people would immediately be turned over to Public Health Agency officials to assess their situation. That's our hand-off point with them.
For the rest of the travellers, for the asymptomatic people, they would proceed into the customs hall, where if you've travelled internationally recently you would see our PIK machines. These are our primary inspection kiosk machines. The advantage we have with these machines is that they ask the questions in 15 different languages, so we're able to carry a very broad spectrum of travellers into the country.
After answering the questions about whether they have a cough, a fever or other symptoms, they also acknowledge that they are subjecting themselves to mandatory isolation for 14 days upon arrival in the country. As they're in the baggage hall, there are additional border service officers roving and looking for people who are displaying symptoms. We have referred people through these functions to the Public Health Agency.
Upon departure from the customs hall, they're all given forms about how to conduct themselves should things happen after they leave and to acknowledge once again that they're being subjected to mandatory isolation.
It's very layered. It's very complete. It covers more than just French and English.
You're right in your point about the temperature scans. People are expecting different things, but we've not been advised by public health officials that it's something we need to do at the border. We are guided in all of these actions by the advice of the Public Health Agency of Canada on the efforts it wants us to deliver at the border on its behalf.
Thank you very much, Mr. Chair.
First of all, I'd like to say that I'm glad we're having this meeting. Today, I will not try to find those responsible, or guilty parties. We have to manage a crisis and it will take everyone's efforts to get through this.
I also want to recognize the outstanding work that front-line responders do, whether they are hospital workers or people who respond to multiple requests. I would also like to acknowledge the work of all of my colleagues in the House who work on the front lines. Indeed, we have become front-line responders so that together we can get through this crisis, a deadly global pandemic.
That being said, the analyses of when and how we should have done this or that can be done in due course. Count on us to do those analyses. However, today, in the face of a pandemic of this nature, we need to work on our ability to respond to the threat. Many people are calling us from different places. In different parts of Quebec, entrepreneurs and people are ready to push forward to provide what is called personal protective equipment. I would like to know what we are doing to speed up these projects. It would be important to have specific answers on this subject.
There are people who can serve parts of the territory. In Quebec, we try to promote local purchasing. If suppliers are able to supply regions with materials, I think we should encourage that, notwithstanding today's announcements about large orders, the delivery of masks, and so on. I'm talking about other types of supplies, such as disinfectant.
I would like the answer to be addressed to the entrepreneurs who are waiting for an answer in order to be able to contribute to the fight against the current crisis and to help their compatriots. That's my first question.
I'd like to take this opportunity, on behalf of the New Democratic Party of Canada, to thank all of those Canadians, health care workers, transport workers, cleaners, allied health workers, everybody who is working in trying circumstances and helping to keep us all safe. I think I speak for all parliamentarians when I say how important your work is and what a debt Canadians owe to you.
I'm going to ask my first question to Mr. Lucas of Health Canada. On March 9, wrote to the provincial and territorial premiers, asking them to inform the federal government of any critical gaps in supplies or in their capacity to deal with the COVID-19 pandemic, things like ventilators, N95 masks, testing equipment, face shields, etc.
I'd like to know what the major gaps identified to the federal government were. Can you give us an approximation of the size of those gaps, please?
We have had an ongoing process supported by the Public Health Agency of Canada to understand the needs of provinces and territories and to contribute to the bulk purchases the Government of Canada is making on their behalf. Certainly, President Namiesniowski can speak to that further.
From the information in the letters coming in that you referred to, we have reinforced areas where the provinces have been seeking additional support in the form of N95 masks and ventilators, and we have moved proactively to order those from all available suppliers, as well as have been noted in the comments already made, and to work with Canadian businesses either on existing production or in areas where they can create new production to address those needs. We are monitoring this on a day-to-day basis and are in constant dialogue, on a daily basis, with provinces and territories to understand those needs and to work to address them.
In addition, provinces and territories have provided information on other areas of focus including support for Canadian unemployed workers and businesses, and those have been addressed through measures announced to date and with work under way.
I'll turn now, Mr. Chair, to President Namiesniowski for any further comments.
I want to thank all of the witnesses for being here today and for all of the work you're doing to help us get through this pandemic.
I have a few questions for Ms. Namiesniowski from the Public Health Agency of Canada regarding our nation's supply of personal protective equipment. I appreciated her comments in her initial presentation on the details of securing personal protective equipment. Thank you for that.
Of course, we are all hearing concerns about the rationing of personal protective equipment and the warnings of outright shortages in this country. This of course would lead to our frontline workers being unprotected. I understand that just recently, announced today even, the government has committed $2 billion to purchase medical equipment and supplies. That's great news, but it leaves me to wonder why the government would allow 16 tonnes of personal protective equipment to be shipped to China last month, leaving us here in Canada in a very vulnerable situation.
I have just a few questions regarding that shipment. Was it part of a formal contractual agreement? Did China promise to repay that shipment with an equal or larger shipment? If so, when was that repayment negotiated for?
Also, Ms. Namiesniowski, has the federal government either shipped or facilitated the shipment of equipment to other countries, and if so, to whom, when and how much?
Thank you for the question.
As has been raised during previous appearances at the committee, Canada was approached, as were a number of other countries, by China for assistance in the context of China responding to the crisis that was happening in the country. In the context of Canada's response, there were supplies made available, but I believe there were supplies beyond simply what the federal government offered in the context of the request that was made. That is something I do not necessarily have the details on.
In the context of the request that was made to the federal government, at that point in time it was very clear that there was a direct benefit to Canada to respond in a positive way. Every effort was being extended within China to contain the virus and what was happening on the ground. From a Canadian perspective, that was very important, in the sense that any effort that could be made to limit the exportation of cases to the rest of the world was directly of benefit to all countries, including Canada.
Canada's donation was positioned in the context of being helpful to a country that was in crisis, but there was also a broader benefit to Canada as well as to the rest of the world.
Okay. Thank you, Mr. Chair.
Perhaps I can start, and my colleague from Health Canada can follow.
In relation to the measures that have now been instituted across the country, I think that if Dr. Tam were answering this question, she would say that generally it takes a few weeks to be able to ascertain the impact of those measures. I think at this point it is hard to comment, in terms of the data that we're seeing, as to the impact.
But that being said, I think from the point of view of our awareness of the extent of those measures taking place across the country and the data that we have to date, it is looking positive in relation to the impact that we expect those measures to have locally on the ground across the country.
As I think I said in the context of my opening remarks, now is not the time to lighten up; now is the time to ensure that Canadians are very seized with the importance of those measures and that they continue to follow the direction that's offered, both federally and by their jurisdiction and local public health, to double down to ensure that we're all doing everything we can to flatten the overall epidemic curve.
Perhaps I will now turn it over to my colleague from Health Canada.
Again, I think this is an answer that will involve both a response from me and a response from my colleague at Health Canada.
At the federal level, we have been working very closely together with key organizations that are involved in research and development, which involves both our National Microbiology Laboratory and other federal players, including another member of the health portfolio beyond Health Canada—the Canadian Institutes of Health Research, CIHR—and some of our colleagues at the National Research Council, to name but a few.
Certainly in the context of different initiatives, there are efforts under way to support researchers in Canada and abroad in the context of the development of a potential vaccine for COVID-19.
This question has come up a couple of times at committee in the past, and I think we all recognize that it will take a number of months before any vaccine may be developed, trialed, proven to be successful, and then potentially produced and rolled out for the general population. I think when Dr. Tam was asked that question, which I think was the first time we were at committee together, she talked about an 18-month window.
Perhaps I will ask my colleague from Health Canada if he would like to add anything.
As I am sure you are aware, following the SARS epidemic in 2003, the country came up with a number of testing protocols, etc., on how to [Inaudible—Editor] up. That was not only the Public Health Agency of Canada, but also the provincial public health agencies. They developed programs and protocols to be followed as to when another epidemic should happen.
The minister stated that the Public Health Agency of Canada is working closely with provinces and territories to ensure that there is a consistent, evidence-based approach to addressing this crisis.
If this is the case, why are we seeing varying protocols from province to province? Why is there no standardized testing across the country? What steps did the Public Health Agency take to ensure that every hospital in Canada, no matter where it is—local, in rural areas, urban areas, etc.—had in place protocols and procedures to be followed from the very moment this happened?
Let me begin by again saying thank you to all the very many people who are involved in this, including all the witnesses. I know it's difficult work. I know you're trying hard to keep up the good work.
The response to Mr. Kitchen's question was that we're trying to take a common approach among the provinces. Maybe we should have national standards as to who gets tested for COVID-19 and national benchmarks as to how quickly the tests get done. For example, I know with respect to testing that until recently tests that were done in Thunder Bay were taking up to seven days to come back, whereas I was hearing vastly different numbers, such as one day in other parts of the country. So maybe we need to look at setting up those national standards so places like Thunder Bay or Nunavut don't end up with much inferior services compared to other places.
The situation we want to get to is basically something like the one in Singapore, which seems to do a lot of testing. Basically everyone who has cold-like symptoms gets tested. If you look at their numbers, you'll see that they've done exceedingly well. That's more a comment than a question.
Mr. Lucas, in a response to an earlier question, you said that provinces sought help from the federal government with respect to bulk purchases of N95 masks and ventilators. Where are we with that now? I know Ms. Namiesniowski in her earlier remarks said something about the number of ventilators, but the line was very poor and full of static, and I didn't really catch that. Could you give us some specifics on what we're doing with N95 masks and the ventilators? Are the purchase orders in, and if so, what kind of ventilators, how many ventilators and how many N95 masks are we talking about?
Certainly, as I referenced in my opening remarks, there has been incredible effort from early on to work with provinces and territories to come together and, on Canada's behalf, to work the international marketplace to secure needed product for front-line health care workers. As everybody has underscored throughout today's conversation, it's critically important that we're able to equip those individuals who are working on the front line, who are so essential to our ability to be successful in the context of COVID-19.
Certainly from the point of view of which items are being prioritized for purchase, very early on—even in advance of potentially getting requests from provinces and territories—the federal government focused its efforts on key items that we knew would be necessary, including the N95 masks and ventilators, among other things.
Those orders are in and have been in for some time. Our colleagues at PSPC, Public Services and Procurement Canada, are working incredibly hard around the clock on behalf of everybody to secure supplies in a global marketplace that has many actors who are also looking to do the same thing.
In addition to the international marketplace, as we've highlighted during this conversation, there are efforts under way also to make sure that we are taking full advantage of domestic capacity and looking to see how, domestically, we can also produce products locally, taking advantage of the exceptional entrepreneurial spirit we have in Canada and using companies, their knowledge and their know-how to also produce product in Canada. That includes ventilators, for example. There has been a lot of effort expended to ensure that we are able to secure the supply that's necessary.
Maybe at this point, Mr. Chair, I could turn to my colleague, Deputy Minister Lucas.
I have perhaps just a couple of notes further to the response. One, as I have noted, is that we are working with provinces and territories as well to ensure that there is guidance on appropriate use to protect our front-line workers and to ensure that there is no unnecessary utilization of these critical products. That's why the earlier questions pertaining to establishing COVID-focused hospitals or facilities were critical in terms of the use and protection of our front-line workers.
As noted earlier, we are in daily contact with provinces and territories to understand their needs and to ensure their ability as the supplies come in. As noted, we are working around the clock through PSPC to identify those critical products, to arrange transport and to bring them to Canada so that they can get out to places where they are needed.
I would just note in closing, Mr. Chair, on testing that throughout the pandemic, there has been work on COVID with the provinces and territories through the public health network to establish and update testing protocols as we go along. They have different lab capacity, but we have been working hard to support them to augment it and to optimize their work to ensure there is as fast as possible turnaround for Canadians and that the increasing number of Canadians who need to be tested are tested. That work will continue.
Mr. Chair, I think from our perspective we always are open to what the science is telling us. We also recognize from the point of view of individuals that they make personal choices about what makes them feel comfortable. We're fully supportive of individuals making that choice, and if they feel the need to wear a mask, we believe that is something which individuals have a right to do. We certainly watch the science very closely.
Dr. Tam has offered that if people are to wear a mask, it's important that they know and understand the importance of wearing it properly and to think about how they should be putting on and taking off a mask. She has offered comments in the past about the importance of doing that correctly. In the context of all of the advice that we've given from a public health perspective, it's really important to do the right kind of respiratory hygiene: wash your hands and keep your hands away from your eyes, nose and mouth. Of course, as you're putting on and taking off the mask, you're certainly putting your hands near your eyes, your nose and your mouth. I think my colleague made reference to donning and doffing of personal protective equipment and the importance of doing that effectively from the training perspective. That would be our position in the context of wearing masks.
Certainly if individuals are sick or are symptomatic and are out and have the potential to interact with anyone else, we highly encourage wearing a mask, because that is one way to potentially restrict the transmission of whatever an individual may have to another person. Generally, we believe it's very important in the context of anybody who is symptomatic. Also, in the context of the air environment at an airport, I think my colleague Mr. Ossowski mentioned earlier that if there are individuals who are arriving in Canada and we believe that they are symptomatic, we ask them right away to put on a mask.
I'll stop there, Mr. Chair.
My first question is for Mr. Vinette of the Canada Border Services Agency.
Several weeks ago, there were no cases of coronavirus in Canada. So the border was our first line of defence. As we've seen, cases have finally crossed the border, particularly in Quebec, so that today we now have several thousand cases.
I understand this is a huge burden for the Border Services Agency. However, I would like to know immediately, without waiting for a report in six months' time, whether stricter procedures could have been put in place a few weeks ago.
Is it still possible to change procedures to ensure that future passengers arriving in Canada will be better screened, as we see in some countries?
From the onset of the situation, we began to explore and work with the Public Health Agency of Canada on what measures we needed to put in place both at the land-air borders and at Roxham Road.
We began to introduce measures to effect the screening of all individuals, as requested. Recently we began to implement, with the RCMP at Roxham Road specifically, the review and questioning of individuals. We have always questioned all of those I would call “irregular arrivals” at Roxham Road, from a health perspective. In instances where an individual was not of well-being or was ill, we also had the services of the Red Cross to whom we could refer an individual for further verification.
Since we began the measures back on January 21, we've gradually increased our posture, informed by the Public Health Agency of Canada, in terms of what was required. We have continued to sustain an enhanced level of screening of individuals throughout that period.
In the event that someone was demonstrating symptoms of COVID-19, we would refer them to the Public Health Agency of Canada for additional screening and engagement with a quarantine officer.
We may do a bit of a tag-team approach perhaps.
In response to that question, certainly in the context of the discussions that are taking place among the chief public health officers, the Canadian chief public health officer and all of Dr. Tam's colleagues across the country, there is widespread recognition of the vulnerability of older Canadians, particularly those with underlying medical conditions, and the importance of trying to prevent any kind of introduction of the virus within a setting such as a long-term care home, given what could potentially happen. The tragedy that happened in the nursing home in Ontario is one that we all feel terrible about in the sense that it is not what anybody would ever want to see for elderly loved ones, or anyone at all for that matter. We have had a few instances, across the country, of clusters of patients within long-term care homes. In that context, there was work very early on among the chief public health officers to establish guidelines around infection prevention and control, which is a critical piece when it comes to dealing with those types of institutions.
In terms of the broad national guidance that obviously is taken by each jurisdiction and also interpreted by the kinds of institutions you would find within every single jurisdiction, right down to the level of an institution such as a long-term care home, which also would have plans and protocols in place for what should be done from the point of view of infection prevention and control, it is something that is discussed regularly in an effort to ensure that all are putting the necessary emphasis on trying to prevent those types of incidents that were described.
Perhaps I'll ask my colleague at Health Canada to see if he has anything he would like to add.
I think the unique demands of quarantines and lockdowns require a different approach, and we saw this with Canadians who were in Wuhan, and again those to whom we were providing consular services during the Diamond Princess
quarantine in Japan. They require assistance in making the right contacts with local governments; they require support with interpretation sometimes in making themselves understood with foreign doctors; and they need to know where to reach out for help, and what kind of help is available to them.
We're providing instructions on preparedness, things that you can do, which are similar to what public health officials are telling Canadians here at home: to make sure that you have adequate supplies, that you have prescription medication you might require, that you are able to sustain yourself and that you have a local SIM card and a phone. There are a lot of very practical tips in our material.
Also, there is information on who you can reach out to at the embassy, the things that should cause you to reach out, for example, if you become ill or believe you might be sick. There is also information on the local restrictions and what will happen to you in different circumstances and on how to reach out to us 24-7.
Then if and when people are hospitalized or need medical care, it's about facilitating their communications with their families. It's about trying to make sure, even in environments where isolation and quarantine are necessary, that they can receive the essential goods and things they need. It's a different kind of consular service for someone who is required, by quarantine, to be at a distance, but we're equipping our missions to be able to provide those services in situ.
At this stage it's really about preparedness, just as it is here in Canada, to get through a few weeks of mandatory isolation until the quarantines are lifted around the world.
I think, as Tony has said, it really deserves re-emphasizing that we're all in this together and we need to collaborate and work together, each and every one of us, and we will get through it, of course.
My question is for Mr. Lucas from Health Canada.
It relates to the fact that while we're in the midst of this pandemic, of course life goes on, and people are sick with many other health issues. We're hearing about elective surgery here in Ontario being deferred.
I would like to hear from Health Canada how they are looking at the supply of prescription over-the-counter drugs and medical devices. Are there any supply disruptions? What does Health Canada do in the face of potential shortages?
Also, we've heard from south of the border about some of the potential therapies like chloroquine, hydroxychloroquine. I'm sure there are patients on Plaquenil for arthritis who are very anxious about shortages, so could you please address what Health Canada does?
Certainly, I'm pleased to do that.
We have an ongoing challenge with drug shortages, exacerbated now given the pandemic situation and the impact on global supply chains.
To that end, we have a team dedicated to working on this. They work with a network of people in the provinces and territories—industry, distributors and patient groups—to make sure we have a line of sight as far in advance as possible on shortages. We are co-operating with regulators in the United States, Australia, Europe and other places to identify where there are potential disruptions in supply chains of active pharmaceutical ingredients and other key elements in producing needed medicines and medical equipment.
In addition, steps are taken to find substitutes and to allow for the importation of other products that can help address it with an ability, through interim orders, to look at alternative labelling requirements to ensure that the needed medicine can get to Canadians.
In addition we are working with manufacturers here in Canada on moving to producing pharmaceuticals if we need to. The powers provided last week through the bill will further enable that to help manage shortages and to have domestic production if we need to, to ensure that the needs of Canadians are met.
We know that millions of Canadians report unmet mental health care needs each year. We know that the Mental Health Commission of Canada's mental health strategy for Canada recommends raising the proportion of health spending that's devoted to mental health to 9% by 2022, over the current 7%.
Earlier this week I spoke with the Mental Health Commission of Canada. They said to me, “You don't need a crystal ball to forecast increased mental health challenges, including depression, anxiety, perhaps even suicides or attempted suicides due to job loss, money problems, social isolation, etc., over the next months.”
I heard a reference to setting up a phone line, but Mr. Lucas, will the government be committing any additional resources to an expedited implementation of a Canadian mental health strategy, in light of the COVID-19 stress on Canadians?
That wraps up our third round.
I'd like to thank the witnesses for joining us.
As always, you have provided excellent information. We appreciate your time and all the work you're doing on this crisis.
I would like also to acknowledge again the House of Commons conference service, which has taken on this challenge of providing, for the first time ever, a fully virtual committee meeting. It has never happened before. There are certainly challenges, but I think we've been able to work through them quite successfully. There are particular challenges involved with doing a meeting of this kind that are not found in normal business communications, such as having to interface with ParlVU for public access, as well as having three different channels for language and translation, so I appreciate their effort. I know they are working around the clock to get us a video conference solution, hopefully for next week. I would like to thank them for responding so quickly. They have had less than a week to work on this, so I really appreciate what they are doing.
Members of the committee, I would like to remind you to get your priority list of witnesses for the next meetings to the clerk, hopefully by 4 p.m. eastern time tomorrow. The analysts will collate them into a single document and I will have my staff arrange a conference call among the members of the subcommittee to discuss witnesses for the next meeting.
With that, I would like to thank everyone for participating. I hope we're all doing well during this crisis.
The meeting is adjourned.