I call this meeting to order.
Welcome, everyone, to meeting number 29 of the House of Commons Standing Committee on Health. The committee is meeting today to study the emergency situation facing Canadians in light of the COVID-19 pandemic.
I would like to welcome the Honourable Patty Hajdu, Minister of Health, and the Honourable Anita Anand, Minister of Public Services and Procurement.
I'd also like to welcome senior officials joining us today. From the Department of Health, we have Dr. Stephen Lucas, deputy minister. From the Canadian Institutes of Health Research, we have Dr. Michael Strong, president. From the Department of Public Works and Government Services, we have Mr. Bill Matthews, deputy minister; and Mr. Michael Vandergrift, associate deputy minister. From the Public Health Agency of Canada, we have Mr. Iain Stewart, president; Major-General Dany Fortin, vice-president, vaccine rollout task force, logistics and operations; Dr. Theresa Tam, chief public health officer; and Dr. Matthew Tunis, executive secretary for the National Advisory Committee on Immunization.
We will start with witness statements. I will invite Minister Hajdu to begin. Minister Hajdu, please go ahead, for seven minutes.
Thank you very much, Mr. Chair. I'll just give my remarks in English to go easy on the interpreters, given this virtual environment. I will say that I'm very happy to be here with you all, and I thank the committee for the opportunity to share an update on our work to protect Canadians against COVID-19.
Of course, many people have used the word “unprecedented” to describe this pandemic. In fact, around the world, we've talked about the unprecedented nature of a global pandemic of this sort. Besides being unprecedented in its scope, it is obviously also unpredictable, as the virus has changed and shifted and as we've attempted to keep ahead of our knowledge on how best to protect people from COVID-19.
As we see case numbers rising across the country, Canada and indeed the world have worked hard to manage COVID-19 and to protect our citizens in each of our jurisdictions. Every step of the way, since January 2020, our government has responded and adapted to information as it has evolved. Information is coming to us in real time. On many fronts, we learn as we go, and I want to take a moment to thank the scientists, the researchers and the public health officials who have worked non-stop to better understand this virus, to better understand measures to protect against this virus, and to better understand how it's affecting the many communities in our country.
Mr. Chair, it's important to establish that context as we address the important questions before us today. All levels of government are racing to ramp up vaccination, to suppress the rapid spread of variants of concern and indeed of the virus itself, and to help bring the pandemic under control. As of April 16, more than 12 million vaccines have been distributed to the provinces and territories, and we delivered over 10 million doses by Easter weekend, which exceeded our initial goal of six million doses for the first quarter of this year.
As of now, more than nine million doses of COVID-19 vaccines have been administered in Canada; 81% of people 80 years of age and over have received their first dose, and 10% have received both doses. The Government of Canada is going to continue to do its job to make sure more and more doses are delivered throughout the country, and will also be there for provinces and territories for any additional support or resources they might need.
We're also going to continue to provide advice to Canadians about vaccination and about how to protect themselves against COVID-19 as we see the virus accelerate in many jurisdictions across the country. We work with real-time data, and Health Canada carefully reviews any new information that becomes available so that our advice continues to evolve and be based on the best and latest science.
As the vaccine rollout continues, we continue to work with partners in industry and the not-for-profit sector to increase testing and screening capacity across the country. Testing and screening continue to be the foundation of slowing the spread of COVID-19, although of course it's very important that provinces and territories also manage people well and in a supportive way who have tested positive for COVID-19. Mr. Chair, it's important to know if people are sick, and it's important to support them when they are. That's the best way to stop the spread of COVID-19.
On testing, as of April 8, 2021, more than 25 million rapid tests had been shipped to provinces and territories. That's 25 million, Mr. Chair. When combined with the federal allocation, over 41 million rapid tests have been distributed across the country. Not only have we delivered those tests, but we've also been working with provinces—
I'll begin at the testing section and talk about testing.
As the vaccine rollout continues, it's important that we continue to test and contact trace, support people who have been infected with COVID-19, and isolate in order to contain the spread of the virus as we do that important work. The government has been working with partners in industry and in the not-for-profit sector to increase screening and testing capacity across the country.
As of April 8, 2021, more than 25 million rapid tests had been shipped to the provinces and territories. When combined with the federal allocation, over 41 million rapid tests have been distributed across the country. We've supported the provinces and territories, along with the private sector, to ensure that rapid testing can help identify the spread of COVID-19 in essential workplaces and in congregate living settings. In fact, in pandemic spending, eight dollars out of every $10 spent on our national response have come from the federal government.
Recently, the Province of Alberta announced that more than two million rapid tests will be available for businesses in Alberta, and this is an expansion of a program that has already successfully rolled out more than 1.2 million rapid tests to long-term care facilities, schools, hospitals and homeless shelters. In this next phase of Alberta's program, test kits will be provided to employers and service providers, with priority given to organizations that work with vulnerable people. This will give employees a sense of security and comfort when they go home to their families at night after working with the public all day.
There's no silver bullet to fighting COVID-19, but adequate rapid testing and appropriate contact tracing and isolation are layers of protection to keep essential workers safe as they stay on the front lines for all of us. From border measures to mandatory quarantines to digital tools to the establishment and funding of safe isolation sites, the Government of Canada has been working with the provinces and territories every day to keep Canadians safe. We're going to continue to use all the tools at our disposal to help the country through the pandemic. We will do whatever it takes, for as long as it takes, to protect Canadians.
I would like to conclude with a few words about the report recently published by the Office of the Auditor General of Canada.
As you know, it raises issues concerning the Public Health Agency of Canada's response to the emergence of COVID-19. We have accepted every recommendation from this audit, and work is under way to respond to these recommendations. We have to keep the health and safety of Canadians our top priority across government.
That's why the Government of Canada has provided significant funding and resources. As I said, eight dollars out of every $10 in the pandemic response has come from the federal government. This includes, recently, $690.7 million in the fall 2020 economic statement to strengthen the Public Health Agency of Canada's response and surge capacity.
The agency has grown tremendously. It has expanded by more than 1,000 new employees to bolster our capacity to have more people able to support and protect Canadians across a number of areas. The agency continues to grow to support our response to COVID-19. In October, the agency implemented a national COVID-19 public health data portal to support data collection, sharing and management, something we know that we need to get better at all across the country. Also, I've asked for an independent review of Canada's global public health surveillance system, commonly referred to as GPHIN, and a final report and recommendations are expected later this spring. These measures will help us improve Canada's pandemic preparedness and response capacity.
There have been financial supports for Canadians through the CERB and the CRB, wage supports for businesses through the CEWS, and wage top-ups for health care workers. Through my portfolio, there have also been things like safe isolation sites for communities; Canadian Red Cross personnel, field epidemiologists and other experts; contact tracers; and mental health supports that are free and directly deliverable to Canadians through Wellness Together Canada. This is along with $19 billion through the safe restart agreement; supplies and resources, fully paid, for the provinces and territories to test, track and treat COVID cases; treatments for COVID-19; and millions upon millions of vaccines. Every step of the way we have stopped at nothing to support the provinces and territories to deliver on their responsibility to provide health care to Canadians in their jurisdictions.
As we see this third wave threaten so many lives, we know we have to keep working together, with all hands on deck. This is a team Canada moment. We have to keep working together and working with our partners, because Canadians want us to do that. They need us to do that. They need us to continue to be collaborative and to look for ways to help. They want us to know that they need us to work together and that we are going to get through this together.
To my colleagues here today, I hope that you will use your platforms, your ability to communicate as leaders in your communities, to encourage Canadians to get tested, to stay home when they're sick, to wear face masks, to isolate when they're close contacts, to restrict their movements and indeed to get vaccinated when it's their turn. It's very important that we are all speaking from the same page on this.
Thank you very much. I look forward to your questions.
Thanks so much. I was just actually thanking everybody for having me here. I look forward to taking your questions.
I also wanted to thank the translators, who I know have been working so very hard during this whole pandemic and in various committee meetings.
I would like to also acknowledge that I'm meeting you from the territory of many first nations, including the Mississaugas of the Credit, the Anishinabe, the Chippewa, the Haudenosaunee and the Wendat peoples.
I understand the sense of urgency with which this meeting has been convened. The government has been dealing with this crisis for over a year now. Canada is in the third wave of the virus, and my department, Public Services and Procurement Canada, has been working around the clock since the beginning—
Public Services and Procurement Canada is working 24 hours a day, seven days a week, to secure the goods and services needed to help Canada get through the pandemic.
Our primary goal at PSPC has been to meet the needs established by the Public Health Agency of Canada and Health Canada as they worked—and continue to work—with the provinces and territories to support Canada's health care professionals on the front lines.
Early on, we focused on buying urgently needed PPE in what proved to be a hyper-competitive global market, with huge international demand for a finite supply of goods. My team accelerated procurement processes, and in some instances established completely new international supply chains to ensure that Canada had access to the most vital PPE from overseas as well as right here in Canada.
Indeed, we tapped into the ingenuity of Canadian companies. We put in place contracts with those who answered our call to action and stepped up to deliver what they could.
At the same time, our government made significant investments in domestic production of much-needed personal protective equipment, or PPE, helping several Canadian companies retool and expand their production lines.
To date, my department has now procured some 2.5 billion pieces of equipment, which we are continuing to receive, with a substantial amount of that equipment being made right here, at home.
We have also procured other vital supplies and services on behalf of the Public Health Agency of Canada, such as rapid tests and medical equipment.
As the members of this committee well know, our focus now is on vaccines—getting them into Canada and into the arms of eligible Canadians as soon as possible. We are also supporting the Public Health Agency of Canada and all provinces and territories with the supplies necessary, including the low-dead-volume syringes.
Moving to vaccines, Mr. Chair, our work from the outset has been to follow the advice, in our procurements, of the Public Health Agency of Canada and the COVID-19 vaccine task force. On their advice, we began by building a diversified portfolio of vaccine candidates as soon as they began to show promise. As soon as we received the advice of the vaccine task force, we began signing agreements in principle with potential suppliers. That was as early as July 2020.
Our objective was to place Canada in a solid position to take delivery of doses as soon as vaccines were deemed safe and effective—and that is precisely what we have done. We gained access to more than 400 million doses of potential vaccines from eight different manufacturers, resulting in one of the most diverse portfolios in the world.
This diverse portfolio is giving Canadians some security in what continues to be a volatile marketplace for vaccines, and it is thanks to this diverse portfolio that we are seeing inoculations happening across this country. We have four approved vaccines. We have received more than 12 million doses in this country since December. Millions more are arriving on our shores every week. We are working directly with our suppliers to keep them coming.
At the same time, we continue to negotiate for earlier deliveries from vaccine suppliers. Indeed, the and I just announced that we have secured the delivery of an additional eight million Pfizer vaccine doses. The first four million additional doses are scheduled to arrive in May. Two million doses a week are coming to Canada in May. That is double the amount of Pfizer doses that we had previously expected.
Indeed, in June we will also see more than two million doses arriving per week. Then, in July, there will be two million more doses, so Mr. Chair, Pfizer has really stepped up in order to ensure that we get vaccines into Canadians' arms as soon as possible.
All of this means that from April until the end of June, we are set to receive at least 24.2 million doses of Pfizer and, by the end of September, Canada will have received 48 million Pfizer doses. This is in addition to the other shipments of vaccines that are coming in from Moderna, AstraZeneca and Johnson & Johnson.
This is tremendous news for Canadians. It means more Pfizer vaccine doses sooner, on top of the millions of other vaccines we already have coming.
I can also now provide an update on our anticipated deliveries of Johnson & Johnson's vaccine.
We expect an initial shipment of approximately 300,000 doses during the week of April 27, with more substantial deliveries coming in the latter part of this quarter and into the third quarter.
For AstraZeneca, Canada is scheduled to receive 4.1 million doses from various sources by the end of June, with further deliveries in the third quarter.
In total, prior to the end of June, Canada will receive between 48 million and 50 million doses of vaccines.
Mr. Chair, as we have said many times, by the end of September, we will have more than enough doses so that every eligible person in Canada will be able to be fully vaccinated.
Once again, this is good news for Canadians, but it doesn't mean our work is done. Our government continues to work with suppliers and our international partners to ensure the steady flow of vaccines into this country, and we are continuing to push for earlier delivery of vaccines from our suppliers.
Mr. Chair, this is the most important work that I have ever undertaken in my professional career. Like many of you around the table and Canadians across this country, I am worried about the third wave, and I am working—
It really speaks to the different experiences that provinces and territories have had.
I have to say it's been a pleasure to work with all the health ministers from the Atlantic provinces, who have been extremely supportive of the other provinces. Even recently, the ministers and the Premier of Newfoundland were suggesting they would be there for Ontario. You're right that this demonstrates that provinces and territories acknowledge that we really are in this together. No Canadian is safe until all Canadians are safe.
One of the things I've noticed with the Atlantic provinces—really speaking bluntly here—is that those provinces did not wait to take action when there were outbreaks in communities. In fact, the measures they imposed probably felt very stringent, as an Atlantic member, when there were potentially very few cases in these outbreaks—five or 10 cases, in some cases. However, these premiers and health ministers made a decision to act very quickly on very few cases and to do the really hard work of contact tracing and isolation. The population itself understood that even though they were few in number, it was better overall to make a collective sacrifice to keep the region safe.
There's been a real focus on protecting and supporting people who are sick, and on isolating them appropriately so that they can indeed stay home. It seems easy to say to people, “Stay home when you're sick,” but isolation is actually really challenging. You can't leave your house. You cannot leave to get groceries. Oftentimes, if you don't have Internet or digital access, you are cut off from the world. Of course, if you're single or living in poverty, there are other barriers.
When I think about east coasters and the way they band together in general, it's true testimony to working together and collective action to fight a significant threat.
Vaccine disinformation is not new. We've seen anti-vax types of information and disinformation sown in communities for other health threats, and this does lead to loss of life and to great suffering. Many of you have met Jill Promoli in your travels as MPs. She's the woman who lost her very young child to influenza, and she has been advocating for years for people to be immunized against the flu. When you hear the stories, you realize this is not specific to COVID-19.
Of course, these vaccines were developed in record time, and it's really a testament to the coordinated will and determination of science and researchers working together on a common goal. It's important that Canadians have access to and are pointed to credible sources. I always say to people who are hesitant or unsure that the best source of information for them is a personal health care provider, if they have one. Then of course there are health care websites that are government run and credentialed as such.
Part of it is our responsibility as leaders to make sure we're pointing the people who trust us in the right direction and that we're not giving messages that are meant to sow division. Rather, we should give people access to accurate information so they can make the best decision for themselves with a foundation of credible information. It isn't about trying to force people to accept vaccinations; it's about making sure they have the right information and credible information.
I'll end with this, MP Kelloway, because it's important. The risk from COVID-19 far outstrips any risk from vaccination. We know this. If you allow it, MP Kelloway and Chair, I'd love for Dr. Sharma to talk a bit about the technical end of what goes on at Health Canada to make sure these vaccines are indeed safe.
Not only am I trying to understand, but I am also trying to put myself in the shoes of taxpayers wanting to understand how Canada negotiated its vaccine supply. Yesterday, we found out that, according to Pfizer's CEO, a third vaccine dose would probably be needed six to 12 months after the initial round, followed by a yearly booster. You negotiated with Pfizer for a vaccine that was supposed to be 95% effective against the virus with two doses. Did you get the same type of deal we see in those TV commercials, “buy two and get the third one free”?
How does this new information affect your negotiations, because it certainly changes things?
What are the scientific implications, and what do you plan to do?
Are we going to be at the mercy of pharmaceutical companies suddenly taking advantage of the situation to fill their order books?
How much will all this cost?
Are you going to skip your turn when it comes to getting the third dose of Pfizer?
I would like Ms. Anand and the NACI representative to answer.
Actually, with respect, Minister, I have limited time, and it was a pretty specific question. Thank you for answering; I appreciate it.
This week, B.C. health minister Adrian Dix said, “The real issue with vaccines is the amount of vaccine we have. If we could get a million more doses, we have the system in place, we have the capacity in place to deliver that...quickly.” He also said, “Despite the unpredictability of deliveries, we are administering the Moderna vaccine as efficiently as supplies allow.”
Saskatchewan premier Scott Moe says that erratic deliveries are challenging his province's vaccination program. The City of Ottawa announced that it's looking to fill a gap in its COVID-19 vaccine supply. The City of Toronto announced that a vaccine shortage is to blame for the fact that local clinics in COVID-19 hot spots in the city have had to close. Also, Dr. Isaac Bogoch, who sits on Ontario's vaccine distribution task force, said, “It's obvious we don't have enough supply.”
Minister, do we have enough vaccine supplies in this country right now?
I have to say that I'm a little confused about the order here.
I wanted talk about the risks associated with AstraZeneca and now Johnson & Johnson. I think a lot of Canadians are anxious about these vaccines and whether they're safe, so I want to address that problem.
Specifically, the concern is with blood clotting, but specifically one kind of blood clotting, called VIPID. That is vaccine-induced prothrombotic immune thrombocytopenia, which is associated with cerebral venous sinus thrombosis. It appears mostly in women under 55. The risk of this in the United Kingdom, where they've given a lot of doses of AstraZeneca, has been estimated at between 1 in 100,000 and 100 in 250,000.
I'm a long-time doctor, and medicine is all about balancing risks and benefits. With that in mind, I want to talk a little about risks and benefits and get a response from the doctors on the panel, for example, Dr. Tam and the person from NACI.
My understanding of the British data is that, up until the end of March, they gave over 20 million doses of AstraZeneca, and there were 79 cases of VIPID with 19 deaths. This is probably causal, because this is a very rare combination, but, as a result of giving those vaccines, it's estimated that the British saved around 6,000 lives. There's always a risk in medicine with almost anything.
If you think about an appendectomy, this is a relatively simple operation, and I've done them myself. If it's your kid, you say, “Okay, you have to have your appendix out”. Well, the mortality is 1 in 100, approximately, from my readings. If they take your gall bladder out, the risk is about 1 in 200. We do CAT scans all the time. As a doctor, you have to explain to people the risks and benefits. If your kid is getting a CAT scan, you tell them, “Well, we're not sure of the risk, but it might be something in the order of 1 in 2,000 who will get cancer from a CAT scan”.
With drugs and antibiotics, I've seen people almost die from reactions to antibiotics. As for vaccines themselves, the measles vaccine has a risk of 1 in 700,000 of getting something called SSPE, subacute sclerosing panencephalitis, which is universally fatal. We give the measles vaccine to our kids all the time. My little baby, whom you may have seen occasionally with me on the panel, is going to be getting it in a couple of months. There is always a risk and benefit. No one is forcing people to have AstraZeneca or Johnson & Johnson. I have to say, the risk with Johnson & Johnson seems to be 1 in a million.
Before the practitioner, nurse or doctor gives you the vaccine, AstraZeneca, they're going to explain the risks and benefits. I would submit there's a very, very small risk from the vaccine. In fact, I calculated that you're seven times as likely to die in a car accident the year after you've been vaccinated with AstraZeneca as you are to die from a blood clot, so the risk is very low. The benefits in terms of protecting yourself from the virus are significant.
I want to ask Dr. Tam or the representative from NACI about the risks and benefits. Obviously, I've outlined my view of it.
Mr. Chair, thank you for asking me to be here today. I'll take the question first.
I would say that Canadians should be very comforted in knowing that we have a very rigorous system in Canada for ensuring that the vaccines that they will get in their arms are safe as well as effective. Health Canada, as the regulator, does very rigorous assessments of vaccine safety, and they've been linking with European and other international regulators to get the information we need.
We acted fast when we saw that there was a signal from Europe. With that, the National Advisory Committee on Immunization also took an initial assessment and a precautionary approach in putting a pause on the use of the AstraZeneca vaccine in persons under the age of 55.
Right now, Health Canada, having asked the company, AstraZeneca, for more information, has done its assessment and analysis and concluded that the benefit outweighs any risk of this rare but serious adverse event overall. The National Advisory Committee on Immunization is doing its due diligence in analyzing this information right now. What the committee has to do is not just analyze the risk of this rare side effect but also the balance in terms of the benefits of prevention of COVID-19 in different age groups. The committee is doing this work very diligently right now and will come out with a new reassessment soon, as Dr. Tunis indicated.
Again, Canadians should be very heartened by the fact that our vaccine safety system and how we assess vaccine safety is extremely rigorous.
In order to maintain the public's confidence and support when it comes to the Public Health Agency's guidelines and messages, the agency has to act in a consistent manner and, as Dr. Tam said, apply the precautionary principle.
The last time we met, three countries had decided to suspend use of the AstraZeneca vaccine. Back then, the agency and Health Canada were saying that it was just three countries, that the cases were not that serious, and that Canada would keep using the vaccine.
I've lost count of all the attempts made to save the AstraZeneca vaccine and keep the same messaging out there. Nevertheless, had we suspended use of the vaccine and waited for the European Medicines Agency to come out with its decision, it would have saved a lot of wasted breath and defensive communications. Not to mention, it would have fostered greater public confidence.
It would have been clear that the authorities were being proactive and applying the precautionary principle. We were not proactive and we did not apply the precautionary principle, undermining the very principle we wanted to uphold. Instead, we went against it. Public fears about receiving the vaccine have emerged. Conversely, when the vaccine was offered to people 55 and older in Quebec, without an appointment, we did see an appetite for it. However, it was thanks to the fact that they did not need an appointment.
Since then, the appetite for the vaccine has dropped significantly. Vaccination clinics are nowhere near full, even when people don't have to have an appointment. It pays to take a cautious approach so as not to produce the opposite effect. A mistake was made, and recognizing that is important.
Dr. Tam, can you explain how the variants work to help us understand what's going on right now? How are we seeing so much variant spread when we are taking so many precautions and when the government claims to be strictly enforcing measures and controls? Do you have any data that would tell us more about the main hot spots?
I'd be pleased to share the good news from Pfizer today. We have negotiated the exercise of an additional eight million options with Pfizer, so that means that not only are we purchasing these options, but they're going to be delivered in the very short term.
We expect to have two million doses of Pfizer delivered in May, and 12 million over five weeks in June. In addition to the other vaccines in our portfolio, this means we are going to, cumulatively, have between 48 million and 50 million vaccines in this country prior to the end of June.
I want to reiterate that when we put our contracts into place last summer—and indeed our portfolio is a diversified one, with multiple contracts and multiple suppliers—we wanted to make sure we had access to multiple sources of vaccine supply. We are pulling vaccine now not only from Pfizer but also from Moderna, AstraZeneca and J&J. That is very important.
I would like to clarify a point about our rankings. I was speaking about the G20, whereas my honourable colleague was speaking about all countries in the world. We are indeed second in the G20 for the rate of vaccinations, and fourth in the G20 for the total doses administered per 100 people. Why? It's because of our diversified portfolio, and because we're pulling in vaccine from multiple sources.
We will continue to do that, and distribute those vaccines to the provinces and territories as soon as we receive them. Indeed, Pfizer's go directly to the provinces and territories as it currently stands. We want to make sure we are with Canadians and supporting Canadians right through to the end of this pandemic with our vaccines.
First of all, my heart goes out to everyone working in the Peel and Brampton area and everyone living in the area, because you're right that your region of the province has been very hard hit for, I would argue, a very long time. The appropriate supports have not been in place to help people isolate and stay safe. Our federal government, as you know, has been trying very hard to make sure people have access to, for example, financial supports if they're sick, as well as other kinds of health supports through Red Cross support. I work very closely, as you know, with Dr. Loh, and we've provided isolation housing, for example, in your community.
More needs to be done.
You asked me first about how we could tell who's getting which vaccines, and we can't really. This is the job of the Ontario government to provide that transparency about how they are further distributing vaccines in the province. You heard my colleague speak about Pfizer deliveries going directly to provinces and territories. That's really the only data we have. Data from other vaccines and how they're distributed across the province is owned by the province, and they have not as of yet been transparent with that data, although I believe Dr. Adalsteinn Brown just recently gave some modelling and some updated data on vaccine distribution.
The best approach in terms of trying to understand Peel's allocation of vaccinations from the Province of Ontario is directly with the province itself. Mayor Brown would know that, but of course Dr. Loh would know that as well.
You're absolutely right. We stand by, ready to help the Province of Ontario and indeed local public health units with anything they need. If it would be helpful, I'm happy to speak with Dr. Loh again, or the public health units, just to make sure we haven't missed anything. As I said, we have been providing rapid response supports, including Red Cross workers, isolation housing, contact tracers, epidemiological support to break out where those clusters of outbreaks are happening, and of course the financial supports. It's very important they have someone like you also, MP Sidhu, to advocate for them.
Thank you so much for being a constant voice for your community members. In every meeting I'm at, you are speaking out for the health and safety of the people you care for.
I will start off at the end of my remarks. Thank you to the honourable member for asking me to continue.
We began with our procurements in vaccines by building a diversified portfolio of vaccine candidates as soon as they began to show promise, signing agreements in principle with potential suppliers as early as July 2020.
Our objective was to place Canada in a solid position to take delivery of doses as soon as vaccines were deemed safe and effective—and that is precisely what we have done.
We gained access to more than 400 million doses of potential vaccines from eight different manufacturers, resulting in one of the most diverse portfolios in the world.
This diverse portfolio is giving Canadians security in what has been and continues to be an extremely volatile marketplace for vaccines. It is thanks to this diverse portfolio that we are now seeing inoculations happening at record numbers across this country, and that we have been able to bring into Canada record numbers of vaccines. Yes, we of course continue to understand that more supply is needed. That is why our team and Deputy Matthews's team are continuing to work around the clock.
The deal with Pfizer that we announced today is just one example of the type of work we are doing. We have accelerated more than 22 million doses already to earlier quarters. This deal with Pfizer today indicates that even more doses are being accelerated to next month. We are doubling the number of Pfizer doses coming into the country next month and in June.
We will continue this work. We will continue to pull vaccines from multiple sources around the world, including from Europe—from Belgium, Spain and Switzerland—from South Korea, from India and from the United States. It is this diversified portfolio of vaccines that we will continue to lean on as we bring vaccines into this country.
In addition, I would like to thank all colleagues around the table for their concern and work on ensuring that our country sees itself through this pandemic together. What we need, now more than ever, is to collaborate together with provinces and with territories, and indeed as parliamentarians.
Mr. Chair, she is much over time.
You also said that the border measures don't work, and that you shouldn't wear masks. There are different things you've said through communications over time.
I just want to ask Ms. Anand a question about the boosters.
Pfizer has indicated very clearly in previous meetings, and I asked the question about boosters a month or so ago and have gotten no reply yet, that they would recommend still that the second shot be within three weeks. The government has gone to 16 weeks in a decision.
Will we see boosters be necessary? That is the question I asked before, and they didn't say they wouldn't be. Now it has come out that they might need that.
Is it because the efficacy of the drug diminishes between the three and 16 weeks that we would need a third booster sometime within six months to a year?
Thank you, Mr. Chair, and thank you to all the witnesses for attending today.
For the level of concern that the Conservatives brought up in having these witnesses here, the best they had in terms of questioning was mocking an individual's name, one of our colleague's names. That's pretty disappointing.
After a decade of muzzling scientists and ignoring the Public Health Agency and ignoring experts, it's clear that Conservative Party ignorance is alive and well today, when it doesn't even seem to understand the evolution of science and the evolution of data. However, here we are, and I'm just very thankful to all the witnesses who are here to work on behalf of Canadians.
I want to get back in the time I have to the Ontario modelling that was raised. In fact, Ms. Rempel Garner left out a very important part of that modelling that was just released. Ontario, for example, has said it would be capable of doing about 150,000 vaccinations a day if it had the supply. Even in that modelling, even if Ontario did 300,000 vaccinations a day, the trajectory of cases was still on the rise; therefore, as has been said by the minister and the doctors on the panel today, vaccinations alone are an incredibly important tool for keeping Canadians safe.
Dr. Tam said that vaccines prevent death and attendance in the ICU, as well as strong public health measures. If the Conservatives were in power, they said several weeks ago they would open up, ignore science, ignore the experts and ignore the data. Even 300,000 vaccines a day in Ontario wouldn't have helped if Conservatives were in power making those decisions.
The U.K. has very high vaccination rates. Prime Minister Boris Johnson has credited lower case counts to both vaccinations and public health measures. Can we elaborate with regard to those strong public health measures in connection to vaccination rates, and how that is going to help?
Frankly, there's a very important piece that hasn't been touched, and I'm not surprised the Conservatives haven't talked about it, because it doesn't fit with their ill-conceived, wacko science data, conspiracy theory type of questioning. However, in and around our health care workers, they are strained and stressed, so it's not just about keeping Canadians safe and getting them vaccinations, but there is enormous pressure from our health care sector.
Could the minister or a member of our team here talk about why the two measures have to go together hand in hand, and why vaccinations are incredibly important and Canadians are committed them? Why do public health measures matter so much, especially for our public health care workers?
I'll just say thank you for acknowledging the hard work of the health care workers. You're absolutely right—vaccines save lives and stop the spread, but they are not the only solution. We also have to continue to work hard on disease control.
We see that with other diseases, quite frankly. We have very high rates of vaccination for many other diseases, but it takes hard work on both ends. The public health measures, protecting communities, preventing disease outbreak, and also making sure people are vaccinated are extremely powerful tools in the tool box, but we also need other tools. Those include, for example, having safer workplaces, having financial supports to help people stay at home when they're sick, and making sure people feel they have the appropriate access to health care. All of those kinds of things matter.
Thank you for thanking the health care workers, because—you're right—not only is it hard for people when people get sick, but our health care system, as you can see in Ontario, is surging. When we don't take strong measures to protect our health care system, even more people suffer and sacrifice.
I'll turn to Dr. Tam to talk a bit more about the theory behind that.
I also need to examine the Ontario report, but it was very clearly stated in a sound bite coming from that report that a six-week stay-at-home order along with a vaccination rate of at least 100,000 doses a day is the only way to flatten the curve. Ontario also has the same message, which is that you need both right now.
The United Kingdom has shown—they are ahead of us, of course, so we look to them for data—that despite a very high vaccination rate, they've kept up some very stringent public health measures and are relaxing them very, very cautiously. Israel is another country. We've done a lot of modelling, but we also look at the real-life data. Israel has a high rate of vaccination. The moment they relaxed a little between February and March, they had a resurgence. They had to push back down on the stringent public health measures a bit more, while getting more people vaccinated. That points us towards the kind of strategy we're going to have to have.
That, together with vaccines, is the only way to combat the variants.
The whole public health system and other systems need to work together to get the data from the bottom up.
More than $4 billion was provided to the provinces. I was very happy about that, because it's not just about asking for the data. You need the capacity on the ground to do that. Through these investments, if you like, we have been able to get more information to fill in some of the gaps, but doing so requires collaboration across not just public health data but other research.
The modellers have been supported now by another huge investment in the modelling—the academic modelling that works. They thus have to do a lot of research to gather the parameters to fill in their models.
As you've seen, for those models there's collaboration with, for example, McMaster University and Simon Fraser. I believe those models are becoming increasingly robust, although very complex.
Mr. Chair, I think the member hit the nail on the head, which is that these are layers of protection. If you think of all of these as layers that you put on to protect yourself and those around you, that's how we look at both public health measures and the vaccines.
Let's go to vaccines first. We have been incredibly fortunate in that we have a suite of vaccines, which we would never have imagined arriving so fast, and that they're safe. The vaccine effectiveness has been great. For our parents and grandparents, the vaccines have been very effective for this part of the population at the outset.
For those in long-term care facilities in particular, it's been very effective in reducing cases, reducing severity of illness and reducing the number of outbreaks in long-term care. That's the population that was most impacted at the start of this pandemic, and we're seeing the vaccines at work right there.
The provinces and territories are now readjusting their measures at those long-term care facilities, still with layers of protection, with the masking, hand hygiene and testing and screening as needed, and people are able to have more visitors, to see more of their family members. That's what vaccines are doing right now.
Health care workers, based on some data from our provinces, are well protected even after that very important first dose. Vaccines are thus definitely at work and are doing well.
As everybody has articulated, we need to ensure that people roll up their sleeves when their turn comes. Particularly at the moment, when the population in that protective layer of vaccines is escalating, public health measures are extremely important when variants are around. They mean that we need to get the cases down in your communities in order to protect everybody. Vaccines alone are not going to be able to do it, but they play a really key part.
I have to say that there are some very good early signals that not only do vaccines protect you against serious illness and death, but particularly some of the mRNA vaccines are demonstrating that you can probably cut down on the onward transmission as well.
We are, then, continually analyzing the data, but it's all really great news.
I actually want to ask about the same thing—the interval between the first and second doses. Certainly, a lot of people are concerned about the interval. I have had health care people saying, “Look, we're high risk. Why are we getting only one dose?” I've also had concerned elderly people saying, “We're supposed to have the same dose after three or four weeks. Why is it longer?”
The evidence, certainly for AstraZeneca, seems to suggest that it's better if you have a longer interval between doses. With both Pfizer and Moderna, to my understanding, although I haven't looked in the last few days, the evidence was that starting at about three weeks, at least in young people, you had about 90% efficacy. The evidence from British Columbia, Quebec, Israel and the United Kingdom seems to be that for at least two months you have pretty good immunity. We have other vaccines where there are two doses and where it's six months in between. We have reason to believe that immunity is going to last for the full four months.
For someone like me, that's no problem. As somebody who still works a bit in health care, I've had my first dose. I'm not going to have my next dose for four months. The concern is more with the elderly, because studies seem to at least suggest that their immune response is poorer. The initial data from Israel suggested that one shot wasn't protective, although that seems to have been reanalyzed in that, well, a lot of those people were getting infected in the first two weeks, when no vaccine was going to work.
I want to ask the person from NACI what the current evidence is regarding the safety of that increased interval in elderly people and people who might otherwise be immunosuppressed, such as people on chemotherapy.
NACI has certainly been reviewing in detail all of the emerging evidence on effectiveness in the elderly and also, as you mentioned, some immunosuppressed populations.
There are a few things that are important to establish. First, there is no correlative protection established for protection against COVID-19, as you're probably aware of. Many of these studies, the preprint studies, on certain immunosuppressed or solid organ transplant populations are based on antibody measures, and in some cases cellular responses, but not true effectiveness in the real world. It's hard to bridge those data over to real-world effectiveness. That's one thing the committee advised us in their report.
The second thing is with respect to the elderly. Much of the data that was reviewed by the committee early on in making their recommendations in fact came from long-term care settings and from the elderly. If we look at their analysis of what's been reported from the United Kingdom, where they were using an extended 12-week interval, for example, they found very good protection and very good effectiveness against severe outcomes—hospitalization and death—certainly above 80%. The effectiveness against symptomatic disease is lower, and we're seeing that reported, but the most critical outcomes are being very well protected.
Looking to Canada, the committee was reviewing presentations, as Dr. Tam mentioned, from Quebec and British Columbia. Both provinces, by the way, are doing weekly vaccine effectiveness monitoring. They're keeping a very close touch on how this is evolving. That's being fed back to NACI and the provinces and territories. We've seen in the range of 80% to 90% effectiveness in the long-term care setting in those jurisdictions, not only against severe outcomes but actually against PCR-confirmed COVID-19 infection.
It's a very strong evidence base, at this point, understanding that it's not out to 16 weeks. As Dr. Tam mentioned, we're getting up to the 10- to 12-week mark in Canada with no signs of deterioration, even in those elderly populations. The committee is watching carefully, but at this time was very comfortable to say that up to four months could be considered by jurisdictions, understanding that they may choose to shorten it for specific populations, based on their epidemiological context.
Yes. The basic immunity in the population is still very low, based on our serologic surveys, for example, and vaccines are only just getting going while there is a significant resurgence of cases.
Every person in Canadian needs to layer up the layers of protection. The masks are important because the virus can spread through these droplets and aerosols that can be generated, and when someone's infected.
Of course, there's the distance thing when you're not with people from your household. People want to have many celebrations, but they should do that virtually, because it is that closeness between infected individuals and the uninfected that helps the virus transmit.
Also, avoid the three Cs—the closed, crowded environments where there is close interaction between people—as well as, of course, maintaining hand washing and hand hygiene measures. Those are the very important basic individual measures, and of course respect your local public health unit's advice about what to do in your community.
Yes, of course. The provinces and territories are responsible for the delivery of the vaccine programs. I think the federal government can help in many ways. Of course, providing credible information in multiple languages is really key; that's one investment.
We're quite excited about investment in community-based projects whereby people can apply for funding to communicate credible information to their communities, whether they're faith leaders or business leaders who can speak the language and can do the outreach to others.
I've been very fortunate to be able to participate in some of those events with business leaders, but also with Black physicians, for example in BlackNorth, a public-private sector collaboration to reach those hard-to-reach populations. They're also giving health care workers who are trusted by their communities—family physicians and others—the tools to be able to answer the questions that their communities might have.
In the end it's about access as well, so we're helping where we can, supporting the provinces, if needed, to mobilize to areas where some of the increased access is required. For example, Major-General Dany Fortin and the Canadian Armed Forces are helping to get the vaccine into certain indigenous communities.
In the end, it's the people and the leadership in those communities, like the elders getting vaccinated and communicating about this, that have really helped. The vaccine uptake has been great in those communities.
Yes, and Dr. Lucas has part of this because the regulators in Health Canada, even though they've authorized a vaccine and continue to have a role in monitoring its safety post marketing, are also asking the manufacturers to provide data on this on an ongoing basis. That's one stream.
The health system that is administering the vaccine also provides their data on any adverse events following immunization to the Canadian adverse events surveillance system. This data comes to the Public Health Agency, where we publish it on our website and share it with Health Canada as well.
Any serious or unusual events reviewed by medical experts are being taken very seriously. This is why, for example, very recently, given the signal of the thrombosis with low platelet event, the whole system was activated and one report was picked up from Quebec. That's one. It's reassuring that the system is actually working and monitoring that safety signal. That is really important.
Then we have active surveillance systems. There are hospital networks that are actively engaged in searching out cases that may be adverse events following immunization, so they can be investigated. There are specialty clinics set up as networks, where patients who may have experienced an adverse event following immunization can receive the specialist advice needed to sort out whether the event was indeed related to the vaccine.
It is actually a multi-layered, interconnected system. That's why I think Canadians should rest assured that anything unusual, any signals, will be investigated.
When the modelling was done, people were a bit concerned about that trajectory and were plotting against that.
The measures are to reduce social mixing through whichever means is appropriate for that community, and whether it's Toronto or whether it's Montreal it might be a bit different.
Some of those measures you've seen the provinces put together now in reducing workplace transmissions. Ontario has decided that people should follow essentially staying at home and mixing only with their household and going out only for essential activities. All those things are really important.
At the same time, I believe that outdoor spaces are safer and that you can go out more safely and keep healthy and physically active. It's also good for your mental health, particularly if you stick to your household, like in Ontario.
Those are the tried and true measures. They have worked. If you look at the United Kingdom and that massive spike, all those measures have helped them for sure.