Good afternoon, everyone. Welcome to meeting number 10 of the House of Commons Standing Committee on Health. Today, we will be meeting for two hours to hear from witnesses on our study of Canada's health workforce.
Before I introduce today's witnesses, I have a few regular reminders for hybrid meetings. Actually, I think we can dispense with the reminders, because we have all of our members present, and the witnesses who are appearing virtually have all appeared before. In the interest of brevity, we're going to go right to our witnesses.
We have with us today the Honourable Jean-Yves Duclos, Minister of Health; and the Honourable Carolyn Bennett, Minister of Mental Health and Addictions and Associate Minister of Health.
Online, from the Canadian Food Inspection Agency, we have Sylvie Lapointe, vice-president, policy and programs branch. From the Canadian Institutes of Health Research, we have Michael J. Strong, president. From the Department of Health, we have Stephen Lucas, deputy minister. From the Public Health Agency of Canada, we have Harpreet S. Kochhar, president; and Dr. Theresa Tam, chief public health officer.
Thank you for taking the time to appear today.
We will begin with opening remarks from each of the ministers, beginning with Minister Duclos.
Minister, welcome to the committee. You have the floor for five minutes.
Thank you for giving us the opportunity to appear before you today to speak about main estimates for the health portfolio. As you mentioned already, joining me today is my honourable colleague, Ms. Carolyn Bennett, Minister of Mental Health and Addictions and Associate Minister of Health. Joining us virtually are Stephen Lucas, deputy minister of Health Canada; Dr. Theresa Tam, chief public health officer of Canada; Dr. Harpreet Kochhar, president of the Public Health Agency of Canada; Sylvie Lapointe, vice-president of the policy and programs branch of the Canadian Food Inspection Agency; and Dr. Michael Strong, president of the Canadian Institutes of Health Research.
Let me begin with a few words about the current COVID‑19 situation.
Across Canada, the pandemic outlook is improving. Infection rates have peaked in many areas of the country, followed by a slow decline in hospitalization rates.
After two years of following individual public health measures, people in Canada know what to do to keep themselves and each other safe.
Now, as jurisdictions across the country are adapting their public health measures and restrictions in alignment with their respective situations, we are collectively moving towards more sustainable management of the virus.
Today, I'm here to talk about resourcing plans for the health portfolio.
As you know, we tabled our supplementary estimates (C) on February 19. These estimates seek parliamentary approval for $7.1 billion in new spending. Keeping Canadians healthy and safe has been the top priority for the health portfolio, and these supplementary estimates identify key actions toward this goal. This includes the procurement of rapid tests and therapeutics, funding to address anti-indigenous racism in health care, funding to support long-term care, and advancing pharmacare in Prince Edward Island, among many other important investments.
I'm happy to answer any questions you may have about these estimates later this afternoon.
I would like to turn my focus and your attention to the main estimates for 2022-23. In total, we are seeking $14.47 billion on behalf of the health portfolio, which includes Health Canada, the Public Health Agency of Canada, the Canadian Food Inspection Agency, the Canadian Institutes of Health Research, and the Patented Medicine Prices Review Board.
I’ll start with an overview of Health Canada’s plans.
The 2022‑2023 main estimates reaffirm Health Canada’s focus on providing services that are important to people in Canada, including support for long-term care, improved access to palliative care and safe access to medical assistance in dying.
To achieve these and other objectives, I am seeking a total of $3.88 billion.
As you know, the COVID‑19 pandemic has exacerbated existing mental health and substance use challenges for people in Canada. My colleague Dr. Carolyn Bennett will provide details on the investments that address these challenges.
The main estimates for the Public Health Agency of Canada for 2022-23 propose a total budget of $8.49 billion. This proposed spending will help ensure that PHAC has the resources in place to continue to deliver on its mandate to protect the health of Canadians during the pandemic, including for the procurement of boosters and therapeutics, and the continuity of PHAC's pandemic response and recovery.
The Canadian Food Inspection Agency protects people in Canada against food safety risks, supports the food supply chain and safeguards the health and safety of people working in food manufacturing and distribution.
The CFIA has a proposed net increase of $52.1 million in its 2022‑2023 main estimates.
This budget includes funding for three items: maintaining a daily inspection presence in federally registered meat processing establishments, maintaining and further strengthening food safety measures, and addressing antimicrobial resistance.
As we learn to live with COVID‑19, the importance of investing in health and medical research becomes more important than ever.
The Canadian Institutes of Health Research proposes to spend $1,242 million on health research in 2022‑2023. These investments will help provide the evidence needed to make better health care decisions, during the pandemic and beyond.
In closing, Mr. Chair, the investments I have outlined today will help the health portfolio deliver on its mandate of maintaining and improving the health of people in our country. Our commitments, as set out in our estimates and departmental plans, are a reflection of our most pressing health priorities. They demonstrate how we are taking action, and are an assurance to Canadians that we'll continue to protect and improve the health system.
Thank you for the opportunity to provide my comments. I would be pleased to take questions from the committee after my colleague Dr. Bennett presents her remarks.
Thank you for the opportunity to appear before the Committee today for the first time as Minister of Mental Health and Addictions and Associate Minister of Health. I am here today with my colleague, Jean‑Yves Duclos.
I would like to begin by acknowledging this meeting is taking place on the traditional territory of the Algonquin people.
I'm pleased to share with you our resourcing plans for 2022-23.
We all know that COVID-19 and the protective public health measures associated with it continue to adversely affect the mental health of individuals and families across the country. It's no surprise that many people are reporting an increase in stress, anxiety, depression and loneliness. The pandemic has also led to an even more uncertain and dangerous illegal drug supply, resulting in significant increases in overdose-related deaths.
Our government is committed to being there for Canadians, particularly in these exceptionally difficult times.
As the Government of Canada's first Minister of Mental Health and Addictions, I have been mandated with ensuring that mental health is treated as a full and equal part of our universal health care system. I'm working collaboratively with provinces and territories, experts, community leaders and those with lived and living experience to develop and implement a comprehensive, evidence-based plan to support the mental health of Canadians.
Early in the pandemic, we launched the Wellness Together Canada online portal to provide free, 24-7 mental health and substance use services and resources to people in need across Canada, including one-on-one counselling. In January, the digital access to this platform was enhanced with the companion app called PocketWell, to ensure that Canadians have access to the mental health and substance use services they need, no matter where they live.
Last week, I announced that we will be moving forward in partnership with the Standards Council of Canada, as well as other stakeholders and partners, to develop national standards to address the needs of Canadians related to mental health and substance use. This work on national standards is supported by $45 million from budget 2021. We are committed to ensuring that all Canadians have access to high-quality, safe and equitable mental health and substance use services.
Our hearts go out to all of the loved ones and communities of those we have lost to the worsening toxic drug supply and opioid overdose crisis. We are working closely with our provincial, territorial and municipal partners—along with other key stakeholders like the impressive Moms Stop the Harm—with over $700 million to reduce harms, save lives and get people the evidence-based supports they need.
We know the provision of a safer supply of drugs is essential to help prevent overdoses, and a safer supply is a vital part of our comprehensive approach to combat this crisis. We have invested over $60 million to expand access to a regulated supply of prescription opioids and are committed to doing more. We firmly believe that this is a health issue, and we're working to divert people who use drugs away from the criminal justice system and toward supportive and trusted relationships in health and social services. Our government will use every tool at our disposal to end this national public health crisis.
Our commitment to these and other key priorities is reflected in the health portfolio’s main estimates and supplementary estimates (C), which we are here to discuss with you today. These include $82.4 million requested by the Public Health Agency of Canada to support the mental health of those most affected by COVID-19, and $14.3 million requested by Health Canada for the Mental Health Commission of Canada. Health Canada is also seeking an additional $65.1 million for its work to address the opioid overdose crisis, and the Canadian Institutes of Health Research is requesting $2.25 million for two catalyst grant funding opportunities to support the development of national mental health and substance use standards.
Thank you for this opportunity to discuss my new mandate and the health portfolio’s estimates. I look forward to expanding on my remarks through your thoughtful questions.
Right now, the epidemiologic situation is improving, but it is a little bit unstable. We have seen in European countries, for example, that a resurgence is being undertaken at this point in time.
As the Minister of Health indicated, the federal responsibility, for example, is for the borders. We have to look at the international as well as the domestic situation, and not just the domestic thresholds. At the same time, there is a phased approach being undertaken to begin to lift some of these measures, as you have seen being announced.
Right now, the omicron resurgence, particularly the subtype BA.2, can still occur. I think this is just waiting to see what happens with that situation, ensuring the provinces are still able to cope as they release their measures—they're just doing that at the moment—and having that observation as the federal government makes a decision.
Okay. Thank you for that reply, Dr. Tam. I have very limited time left.
The theme I'm looking to establish, through the chair to Dr. Tam and the Minister of Health, is that we appreciate that the situation is evolving, but we have 10 provinces whose top doctors have all agreed that the epidemiological situation in Canada—based on hospital occupancy, based on waste-water surveillance reports, based on test positivity, based on reported cases every day—has created a situation where their requirements for vaccine mandates and for mask mandates have been lifted almost entirely, with all of them being lifted basically in the next 40 days. We know what that target is.
To the Minister of Health, what is the target we're going to see? If it's hospital occupancy and the situation evolves, once it drops back to 95%, to pre-COVID levels, the restrictions will be lifted, and then if it exceeds 105%, the restrictions will be re-engaged. Is that what we're talking about?
We're looking for what that benchmark is, Mr. Chair.
We've done two things regarding safe long-term care, and we'll do more, as I'll mention in a moment.
When we first invested in the safe restart agreement, there was a significant amount of resources intended for and used to help workers, personal service workers in particular, take care of our seniors. We then added last year, in budget 2021, another $3 billion for exactly the same purpose—to support health care workers in order for them to help care for our seniors.
We also said that we would put into place standards, which we are currently developing with external stakeholders and internal capacity, so that as we work with provinces and territories respectfully, we also treat our seniors in a respectful manner.
Thank you for the question.
That is $45 million that came out of last year's budget. The Standards Council does not set the standards. The Standards Council works with the people who know the most—the researchers, but also those with lived and living experience and community workers—to find out where there is a consensus that should and could be a national standard coast to coast to coast: the most appropriate care, in the most appropriate place, by the most appropriate provider in the most appropriate time.
What's exciting, at the moment, is that the integrated youth services seem to be a place where nine out of 10 provinces have begun that work of individualized wraparound services for young people up to age 26. That's an example of a national standard, an integrated youth service that would go to 26 wherever you live, so that young people wouldn't be left out.
I think there are some really good examples of national standards. It's a common statement that the provinces and territories came out with together in 2017. I'm very excited about the opportunities to do that. Perhaps perinatal mental health.... One of the things we're worrying about is wellness checks, as well as appropriate medically supervised withdrawal. There are things I've been hearing, and then I go to the CIHR and the Standards Council and say, “Do you think there's a possibility of developing a team that would work on those kinds of standards?”
Thank you very much, Mr. Chair.
Ministers, welcome to this meeting of the Standing Committee on Health.
My first question is for you, Minister Duclos.
The 2019 budget announced $1 billion over two years starting in 2022‑23, and up to $500 million per year thereafter for the implementation of a national rare disease strategy. However, the 2022‑23 main estimates contain no funds for this initiative, although the measure is included in Health Canada's 2022‑23 departmental plan.
The [government] will also launch a national strategy on drugs for rare diseases and invest up to $1 billion over 2 years to help Canadians with rare diseases access the drugs they need.
Why isn't there any money for it in 2022‑23?
What is the status of this strategy's implementation?
Thank you for the excellent question.
I will give you two clarifications and then ask the deputy minister to give a third.
First, the commitment regarding the billion dollars has been made and will be respected.
Second, this commitment drew a great deal of interest, I would say even a certain enthusiasm, from my fellow health ministers throughout the country.
As for the way the billion dollars is included in the estimates, I will ask the deputy minister, Mr. Lucas, to give you an exact answer.
I have a slightly more specific question.
Minister, I think you would agree that having more than one antiviral available to us to counter COVID‑19 is not a luxury.
When I searched the Health Canada website, I saw that Paxlovid, an antiviral for COVID‑19, was submitted on December 1, 2021, and accepted on January 17, 2022. It was therefore very quick. I also saw that on August 13, an application for ongoing review was filed for molnupiravir, which has not yet been accepted by Health Canada.
The administration of Paxlovid is known to be restricted because of interactions with other drugs, due to one of its components, ritonavir. Molnupiravir is known to have fewer restrictions related to interactions with other drugs, as it does not contain ritonavir.
My question is simple: when will molnupiravir be approved? Why is the process taking so long? Is there a lack of human resources to do the work required for its approval?
First of all, you won't be surprised to hear my congratulations for your serious work, Mr. Thériault. Not only is this serious work, this is a serious problem.
Second, you rightly noted that Health Canada gave its approval quickly. One reason in particular was that the department worked with its international partners. I believe we were among the first four countries in the world to approve Paxlovid and the second country in the world to administer it.
Third, provinces and territories already had a fairly large stockpile of Paxlovid and are starting to use it clinically rather effectively. In the last few days, we have had encouraging news regarding the availability of the drug in Quebec's pharmacies.
Fourth, for any other drug, including the Merck company's drug, Health Canada's concerns and obligations are obviously based on the safety and effectiveness of that drug.
If you want to know more, I could turn to the experts at Health Canada.
Thank you very much, Mr. Chair.
Thank you to the committee for allowing me to ask some questions on behalf of my colleague .
It's good to see you, Ministers.
My first questions pertain to the toxic drug crisis that is being experienced across the country, particularly in my home province of British Columbia, and is leading, as everyone here knows, to a devastating number of deaths in communities of all sizes.
Minister Bennett, my questions are for you as the minister responsible for mental health and addictions. Do you believe that criminalization contributes to the stigmatization and marginalization of people who use drugs?
I'm wondering if the minister could table those answers to this committee, please. It's very important. I appreciate that.
To the Minister of Health, I'm having difficulty here, sir, understanding in my own mind.... You suggested that Canadians know what to do with respect to mandates, and I think Canadians know what to do. However, sir, we've heard from both you and Dr. Tam that the answer as to why federal mandates continue is complicated. I find it quite shocking that there's not an answer to be given and that it's much too complex for the health committee and Canadians to understand.
I guess what I have heard from Dr. Tam is that there are perhaps worldwide issues that play into that. Could you please, sir, give us the plan for the Canadian part of that? What are the metrics and benchmarks for Canadians? Canadians want an answer, and I guess that's why we continue to ask this question.
I'll give you a couple of numbers, which will broaden the discussion, perhaps.
Yesterday, there were probably around 20,000 new cases of COVID-19. Past estimates of the rates of long COVID among infected Canadians are between 10% and 30%. We don't know with omicron exactly, but 10% to 30% of people infected by COVID end up with long COVID. That is a very significant economic and social cost for which there is obviously little precise value when it comes to dollars, but it's a big thing.
Another number is $23,000. That's the average cost per hospitalization due to COVID-19. Again, costs are something. It's not enough, but it gives you an example of the types of numbers and people impacted, which we need to consider.
I'd like to welcome both ministers to our committee. I'm going to start with Minister Bennett.
Minister Bennett, in your opening remarks, you talked about the $45-million investment for national standards. As my colleague MP Sidhu was following up, in an announcement on March 14, you talked about the Standards Council of Canada and the fact that they will be working with various stakeholders.
Can you explain to me how these standards are going to help with the following? We know the investment in mental health as part of a total health transfer is an area of interest for a lot of us. We know that there are a lot of gaps in the timelines and the delivery of the services. A lot of the constituents in my health community council are talking about transparency, accountability and regular reporting, as well as benchmarks that right now we don't have, whether they are against some of the leading countries or even nationally here.
Can you explain to us how these standards are going to help us? Thank you.
Thank you for the question. I very much enjoyed meeting with your council as well. It's a pretty knowledgeable group.
It is a process. People know what the standards are on blood pressure or what's appropriate for cancer. I think what people don't feel is that we actually know what is the appropriate treatment.
One of the things that are most exciting for me—as I continue to talk about the most appropriate care in the most appropriate place by the most appropriate provider at the most appropriate time—is that throughout COVID we have also seen that the most appropriate place may be virtual. Up until now, the medical community and the mental health community haven't had as much experience with or even a way of paying for virtual care, until COVID.
What we're saying is that developing the standards means that Canadians will know what the appropriate care is, and they can ask for it. They can ask their family doctor or their nurse practitioner to get it. The other exciting part is that we are seeing a stepped care model in which, for maybe the strongest families, the families are just being coached, or it may be that it is peer support or it can be co-treatment with a family doctor and a mental health provider, a social worker, a psychologist or a psychiatrist.
What was really interesting last week, when we did the round table on perinatal mental health, was that from the study of Dr. Vigod, of the 40 people needing perinatal mental health care, only two ended up needing to see the specialized psychiatrist. The rest were helped with other levels of care, so that's the kind of thing.... I think some people think it's not appropriate care unless they get to see a psychiatrist. We know that there are many other mental health providers who are skilled at various other aspects of mental health and substance use treatment.
I think the standards won't mean anything on their own unless Canadians know what they are in terms of mental health literacy, health literacy and all those things that we as parliamentarians are working on.
Mr. Minister, for the record, I'd like to say one thing about molnupiravir. Right now, approximately 22 countries have approved this drug, including the United States, Mexico, Morocco, Great Britain, Germany, Denmark, Italy, Indonesia, Slovenia, Serbia, Australia and Japan, through patent waiver agreements. It seems to me that we should speed up the process a little to give our workers on the ground, that is, our physicians, a variety of treatment options in certain cases.
Also, Health Canada held a public consultation from March 8 to May 7, 2021, to highlight the multiple problems associated with personal production of medical cannabis. All levels of government have taken exception to the regulations because they lead to issues related to overproduction and misuse of the program, overprescribing by physicians, limited inspection authority for police forces and a shortage of Health Canada inspection officers, resulting in insufficient inspections.
All stakeholders agree that the government needs to overhaul the medical cannabis licensing program and enhance its inspection and enforcement measures. The program has been in place since 2018. It is 2022, so it's been four years.
What steps have been taken so far and what are you going to do in the next few months to address this issue?
We already have a 24-7 line that the Government of Canada promotes on its website. We have a 988 line that's not in use right now but that could be used so that the 24-7 line is just readily available in people's minds. Certainly, there's work that needs to be done on the part of the stakeholders to make sure the capacity is there, but of course we have that line that exists already.
It's 465 days and 5,115 deaths at this point in time since we passed the unanimous consent motion. I'll note that in answers to questions, the first time I asked the question, on December 7, you said, “The CRTC is currently considering public input from consultations that concluded on September 1.” That wasn't actually the case, because at that point, the time frame had been extended. Your , who happens to be with us today, later pointed out, as you've just mentioned, that the time frame was extended to reopen the consultations: “the CRTC reopened the consultations to allow for new interventions in accessible formats, such as video.” That was to accommodate people with disabilities.
Now, in the last four or five years, on a repeated basis, including in two election campaigns, your party has declared that everything the government does will be undertaken through a disability lens. In fact, in the House of Commons, there was a big debate on accessibility prior to the 2019 election. I took part in that, as many of your colleagues did. That was a declaration made by your party.
We are now six months past the original September 1 deadline and still consulting, it seems, because the government didn't apply a disability lens to the suicide prevention hotline. Was that an oversight on the part of the government?
Thank you very much, Brendan.
I'm pleased to be able to have this discussion with you. Being a medical doctor and public health specialist, you know that in a pandemic there are eventually a lot more impacts than what we had thought earlier. One of these impacts is long COVID.
I mentioned earlier that the best estimate we have up to now is that between 10% and 30% of those infected with COVID will end up with long COVID. That means having up to 100 different symptoms affecting 10 different vital organs. A large number of these people have to either stop working or significantly reduce their hours of work. The estimate is that about 30% of those people affected need to stop working or stop studying; 70% of them need to reduce their hours of work or are absent. A large number—I think about 30%—will consult health care workers more than 10 times, so you see the impact on the health care system as well. All the human costs, the life costs and the tremendous economic costs obviously add up.
I would be glad to turn, if you want, to Dr. Michael Strong from CIHR. He's on the line and would be very pleased—and it would be very useful—to detail the type of research that CIHR is conducting to understand the nature and the impact of that other pandemic.
Dr. Strong, would you be able to do that?
Yes, thank you very much, Minister, and thank you very much for the question.
As the minister has indicated, the consequences of COVID-19 for upwards of 30%, and higher in some populations, will be long-term. That is measured as greater than six months. No organ system is spared. The research that will be conducted going forward will be not only to develop the diagnostic criteria for some of these syndromes, so there can be clarity for the patient populations as to what needs to be treated, but also to clearly understand what the underlying basis of the disorders is.
It is not going to be the same for each target organ, as we look forward on this, so it's going to be complicated. These will be long-term studies that are internationally driven. CIHR will begin that process soon, through the commitments of the government for the $100 million for the long COVID research.
Mr. Chair, if I may, I'll move on to Dr. Tam.
Dr. Tam, hello again and thank you for being with us today.
There has been a lot of talk from our colleagues, including in this meeting, on mandates and various public health measures and the lifting thereof. I would like to give you an opportunity to explain what we have learned and what we hope to learn from Canada's experience with vaccine mandates and passports.
How would we apply these learnings to either future waves or future viral threats?
Thank you very much for that question, Mr. Chair.
I think there is no denying that vaccines are extremely foundational to our response to COVID-19, and right now the National Advisory Committee on Immunization has provided recommendations, including up-to-date vaccination booster doses, particularly for the high-risk populations. I think it is really important that anyone for whom the booster is recommended and who is eligible get that at this point.
Increasing vaccination in the general population and in targeted ways requires a multipronged approach. I do think that when vaccine mandates were introduced by provincial and territorial governments, and also the federal government for its own area of rules and responsibility, they occurred at a time before omicron, when we saw extremely high vaccine effectiveness against both infection and severe outcomes. Omicron changed that picture, but we know there are certainly studies, including from Simon Fraser University, that show the initial impact, collectively, of the vaccine mandates that were implemented around mid-August, which saw an increase in coverage. But that's different in each jurisdiction, and I think that needs to be studied at a more granular level in terms of the impact of vaccine mandates.
Going forward, I think there is a movement, certainly in the provincial and territorial setting, to move from requirements to recommendations. That's going to be really all hands on deck yet again, using all kinds of techniques to improve vaccine confidence, providing the information that patients and individuals need, and that information has to be provided by credible sources, trusted by the community, including indigenous leaders and racialized communities and their leaderships.
I think there are multipronged ways in which we encourage, recommend and get people to get that additional dose. As the Minister of Health said, the number is not really very high. I am, though, encouraged that booster doses are quite high in the higher-risk populations, but I think in the 50-plus portion, we need to up our game on that coverage. I think all of this can be used—
My first question will be on the subject of mental health. Earlier in this meeting, the PocketWell app was mentioned. I downloaded it just before my 40th birthday, a couple of months ago. I was having some ups and downs, as a lot of people do. I've used it a couple of times, and it actually just gave me a notification that it's time to do another assessment. I have to say that anybody who has downloaded this as a result of my putting it on social media or through word of mouth has come back to me to say, “You know what? That thing identified a couple of things I can do, and it's making a difference for me.” So I want to say thanks.
I want to ask about PocketWell a little bit and about what else we're doing. I know there are lots of other concrete steps that our government is taking to address mental health. There are a lot, because it's a complex challenge and problem.
I also want to talk about kids. In the previous Parliament, I got to serve as parliamentary secretary for youth. On that file, I got to work with a lot of kids and youth groups. COVID-19 has affected all of us negatively and we've all made lots of sacrifices, but with what kids have lost—particularly when the pandemic has accounted for a quarter of their lives, in the case of my goddaughter—it's meant a really extraordinary upheaval of everything they know.
Through you, Mr. Chair, could the Minister of Mental Health and Addictions talk a little bit about what else we're doing with respect to mental health for people, and particularly for kids?
I did have my youth council have a look at both Wellness Together and PocketWell. They're hard markers, but they were very positive about them. I've signed up too.
I think it's because of people like those at Kids Help Phone, Homewood, and Stepped Care that the consortium that and the department put together at the very early part of COVID has really worked. Now 2.2 million Canadians have used it, not only to browse the kinds of resources that are out there, but also to get 24-7 care and advice if they need it. We will continue to evaluate it, but so far we think the $62 million has been well spent.
For younger people using it, we're very happy that it is something they can access without stigma.
As I was saying to your colleague, I think the integrated youth services are one of the really exciting advantages now coming forward, in terms of consensus, in that you can get wraparound individual care for a young person. It's now building into a real movement across the country, because of places like Foundry in British Columbia. There are actually now training handbooks for peer support. They're getting all of the resources so this can take place coast to coast to coast.
With great leadership like Kids Help Phone, I think we're going to get there.
My next question is for the Minister of Health.
On a similar subject, my PocketWell app gives me advice. It asked me to create a little bit of a strategy to deal with some of those ups and downs. I made a list of things that I should be doing better. Two of those things are getting enough physical activity and exercise—I certainly don't get as much as I used to, but it's still a really important component in ensuring that I'm good at my job and I'm as happy as I can be. It also tells me to eat well and to remind myself that this job can be time-consuming and challenging, but diet and exercise are a part of my strategy.
I know that for us as a government, a big part of our strategy is to ensure that people have resources they can access, including physical activity programs and activities and the infrastructure to do those, and to ensure that we have information on how to eat well and access food, particularly in the era we're in with the rising costs of food.
Can you detail for the committee some of our strategies to help people eat well and exercise more?
Thank you, Adam. Thank you for referring to your former life. It would be hard for most of us to have the type of active living that you had when you were slightly younger. That would be a standard that, I think, would be of some concern to some of us.
You are correct. I have my five objectives as well: sleeping well, eating well, exercising, looking after my family, and spending some time with friends. When I do those five things, I feel fine.
It's all about recognizing, as you said, that COVID-19 has been hard on all of those five things, especially sleeping well and eating well. You're at home, and not necessarily always happy to cook your own food, so you cheat and buy fast food more often. Exercising is not necessarily the best option when you have to stay home. Spending time with your friends is, obviously, also complicated with COVID-19. Looking after your family, when everyone feels a bit stressed, is perhaps the right thing to do but not always straightforward.
I think the healthy food guide is something that we need to promote more often to better connect it to healthy living. That will increase mental health and physical health, combined together. Without physical health or mental health, there is no health. We as leaders, and you as a very global person, can show the way forward.
I'll direct my next questions to Dr. Tam.
Dr. Tam, since I haven't yet had an opportunity to thank you for your work, I'd like to do that, and really express my appreciation for all of your efforts since the beginning of the pandemic.
At a news conference last Friday, you announced that the federal government is actively reviewing all vaccine mandates. You noted that policies may soon shift from an emphasis on requirements to recommendations.
Can you confirm when that review will be complete?
Minister, the question is fair, as you said. It's reasonable that Canadians want a plan.
When we were provided, as Canadians, with a solution, which was to get vaccinated, we got vaccinated. When we were told to get boosters, we got boosters. We were told to wear masks, and we're wearing masks.
All Canadians are asking, every single day, is what it is going to take to see the mandates end. They're not necessarily asking that the mandates end today; they want to know what it will take for the mandates to end.
You talk about all of those epidemiological factors. What is the number? If you don't have the numbers today, Minister, I accept that, but will you undertake to come back to us by a certain date with a number that will then trigger an end to the mandates?
Well, we certainly realize that you're not progressive.
Mr. Barrett, to give him credit, wasn't asking for a date. He was asking us for benchmarks on which we're going to base our decisions. Now, I'm pretty sure we aren't making our decisions arbitrarily on when we're going to drop the mandates. I think it's obviously based on complicated things, on modelling. Even though I, too, have a Master's of Public Health, I don't even understand things like regression analyses and how they work.
I think the Canadian public wants, and I think we all want, the government to be basing its decision on something other than dumbing it down, because in Parliament, that's what we do: We dumb it down. But I don't think we want our policy decisions with respect to health and the pandemic to be dumbed down.
I'd like to give you an opportunity in a couple of minutes to explain it. I want you to explain it in a technical fashion, because I think that's what we base our decisions on. Some of us in this room are doctors. Feel free to maybe go over our heads in describing this. What is modelling, and when you're doing the modelling, what is it based on? Presumably it's case rates. Presumably it's based on hospital admissions and ICU admissions.
Just give us a bit of the hard science on this, please.
Thank you for that question.
Mr. Chair, as you and many who watch the media briefings or the press conferences will know, we've been providing modelling information on a regular basis. There are different types of models. There are ones that are longer-term, but only good for, let's say, a month's time frame, where we input, through surveillance and epidemiological data, some forecasting on the case trajectory but also on hospitalizations, as well as projections on mortality. Those are important if you are thinking about adjusting policies. Are the cases going up? How fast are they going up? Are they coming down and at what rate? What might the impacts be?
Our last modelling certainly would suggest that, with the lifting of provincial public health measures, there could be some resurgence, particularly in the context of a very highly transmissible variant. We are watching that very carefully right now, because the cases are plateauing as they are coming down. They may be at a point of resurgence. We do want to know that the hospitals are not being impacted as that resurgence occurs and feeds into some of the federal decisions.
We also have other types of models that are used for planning purposes. They input a number of variables that include vaccine uptake and vaccine effectiveness. They don't as yet include waning immunity, but all of those models tell us something about how we should strengthen booster doses and look forward to the timing of those and what might happen in terms of provision of those models in the slightly medium and longer term.
Vaccine effectiveness, uptake and all that is taken into account as well. Then there's the international epidemiology and, as many people have seen, there's a resurgence of cases in many areas of the world at the moment.
The main reason it will be possible to ease restrictions is that the COVID‑19 infection rate is falling. It's not quite where we hope to see it in the next few weeks, but it is fast approaching that.
Second, it was not magic that got us here. We're able to ease restrictions because many people have been getting vaccinated and following public health measures to limit transmission, infection and hospitalization.
The really good news is that, as of April 1, testing will no longer be required to enter the country. However, there will be random testing at the border among returning travellers. First, this will accurately determine the number of people returning with COVID‑19. Second, it will show us if new variants are entering the country. Third, we will know which countries we should be watching more closely and where we should put our resources. We will also know if variants are coming in faster or easier from certain countries and, if so, in what proportions.
On a completely different note, we know that Alzheimer's is the most common form of dementia in Canada. This disease obviously has a significant impact, not only on those living with it, but also their family members. I have experienced it first-hand, as my mother‑in‑law has had Alzheimer's for two years. It has changed her life and my father‑in‑law's life, but also our own lives.
We're seeing an increase in Alzheimer's cases among people 65 and older.
Can you tell us, Mr. Minister, what is being done to support people with Alzheimer's and other types of dementia?
Thank you for the question.
Mr. Chair, this is an area of ongoing scientific studies. Variants actually also differ in the amount of immunity that they confer. For example, we do know that those who just got the infection and haven't been vaccinated are not as well protected as those who got two doses of vaccine, for example, and then subsequently got an infection.
The omicron virus variant is also under study at the moment. There is certainly some preliminary data showing that the immunity conferred by this variant varies from person to person. That is why the National Advisory Committee on Immunization still essentially recommends vaccination, even if you have had COVID-19 or if you think you got infected, after a suitable time period, depending on whether you're looking at the primary series or a booster dose, for example. Those who got infected just recently can wait three months before getting their booster shot because of this variability we're seeing in infection-conferred immunity.
Minister Bennett and Minister Duclos, thank you so much for being here with us for an extended meeting. We certainly appreciate all the work you do and your patience with us today.
To those who are with us virtually, I offer the exact same thanks and gratitude to you for all your work and for being with us here today.
To all of our witnesses who are with us, you are welcome to stay, but you're free to leave.
To the members of Parliament, please stay put. We now have to consider the estimates and consider some standard motions that come with the presentation of the estimates.
Thanks again, ministers and witnesses.
With respect to the supplementary estimates, is it the wish of the committee to vote now on the supplementary estimates? Okay.
In all, there are seven votes in the supplementary estimates 2021-22. Unless anyone objects, I suggest we group them together. Is there unanimous consent to proceed in this fashion?
I see consensus in the room.
Shall all votes referred to the committee in the supplementary estimates 2021-22 carry?
CANADIAN FOOD INSPECTION AGENCY
Vote 1c—Operating expenditures, grants and contributions..........$17,623
(Vote 1c agreed to on division)
CANADIAN INSTITUTES OF HEALTH RESEARCH
Vote 1c—Operating expenditures..........$488,824
(Votes 1c and 5c agreed to on division)
Vote 1c—Operating expenditures..........$3,724,376,371
Vote 10c—Grants and contributions..........$9,934,194
(Votes 1c and 10c agreed to on division)
PUBLIC HEALTH AGENCY OF CANADA
Vote 1c—Operating expenditures..........$2,963,251,274
Vote 10c—Grants and contributions..........$57,150,105
(Votes 1c and 10c agreed to on division)
The Chair: Shall I report the votes back to the House?
Some hon. members: Agreed.
The Chair: Are we ready now to vote on the main estimates?
In all, there are 11 votes in the main estimates for the fiscal year ending March 31, 2023. Unless anyone objects, I will seek the unanimous consent of the committee to group the votes together for a decision. Is there unanimous consent to proceed in this fashion?
Some hon. members: Agreed.
The Chair: Shall the votes referred to the committee for the main estimates 2022-23 carry?
CANADIAN FOOD INSPECTION AGENCY
Vote 1—Operating expenditures, grants and contributions..........$644,613,251
Vote 5—Capital expenditures..........$43,425,832
(Votes 1 and 5 agreed to on division)
CANADIAN INSTITUTES OF HEALTH RESEARCH
Vote 1—Operating expenditures..........$64,900,611
(Votes 1 and 5 agreed to on division)
Vote 1—Operating expenditures..........$1,215,459,268
Vote 5—Capital expenditures..........$17,149,187
Vote 10—The grants listed in any of the Estimates..........$2,481,521,084
(Votes 1, 5 and 10 agreed to on division)
PATENTED MEDICINE PRICES REVIEW BOARD
Vote 1—Program expenditures..........$15,677,393
(Vote 1 agreed to on division)
PUBLIC HEALTH AGENCY OF CANADA
Vote 1—Operating expenditures.........$7,853,559,297
Vote 5—Capital expenditures..........$23,300,000
Vote 10—Grants and contributions..........$538,766,436
(Votes 1, 5 and 10 agreed to on division)
The Chair: Shall I report the main estimates 2022-23 to the House?
Some hon. members: Agreed.
Is it the will of the committee that we now adjourn?
Some hon. members: Agreed.
The Chair: Thanks, everyone. We are adjourned.