I call this meeting to order.
Welcome to meeting number three of the House of Commons Standing Committee on Health.
Pursuant to the motion adopted by the committee on Friday January 14, we are meeting to receive an update on recent COVID‑19 developments from the minister and officials.
Today's meeting is taking place in a hybrid format, pursuant to the House order of November 25. Members are attending in person in the room and remotely by using the Zoom application.
Regarding the speaking list, the committee clerk and I will do the best we can to maintain a consolidated order of speaking for all members, whether participating virtually or in person.
I'd like to take this opportunity to remind all participants in this meeting that screenshots or taking photos of your screen is not permitted.
The proceedings will be made available via the House of Commons website.
Given the ongoing pandemic situation and in light of the recommendations from public health authorities, as well as the directive of the Board of Internal Economy on October 19, to remain healthy and safe, the following is recommended for all those attending the meeting in person. This is specifically for Monsieur Berthold and Ms. Kramp-Neuman, who are here in person today.
Anyone with symptoms should participate by Zoom and not attend the meeting in person. Everyone must maintain a two-metre physical distance, whether seated or standing. Everyone must wear a non-medical mask when circulating in the room. It is recommended in the strongest possible terms that members wear their masks at all times, including when seated. Non-medical masks, which provide better clarity over cloth masks, are available in the room. Everyone present must maintain proper hand hygiene by using the hand sanitizer at the room entrance. Committee rooms are cleaned before and after each meeting. To maintain this, everyone is encouraged to clean surfaces, such as the desk, chair and microphone, with the provided disinfectant wipes when vacating or taking a seat.
I thank Ms. Kramp-Neuman and Monsieur Berthold in advance for their co-operation.
Today, we have with us for the first two hours the Minister of Health, Jean-Yves Duclos, and the chief public health officer, Dr. Theresa Tam. They are accompanied by officials from the Department of Public Works and Government Services, the Public Health Agency of Canada and, as of 1:45 p.m. eastern, Mr. Matthew Tunis from the National Advisory Committee on Immunization. All will remain until we conclude at 4 p.m. eastern.
Pursuant to the motion adopted by the committee on Friday, January 14, each witness organization will have five minutes to make their opening statement, up to a total of 20 minutes, before we begin rounds of questions.
With that, Minister Duclos—
I will begin by saying that I am currently on the traditional territory of the Anishinabe Algonquin people.
Mr. Chair, honourable members, thank you for inviting me to speak to you today about recent COVID‑19 developments in Canada.
I would also like to thank all members of the Standing Committee on Health and all committee staff for their important work over the past few months of the pandemic.
The senior officials joining me today include Stephen Lucas, deputy minister of Health Canada; Paul Thompson, deputy minister of Public Services and Procurement Canada; Dr. Theresa Tam, chief public health officer of Canada; Dr. Harpreet S. Kochhar, president of the Public Health Agency of Canada; and Matthew Tunis, a member of the National Advisory Committee on Immunization, or NACI, who will be joining us shortly.
I would like to thank them for being here and, in advance, for their cooperation today as part of the committee's work.
As you know, with the rapid spread of the omicron variant in our country, we continue to be on high alert. COVID-19 is a crisis unlike any other we have experienced in recent memory in this country. The omicron variant has added a new layer of complexity. Despite this, our government and our whole country continue to respond quickly to protect the health and safety of everyone.
Today, my colleagues and I will bring you up to date on these efforts.
Last week, on January 13, I met with our provincial and territorial colleagues for the sixth time since December to discuss our collective efforts to strengthen our defences against the omicron variant.
The conversation was extremely productive, as were the measures. For the past two years, the provinces and territories have stepped up public health measures to contain or at least limit the spread of this virus, and the federal government has supported them.
The Government of Canada has provided significant federal surge funding and resources to protect Canadians and support the response to COVID‑19.
Indeed, the federal government has provided the provinces and territories with eight out of every 10 dollars spent in Canada to fight COVID‑19.
As you know, vaccination is one of the most effective ways to protect ourselves against COVID-19. So far, nearly 78% of all Canadians of all ages have received their primary vaccination of two doses.
In terms of continuing access to vaccines, Canada has secured COVID‑19 vaccines from Pfizer and Moderna for 2022 and 2023, with options to extend into 2024.
In addition to providing booster vaccine doses, these agreements provide flexibility to procure future COVID‑19 vaccine formulations, based on the evolution of the epidemiological situation in Canada.
Vaccination campaigns are going very well across the country. Booster campaigns are well under way, and 34% of eligible Canadians have received a booster dose.
Furthermore, more than 48% of children aged 5–11 have received their first dose.
Rapid tests are another important tool in our fight against COVID-19 and its variants. Earlier this month, the Government of Canada announced that an additional 140 million rapid antigen tests will be delivered to provinces and territories on a per capita basis in January. Deliveries are on the way.
The Government of Canada is also working to ensure that health care and frontline workers have the medical and protective equipment supplies they require to do their jobs.
The Government of Canada launched a bulk procurement process in 2020 to rapidly and efficiently procure personal protective equipment. Thanks to this aggressive approach, the Government of Canada has now secured over 2.7 billion pieces of PPE.
Our government also remains committed to using all the tools available to protect Canadians. This includes easy access to easy-to-use treatments for Canadians, such as Paxlovid, which is critical to reducing the severity of COVID-19 in those people who are at high risk of progressing to serious illness, and will therefore help ease the burden on our health care system. That's why yesterday I was so pleased to announce, alongside , that Canada has received the initial delivery of a shipment of 30,400 treatment courses of Pfizer COVID-19 oral antiviral treatment.
Mr. Chair, in conclusion, this is just a snapshot of some of the current and recent actions our government is taking to protect the health of all Canadians.
As you know, a lot of work is going on behind the scenes with our many partners across all levels of government.
We know that we must continue with public health efforts to reduce transmission of the virus and minimize its overall impact.
The Government of Canada will continue to do everything within its power to protect the health, safety and well-being of Canadians.
I'll now pass it over to my deputy minister, Dr. Stephen Lucas.
Thank you, Mr. Minister.
Mr. Chair, hon. members, thank you for this opportunity to speak to the committee today. It is my honour to be here to talk about what Health Canada has been doing to keep Canadian safe and healthy, as we fight COVID‑19 and the omicron variant.
As part of the health portfolio, Health Canada has played a key role in Canada's response to the COVID-19 pandemic. As new vaccines and treatments are developed, they must come to Health Canada for review and authorization before they can be used in Canada.
Health Canada's regulatory branch ensures that drugs and treatments, including vaccines, meet Canada's strict standards for safety, efficacy and quality. Given the urgency of the pandemic, measures were put in place to safely expedite this authorization process. This included an interim order, introduced in September 2020, allowing Health Canada to accept rolling submissions for drugs, including vaccines, related to COVID-19. This expedited process helped make COVID-19 vaccines available to Canadians as soon as possible in late 2020.
When the interim order expired the following year, amendments were introduced to the food and drug regulations to give permanent legal status to drugs and vaccines authorized under the order and to maintain regulatory flexibilities introduced through the interim order.
I want to assure you that my department continues to review safety and efficacy data for all authorized drugs and vaccines on an ongoing basis. That includes regular reporting on side effects.
As the pandemic continues, it is vital that we have timely access to life-saving vaccines and leading-edge treatments for COVID-19, particularly in light of the highly transmissible omicron variant.
While vaccination continues to be the best way to protect ourselves from serious illness, hospitalization and death, treatments that reduce the severity of infections are an important tool in the fight against this disease.
Health Canada has authorized several treatments for COVID‑19, including monoclonal antibody treatments.
Yesterday, Health Canada authorized Pfizer's Paxlovid, an antiviral treatment for adults with mild to moderate COVID-19 who are at high risk of progressing to serious disease. Other submissions are being reviewed on a priority basis, including Merck's antiviral treatment molnupiravir.
Paxlovid and molnupiravir are significant, because all existing COVID-19 treatments require intravenous administration or injection in a hospital or clinical setting. These new antivirals are in pill form. They are taken orally. This represents an important step forward in ensuring timely access to COVID-19 treatments. As such, the Government of Canada has signed an agreement with Pfizer to procure an initial quantity of one million treatment courses of Paxlovid, and with Merck for 500,000 treatment courses of molnupiravir.
Now that Paxlovid has been authorized, the Public Health Agency of Canada will work in close collaboration with the provinces and territories to facilitate its distribution and provide support on its use.
Throughout the pandemic, the Government of Canada has been working closely with provincial and territorial governments to help them adapt to the challenges of delivering health care during this crisis.
Whether coordinating PPE, providing surge support, or collaborating with provinces and territories on vaccine rollout, we at the federal level have been doing everything we can to make sure that our provincial and territorial partners have the support they need. This includes supporting surge capacity, such as contact tracing, testing assistance, testing equipment, PPE and medical equipment, laboratory services, outbreak management, voluntary safe isolation sites, public health response teams and health human resources.
After two years of fighting the COVID-19 pandemic, including the recent omicron surge—
That's excellent. Thank you very much, Mr. Chair.
I want to thank the committee for inviting me here today. As do my colleagues, I fully appreciate the urgency of the meeting.
Having joined the department only a week ago, I'd like to start by saying I'm very proud to lead a very talented group of public servants who have been crucial to fighting COVID-19.
Since the very beginning, Public Services and Procurement has been working tirelessly to obtain the equipment and the supplies required to protect the health and safety of Canadians. Our goal is to meet the needs established by the Public Health Agency of Canada as they work with the provinces and territories to support Canadians and our health care professionals on the front lines.
Early on, our department focused on buying urgently needed PPE in what proved to be a very competitive global market with huge international demand for a finite supply of goods, most of which were being made overseas. More and more, as domestic capacity for producing PPE was stood up, we also tapped into several Canadian manufacturers. To date, PSPC has now procured some 2.7 billion pieces of equipment with a substantial amount of that being made right here in Canada. For example, we have a 10-year contract with Medicom out of Montreal to supply N95 surgical masks, and we have a contract with 3M based in Brockville for 25 million N95s annually through to 2026. Both domestic manufacturers are now providing Canada with a steady supply of masks.
When it comes to vaccines, our approach has been deliberate and comprehensive. The department led negotiations for the establishment of a robust vaccine portfolio, which has put Canada in a very fortunate position. Whether it be a first or second dose, a pediatric dose or a booster, we now have access to more than enough vaccines for every eligible Canadian, and we have contracts in place with our vaccine suppliers that will ensure a steady flow of doses into the country for years to come.
However, we know that other tools, such as rapid tests, are now more important than ever, particularly with the highly contagious omicron variant. PSPC currently has 14 agreements in place with suppliers for more than 430,000,000 rapid tests that have been secured to date. This month alone these agreements are enabling our colleagues at the Public Health Agency to distribute 140,000,000 rapid tests to provinces and territories to meet these urgent needs. We are planning for shipments to continue steadily coming into Canada over the coming months, but given the global demand, there will be challenges, and that's why we are in constant contact with suppliers.
On border testing, we've put in place new contracts to increase the capacity to collect and process tests for national travellers. These contracts are structured to allow flexibility to ensure that we can adapt to any future border-testing requirements.
We are also ensuring that Canada has access to effective treatments that can reduce the severity of COVID-19. Our department has established agreements for seven different kinds of therapeutics, and we continue to aggressively pursue additional agreements. Just yesterday, immediately following Health Canada authorization, the government announced that we have already received our first shipment of more than 30,000 treatment courses with another 120,000 coming before the end of March. In total, we have an initial order of one million treatment courses of Paxlovid secured under contract, and delivery schedules for those remaining courses are being finalized as we speak.
Mr. Chair, those are just a few examples of the department's recent works to support the pandemic response. I look forward to continuing to support the government's efforts on this front and to answering any questions.
Thank you very much for this opportunity to appear before you today to speak to the current state of the COVID-19 pandemic.
As we continue to deal with the challenges posed by COVID-19, preventing severe illness and death while minimizing societal disruption remain top priorities in Canada's response to the pandemic.
Omicron continues to spread rapidly and is now the dominant strain in Canada. We have seen an unprecedented surge in case counts far beyond what we experienced in previous waves.
The global consensus is that omicron is associated with less severe illness than the delta variant at the individual level. However, given omicron's substantially higher transmission rate, the smaller proportion of infections with serious outcomes is having a bigger impact at the population level. Already, the enormous volume of cases is driving an increase in severe illness trends nationally, and the surge is expected to exceed historical maximums for new daily hospital admissions, which is already having a heavy impact on hospitals across the country.
It is with this in mind that the Public Health Agency of Canada continues to actively engage with provincial and territorial partners to inform public health guidance and share experience, lessons learned and identified best practices.
In particular, PHAC continues to work with and support provinces, territories and indigenous partners on key challenges they are facing in their ongoing COVID‑19 responses, including vaccine supply, treatments, procurement and distribution of N95 respirators, distribution of rapid tests, and surge testing.
To date, a total of over 74 million doses of vaccines have been administered in Canada, as vaccination continues to be crucial for reducing the risk of severe illness due to COVID-19. Canadian and international evidence shows that two doses of COVID-19 vaccines reduce the risk of hospital admission, including due to omicron infection. Moreover, recent data shows this protection is enhanced by receiving a booster dose following the primary series.
On average, we are seeing positive trends in vaccination rates, with a seven-day rolling average of 375,000 doses administered daily. Nationally, over 88% of eligible Canadians five years of age and older have had at least one dose of a COVID-19 vaccine, while close to 82% are fully vaccinated. In addition, more than 11 million eligible Canadians have received an additional dose as of January 14. Booster doses are particularly important for certain groups, such as health care workers and those at highest risk of severe illness from COVID-19, including older adults, people with high-risk medical conditions and people in and from indigenous communities.
Canada currently has enough mRNA booster doses for all eligible Canadians. However, vaccination alone is not enough. While COVID-19 is still circulating in Canada and internationally, vaccination, including getting an mRNA booster dose as one becomes eligible, continues to be important in combination with timed and targeted public health measures and individual protective practices for slowing COVID-19 infection rates and helping to reduce the impact on health care capacity.
Omicron has shifted the international outlook of COVID‑19. We will continue to monitor our borders, assess risks and ensure testing and public health measures are in place to protect our communities.
We are at a critical point in the pandemic. Keeping infection rates down remains key to mitigating the rise in severe illness trends as much as possible over the coming weeks.
As we push through the omicron surge, continuing to prioritize the health and safety of Canadians through vaccinations, phased border reopening, and the continuation of personal protective measures, such as wearing high-quality, well-fitting masks, will help us save lives and get through this difficult period sooner.
The COVID-19 pandemic continues to generate stress and anxiety for many. Through the Wellness Together Canada online portal, people of all ages across the country can access immediate, free and confidential mental health and substance use supports 24 hours a day, seven days a week. As Canadians continue to demonstrate perseverance and resiliency, despite the duration and the ongoing challenges of the pandemic, I want to thank everyone for their commitment to keeping each other safe.
Thank you. Meegwetch.
Thank you very much, Mr. Chair.
Thank you to all the witnesses and my fellow committee members for being here today.
Certainly, as Conservatives we want to make it very, very clear that there was a failure of leadership in this government in being prepared for the pandemic and the unfortunate circumstances that have continued to persist throughout the pandemic.
The problem here, of course, is that we have lost 30,000 lives in Canada. That is also comparable to the 42,000 Canadians who died during World War II, in which we mounted a massive effort for change. This government has not done that. This failure of leadership has left the provinces with only the ability to have lockdowns as their primary method of treatment. The unfortunate thing is that this is what we're left with as Canadians.
Minister Duclos, I have a few questions for you, sir. Before the pandemic began, acute-care bed occupancy, according to the OECD, in Canada was 91.6%. Only two countries were worse. Are you aware of this problem, sir?
Thank you very much, Dr. Hanley.
Brendan, if I can call you Brendan, we have had the fortune of having you on board for the last few weeks and months. On behalf of everyone in Yukon, I would like to thank you for what you've done during COVID-19—for all of the expertise and experience you're bringing now to Ottawa to serve your community, and for assisting with the important work we now need to do to exit from COVID-19 and repair the damage and build for the longer term.
In terms of surge support, I will turn briefly to my deputy minister. We've had a number of important opportunities to provide surge support to the provinces and territories based on their needs, which have changed and evolved over the last 22 months.
DM Lucas, would you like to provide examples of surge supports that we have provided to the provinces and territories?
I would note that the Government of Canada has invested $150 million in support to address a humanitarian workforce problem, working with non-governmental organizations such as the Canadian Red Cross. The Canadian Red Cross now, with the support of the Government of Canada and working with the provinces, is supporting vaccination in a number of provinces, including Nova Scotia and clinical support in Manitoba. The government has a roster of federal nurses who have agreed to support the provinces, including Prince Edward Island, and is looking to support in Manitoba as well.
Of course, the Canadian Armed Forces have provided support through the Rangers in a number of first nation communities, as well as in deployments, such as the deployment in Quebec now to support vaccination. We have worked with the provinces and territories, and our ministries of immigration, refugees and citizenship and of employment, development and social services to support international medical graduates with foreign credentials to allow them to help out.
We are working collaboratively with a range of partners to support the surge needed to provide clinical support, vaccination support and support for testing, as well as contact tracing through the great work done by Statistics Canada, which has supported over 10 provinces through the course of the pandemic.
Thank you very much, Mr. Chair.
I'd like to thank all the witnesses and the minister for being with us today so that we can take stock.
Mr. Minister, I have question that has lingered since the first wave. From the outset, experts determined that the chronic underfunding of health care networks over the past 30 years had weakened health care systems and our networks to the point where the pandemic would break the weakest links. That is what we have seen.
All along, we have been hearing from the that the issue of substantial recurrent funding, or health transfer payments, will be addressed after the pandemic. We are now in the fifth wave. Right now, the situation is so severe and the contagion is so extraordinary that doctors are being sent to give medicine or clean up patients.
You have invested from time to time, no one can argue with that. However, you know very well that the provinces and Quebec need predictability to fix this fragile system and that we need to make the system more robust. All public health decisions have an impact on our lives, including treatment delays and being unable to treat a cancer patient because the system is stretched too thin. But here we are in the fifth wave and the pandemic has been going on for two years.
What is keeping you from making structured investments that will allow Quebec and the provinces to plan ahead and invest?
In Quebec, we're talking about $28 billion. When I look at $340 billion and $28 billion, I don't understand why the government insists on not settling this immediately. Quebec could use this additional $6 billion to rebuild its network.
What are you waiting for? Is it going to take a sixth or seventh wave for you to address health transfers and pay your fair share to enable substantial recurrent funding for health care systems?
Thank you very much for your question, Mr. Thériault.
You have indeed just summed up the health care challenge that we already had before COVID‑19 across the country, including Quebec. It is a challenge that we knew would grow over time, with more frequent chronic illness, and obviously the aging population, which also includes aging health care workers, the rising cost of medication and technology, which carries both benefits and challenges for managing and delivering health care. All of this further amplifies the challenges with COVID‑19.
As you mentioned, the Government of Canada has been there during the COVID‑19 pandemic, investing $63 billion in either cash or transfer payments to support health care and safety alone. That's on top of the $280 billion in direct support to families, workers and businesses. We were there before and throughout the crisis, and we are still here, as shown by the recently announced Pfizer treatments and the large quantity of vaccines that continue to come into the country and are being paid for by the Government of Canada. We are also getting the rapid tests out there even faster.
So we are still here and we will continue to be over the long term.
With all due respect, Mr. Minister, this is not the first time you have given me that answer, but it's a basic question.
Of the $63 billion you mentioned to me, $42 billion are transfer payments already scheduled each year. You decided to increase health transfer payments by only 4.8% in 2022‑23, while system costs rose by 5.2%. You are keeping indexation at 3%. So all in all, that means you are investing under $3 billion in substantial recurrent funding in the system.
Quebec and the provinces need to be able to plan and rebuild their health care networks. To do that, they need to know how much recurring leeway they will have. Right now, some patients are not being screened for cancer. We are still expecting more and it will cost billions of dollars because we can't treat those people right now.
What are you doing for patients who don't have COVID‑19?
If you refuse to invest and settle the issue of health transfer payments, you are responsible for the non-COVID patients who are not being treated at this time.
I think we've all agreed that one clear deficiency that COVID-19 has exposed is the dangerous shortage of capacity in our health care system that I think, Minister, you've acknowledged happened even before COVID. Some key figures have been pointed out and illustrate this situation. Canada has 1.95 acute care hospital beds per 1,000 people, fewer than every OECD country except Mexico. Our hospital beds have dropped from 6.9 per 1,000 people in 1976 to 2.5 today. We are 26th out of 28 OECD countries in doctors per 1,000 people. Among comparable developed countries, we rank 10th out of 10 for wait times for surgeries.
Minister, you recently called our health care system “fragile” and acknowledged that it is “stretched too thin”. Given that the federal share of health care funding in Canada has dropped from its original 50% down to about 22% today, will you commit, in the upcoming budget, to a significant increase in federal funding through the Canada health transfer?
As we were saying earlier, this was true before COVID-19, with all sorts of pressures that I had mentioned, again because of technology, certainly because of the aging of the population, the greater incidence of chronic diseases and their higher costs, the ever-higher costs of drugs across Canada and issues of equity of access to health care in many of our provinces and territories. That's why we have been not only effective but certainly collaborative in working with provinces and territories in doing what we had to do to help everyone go through this crisis.
As we emerge from it, as we exit omicron and prepare and protect against any possible variant that could come afterward, we also need to build for the future, as you've said, and invest in all of those priorities that provinces and territories have signalled to us over the last few months.
Mr. Minister, thank you for being here and I'd also like to thank all those accompanying you today.
As you know, Canadians are sick and tired of the sweeping public health restrictions all their governments are imposing on them, but they are standing strong against the COVID‑19 threat. Canada has one of the highest vaccination rates in the world. Actually, I thank the Conservatives for pushing so hard to make sure we had enough vaccines from the start.
We knew right away that we needed to focus on vaccination. We can applaud the resilient people who, nearly two years into the pandemic, have made Canada a country with one of the highest vaccination rates.
Unfortunately, it seems the government hasn't learned much from the difficult months we have just gone through. The federal government has normalized lockdowns and restrictions to deal with the pandemic, at the people’s expense.
Mr. Minister, I had COVID‑19 over the holidays, and rapid testing was completely unavailable to me and some of my family members. We were unable to do the tests ourselves.
How do you explain the failure to make rapid testing available to all Canadians during the holiday season?
Thank you, Minister Duclos, for being here. I'd also like to thank our public servants, who have been working tirelessly for over two years.
Thank you for your tremendous work and for joining us today for this important meeting.
I'd first like to acknowledge the obvious, that this is a global pandemic impacting every country around the world and that when Canada is compared with our peer nations, in particular to our neighbours to the south, Canada's response has been formidable. In short, tens of thousands of lives have been saved with good actions and swift policy decisions, and those decisions have been made by many of the officials here today.
So I would like to thank you on behalf of millions of Canadians for your leadership and expertise. As referenced earlier, this is a pandemic that is similar in size and scale to a world war, but instead of lives lost, there has been a similar number of lives saved as the result of policies and decisions made, including to swiftly vaccinate, as well as some tough calls that were necessary at the time. All in all, I do believe that gratitude is warranted.
Whether it's in terms of containing the spread of the virus, rolling out vaccinations, procuring vaccinations and other important things, fighting delta or reopening the economy, Canada has consistently scored above average. Canada is one of the only countries in the world to never have fallen into the bottom half of any metric, according to numerous publications. As we know, among the newest tools in the tool box to fight COVID-19 are antivirals, and this week was a good week for an announcement regarding antivirals that will reduce the strain on our medical system and our health care system, and particularly ICUs.
While vaccination is central to fighting COVID-19 in Canada and around the world, providing everyone in Canada with access to potential treatments remains vitally important as well.
I would like to direct my initial question to the deputy minister.
Can you please tell us about the agreements we heard about this week with regard to antiviral oral medications to combat COVID-19?
Mr. Chair, I'll provide a few remarks and then turn to my colleague Paul Thompson and, if time permits, Dr. Tam.
Yesterday, essentially three elements of our plan to support access by Canadians to Pfizer Paxlovid antiviral were announced. First there was the regulatory decision made by Health Canada after receiving the submission on December 1. The team worked through the holidays and around the clock to complete that review, working with other international regulators and collaborators. The second was the announcement that treatment courses for Paxlovid are in the country. They were pre-positioned to allow for rapid deployment to the provinces and territories. Paul Thompson can speak to this, building on the procurement agreement signed for a million treatment courses of Paxlovid that was announced back in the late fall. Third—and Dr. Tam can speak to this—is work done by the Public Health Agency of Canada, working with experts and in collaboration with the provinces and territories to provide guidance on the use of Paxlovid, recognizing the importance of coordinating for testing and ensuring that priority populations have it.
Mr. Chair, I'll pass it to Paul Thompson to speak further to the procurement agreements.
Mr. Chair, the solution is to increase my time.
That said, the other key measure to get us out of the pandemic is global vaccination. Experts say that, as long as we haven't vaccinated the entire global population, we won't be safe from a variant crisis every eight months. This is significant.
Canada's premiers have been very clear on this issue. However, several experts believe that they have lacked leadership. They don't walk the talk. The equivalent of 200 million doses were promised, but half of them were delivered.
I'll make four statements. You'll tell me whether you agree with them.
First, the patents must be lifted. To that end, why hasn't Canada supported the waiver of the WTO's Agreement on Trade‑Related Aspects of Intellectual Property Rights, or TRIPS? Why didn't it accept President Biden's invitation to do so?
Second, vaccines must be provided to developing countries. We mustn't do what Canada is doing now, namely, sending out doses that are about to expire. There must be predictable and realistic timelines for these countries, as well as logistical support.
Third, we must participate in the outreach efforts to get these populations vaccinated.
Lastly, logistical support for countries is crucial. We must be able to meet the storage requirements. These requirements are very complex, but they ensure that we don't lose all these doses and vaccines.
Will the minister commit to implementing these measures?
Will you accept President Biden's invitation?
Thank you, Mr. Thériault.
I'll start by saying in a slightly different way what you said. COVID‑19 won't end anywhere in the world if it doesn't end everywhere on the planet. We know why, and we knew it a few months ago. The Omicron variant is a reminder that other variants can emerge as long as everyone isn't sufficiently vaccinated.
The global response includes three parts: the international program for patents and international production; the vaccine direct delivery program; and the support program, as you said, for immunization in the field.
First, with respect to patents, there are discussions and a set of international measures.
Second, in Canada, we have more direct control over our participation in Operation COVAX. We're among the six largest contributors, largest donors, in terms of the number of doses from any country in the world. Canada has a total of 200 million doses, many of which are already being delivered or have already been delivered.
Lastly, we're one of the world's largest providers of administrative and logistical support. Canada has invested $2.5 billion around the world to help some countries receive vaccine doses. That's what we're doing through COVAX. We must also be able to help these countries administer the doses in situations that are often even more difficult than the circumstances in Canada. Some communities are remote. In these countries, the health care system is weaker and equipment may not be available. In addition, people must have confidence in the system for distributing and administering vaccine doses.
Thank you, MP Davies. There are three things here—first, the portfolio; second, the actual vaccines to which we have access; and third, the regulatory process at Health Canada.
First, on the portfolio, you are indeed correct. It's not my fault and it's not the fault of . It's the fault—the success—of lots of experts, including at the federal government, that we were able to choose a portfolio of seven vaccines, four of which, as you said, have been already approved in Canada.
Second, on confidence, we have access to loads of mRNA vaccines in Canada. We have currently in Canada 22 million booster doses that we could administer right now, with another 35 million coming very quickly. We have ample confidence and ability to use those existing vaccines.
Third, on further approval processes for other vaccines, I will turn to DM Lucas for a brief remark.
Thank you, Mr. Minister. Thanks for being here.
Canadian innovators stepped up when asked to solve the shortage of PPE in 2020. Distilleries switched to make hand sanitizer and cleaning products. Canadian companies retooled and produced whatever was needed for the pandemic. However, Canadian companies like Eclipse Innovations in Cambridge, Ontario, have millions of respirators sitting on shelves as of this month. They can't move them, while some nurses and doctors in Canada are still saying they lack proper PPE.
Health Canada had announced a made-in-Canada change for companies that met the National Institute for Occupational Safety and Health, or NIOSH, standards to get Canadian PPE out the door, but so far this PPE is sitting in warehouses and not in our doctors and nurses' hands. This is because it was not properly communicated that the made-in-Canada designation would suffice in local hospitals and health care settings. Those settings are still procuring PPE from international and not Canadian companies.
Minister, what percentage of PPE procured by the federal government at this date is made in Canada?
I'm hearing that you don't have those procurement numbers yet, but what I'm hearing from local manufacturers and from across Canada is that they are not able to get their PPE out. We want to make sure the federal government is buying Canadian-manufactured PPE. I think it's very important. If you could just please put that out, let's make sure we have some communication. I think we want to help Canada to be ahead of this, not be average.
With regard to my second question, Minister, I know that my colleague Mr. Davies has already asked about some of this. Novavax and Medicago offer made-in-Canada vaccines that are not only innovative but can help vaccinate the world. The new news from Novavax is they are helping to develop a flu and COVID vaccine, but Novavax is still not approved in Canada.
My question for you, Mr. Minister, as we have had $126 million of our money invested in the new facility in Montreal and as said we would be producing these vaccines in December, and we are not, when will Canada be producing its made-in-Canada vaccines, sir?
Thank you, MP Sidhu. Thank you, Sonia. I'm glad to see you during this new year.
A large part of the $63 billion additional investment that the federal government made in protecting the health and safety of Canadians was designed to help our health care workers, to whom we have such a debt of gratitude for the hard work they did during COVID-19. Furthermore, we promised in the campaign a rapid investment of an additional $6 billion for greater access to primary care, including training, hiring and retaining personal service workers, nurses, doctors and all the people we need, because these people are looking after the health needs of so many other Canadians in Canada.
The third thing is an additional $6 billion to reduce the backlog in surgery. It's a key input to help surgeons, doctors, nurses and hospitals across Canada and to support health care. It's a personnel investment, but it's obviously also to look after the large number of Canadians who have seen their surgeries—heart surgeries, cancer surgeries—delayed by the COVID-19 crisis.
Yes, mental health is an extremely important aspect of the pandemic response as well as an ongoing issue.
I have been a great advocate to consider physical and mental health together, so the Wellness Together platform is extremely important, and there is a new application called PocketWell that links to this platform to provide instant access to resources that Canadians need, be it a counsellor or other support.
I actually think the pandemic has given us an opportunity to learn from these innovative measures. They could help us on an ongoing basis, so from my perspective it is important to see these gains and innovations being sustained going forward. Of course, they may need evaluation, but we must not take a step back.
I know that Health Canada is the lead on the mental health file, so there may be other responses to supplement mine.
Hi there, and thank you, Mr. Minister, Mr. Chair and honourable members.
I appreciate this is a very difficult time for everyone, but years ago when I first started working on Parliament Hill, a fine gentleman once told me, “Facts, ma'am, just the facts”, so this is what we're looking for today.
I'm going to switch gears this afternoon and ask questions that are a little more specific and pointed.
Mr. Minister, what is the status of the mobile field hospitals that SNC-Lavalin was contracted to produce? Also, has the company delivered all the units the government requested, or does the work still continue?
I'd like to welcome the minister and all the officials to our committee. It's good to see all of you.
First of all, let me thank you once again on behalf of millions of Canadians for the great work that you've done, and also our health care workers, who have been [Technical difficulty—Editor].
Minister, in response to the high number of infected health care workers and to mitigate the worker shortage in health care settings, several provinces have shortened the length of time that infected health care worker must self-isolate. As of December 21, the federal government's self-isolation period of 10 days has remained the same for those with symptoms or for asymptomatic cases following testing.
What advice have you or your department given to the provinces and territories, and especially to the provincial public health authorities, with respect to the isolation guidelines for health care workers?
Thank you for the question.
Mr. Chair, we have been trying to update our information on the period of communicability, which means how long you can potentially spread the omicron variant once you're infected. There is very little information on that, but the studies that we've managed to amass, including a recent one from Japan, suggest that the period of communicability is no shorter than for the other variants because the viral shedding and the viral load don't decrease until day 10 following symptom onset or specimen collection after the diagnosis.
We do recognize that because so many people are infected with omicron at the moment, maintaining business continuity and continuity of critical services is extremely challenging on the front line for the province and territories, so they have reduced some of these requirements in order to maintain that health care workforce.
Of course, any reduction is associated with a certain amount of risk, so the other layers of protection, such as masking, are particularly important, as is supplementing them with testing in order to reduce those isolation periods.
Thank you. I'll answer that question briefly.
First, the best economic policy that we can put into place to exit from the crisis is a health policy. That obviously has to be around the importance of vaccination for everyone, not only to protect supply chains, businesses and the flow of goods and services across Canada, but also to protect people—truckers, workers and everyone else across Canada.
The second thing I would say is that as we move through this crisis, we will have to reinvest in all sorts of ways to build back. Our country has suffered tremendous damage in all sorts of ways, and that's why the significant investment we announced in the campaign and prior to the campaign will be important from a health, economic and social perspective, because all of these perspectives go hand in hand.
Thank you, Minister Duclos. You answered my question.
In that case, why are you rejecting the opinion of Prime Minister Trudeau's own chief science advisor, who says that random screening should be reintroduced at airports?
Why aren't you following Dr. Tam's recommendation? She considers that, in terms of PCR tests at the border:
“it is a capacity drain on the system as a whole”.
These are clear recommendations, Minister Duclos.
Are you continuing to test people against the current scientific opinions because you signed a contract with Dynacare for almost half a billion dollars and you can't terminate it?
Hello. Thank you. Welcome to all the witnesses.
I want to ask the minister something, but of course he's welcome to delegate the answer to someone else. I think for this one it would probably be Mr. Thompson. I want to ask about other therapeutics and the difficulty Canadian doctors have in accessing them.
Certainly I think everyone is overjoyed that Paxlovid has been approved in Canada. It seems to be really promising, with more than 85 per cent efficiency in decreasing the number of people either hospitalized or dying.
We did have medications out there before that were pretty good, when used early on, to treat high-risk people, namely monoclonals—one of my favourite topics, of course—and sotrovimab. I know they've also been using some remdesivir, but it's in very short supply. I'm told by infectious disease people in Ontario—and I know it's the province that basically runs the hospitals—that a lot of people aren't getting it. Similarly, tocilizumab, supposedly decreases mortality by 10% in people who are on ventilators, but there's not a lot of that available. Although this is provincial, my understanding is that the federal government has put some money into purchasing monoclonals and helping the provinces with these treatment modalities.
Could you, Mr. Minister or one of your people, answer that?
Indeed, Health Canada has approved a number of treatments, including monoclonal antibodies, and there is use of some existing treatments such as tocilizumab for rheumatoid arthritis, which has been used to support treatment of patients with COVID.
Public Services and Procurement Canada, working with the Public Health Agency of Canada, has procured doses of a number of these treatments, including remdesivir, as noted, and tocilizumab, as well as sotrovimab, the GlaxoSmithKline monoclonal antibody that works relative to the omicron variant.
We are in close contact with provinces and territories in terms of determining their supply, working with them to reallocate to address areas of need and taking steps to procure more to address those needs going forward.
I have a question on the current requirement of a PCR test within 72 hours of arrival in Canada. I had one of my constituents complain. Well, he's not my constituent—he lives in Winnipeg—but his mother lives in my riding around Rainy River. Because of the 72-hour requirement, he is required to drive all the way around Lake of the Woods; if I could turn my camera, I'd show the snow squalls that are occurring right now in Thunder Bay. He is asking why he has to take this five-hour route when, if he went through the States, it would take him one hour to visit his mother, who is having health problems.
I know that the 72-hour requirement for a PCR test certainly I think seemed to make sense when we were worried about new variants coming into the country; however, right now, it seems to be overwhelmingly omicron on both sides of the border. Lots of people have it on both sides. I'm not sure if the 72-hour requirement for a PCR test still holds.
Is that going to be reconsidered? I know that this is a border measure; however, I'm sure that the people who are making that determination are informed by the Ministry of Health and Theresa Tam, so do you have any response to that, please?
I'm sorry. I thought that the round was over. I'm happy to keep asking the minister questions.
Minister Duclos, it seems clear that, unfortunately, you didn't have many answers to our questions today on a number of issues.
We have questions, especially about the new treatment, Paxlovid, which is causing a great deal of concern. At yesterday's press conference, we learned that a positive test result was required to obtain the treatment.
Unfortunately, PCR tests are very difficult to obtain and there are long delays in getting results. Rapid tests are also still extremely difficult to obtain.
How will the Paxlovid treatment affect this omicron wave, Minister Duclos?
Thank you, Minister and Mr. Berthold.
This is the end of the extended time in which the minister is available.
Thank you very much for being so generous with your time, Minister Duclos, and for staying on for an extra 20 minutes after agreeing to 15.
Colleagues, I would ask that we suspend briefly for a health break while the minister disconnects.
Minister Duclos, I expect we'll be seeing lots of each other in our roles as health committee members and in yours as minister. We certainly appreciate your being here on short notice and your generosity with your time and, of course, your service.
Colleagues, we stand suspended for three minutes.
I call the meeting back to order.
Before we recommence, we started about 15 minutes late because of some technical difficulties. Do we have consensus among the witnesses and among the members of Parliament to go until 4:15? We require that in order to extend the time. If anybody has a big problem with that, please say so. If there are any witnesses who can't accommodate that, then just let us know.
Some hon. members: Agreed.
The Chair: I don't see any objections, so we'll cut it off around 5:15.
We're continuing now with questions. The next member of Parliament up is Dr. Hanley, for the Liberals, for five minutes.
Dr. Hanley, you have the floor.
Thank you for the question.
Mr. Chair, this is quite a complicated question. Of course, maintaining surveillance as well as keeping an eye on all the evolving international data on omicron is really important.
First, we have laboratory networks, including genomics networks, connected to the international community that are on a constant lookout for any new variants of concern. They're also conducting domestic surveillance with the collaboration of the provinces and territories to look at not just cases but hospitalizations and ICU admissions as well as outbreaks in high-risk settings such as long-term care facilities. Monitoring vaccine effectiveness over time is really important as you've just seen. With the advance of treatments you need to also monitor for any resistance to some of the drugs that are being provided.
We know, for example, that some of the monoclonal antibodies were not working for this omicron virus. There are many streams of surveillance, data and modelling.
One of the key innovations during this pandemic is waste water surveillance, which is another indicator we're using to track where the omicron wave is going and when it might subside. All of these measures are ongoing as is modelling. Modelling projections we have been providing on a regular basis, the last of which was last Friday.
We have to be very careful with the projections. We think the omicron wave might spike very quickly and potentially come down fairly quickly as it has done in other countries but we have to be very careful about that. Right now we're seeing a little bit of plateauing in the cases. I advise that we wait until at least the end of this week to have another snapshot of what's going on. Given the testing limitations at the moment, we need to look at all of these indicators.
I look at the current context as the pandemic period, which is that we are still in crisis and our health care system cannot cope, moving to an interim transitional period towards a state of endemicity. This means I do not believe that this virus is going away from the world. Every country has it, so we need to adapt our response going forward. However, the endemic state is not yet in effect. The omicron wave may push us towards that state—one step into that future state. We have to evaluate the post-omicron wave using things such as sero surveys, whereby you look at the proportion of the population that might have immunity.
Yes. I think the committee has noted that we need to strengthen Canada's health system, and my report is focused on the public health system, but it's part of the health system as a whole. Given the enormous challenges of the pandemic, my message is also to recognize the prevention, health promotion and preparedness aspects, not just the response. We need to get ourselves well set up for any future complex public health issues, including climate change and anti-microbial resistance.
My recommendations really fall into four different streams, one actually on workforce capacity, and the second on some of the tools that are needed to modernize our health system, and this means at every level of the public health system, not focused on the Public Health Agency, but on the local, the provincial and the federal systems, so that we're better set up with data, for example, as one of the tools, and also to address things like misinformation in the social media age.
The third aspect is governance. We need to have a modernization of governance, recognizing the multisectoral nature of some of the work we do, including the pandemic response, and of course the financing of the public health system as well, because it is a very small proportion of the health spending in different jurisdictions. It's very difficult to estimate how much that budget is, but CIHI, the Canadian Institute for Health Information, estimates it is probably not more than 6%. If we want to be better supported in our pandemic response in the future, we've got to strengthen the public health system.
Mr. Chair, I'll respond.
Health Canada has approved 25 rapid tests and, in addition, 10 self-tests. This is comparable to other countries. In fact, it exceeds a number of our key comparator countries. These cover a range of antigen tests and some molecular rapid tests. As has been described, we're working with Public Services and Procurement to procure and deliver 140 million to provinces and territories this month.
In regard to utilization, provinces and territories are using rapid tests as well as PCR tests to support key areas of both diagnosis and critical functions, including in the health system, long-term care, schools and essential services. Dr. Tam can speak further, if you wish, to use guidance prepared by the Public Health Agency, with experts, in terms of enabling both test diagnosis and utilization of Paxlovid.
I wish to use some of my time today to clear up something that has come up a couple of times in this meeting, but first I'd like to just acknowledge or say that science often involves careful observation and it is not limited to such a narrow view that everything needs to be published or peer-reviewed in order to be called science. I'm not a doctor. I have a science degree. The science is evolving during COVID-19. We are, in fact, in an emergency situation still and relying on information. I would just call into question the kind of narrow view of science that Dr. Ellis has been using.
In addition to that, I'd also—
Mr. Stephen Ellis: On a point of order, Mr. Chair, I really think that if someone's going to specifically address me, then I should have the opportunity to address that, sir.
The other thing I would like to address is the usage of the term “personal cellphone data” earlier and also the word “scandal” in referring to the usage of such data. When I google my route to work, for example, oftentimes Waze or Google will tell me that a specific route is busy. If you google a restaurant location or a grocery store location, oftentimes Google will tell you that location is busy.
The same data is used and has been used—it's not secret—by the Public Health Agency of Canada. In fact, I believe that Dr. Tam was tweeting about it last summer in a transparent manner, telling Canadians how their data, which is aggregated, non-personal, and anonymized.... That means it's not as though they know Adam Van Koeverden was at the grocery store yesterday; they just know that more people were at the grocery store or something like that.
I was hoping that one of the officials who knows more about this than I do, and certainly more about this than members of this committee referring to it as personal data do, could elaborate, please.
Mr. Chair, I was just going to mention very quickly that the actual reason we collected this data is that reliable, timely and relevant health and public health data comes out of this for other policy- and decision-making. This is population-level mobility data analysis. This is what we have collected. No personal information was asked for or was received, and no individual's identifiable data is contained in any part of the work.
The mobility data, which were offered through the service provider, was actually analyzed by the communications research centre here at Innovation, Science and Economic Development. That would help us to understand the possible link between the movement of populations within Canada and the impact of that on COVID-19. We did that in a very clear way, keeping the means of collection open and transparent. When we use that information, it is never individually identifiable. Again, it is aggregated data.
Throughout this process, Mr. Chair, the Public Health Agency of Canada engaged with privacy as well as ethics experts to ensure that the government was following best practices. We engaged our Privacy Commissioner on this initiative as early on as April 2020, and technical briefings have continued. To mitigate any privacy risks we may have, we actually require that mobility data vendors apply very robust data anonymization and aggregation controls even prior to data extraction and access.
That is what I would offer, Mr. Chair, at this point.
Thank you again, everyone, for being here today. It's very important.
Last week, Dr. Tam, you stated that Canada's COVID testing requirements for travel are a “drain” on our already overwhelmed system and that the resources could be better used elsewhere. These testing requirements were put into place to stop the omicron variant from spreading to Canada, and we all know what the elephant in the room is—omicron is here. We have to continue—again, in your own words, Dr. Tam—monitoring sporadically for new variants, but when will the government get rid of these cumbersome resources and put them where they're needed?
I'll ask this of Dr. Lucas, please.
That's an excellent note on which to finish.
To all of our public servants, though it's trite to say and we've heard it many times that COVID didn't come with a manual, so allow me, on behalf of the committee and more broadly, to sincerely thank you for your service. Thanks for being available to come here on an emergency basis, as was required, and to stay as long as you have. Your dedication testimony are greatly appreciated. I have little doubt that our paths will cross again in this session, so we say “thank you and goodbye” but probably not for long. Thanks again.
Colleagues, there's just one item before we adjourn. Unless something else arises over the next couple of weeks, the plan right now is that our first meeting upon the reconvening of Parliament on January 31 will be a meeting of the subcommittee to discuss the business and activities for the upcoming session, with the full committee meeting thereafter on February 2 to ratify or discuss the subcommittee's recommendations. That's just to give you a heads-up that this is the plan as it presently stands.
With that, is it the will of the committee to adjourn?
Some hon. members: Agreed.
The Chair: Thank you very much, everyone. A lot of excellent information was disseminated today and I thank you all for that.
Have an excellent evening. We are adjourned.