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Results: 1 - 15 of 1438
Michael Silverman
View Michael Silverman Profile
Michael Silverman
2021-06-18 13:11
Thank you for the invitation to speak to you today.
I would like to address the issue of health care worker COVID vaccination.
Vaccination of health care workers has been an incredibly effective intervention in the control of COVID-19. A study by the Cleveland veterans affairs department found that health care workers who had been vaccinated had a 19-fold lower risk of acquiring COVID than those who were unvaccinated. Furthermore, the institution suffered from four COVID outbreaks, all of which were associated with transmission from unvaccinated health care workers. There were no outbreaks from vaccinated workers.
A recent outbreak involved a single unvaccinated health care worker who transmitted COVID to 20 other health care workers and 26 residents, and led to three patient deaths. This occurred despite the facility having extensive patient vaccination.
In Canada, there is a wide variation in health care worker vaccination rates between institutions, with many having staff vaccination rates well below the general population. As having your personal health care worker vaccinated can help protect you from exposure, these variable rates in vaccination raise an important issue of equity in health care delivery and patient safety.
Many patients do not respond to the vaccine because of serious underlying conditions, such as cancer, dialysis, organ transplantation or other immunocompromising conditions. They are vulnerable, and thus dependent on the health care workers and those around them to shield them from exposure to COVID.
Unlike going into a private business, patients who need to go to hospital cannot simply choose to stay home. Therefore, we have a moral obligation to assure these people that we will do everything we can to prevent them from becoming catastrophically ill and dying while in our care.
This then raises the issue of whether vaccination should be mandatory for health care workers who provide direct patient care.
Several concerns about a mandatory vaccination policy have been raised. Firstly, due to personal privacy concerns, health care workers do not have to even report their health care information to their institution.
Although it is true that the principle of privacy of health care information needs to be maintained, there are well-established exceptions where the public has a right to know in order to be protected. An individual’s struggles with alcoholism should remain a private matter. However, if that individual is a commercial pilot, the airline safety regulator has a well-established right to demand this information.
In our own experience, many of us would not be comfortable having someone who was unvaccinated come into our home. However, when a patient is ill in hospital, they at present have no right to even ask whether the health care worker entering their room is vaccinated.
The vast majority of patients would not consent to being directly cared for by a non-vaccinated person. However, this practice is still commonplace and is only maintained because of a lack of transparency, which enables the system to deny this information to the patient.
Patients have a right to expect that when they are being cared for in a medical facility, scientific principles will be used to determine the approach to care. We would not accept a health care worker making a unilateral decision, based on the belief that hand washing is not necessary, to continue to provide care between patients without washing their hands. Certain scientific principles that have overwhelming consensus and important patient safety issues must be maintained in order to provide a science-informed basis in care.
I am not recommending that any individuals who feel strongly opposed to vaccination must undergo it against their will. However, I do say that providing frontline health care services is a privilege and not a right.
If health care workers choose not to be vaccinated, despite the well-documented risks to both themselves and their patients, then hospitals should be able to decide not to allow their patients to be put at risk. These workers may be redeployed to non-frontline activities, if possible, or if not, then terminated. Special arrangements for health care workers with a vaccine allergy will have to be made, but a true vaccine allergy is an extremely rare phenomenon.
Our hospitals already mandate that health care workers provide proof of vaccination against other common transmissible agents, including measles and hepatitis B. Several countries have instituted mandatory health worker COVID vaccination policies.
The United States Equal Employment Opportunity Commission has ruled that all companies can mandate employees to be vaccinated in order to protect their customers. Many large U.S. hospitals have, therefore, undertaken a mandatory staff vaccination policy.
In Canada, however, despite the fact that most health care leaders would like to institute such a policy, they have been hamstrung by concerns regarding the legal framework, including the Charter of Rights and Freedoms, and a lack of federal or provincial direction.
Federal guidance and a national strategy on this issue are urgently needed. I therefore request that a committee be set up that would include representatives of health care institutions, health care providers, ethicists, patient advocacy groups and legal experts. This would enable rapid development of guidelines regarding implementing mandatory COVID vaccination policies for frontline health care workers.
Thank you.
View Marcus Powlowski Profile
Lib. (ON)
Perfect.
I want to start off by congratulating you. I think you did a very good job of making a very good argument that the COVID vaccine should be mandatory for health care workers, and perhaps there's a need for national leadership with recommendations on this subject, perhaps under the auspices of PHAC.
I want to switch to another topic, and that is the issue of whether or not we should be keeping schools open, given the number of COVID cases. You recently wrote a paper that I think was published in the Canadian Journal of Public Health, entitled “Ethics of COVID-19-related school closures”. You talked about the pros and cons of school closures and who ought to be making the decisions as to whether or not to keep the schools open.
Could you maybe summarize your conclusions in that paper?
Michael Silverman
View Michael Silverman Profile
Michael Silverman
2021-06-18 13:41
Thanks.
The issue of school openings and closures has been highly debated. However, there is strong consensus that because of both the short-term and long-term developmental and mental health risks of missing in-person learning and the low likelihood of severe physical harm to children from COVID, the safest place for children is in school.
However, these considerations must be balanced against the health risks to teachers of in-person learning as well as the potential health risk to parents and the overall trajectory of community transmission. These are all medical questions. They involve triaging between various medical priorities and, therefore, are best decided by the medical officer of health.
I would differentiate these issues from political concerns such as business closures. In the setting of closing the economy, economic bailouts and mitigating strategies that involve the public purse can be employed, so the politicians have an important role in decision-making. In contrast, school closures are purely a matter of triaging health care priorities. No amount of economic bailout can compensate a child for changes in their long-term development.
Politicians are subject to community advocacy pressures, which should not impact decision-making on the best approach to maximize public health. Promises are commonly made that schools should be the last thing to close and the first to reopen. However, in practice, this doesn't happen due to strong political pressures by various advocacy groups. Data from the United States shows that with the same level of community transmission, states run by Democratic governors were much more likely to have closed their schools than states run by Republican ones.
Decisions about school closure should be apolitical and made by the public health system, with the same separation of decision-making as occurs with the justice ministry. This would assure that public health priorities remain paramount.
View Patty Hajdu Profile
Lib. (ON)
Thank you very much, Mr. Chair.
Thank you for the opportunity to appear before all of you today to speak to the supplementary estimates (A) for the health portfolio.
First of all, I wish to thank the committee members for their exceptional work over the last several months as Canada responds to COVID-19 and the pandemic. Your diligent oversight is key to ensuring we continue to work effectively together to protect Canadians during the pandemic and beyond.
COVID-19 continues to dominate our work in the health portfolio. It's, therefore, the driving force behind the spending plans I'll outline for you today.
Today, I'm joined by Dr. Stephen Lucas, deputy minister, Health Canada; Iain Stewart, president, Public Health Agency of Canada; Dr. Theresa Tam, chief public health officer; Brigadier-General Krista Brodie, vice-president, vaccine rollout task force, logistics and operations; Dr. Siddika Mithani, president, Canadian Food Inspection Agency; and Dr. Michael Strong, president, Canadian Institutes of Health Research.
I'll begin with an update on our ongoing response to COVID-19.
It's pleasing for everybody to see that disease activity continues to decline across Canada. We're seeing fewer new cases, and the number of people who are severely ill is also decreasing as overall infection rates come down. At the same time, the vaccine supply continues to increase, making it possible for more and more Canadians to get their first and second doses. As of earlier this month, there was enough Moderna vaccine delivered to the territories to fully vaccinate 85% of the adults who live and work there.
In total, 29 million doses of vaccine have been delivered across Canada. I believe that's probably outdated a bit as of today. As a result, more than 70% of eligible adults in Canada have already received at least one shot.
These trends are encouraging and of course increased vaccination, combined with strict public health measures, are working. The national case count is now at its lowest level in weeks, and we are hopeful the summer ahead will be a safer and healthier one for all of us.
Nevertheless, we are at a critical junction in the pandemic. As immunity builds across the population, we have to continue to work to keep those infection rates low, so that everybody has a chance to get fully vaccinated. This is particularly important with the more transmissible variants of concern circulating in most provinces and territories.
That's why, for the time being, we're asking all Canadians, whether they're vaccinated or not, to continue to follow their local public health guidance. Some extra caution now will set the stage for a safe reopening in the months to come and a resumption of our lives with, hopefully, a resumption of our capacity to have more normal activities in the fall.
In the health portfolio, we're focused on keeping Canadians healthy and safe as we navigate this precarious moment in the pandemic. The supplementary estimates I'm presenting today support this commitment.
Given the shifting nature of the pandemic, we've realigned some of our resourcing plans to better support our evolving work. In total, I'm seeking an additional $5.5 billion on behalf of the health portfolio, which includes Health Canada, the Public Health Agency of Canada, the Canadian Institutes of Health Research and the Canadian Food Inspection Agency.
Let me begin with Health Canada. Through these supplementary estimates, Health Canada will receive a net increase of just over $1 billion. This amount, which includes both new funding and funds reprofiled from last year, will go primarily towards Canada's COVID-19 response. This includes investments to strengthen the long-term care sector, improve virtual care and digital health tools, and safely restart the economy.
These estimates also include funding to support Health Canada's ongoing work in other areas, including $53.5 million for Canada's chemicals management plan, $27 million to extend the territorial health investment fund and $14.25 million to support the Mental Health Commission of Canada. There is also just over $15 million for employee benefit plans.
The Public Health Agency of Canada continues to focus on mounting a robust response to the COVID-19 pandemic. Through these supplementary estimates, the agency is proposing an increase of just under $4.4 billion. This includes new and reprofiled funds. Most of these requested funds will support the ongoing response to COVID-19, including research and vaccine developments, border and travel measures and isolation sites, and medical countermeasures. It will include testing, contact tracing and data management as part of the safe restart agreement.
Some funding will also go towards indigenous early learning and child care through the aboriginal head start program, as well as Canada's chemicals management plan.
Next, I'll turn to the Canadian Institutes of Health Research, which is seeking an increase of approximately $111 million in the supplementary estimates. This investment, resulting from a reprofile of the medical countermeasures phase three funding from 2020-21, helps address persistent and emerging gaps in the research on COVID-19 and priority areas such as variants and long COVID.
Finally, I will speak to the Canadian Food Inspection Agency, or CFIA. As you know, the COVID-19 pandemic has put a great deal of pressure on Canada's food production and supply chain. With this in mind, CFIA is proposing a net increase of just over $35 million to help safeguard the integrity of Canada's food safety system. This includes an increase of $28.7 million to increase food inspection capacity and maintain a daily shift inspection presence in federally registered meat processing establishments. It also includes $6.4 million to support employee benefit plan adjustments.
Mr. Chair, as I said, this is a key moment in the pandemic. The government's top priority remains protecting Canadians' health and safety. With continued care, caution and vigilance, we will set the stage for a safe reopening and a return to all of the activities we have missed over the past year.
The supplementary estimates (A) that I presented today will support the important work that must take place before, during and after that transition.
My colleagues and I are happy to take your questions.
Thank you, Mr. Chair.
View Sébastien Lemire Profile
BQ (QC)
Thank you, Mr. Chair.
During our meeting, we learned some significant news that greatly concerns all Canadians. The head coach of the Montreal Canadiens hockey club has caught COVID‑19.
I'm talking about this because the club confirmed that the head coach received two doses of the vaccine.
I want to ask Dr. Tam or someone else the question.
How is it possible to contract COVID‑19 and test positive for the disease when you have already been vaccinated twice? This has a major impact on the national interest of Canadians.
Theresa Tam
View Theresa Tam Profile
Theresa Tam
2021-06-18 15:58
We're very fortunate in Canada to actually have very effective vaccines. However, vaccines are not 100% effective even with two doses.
To illustrate this, if a vaccine is 80% effective, you might still get a fifth of the population, even after vaccination, who may be susceptible to infection. What we do know, in general, is that these infections are going to be milder, so the prevention of serious outcomes is also very key.
You've brought up a very important point, which is that you can still get infected. Even though you have a mild illness, you could pass it on to someone else who might not have been well vaccinated. The bottom line still stays the same, whether it's the variants we have now, or the fact you may still see cases after vaccination. The bottom line is to get two doses of a vaccine, or to complete a full course of vaccines. That will still work.
Sports teams have to have protocols. At this time, these types of games are performed under the auspices of public health departments that have safety plans in place so that, should people become positive, they don't spread that virus to a lot of other people.
Stéphane Perrault
View Stéphane Perrault Profile
Stéphane Perrault
2021-06-15 11:05
Thank you, Madam Chair, for the opportunity to speak with the committee today about Bill C‑19.
Given where we are in the parliamentary calendar, I want to start by saying a few words about our electoral readiness before addressing certain aspects of the bill.
Over the last year or so, we have undertaken extensive readiness activities, not only to prepare for the next election, but also to adjust to the circumstances of the pandemic and ensure that voting can take place safely.
We continue to engage a range of stakeholder groups across the country, as well as with a network of federal, provincial, territorial and indigenous health authorities. We have adjusted voting operations and procured a full range of protective equipment to ensure the safety of electors and workers at polling stations.
We have also prepared a range of service options to deliver the vote in seniors' homes and long‑term care facilities, based on local needs and circumstances. It is these institutions that will choose the options.
Since last fall, we have dramatically increased our capacity to process mail‑in ballots, and we have developed, tested and implemented an online vote‑by‑mail application system. Finally, we have planned for the deployment of drop boxes inside all polling places to help ensure that postal ballots can be returned in time.
I note that all of these measures are possible under the current regime, without Bill C‑19, with some adaptations that I am empowered to make.
With this, Elections Canada is in a relatively good position to administer an election under the current regime, despite the challenges inherent to the pandemic, which is not fully behind us.
In early October I recommended a limited number of amendments to the Canada Elections Act to facilitate election delivery in a pandemic and improve services to electors. Among them was the replacement of the traditional polling day, which of course is Monday, with a two-day weekend voting period.
Bill C-19 proposes, instead, to retain Monday voting and add Saturday and Sunday. I certainly understand the intention behind having more voting days. As I indicated when I appeared before you last fall, this was, in fact, my initial instinct, but after careful review, I recommended against it. This remains my recommendation today. Let me explain.
Three polling days over a weekend and a Monday will increase the risk of labour shortage and limit the number of polling places available for the full voting period, in part because in a pandemic, schools will generally not be available on the Monday and places of worship on the weekend, or at least part of the weekend.
This will result in increasing the number of voters per poll and will not facilitate distancing. Fewer polling places will also result in electors having to travel farther than usual to cast their votes, especially in rural areas where they may have to vote outside of their town or in places that may not meet accessibility standards.
I invite members of the committee to amend Bill C-19 to provide for a two-day weekend voting period or else to simply stay with the traditional Monday. Either solution would, in my opinion, result in better services to electors.
Before concluding my remarks, I would like to draw your attention to one item that is not currently contained in the bill, and it relates to the collection of signatures for candidate nominations. This matter was raised during the Toronto by-elections and discussed, I should say, several times, at the advisory committee of political parties after I had made my recommendations.
The act requires that signatures be collected by candidates from 100 electors, each in the presence of a witness. This will be more challenging, of course, during a pandemic. Currently signatures can be collected electronically but not without difficulty, given the legal requirement to have a witness. A more user-friendly electronic solution is possible, but that would require an amendment to the act to remove the witness requirement, as is the case in some provinces. It would also, however, involve developing new systems and business processes. Given the time this will require and the investments, this is something that should be considered more in the long term and not as a quick and temporary solution, certainly not for the next few months.
As a temporary solution, the committee may wish to consider reducing the number of signatures required for a candidate nomination so as to limit in-person contact. I note that most provinces and territories require significantly fewer signatures. For example, Ontario only requires 25. Some have as few as five signatures.
Thank you for inviting me today. I welcome your questions on these matters, and of course, any other matter addressed in the bill.
Madam Chair, when we spoke last week, you suggested that I bring potential written amendments to the bill to support the work of the committee, which is somewhat unusual. I do have amendments and I'd be happy to share them through the clerk, if that is the wish of the committee. I'm in your hands in that regard.
Thank you.
View Alain Therrien Profile
BQ (QC)
Thank you. That's very clear.
I'll ask you another question. I've spoken to the minister about this situation. He considers you a very important part of the decision‑making process. I just want to make sure that this is part of your authority under the act.
Suppose that it's June and an election is called. We're currently seeing cases decrease more and more. However, in September, who will determine whether we're still in a pandemic and whether Bill C‑19 still applies?
Is it you? Is it public health? Is it the bill? How will this work?
Stéphane Perrault
View Stéphane Perrault Profile
Stéphane Perrault
2021-06-15 11:32
According to the bill, if it passes, I must consult with Dr. Tam and decide whether the accommodations are still necessary.
For example, if I still need to provide varied and specific services to each senior centre, even though infection rates have dropped, I can't say that we're finished with the pandemic. I'm still relying on exceptional measures.
As long as I need to use the exceptional measures in Bill C‑19, it means that we're still in a pandemic situation.
Once I'm no longer considering this, and after consulting with public health, I'll issue a notice and the provisions will stop [Technical difficulty—Editor].
View Kirsty Duncan Profile
Lib. (ON)
Thank you, Madam Chair.
Good morning. Thank you for coming.
I think right now we're all encouraged by increasing vaccinations. In fact, Canada leads the world in first doses, and of course we have cases going down. However, things can change in a pandemic. Preparedness is everything when it comes to pandemics. My concern is really about protecting the health and safety of Canadians. I'm going to ask a series of questions, which will largely be “yes” or “no”.
Is Elections Canada consulting and receiving guidance from the chief public health officer on running an election during COVID-19?
Stéphane Perrault
View Stéphane Perrault Profile
Stéphane Perrault
2021-06-15 11:46
Yes—from all provinces and territories and also federally.
View Kirsty Duncan Profile
Lib. (ON)
Thank you.
Has Elections Canada included IPAC specialists in the planning of an election?
Stéphane Perrault
View Stéphane Perrault Profile
Stéphane Perrault
2021-06-15 11:47
We get our advice from the public health authorities of the provinces and Canada.
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