EVIDENCE

Standing Committee on Health NUMBER 039 2nd SESSION 43rd PARLIAMENT Friday, May 28, 2021 Le vendredi 28 mai 2021 Standing Committee on Health CANADA [Recorded by Electronic Apparatus] EVIDENCE May 28, 2021 Committee NUMBER 039 NUMBER 039 NUMÉRO 039 39 28 05 2021 2021/05/28 13:00:00 House Of Commons Comité permanent de la santé Standing Committee on Health HESA Chair Mr. Ron McKinnon 2 43

(1300) [ English ]

The Chair (Mr. Ron McKinnon (Coquitlam—Port Coquitlam, Lib.)) :

I call this meeting to order. Welcome, everyone, to meeting number 39 of the House of Commons Standing Committee on Health. The committee is meeting today to study the emergency situation facing Canadians in light of the COVID-19 pandemic. Today we are specifically examining Canada's national emergency response landscape. I'd like to start by welcoming the witnesses. Appearing as an individual, we have Dr. James Maskalyk, associate professor of emergency medicine, University of Toronto, and Toronto-Addis Ababa academic collaboration in emergency medicine. Also appearing as individuals, we have Dr.

Andrew Morris, professor and physician, and Mr. Patrick Taillon, professor, faculty of law, Université Laval. From Switch Health, we have Dilian Stoyanov, chief executive officer; Jordan Paquet, vice-president, public affairs; and Olga Jilani, chief financial officer. I will now invite the witnesses to present short statements of six minutes. We will start with Dr. Maskalyk. Please go ahead.

Dr. James Maskalyk (Associate Professor of Emergency Medicine, University of Toronto and Toronto-Addis Ababa Academic Collaboration in Emergency Medicine, As an Individual) :

Thank you so much. It's such a pleasure to be here. I'm an emergency physician and trauma specialist here in Toronto and with Médicins Sans Frontières. I've worked in epidemics before the COVID-19 pandemic and I intend to afterwards. First, I'd like to say that the response overall by Canada and Canadians has been remarkable and exceeded my and so many peoples' expectations. I just wanted to extend my thanks as a citizen and a clinician for feeling so well supported...having mitigated the worst of this for all of us.

Normally, I speak about issues of global equity, particularly knowledge translation through critical care and emergency medicine to the global south. Today I want to speak about issues that are particularly relevant to the Canadian context in the emergency landscape that the COVID-19 pandemic has made so clear. I will focus my testimony today on how we might continue these lessons from the pandemic to create a stronger, more robust and safer health system for Canadians.

In particular, I will focus the discussion today on the topic of national licensure for doctors, nurses and other health care professionals in our country. As you likely know, provincial licensure is what health care professionals require to gain the ability to treat patients. It's only in the confines of their province. Should you want to move to another province, either in times of disaster, pandemic or otherwise, you require an emergency order to do so. That process is cumbersome, ineffective, risky and really unsafe.

I believe we are the last remaining Commonwealth country—I wasn't able to go through the whole list, but we were the last—that doesn't have national licensure. It prevents more equitable distribution of health care resources, particularly as we move into greater virtual care opportunities. What's happening now is that I can't treat a patient in Iqaluit without a special reciprocal licence between our provinces. I think that needs to change. As you can see, the nature of this pandemic, like all disaster, is one of asymmetry. This means that it doesn't just happen demographically; it happens geographically.

You're seeing Manitoba going through a crisis right now that Ontario's just coming through to the other side of. You're seeing patients being transited from Manitoba to Ontario. That's dangerous. It's risky for the individual because if you're a sick person, it's much more risky to send you to Ontario than send a healthy nurse, doctor or RT to Manitoba. I think that through national licensure, we can start to equilibrate some of these resources.

While mathematical modelling can help predict something with the COVID-19 pandemic, it certainly can't predict an earthquake on the west coast or how high the Red River will rise. Giving physicians, nurses and other health care professionals the ability to move freely throughout the country would be an easy way to start redistributing these resources in times of emergency, and also overall. I think, as you'll see in the coming months, we're about to face a crisis of a different kind. We're about to face a crisis of burnout.

Pretty much every doctor I know, as they look to the future of their whole careers perhaps wearing the mask and shield, is thinking about doing something else. This is real. I bring up this issue of national licensure because it's close to my heart. It initially came up when working in Inuit, Métis and first nation communities as a way to distribute health care resources there. Now I see it as a way to respond to a need in our health care community, which is the freedom of mobility to allow doctors and nurses to do what they love to do best, which is treat patients no matter where they are.

It's safer for Canadians, it's better for doctors and 91% of physicians want it. More than half of them say that it would increase the likelihood of their working in remote communities. If we don't take this step, virtual care is going to move into a private sphere and we're going to miss an opportunity to keep it affordable for the average Canadian. With President Biden moving to insure up to 40 million Americans, there's no reason to stop a doctor in Alberta from now treating Americans using virtual care. We have to get ahead of that, in my opinion, and a national licence is the way to do that.

Reciprocity for this licence and allowing greater training is one thing that would encourage it as well, particularly as these people are committed to working in remote and indigenous communities or with those populations that have been made vulnerable by systemic inequity.

(1305) I would suggest that the federal government consider immediately establishing a reciprocal arrangement, or encouraging a reciprocal arrangement, between provinces that allows freedom of mobility of health care professionals during the COVID-19 pandemic. Then it should look to develop a plan to extend this reciprocal licensing arrangement between provinces, territories, indigenous and federal governments, allowing these health care professionals licensed in one to work in other provinces and territories. The requirements are all the same. The training is the same.

The fact is there is this expanse in the hurdles to jump over. It is kind of redundant. It makes the system vulnerable, because if someone has malfeasance in their past, it's less easy to track because they can go to another provincial college. They are siloed organizations. Luckily, as Canadians, we haven't endured the big crimes that we've seen in the U.K. and Australia that allowed doctors to operate truly unqualified and hurt people. We're just waiting for that. Maybe that will never happen, but having a national autonomy and licensor is one way to do it.

In conclusion, there are two ways I think it can be done. One would be to start to focus on health care as administered through federal bodies, like indigenous, Métis and first nations communities. That is something that could allow them certain types of autonomy with registration, regulating who comes in and certain types of accountability. The second and more robust way to do it would be to have the provinces, which have mandated to the college the licensing authority, mandate that authority to a national body.

It wouldn't change the machinery of the provinces necessarily, but it would allow national licensure to be possible. I think ultimately it would be a good step not only to buoy the spirits of the health care workers who have been working very hard during this time, but also to encourage harmonization of health care in the country, improve accessibility to care and universality of care. That is what I think is possible. It is what I imagine would be a positive step for the health care of Canadians.

The Chair :

Thank you, Doctor. I would just note that I have these cards. The yellow one I will display when there is roughly a minute left in your time, unless I become totally enthralled in the testimony. The red one is when your time roughly is up. If you see the red card, you don't have to stop instantly, but try to wrap up. We will go now to Dr. Morris. Doctor, please go ahead for six minutes.

(1310) Dr. Andrew Morris (Professor and Physician, As an Individual) :

Thanks so much. I have never paid attention when given any yellow card before, so I don't know why I should start now. Mr. Chair and honourable committee members, thanks for allowing me to address you. Before I start, I want to acknowledge that I'm currently speaking on what I believe to be the unceded ancestral territory of the Haudenosaunee, where my family home currently rests. I'm a professor of medicine and infectious diseases at the University of Toronto, and I'm also a consultant in infectious diseases at Sinai Health and University Health Network.

Prior to this pandemic, most of my academic work was focused on antimicrobial resistance, that is, drug resistant infections. I currently co-chair, with Dr. Gerry Wright, a project to conceive of a national network to tackle antimicrobial resistance, or AMR, and support the anticipated—and I'll say, massively overdue—pan-Canadian AMR action plan. This is my fourth such appearance before your Standing Committee on Health related to infectious diseases over the past four years, and I'm really quite honoured to be able to have this privilege of presenting to you again.

I want to cover two things: pandemic strategy and antimicrobial resistance. Pandemics require strategy. Strategy should be based on the best available information and should be adaptive to new information. The pace of new information that we have received has been rather incredible and unprecedented. In my first and second HESA appearances, I highlighted for this committee the potential cost involved in preparing properly for an antimicrobial resistance pandemic. I think I quoted $100 million price tag at the time.

Just imagine now only spending $100 million in exchange for properly preparing for a costly pandemic. My guess is, by the way, that this government still won't commit $100 million for an antimicrobial resistance pandemic. If we consider Canada's performance to date regarding this pandemic, and with deference to my colleague who just spoke, I think my personal and, I would say, reasonable assessment is that it was not good, but it could have been worse. We've lost over 25,000 Canadians directly to COVID-19.

The fact that we will see well over 10,000 COVID-19 deaths since January 1 will remain one of the most catastrophic and tragic failures of our nation. However, the cost to Canadians in terms of quality of life, sickness and death from other illnesses, including mental illness, will be orders of magnitude greater than this for years to come, and it didn't have to be this way. If you compare our response in outcomes with the U.S., most of Europe and, say, Brazil, we've done quite well.

When I was a kid, when I came home with a grade that was below my parents' expectations, I always mentioned the classmates who did worse. I never made a comparison when I received an A, however. Canada's first responsibility moving forward will have to be an honest assessment of our performance, and, indeed, the Auditor General is doing some of this work, but we need a more fulsome assessment of our performance. I would suggest that the time to start such a commission, perhaps titled “Why did Canada not get an A in COVID-19?”, is now. The U.K. and Brazil are both holding similar such commissions.

Apart from the obviously gripping theatre both have provided, they've offered insight into the flawed mindset of two governments that dramatically failed their electorate. The question that should be on the minds of all of you and indeed all Canadians is: Why have you failed to seek a maximum suppression strategy? In November, I used the term “COVID-zero” publicly, but “Zero COVID”, “Canadian Shield Strategy” and “No More Waves” have all been monikers to a strategy I've affixed my name to.

It's been abundantly clear that exponential growth has meant that living with COVID-19 was never an acceptable strategy, even though it was attempted. This would be true for any future pandemics.

Moving forward, Canadian governments should have a stated policy that says, “We will work to maximally contain and suppress any new infectious diseases throughout until the nature of that threat is fully understood.” This would have meant clear and consistent pan-Canadian communication, closing our borders sooner, reducing interprovincial and regional travel, making no assumptions on the nature of its transmission, protecting the most vulnerable members of our society with a focus on obtaining the data to demonstrate this protection, rapidly and transparently sharing this data, starting up clinical trials similar to what was done in the U.K., relying on the best available scientific evidence and stating, most importantly, that the primary goal of government and public health with infectious disease threats is not to protect the health care systems or the economies from the threat, but to protect the health of Canadians.

(1315) On May 28, 2021, we can start learning from this. Our government can make a commitment to maximum suppression of COVID-19. This does not mean locking down our society for the entire summer, but doing everything possible to continue to drive our cases down so that we'll be able to start the school year in full force, with an economy that can start working in full force. Before I address AMR, I want to make one last point. It's very possible that in an upcoming school year we will be faced with an outbreak of a non-COVID infectious disease. It could be influenza or maybe another virus.

In that situation, it would be important that we do not dismiss it. I have found myself at times dismissing other infectious diseases. Do we need a flu-zero approach? I doubt it. However, the famous and proudly Canadian overburdening of hospitals in winter is unquestionably due to respiratory viruses. We can and should do much to reimagine respiratory viruses. That brings me, lastly, to antimicrobial resistance. I've spent most of my career tackling AMR. It has not gone away, and it won’t go away.

Moving forward, the AMR pandemic, which is a much slower moving one than COVID, will continue to require close and careful attention. It is not going to come and go like the COVID-19 virus. It will endure and grow in nature. This very committee has a responsibility to Canadians. It has failed in the past to address and push government on properly addressing this. We need to address AMR in Canada and globally in the same manner that we've been addressing COVID-19. Thank you.

The Chair :

Thank you, Doctor. [ Translation ] Professor Taillon, you have the floor for six minutes.

Mr. Patrick Taillon (Professor, Faculty of Law, Université Laval, As an Individual) :

Thank you, Mr. Chair. My name is Patrick Taillon, and I am a professor in the faculty of law at the Université Laval. I will summarize my main remarks briefly based on a very simple idea: one of the best decisions the federal government made in managing this unprecedented crisis was definitely its decision not to invoke the federal Emergencies Act, for the following reasons. First, we can now see, particularly from a rights and freedoms perspective, that there was no need to invoke the act. We can also see how far the judiciary adapted its

interpretation of rights and freedoms to our circumstances at the time. The government's decision not to use the act thus enabled it to maintain control and to let the judges do their work, while at the same time adapting that work. Second, it is clear that, under our federalist regime, governments did not lack authority. The federal and provincial governments had all the necessary authorities in their toolbox to address the crisis. All they had to do was invent solutions that they could not yet know of at the time.

In short, we must not fall into the trap of thinking that each level of government inevitably did good and bad things and that uniform and centralized solutions would suddenly have solved all problems. On the contrary, the logic of subsidiarity, cooperation and autonomy that federalism presupposes runs somewhat contrary to this idea of uniformity. Federalism made a minimum level of experimentation possible during the crisis. No one had a magic solution, and federalism, under which the member states of a federation enjoy autonomy, enabled each state to exercise a degree of innovation.

British Columbia did some things right. Each province handled mask-wearing in its own way. The Atlantic bubble was an original idea suited to that part of the federation. As a member state of the federation, Quebec, where I come from, did good and bad things in its own way. Its curfew and the reopening of its schools in the spring of 2020 made it possible to gather data and to test a solution that was subsequently imitated by others. Quebec did the same when it decided to administer second doses of vaccine sooner than previously planned.

This degree of autonomy, experimentation and innovation in the spirit of cooperation was absolutely necessary in managing the crisis. With a combination of diversified measures, the two levels of government were able to imitate each other and adjust their game plans. Federalism, which fosters the autonomy of every member state in the federation, especially enabled each to play the role of countervailing power, which is essential in times of crisis.

At the lowest points, when nothing was working and the courts were virtually closed, newspapers were on the brink, incomes were clearly declining and parliamentary assemblies were closed, how else could we have exercised that countervailing power in Canada? What countervailing power could have protected citizens?

The tensions and disputes that continued between the federal and provincial governments nevertheless bolstered citizens' trust in our institutions, to the extent that the sight of two leaders and two governments confronting and monitoring each other afforded a form of control, surveillance and countervailing power that were particularly necessary during those difficult times. Obviously, the federal government could have done better. Its performance was partly shaped by circumstances. We can debate at length the state of necessary equipment reserves.

We can say that borders should have been managed more quickly and efficiently. However, at some point, we have to accept that what was done is done. We must especially take note of mistakes that must not be repeated. On that point, the serious impact of underfunding for health definitely suggests that we could have intervened more effectively in that field and that we will have to do better in future.

(1320) It is therefore important to establish stable health funding. To do so, the federal government should either make a lasting commitment, over years, so that the provinces can rely on its participation, or else disengage and allow the provinces to use the necessary fiscal room. Whatever it does, we cannot play at yoyos or Russian roulette with health funding. It cannot be subject to circumstantial fluctuations. It must be stable.

Lastly—and this will be my final comment—as for what was done well but could have been done even better, I would say that cooperative federalism, that necessary cooperation between levels of government, could have gone further. Considering the powers it has, the federal government could have made adaptation measures available to the provinces. Consider travellers, for example. When it had to make decisions on how to manage the borders, the federal government could have played the cooperative federalism card to a greater degree.

In the "Atlantic bubble", for example, borders and flights could have been shut down at the request of the provinces concerned,

whereas other provinces could have established mandatory quarantines, a measure that moreover was ultimately adopted. Uniformity is not the most suitable solution. It is an instinctive reaction that is contrary to the spirit of federalism and should be avoided. Management of the crisis required cooperation between the federal government and the provinces.

It also called for respect for the autonomy of each government instead of the instinctive impulse to claim that one level of government is, by definition, better than another and thus shielded from the necessary interplay of trial and error, good and bad ideas and the competition between levels of government. That competition enabled us to secure countervailing powers, innovate and imitate each other. In that respect, I want to emphasize the importance of the autonomy of the federal government and federated entities in managing such a crisis. Thank you.

The Chair :

Thank you, Professor Taillon. [ English ] We'll now go to Switch Health for six minutes.

Mr. Jordan Paquet (Vice-President, Public Affairs, Switch Health) :

Thanks, Mr. Chair. We're going to split our time very quickly, but we'll be under six minutes. Thank you, and good afternoon, honourable members. Thank you so much for inviting us today to talk about Switch Health's innovative at-home testing solution that was developed in response to Canada's fight against COVID. I am Jordan Paquet, the VP of public affairs, and I am pleased to be joined today by Dilian Stoyanov, our CEO, and Olga Jilani, our CFO. We want to thank the members of this committee for the important work you are doing on this study.

This past year and a half has been very difficult for Canadians, especially frontline workers. We are pleased to be here to tell you a bit more about our company, our services, and to answer any questions you may have.

(1325) Mr. Dilian Stoyanov (Chief Executive Officer, Switch Health) :

In essence, we are a homegrown Canadian success story that met a daunting task during the pandemic, bringing critical health care services to an increasingly virtual world. Meeting this need for increased domestic testing capacity required a company that was forward thinking, flexible and patient-focused. In a matter of months, we were able to hire hundreds of experienced health care professionals, meet the needs of Canadians and collaborate with Canada's leading laboratories. This is a service Canada needed.

Canada needed a novel solution to collect specimens at home with the oversight of a telehealth employee through our proprietary privacy compliant telehealth and results reporting software. Despite the logistical challenges and early hiccups, we're proud to say that our at-home collection kits met demand and, most importantly, minimized exposure to the virus. It is about a 10-minute process, and the results are usually returned to patients within 24 hours of reaching one of our partner labs. Courier times may vary by location.

With our partner, Purolator, and other third party logistics providers, we can reach 100% of Canada. Additionally, we are proud to work with Uber to ship kits in Toronto, Vancouver and Montreal. Our instructional manual is available in 15 languages, including three indigenous languages. In February 2021, Canada introduced new border measures to help prevent further introduction and transmission of COVID-19, including new variants. It needed help with PHAC-directed testing of international travellers, and we applied.

PHAC required an operation with supervised testing and self-collection, kit transportation, electronic results reporting, and laboratory partnerships supported by the latest technological operations. Prior to the federal program, Switch Health was providing testing services via our clinics and mobile units with other levels of government, public health units, major companies, individuals and families.

Ms. Olga Jilani (Chief Financial Officer, Switch Health) :

We scaled up efforts at an extremely rapid pace, with close to 1,200 telehealth staff now servicing travellers. Within this federal program alone, we have administered over 600,000 tests for travellers entering Canada. We have identified over 6,400 positive cases of COVID-19, including over 2,200 second-test positives and 1,500 variants of concern. Because most of these individuals were at home when they took their test, the risk of community spread was greatly reduced.

Of course, we have experienced some growing pains, with the volume of demand for testing rising exponentially and sometimes causing delays in service. We have been working diligently to improve our operations and processes and the speed with which we deliver results, by adding more telehealth and customer service staff. For example, since introducing appointment times for telehealth sessions, the average wait time has been reduced to 10 to 15 minutes.

Currently, over 99% of travellers, including those in rural and remote regions, receive their results on or before their 14th day of quarantine. [ Translation ] We are still adding new resources so we can better serve travellers in both official languages. Although we've been hired to provide additional testing services for temporary foreign workers in Ontario only, we've been asked to intervene temporarily to assist in providing additional testing services for temporary foreign workers from Quebec.

Recognizing the importance of Canada's food security, we are honoured to provide assistance until a permanent solution is found. We are pleased to continue serving travellers from Quebec by supplying our Day-8 test kits. [ English ] Before I conclude, I want to take a moment to address last night's report on Global News. We're proud to employ over 1,100 nursing professionals. We also employ a small number of trained telehealth generalists, who are permitted to oversee this type of testing process.

Any suggestion that Switch Health has ever instructed employees to identify themselves as a nurse when they are not is categorically false. We acknowledge the hard work of all medical professionals during this pandemic and have never instructed any of our staff to mislead the public. Developing an innovative and accessible testing solution in Canada’s fight against COVID-19 is helping transform how health care is delivered.

And with the pandemic having a disproportionate effect on women, we're proud that we're not only offering a flexible work experience for the majority of our employees, who are women, but also that we're a company with women in positions of origin and leadership. Earlier this week, we were proud to announce our new chief medical officer, Dr. Gregory Taylor, who served our country as Canada's chief public health officer. We are proud to be at the forefront of protecting the health and safety of Canadians in one of the most challenging times in global history. We very much appreciate your support in doing so.

Thank you, again, for this opportunity. (1330) [ Translation ] Thank you, everyone.

[ English ]

The Chair :

Thank you to Switch Health, all of you. Thanks to all of the witnesses for your statements. We will start our round of questions now with Ms. Rempel Garner. Please go ahead, Ms. Rempel Garner, for six minutes, please.

Hon. Michelle Rempel Garner (Calgary Nose Hill, CPC) :

Thank you, Chair. Mr. Stoyanov, as it relates to services provided to the Government of Canada for at-home COVID-19 testing of international travellers, has Switch Health ever been legally obligated to ensure that samples collected via the online portal were collected under the supervision of a nurse?

Mr. Dilian Stoyanov :

Thank you for the question. Can you just clarify the last part of the question, please?

Hon. Michelle Rempel Garner :

Has Switch Health ever been legally obligated to ensure that samples collected via the online portal were collected under the supervision of a nurse?

Mr. Dilian Stoyanov :

All specimens collected under the supervision of a telehealth professional, a nurse or a telehealth generalist, are done in compliance with laws in the respective provinces.

Hon. Michelle Rempel Garner :

Were you ever contractually obligated to have the supervision observed by a nurse?

Mr. Dilian Stoyanov :

I believe my colleague Olga Jilani will have more details about the contract, if I may, please.

Ms. Olga Jilani :

The contract calls for any individual who is overseeing specimen collection over telehealth to comply with the regulations of the province in which they reside. As you can imagine, over—

Hon. Michelle Rempel Garner :

Thank you. Has that ever changed?

Ms. Olga Jilani :

Over the scope of the pandemic, in fact, at the time of the pandemic the scope of service—

Hon. Michelle Rempel Garner :

Thank you. I don't have time. Have you ever been contractually obligated to have the samples collected overseen by a nurse, and has that ever changed?

Ms. Olga Jilani :

The contract calls for a telehealth appointment to be overseen by a medical professional.

Hon. Michelle Rempel Garner :

By a “medical professional”. What percentage of samples collected by Switch Health to date were collected by the online portal under the supervision of somebody other than a medical professional?

Ms. Olga Jilani :

We employ 1,172 registered nurses and registered practical nurses and 17 medical generalists. For reference, those medical generalists are respiratory therapists—

Hon. Michelle Rempel Garner :

Thank you. That's not what I asked. Have any samples been collected while not under the supervision of a medical professional?

Ms. Olga Jilani :

A medical professional, under the regulation of the individual provinces, can be someone who is trained to comply with oversight of a bilateral anterior swab.

Hon. Michelle Rempel Garner :

Again, that's not what I asked. Were any samples not collected under the supervision of a medical professional?

Ms. Olga Jilani :

The medical professional who is overseeing collection of samples was trained to the standard of compliance with the regulatory—

Hon. Michelle Rempel Garner :

Thank you. Were any samples collected while not under the supervision of a medical professional?

Ms. Olga Jilani :

Over telehealth, specimens were collected with the oversight of a medical professional—

Hon. Michelle Rempel Garner :

Would it be safe to say that's a “yes”, that there were samples that weren't collected under the supervision of a medical professional?

Ms. Olga Jilani :

Medical professionals were always overseeing sample collection over telehealth.

Hon. Michelle Rempel Garner :

You do realize that obfuscating on this with talking points is not helping your case. Were any samples collected while not under the supervision of a medical professional?

Ms. Olga Jilani :

All the telehealth professionals who observe specimen collection are overseen as well by an RN or RPN.

Hon. Michelle Rempel Garner :

Does the Government of Canada conduct audits to ensure that samples are collected by medical professionals?

Ms. Olga Jilani :

Absolutely, and it is within the scope of our contract to collect specimen—

Hon. Michelle Rempel Garner :

Thank you. To Mr. Stoyanov, has anyone acting on behalf of Switch Health or associated companies ever proactively communicated with any Government of Canada official at the associate deputy minister level or higher relating to matters on the provision of services to the Government of Canada for at-home COVID-19 testing for international travellers?

Mr. Dilian Stoyanov :

I apologize to ask you to repeat the second part of that question: “Has any employee or person acting on behalf of Switch Health communicated to...?”

Hon. Michelle Rempel Garner :

I realize that you guys might be trying to talk the clock out. I will ask one more time. Has anyone acting on behalf of Switch Health or an associated company ever proactively communicated with any Government of Canada official at the associate deputy minister level or higher relating to matters regarding the provision of services to the Government of Canada for at-home COVID-19 testing for international travellers?

(1335) Mr. Dilian Stoyanov :

I believe our VP of public affairs Jordan Paquet would be better suited to answer that question.

Mr. Jordan Paquet :

Yes, thanks, honourable member. Certainly, in relation to the contract we entered into through the RFP, a very competitive process, our dealings throughout the contract have been at the officials level, at a variety of different levels.

Hon. Michelle Rempel Garner :

At what level? What was the most senior level?

Mr. Jordan Paquet :

Is that for dealing operationally throughout the contract?

Hon. Michelle Rempel Garner :

No, that is prior to the contract being signed.

Mr. Jordan Paquet :

Prior to the contract being signed, it would have been officials at PSPC at a level—

Hon. Michelle Rempel Garner :

At what level?

Mr. Jordan Paquet :

I would say it was at management level. We entered through the normal process, applied, as per all of the rules, and followed the process accordingly.

Hon. Michelle Rempel Garner :

Mr. Paquet, prior to the RFP for services being issued, had anyone acting on behalf of Switch Health or an associated company of Switch Health ever proactively communicated with any public office holder or deputy public office holder relating to the provision of services to the Government of Canada for at-home COVID-19 testing for international travellers?

Mr. Jordan Paquet :

Prior to the RFP for services being issued, we entered into the contract competitively, followed the process accordingly and were awarded the contract on its merits.

Hon. Michelle Rempel Garner :

Can you confirm on the record that all persons acting on behalf of Switch Health or associated companies have satisfied all legally required obligations as set out in the federal Lobbying Act?

Mr. Jordan Paquet :

Yes.

Hon. Michelle Rempel Garner :

Why is there no record of any official or associated company from Switch Health in the lobbying registry?

Mr. Jordan Paquet :

That is because we wouldn't have been lobbying prior to the awarding of the contract.

Hon. Michelle Rempel Garner :

You are confirming that the answer to my first question was “no”.

Mr. Jordan Paquet :

That's correct. No lobbying took place.

Hon. Michelle Rempel Garner :

Nobody has ever contacted a public office holder for any purpose that might be construed as lobbying. Are you sure you want to answer “yes” on the record for that?

Mr. Jordan Paquet :

In the process of getting to award the contract for this particular instance, we followed the process completely—

Hon. Michelle Rempel Garner :

I asked whether you proactively contacted any public office holder for any purpose.

Mr. Jordan Paquet :

Is that with respect to awarding the contract or throughout the process?

Hon. Michelle Rempel Garner :

No, it's throughout the process. Have you contacted any public office holder?

Mr. Jordan Paquet :

Yes, throughout the process, we would have been in contact with people at the ADM and DM levels as well.

Hon. Michelle Rempel Garner :

Were those contacts registered in compliance with the federal Lobbying Act?

Mr. Jordan Paquet :

These were sessions on information—operational procedures and sharing of information, for the most part—so everything would have been above board with regard to the Lobbying Act. None of our employees would spend more than 20% of their time lobbying in any form.

The Chair :

Thank you, Ms. Rempel Garner. We'll go now to Dr. Powlowski for six minutes.

Mr. Marcus Powlowski (Thunder Bay—Rainy River, Lib.) :

I think you're going to find my questioning much slower and more labourious. Dr. Morris, let me start off by complimenting you for speaking out on issues of public health. I know a lot of health care workers have been afraid to do so, and for good reason. I was still on staff at the local hospital until January. My hospital, for example, specifically told doctors not to speak to the press or politicians like myself. There certainly have been health care people disciplined or threatened with discipline, especially when they speak up on public health measures and against government policy.

Therefore, I certainly commend you for it. I disagree with these kinds of tactics from the hospitals. I think you'll agree that an ounce of prevention is worth a pound of cure. Certainly when somebody has gotten to the stage that they're on a ventilator, there's not a whole heck of a lot you can do for them medically. It makes more sense to prevent their getting on ventilators, which means good public health. For a good doctor, it's not just a good decision to speak out; I would suggest that doctors have a duty to speak out. You might want to comment on that. However, before I get there, I have a second question.

You probably saw this coming, because we've talked about it before. It's about the use of monoclonal antibodies. It gets to the same thing: keeping people off ventilators. As I suggested last time, I think there's a growing amount of robust evidence that use of monoclonal antibodies in high-risk people, when used early on, can reduce by somewhere between 60% to 80% the number of people who go on to hospitalization. Now, I know when we previously spoke, you felt that there wasn't enough evidence for that. You wrote the guidelines. You sit on the science table.

I would like to point out that, since then, the NIH guidelines panel, in interpreting the evidence, gave a class IIa recommendation for the use of monoclonal antibodies. I talked about some of the evidence before. With Chen et al. in the New England Journal of Medicine, there were certainly good results; and BLAZE-1, Gottlieb et al., in JAMA, is another study with very positive results. I brought these examples up in the last meeting.

Since then, real-world experience from Kumar et al., from the clinical infectious disease group from Chicago, found the number needed to treat was eight, treating eight high-risk people with monoclonal bamlanivimab before they got really sick. If you treated eight, it would prevent one person being hospitalized. Bariola et al., a Pittsburgh group, in Open Forum Infectious Diseases, found that treatment, again with bamlanivimab, resulted in a 60% lower risk of hospitalization or mortality.

Now, to pre-empt you, I know that the FDA revoked approval in the U.S. for bamlanivimab alone, but that was based on in vitro studies showing that it didn't look like it would be effective against the California or New York variants, which we don't have much of here. The estimates have been in Ontario that 90% to 92% of the variants we have here, including the wild type, are covered by that treatment. Even if you don't like bamlanivimab, there are the other newer monoclonal antibodies. The Celltrion phase II and phase III clinical trial showed a 64% reduction in progression to disease.

On the bamlanivimab and etesevimab, there have been further studies with that in chronic care homes; the BLAZE-1 phase 3 trial; and REGEN-COV by Regeneron, which showed that patients who got infused treatment within 10 days of developing symptoms had a 70% reduced risk of hospitalization or death. More recently, in the COMET-ICE study, with GlaxoSmithKline, the independent data monitoring committee recommended stopping the trial early because results were showing an 85% reduction in hospitalization or death, so it would be unethical to continue.

Given all that, do you continue to maintain that there is not enough evidence for the use of monoclonal antibodies, and will the science table re-examine this in the treatment guidelines? Thank you.

(1340) The Chair :

I'm sorry, Doctor, but for whom was that question?

Dr. Andrew Morris :

Sorry, it's was for me. Thanks for the question. I was on mute. I think I'll address the first question later on, if we have time, but to the second question about monoclonal antibodies, I'll say a few things in response. I sit on and chair Ontario's scientific advisory table. Even though much of the country looks to our table for advice, it's Ontario's scientific advisory table. We mainly provide advice on therapies that are currently available to Canadians. The only monoclonal antibody that is available to Canadians at present is bamlanivimab.

As you pointed out, there are problems with bamlanivimab monotherapy, and they continue. They're not just theoretical. They were demonstrated in the trials, especially in BLAZE-1, where there was an emergence of antibody-resistant variants while on therapy. Because of that, I would strongly suggest that we not use bamlanivimab. I see that my time is up, Mr. Chair. I don't know if you want me to finish the rest of the question.

Mr. Marcus Powlowski :

I know the previous speaker got a little extra time. Would you consider combination therapy? If you had funding to set up infusion sites, would you consider using them if they're approved by Health Canada?

Dr. Andrew Morris :

Yes, I think I would absolutely consider it. I think there is emerging evidence that it is of some benefit. There are some challenges with it, especially the practicalities, but definitely, as time has gone on, if you can get patients onto combination monoclonal antibodies early enough, there may be some benefit. Whether the trade-off between the cost and logistical challenges proves adequate for the benefit is something that needs to be decided.

The Chair :

Thank you, Dr. Powlowski and Dr. Morris. [ Translation ] Mr. Thériault, go ahead for six minutes, please.

Mr. Luc Thériault (Montcalm, BQ) :

Thank you very much, Mr. Chair. First of all, I'd like to thank all the witnesses for their testimony. We are looking for seeking solutions and will have to make recommendations once we have completed our study. So I thank them for being here today. I will turn to you first, Professor Taillon. Your presentation was very clear and touched on a number of complex issues in a very short period of time, and you summarized them simply and clearly. Thank you for that. Some people have told us that the crisis would have been managed more efficiently if we had invoked the Emergencies Act or centralized our operations.

Others felt that, on the contrary, decentralized management of operations was the only solution to managing what we didn't know. I understand that you fall into the latter camp. If the government had persisted in using such

an act or centralized management, we might have had to manage both an urgent health crisis—we were told from the first wave that we were lagging two weeks behind the spreading virus—and a political crisis. What do you think?

(1345) Mr. Patrick Taillon :

With regard to a political crisis, I imagine you're alluding to the fact that the government is in the minority position in Parliament. At any event, I don't think that provincial MLAs naturally have better or worse solutions than federal MPs. That's really not the case. It's just a question of subsidiarity. This crisis clearly called for management that was as close to the ground as possible. Even in the provinces, it would have been better at times to have management that was closer to the ground and provided primarily by physicians, healthcare staff, local governments and, obviously, the provinces.

On the whole, I would point out that federal authorities weren't powerless when they discovered that there was a financial need and that a measure like the Canada emergency response benefit, the CERB, would be useful. With their enormous spending power, they could have carried out their policy. They didn't need the Emergencies Act or the exorbitant regime under which we suspended normal federalism, rights and freedoms and so on in a quest for exceptional means. The means at the federal government's disposal were already equal to the task of carrying out that policy.

I don't think we would have produced vaccines any sooner if we had used the Emergencies Act.

Mr. Luc Thériault :

Nor do I believe that the federal government ever possessed all the expertise needed to manage the crisis without calling upon the expertise acquired over many decades by caregivers in the field. There would probably have been resistance to the exercise of this act, which would have caused delays and a situation that could have been avoided; hence my comments on the crisis. There were some gaffes in the government's management, for example with the country's supplies, just as the Global Public Health Intelligence Network was not really effective. We saw the reports about that.

Nevertheless, we'll be able to criticize all of that in due course. How then to explain the government's stance on not immediately wanting to provide funding to the health systems or to transfer the money needed to rapidly restore the decentralized management and coordination required by the health systems? Cancer specialists and cardiologists have come here and told us that the redirection of patients would have repercussions, and that patients who do not have COVID-19 will suffer the consequences for 10 years and that the mortality rate will rise by 10%. Not to mention the dramatically higher health costs!

Let's say that a colonoscopy costs $1,000. Without an early diagnosis, a patient will begin to draw upon the health system and the cost of dealing with advanced cancer will be extremely high. In view of all this, why was it decided to run everything unilaterally? On the one hand, the health transfers were deferred—that was the first mistake, from both the medical and economics standpoints—and on the other, standards and conditions were imposed. There are two sides to the way this pandemic was managed.

(1350) Mr. Patrick Taillon :

I'll be brief, so as not to exceed the allotted time. Health is first and foremost a provincial jurisdiction, but there are exceptions, and certain aspects are clearly defined areas of federal jurisdiction. However, there is the question of funding. When you have spending authority, it's as if the intent of the Fathers of Confederation no longer applied, because spending is not legislating. You are right to point out that through spending authority, the federal government plays a major role in health,

whereas its legislative authority in health is somewhat, or even very, limited. After this crisis is over, health will go into a new phase, in which it will have to deal with new types of problems, specifically for those who had their care postponed. In order to deal with these delays, additional costs will have to be paid and there will be many hours of overtime. These extra costs will create enormous financial pressure on the provinces in the short, medium and long term.

The exercise of federal spending authority on health in a way that is not sufficiently stable, predictable and substantial, will definitely cause enormous problems. It is therefore absolutely essential that this funding be stable, consistent and substantial; otherwise fiscal space will have to be created to allow the provinces to finance these areas on their own, because at the end of the line, the ability of citizens to pay taxes is limited. That will be the major issue in the years ahead.

Now that we are more knowledgeable about the virus, we need to take care of the other patients, and that will be very expensive.

Mr. Luc Thériault :

Thank you.

The Chair :

Thank you, Mr. Thériault. [ English ] We'll go now to Mr. Davies. Mr. Davies, officially you have six minutes, but everyone else took at least seven, so go ahead for seven minutes.

Mr. Don Davies (Vancouver Kingsway, NDP) :

Thank you, Mr. Chair. Dr. Morris, you recently posted on your website the following: “I anticipate we will be hearing definitive word of a 'passport' from our political leaders in the coming weeks, in anticipation of a relaxation of quarantine restrictions. (I cannot imagine we can be seen as safe until the 3rd wave truly recedes in all provinces.)” Now, some provinces, including my own in British Columbia, have just announced plans to open up and are starting to open up, while others, like Manitoba, are clearly in severe crisis. In your view, is it prudent for us to be having some provinces reopen when others don't? Do we need national reopening guidelines?

Dr. Andrew Morris :

I've always felt that we need to, first and foremost, consider this pandemic to be a global pandemic, so we need to appreciate that Canadians won't be fully safe until everyone around the world is going to be safe. If we think of Canada and its borders, and everything within its borders, you have really two choices. One is that you allow provinces to make their own decisions, but you protect the provinces from the strengths and weaknesses of the adjacent provinces where people travel to and from.

At the moment, if you're bordering Manitoba, which has a pretty high case rate at present, and you're allowing travel from your province to and from Manitoba, then you are adopting much of the risk of the other province. I think it's really important that we not only consider international travel, but we consider interprovincial and regional travel in how we open up our economies and, more importantly, how we move forward.

It is important that we move forward, especially as we become more successful within Canada with meeting vaccination targets, but we have to be very aware that the threat won't go away until the threat internationally goes away.

(1355) Mr. Don Davies :

I'm going to turn to something you've written about AstraZeneca on our website. You wrote:

Some have argued—as the Ontario government just acceded—that patients can receive informed consent regarding the risk of VITT prior to getting a second dose of AZ. They are basing this on rather preliminary UK data; the same UK data that has consistently underestimated the 1st-dose VITT risk (starting off with 1:600K, then 1:250K, and is now down to 1:81K). They started off with a 1:1M 2nd-dose VITT risk, and now are quoting 1:600K risk after 15 cases. I am fairly certain the likelihood of risk is higher than this, but the magnitude is entirely uncertain.

What advice do you have, Dr. Morris, for Canadians who have received a first shot of the AstraZeneca vaccine and will reach the end of their four-month dose interval before trial data is available on vaccine mixing?

Dr. Andrew Morris :

There are a few things. I do think it's really important that we appreciate how incomplete and tenuous the U.K. data is on AstraZeneca safety. Their MHRA, which reports on their Yellow Card system for vaccine safety, reported again last night our time, or early this morning, and the risk is now for AstraZeneca and VITT is one in 76,000, so it's been progressively increasing in frequency for first doses. They're really early in their rollout for second doses, and I don't have much confidence in really understanding the risk to Canadians of a second-dose VITT from the AstraZeneca vaccine.

It may turn out to be very safe, but we really don't know. In Canada we are fortunate enough to have adequate vaccine of the combination of Pfizer and Moderna for the very near future. I know what I've been telling my loved ones and I'd be encouraging vaccine task forces as well at the federal level that we should be moving as quickly as possible to getting the mRNA vaccines in arms. They've proven to be exceedingly safe, and we should be affording people who rolled up their sleeve to get the AstraZeneca early on the same if not accelerated benefit as those who have held out for the mRNA vaccines.

Mr. Don Davies :

Thank you. You recently co-signed an open letter in Maclean's, along with a group of leading Canadian physicians and researchers, calling for strict nationwide restrictions to control COVID-19. Your letter said, among other things, the following:

As much as we might wish otherwise, COVID-19 is not done with us yet. The consistent failure to learn from the experience of other jurisdictions and even worse, failure to learn from our own miscalculations, is a sad statement on Canada’s political leadership.

Could you provide this committee with an overview of best practices from other jurisdictions that you think could and should be applied to Canada?

Dr. Andrew Morris :

I think the simple answer to that, without going into too many details, is an intolerance of allowing cases to rise in any manner. As I kind of alluded to, if we're titrating our response to health care system capacity, what we're doing is allowing Canadians unnecessarily to become infected. We also have learned that pretty well everyone in society, especially government and the health care system, is not really good at titrating when there's exponential growth. What we've seen in Manitoba, and to some degree in Alberta and Ontario, is that we've pulled the trigger on trying to control cases way too late. Everything's much easier when we try to keep cases as low as possible.

Mr. Don Davies :

Thank you. This is just a quick question for Mr. Taillon. Mr. Taillon, I presume you've read the anti-inflation board reference at the Supreme Court of Canada. Do you agree with me, sir, that it's quite clear from the Supreme Court that the peace, order and good government power gives the federal government paramount jurisdiction to legislate in all measures, and even to usurp provincial powers in the case of an emergency? Do you agree with the Supreme Court when they say that?

(1400) [ Translation ]

Mr. Patrick Taillon :

A distinction needs to be made between this power and the opportunity to exercise it. The main thrust of my comment was to congratulate the government on its decision not to have exercised it and to have demonstrated just how unproductive and inadequate it would have been to do so under the circumstances. There were also several benefits to refraining from exercising this power. The federal authorities were also not prevented from implementing any standards, regulations or actions by not exercising the Emergencies Act.

That's the first part of my response The second is that the Constitution clearly provides exorbitant powers that are inconsistent with what federalism in its ideal form ought to be, but that can be exercised in certain circumstances. These include the power to act in an emergency, which is time limited and has serious consequences because it can be exercised with impunity towards the principles that are central to our system, like rights and freedoms and federalism. These powers need to be exercised when necessary and useful,and when there are good reasons to do so.

I believe that it was very wise to have paused and taken some time to think before moving in that direction. The good news is that did not have to take this extraordinary and exorbitant action, which should only be used in very limited circumstances.

[ English ]

Mr. Don Davies :

Such as a global pandemic?

The Chair :

Thank you, Mr. Davies. I'd like to thank all of the witnesses. We've burned up all of our time for this panel. Thank you for spending your time here today with us helping with our enquiries. With that, we will suspend and bring in the next panel. Thank you, everybody.

(1400) (1405) The Chair :

I call this meeting back to order. We are resumed. Welcome back to meeting number 39 of the House of Commons Standing Committee on Health. The committee is meeting today to study the emergency situation facing Canadians in light of the COVID-19 pandemic, specifically examining today Canada's national emergency response landscape. I'd like to welcome the witnesses. As an individual, we have Dr. Colleen Flood, university research chair in health law and policy at the University of Ottawa. We also have Dr. Dean Knight, associate professor, faculty of Law, Victoria University of Wellington.

From World Animal Protection, we have Michèle Hamers, wildlife campaign manager; Melissa Matlow, campaign director; and Scott Weese, professor. I should point out that I have these magic cards. A yellow one indicates that your time is almost up, and the red one that your time is up. If you see the red card, please do try to wrap up. You don't have to stop instantly, but try to wrap up. We will now invite the witnesses to give their statements, and we'll start with Dr. Knight for six minutes.

(1410) Dr. Dean Knight (Associate Professor, Faculty of Law, Victoria University of Wellington, As an Individual) :

Greetings. It's a pleasure to join the committee to share some of the experience and insights from Aotearoa, New Zealand. I think there has been understandable interest in the efficacy of New Zealand's response. We've only encountered just over 2,600 cases of the virus and only 26 deaths during the pandemic. And one-third of those diagnosed cases have been caught at the border before entering the community. The virus was, if I can say, first stamped out in the community nearly a year ago, five months after it first infiltrated.

Since then, there's been a handful of flare-ups largely arising from what we describe as “border breaches”, which have again been stamped out in what has become quite a sophisticated game of whack-a-mole. The last instance of community transmission was at the end of February this year. In many respects, I think our current settings, the arc of the pandemic and thus the government response, have been quite different from Canada's and many other countries'.

However, to give you a sense of the nature of the regulation of the government response that has been deployed, I think that story is best told through a series of bubbles, which has been a very powerful metaphor in the New Zealand context. We started with what we described as our “household bubbles” from back in March 2020 nearly, where we had two months of aggressive and strict nationwide lockdown, stay-at-home directives and closure of premises other than those that were essential.

That really broke the chain of transmission and allowed that shift from what was intended to be a mitigation or a suppression strategy to our current elimination strategy. That “go hard and go early” approach—which is how it was branded by the Prime Minister here—has probably been the main driver of New Zealand's success so far in combatting the virus. The achievement of that COVID-free community set the conditions for an ongoing elimination strategy where those re-emergent instances of the virus could continue to be stamped out, and that's been the focus.

After our household bubbles, where we were confined to our houses, we had a nationwide fortified bubble where ordinary day-to-day life largely resumed almost a year ago with most restrictions largely lifted. We have some ongoing restrictions, low-level measures such as a contact tracing system with QR codes, face coverings on some public transport and so forth. Significantly, we had a fortified border fortress with a 14-day state-managed isolation and quarantine system, an escalating system of border testing, and management of incoming border flows through bookings, charges and pre-departure testing.

It was very much trying to create an impenetrable border to protect the nation as a whole. Within that, as I said, there were some flare-ups. I think of this in terms of resurgent localized bubbles where we had a handful of regional lockdowns, largely in Auckland, and other targeted measures to address the small number of flare-ups. More recently, we've developed and moved to a transnational shared bubble where we've reopened our borders with Australia and a couple of other Pacific nations, allowing restriction-free travel.

In order to do that, we've also harmonized our public health monitoring and measures across those countries. Our hope is for a future popped bubble, if I can describe it like that, where there is a slow but steady vaccine rollout. We look forward to hopefully being able to fully open up our borders again and reintegrate with the world. While we can see that success, the government regulatory response I don't think has always been smooth, stable and slick. The early days were characterized by a lack of preparedness for this type of virus, but a willingness to pragmatically innovate and respond.

Legally, the resort was to perhaps ill-fitting public health and civil defence tools, principally directive health orders issued by our senior medical officer of health, the director general of health, enforceable by the police. There was also heavy reliance on an extra-legal alert level framework as a communication tool, characteristic communication from our Prime Minister, ministers and director general in building a collective community trust in the government and the government's response.

(1415) I should note that there was one notable instance where the high court found that the government messaging overreached the underlying legal requirements, and I'm happy to talk about that some more if that's of interest. After the lockdown was lifted, more COVID-specific, bespoke legislation was passed, which gave broad power to ministers to continue to issue directive health orders mandating public health measures and continuing police enforcement. The authority to do that was moved from the officials to the minister. I think of it in terms of belt and braces protections being overlaid on top of that.

Preservation of the right to contest any of the measures was, for example, inconsistent with the Bill of Rights Act's protections, such as freedom of movement and so forth, select committee scrutiny of orders and House confirmation of orders and other examples of checks and balances being grafted onto that power. My final comment might be to say that the other notable feature has been a strong social licence in the community for these very aggressive measures.

My analysis is that the legitimacy for that response has been catalyzed by the government maintaining and enhancing accountability through direct, face-to-face, reasoned explanation of the problem and the measures, openness and transparency—for example, all of the cabinet papers dealing with measures and so forth are publicly available—active scrutiny, continuing improvement and large doses of kindness. Thank you.

The Chair :

Thank you, Dr. Knight. We will go now to World Animal Protection, and I believe Ms. Hamers will give the statement.

Ms. Michèle Hamers (Wildlife Campaign Manager, World Animal Protection) :

That will be Melissa Matlow. She will give the statement for us.

The Chair :

Very well, Melissa, go ahead for six minutes.

Ms. Melissa Matlow (Campaign Director, World Animal Protection) :

Thank you, Mr. Chair and committee members, for this opportunity to speak about a very important issue of pandemic prevention. I am Melissa Matlow, the Canadian campaign director for World Animal Protection. We are an international animal welfare charity with offices in 14 countries and more than 300,000 supporters in Canada. We have general consultative status with the United Nations. We are members of the civil society 20 that is engaging the G20 and we have a formal working relationship with the World Organisation for Animal Health—the OIE.

Working together with environmental and infectious disease experts, we are encouraging the federal government to take a “one health, one welfare” approach to preventing pandemics through curbing the commercial trade in wild animals and products made from them, not only to prevent pandemics, but also to prevent animal suffering and biodiversity loss. I should say that we are concerned about the growing legal commercial trade in wild animals that, in our opinion, is under regulated, unsustainable and presents disease risk. Our focus is on non-essential wildlife use such as exotic pets, entertainment and trinkets.

It's not on subsistence community use. It is widely acknowledged that wildlife markets, breeding farms and the trade supplying them played a significant role in the outbreaks of SARS and COVID-19. In April, the one health tripartite—the World Health Organization, UNEP, and the OIE—issued emergency guidance that called on national authorities to suspend the trade in live-caught wild mammals for food or breeding. That guidance also stated that it was relevant for other wild animal uses. Canada should adopt these recommendations immediately, but more transformative change is needed.

Seventy-five percent of new or emerging infectious diseases originate in animals, mainly wildlife. These include MERS, avian flu, Ebola, SARS, HIV/AIDs, Nipah virus and monkeypox. I could go on, but I won't. Recent reports by UNEP and the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services recognized the commercial wildlife trade as a key pandemic driver and animal welfare is at the root of it.

When a variety of different wild animals that wouldn’t normally encounter each other in nature are kept in close proximity in crowded, unsanitary and stressful conditions, it is the ideal environment for the emergence and spread of infectious diseases that can then be transmitted to humans. These conditions exist throughout the wildlife trade and studies show that the risk of transmitting diseases can increase significantly as animals are traded up the supply chain. This is a global problem that requires a comprehensive global solution. Canada has an important role to play.

Our research shows that more than 1.8 million wild animals were imported into Canada between 2014 and 2019 and it would seem that the vast majority—93%—were not subject to any permits or pathogen screening. Animals are coming in for a wide variety of purposes, but there’s been a dramatic increase in the number imported to supply the exotic pet industry. We found that different federal government agencies regulate different aspects of the trade, with their own data collection systems and requirements.

This is leaving gaps in important information like the names of species, the purpose of the trade, whether the animals were wild caught and the country that they come from. Once animals are brought into our country or if they are captive bred here, they are subject to a patchwork of inadequate domestic regulations. Nobody is tracking these animals. Other countries are taking action on this issue. China has permanently banned the farming and consumption of many terrestrial wild animals and it is helping farmers transition to alternative livelihoods.

In the U.S., the preventing future pandemics act, if passed, would prohibit the import and export of wildlife for human consumption and medicine. The Netherlands is fast-tracking their ban to end fur farming for good because COVID-19 is running like wildfire across mink farms. Germany has agreed to reduce the trade in wild animals for pets, ban the sale of wild-caught animals and set up a centralized trade register. Last month, Italy, which holds the G20 presidency, approved a ban on the trade of wild and exotic animals.

Just a couple of days ago, Thailand announced its interest in being free of illegal wildlife trade. We urge Canada to join these countries and do its part. Specifically, Canada should immediately adopt the guidance issued by the one health tripartite and prohibit the trade in live-caught wild mammals, promote a greater emphasis on pandemic prevention and address the key drivers of pandemics, particularly the commercial wildlife trade at the G20.

It should urge the one health tripartite to present a list of wildlife species and conditions that present significant risks of transmitting zoonoses and guidelines for mitigating them. This was actually recommended at the G20 agriculture ministers meeting last year.

(1420) Here in Canada, to do our domestic part, we need to adopt a more preventative regulatory framework and improve our systems for collecting data and monitoring the trade. The federal government should work collaboratively with the provinces and territories to improve their regulations to significantly reduce the trade and improve enforcement through better coordination and resourcing across all agencies and jurisdictions. Those are all my remarks, but I want to say that joining me today to help me answer your questions, I have two experts.

Michèle Hamers is a professional biologist who works with our organization. She conducted our research on Canada's wildlife imports and is one of the leading experts in Canada on the exotic wildlife trade. Dr. Scott Weese has contributed his veterinary infectious disease expertise to our organization and this cause. He is the director of the University of Guelph's centre for public health and zoonosis, and is chief of infection control at the Ontario Veterinary College teaching hospital. Thank you.

The Chair :

Thank you, Ms. Matlow. I see that Dr. Flood has been able to rejoin us, I believe from New Zealand, where we've been having some communications connection issues. Before we start your statement, Doctor, I will ask you to speak for 10 seconds so we can get a sense of whether the interpreters can hear you well. Maybe tell us where you are and what the weather is like.

Dr. Colleen Flood (University Research Chair, Health Law and Policy, University of Ottawa, As an Individual) :

Well, I'm here in the top of the South Island, which is not too far from a little city called Nelson. Normally the weather is glorious, but it's actually pouring rain, so bummer. It's my son's ninth birthday today, so bummer again, because we were meant to be going to Laser Tec.

The Chair :

Let's try. I'll invite you now to present a statement of up to six minutes. I don't know if you saw the caveat. When I wave my cards, this yellow card means your time is imminent and the red card that your time is up. Try to wrap up when that happens, okay? Please go ahead, for six minutes.

(1425) Dr. Colleen Flood :

Thanks very much. Six minutes is not really too much time to talk about how COVID has irrevocably changed our world. I know you all are working so hard to try to unpack all of that, and I want to thank you for the work you're doing, first of all. I want to make two points. The first is that the federal government needs to manage the border and coordinate with the provinces to restrict the potential for new variants of concern to enter Canada. The second point is that the federal government should launch a royal commission into the treatment of people in long-term care homes across Canada.

Those are the two things I want to talk about. I might not get to talk too much about the second claim, so perhaps I could pick that up in questions. On managing the border, Canada's performance on COVID has been a very mixed bag overall. Smaller provinces, like New Brunswick, Nova Scotia, P.E.I. and Newfoundland, have aimed for zero COVID.

The Chair :

I'm sorry, Doctor, we're getting popping noises. It's going to be hard for the interpreters. Just maybe put the mike a little bit away from your mouth, but roughly above and kind of adjacent to it, if that's—

Dr. Colleen Flood :

I'm sorry about that.

The Chair: It's not a worry. Let's go with that. Please go ahead.

Dr. Colleen Flood: Okay. Smaller provinces have aimed for zero COVID and attempted to eliminate community transmission and quickly manage any new outbreaks. This has involved tightly managing their respective borders to prevent new infections entering their safe or green zones. If we look cross-nationally, the countries that have aimed for zero COVID—New Zealand, Australia, Singapore, South Korea, Iceland, Vietnam and so on—have been able to live comparatively normal lives over most of the year.

Since we arrived in New Zealand in January, our son, who's just turning nine today, has been in school constantly with no masks and no social distancing, but with lots of play and social interactions. We go to dinner parties, movies and volleyball matches. This has been the case, as you've heard from Dr. Dean Knight, for over a year, with some brief windows of very short lockdowns to stamp out possible community spread. Most Canadian provinces have not aimed for zero COVID, but instead have stated that their goal has been to reduce cases to a level where hospitals are not overwhelmed.

By having this as a goal rather than trying to eliminate transmission, most Canadian provinces have thus accepted a certain level of death and disease, mostly in the elderly in long-term care institutions and those living in racialized and poor communities. In Canada around 25,000 people have died. If New Zealand had adopted Canada's policy instead of what it did, then 3,600 New Zealanders would have died instead of the 26 who actually did. Canada's goal of “bending the curve”, as they describe it, has not worked on its own terms.

The problem has been that as soon as the curve has bent—that is, there's been some improvement in infection numbers—provinces have rushed to reopen without a serious mitigation strategy in place, causing a new cycle of lockdowns and reopenings, prolonging pandemic suffering for Canadians. The federal government and the big Canadian provinces have pinned their hopes instead on vaccines. Fortunately, science has delivered on this. Canadians from coast to coast, despite many barriers, are rolling up their sleeves to get vaccinated. As the vaccines roll out, there is the inevitable clamour to open up again.

Restaurants and shops, schools and camps, universities and faith-based organizations, opening up the U.S. border for travel—everyone has a good reason that their particular group or venue should be able to open up now. But great caution is required. Canada has already lost so much physically, emotionally and economically that I don't think Canadians can afford or tolerate yet further cycles of lockdowns and reopenings for short-term political gain or because of a short-sighted economic outlook.

In this regard, I make a plea to the federal government to do a much better job than is presently being done of ensuring that new variants of concern do not enter Canada and undermine all the gains we have made in recent months with vaccinations, at least not until we are certain that vaccinated individuals are protected against them. We know that in parts of the world, such as Brazil, India and Iran, COVID-19 is still on a rampage, with no vaccine path in sight. We still do not have great science on the extent to which the vaccines will protect against the variants that are emerging.

Now, I realize that there's a lot of politics about border management and a lot of politics about fed-prov and who should be doing what, of course, but Canadians themselves are amazing. They are resilient. They are getting out there. They're getting vaccinated. Soon, widespread vaccinations will drive transmission rates low. But once we largely have the forest fire of COVID under control through the miracle of vaccinations, imagine that we allow variants of concern into the country with the potential to evade immunity.

To me, this is akin to the federal government permitting more small fires around the perimeter of the forest and hoping the forest rangers are not too tired to put them out.

(1430) In managing its border, Canada will not abandon its humanitarian and other values—and we can speak about that during the questions—but Canada should not permit those crossing land borders to circumvent any requirements for management at the border. All Canadians coming from countries or regions of concern where there are variants emerging must be required to enter through a managed border.

If the science emerges—and I hope it comes quickly—to show that our available vaccines prevent transmission of variants of concern, then some of these requirements could be softened for returning Canadians or other travellers, with the recognition of vaccine passports and rapid testing. However, we need the science first. I've run out of time to speak to my second point, but I hope we have some time to come back to it in questions. Thank you for your time. I'm sorry about this stupid headset that died.

The Chair :

Thank you, Dr. Flood. In passing, Dr. Knight, are you also in New Zealand?

Dr. Dean Knight :

Yes, I am. I'm in Wellington, at the bottom of the North Island, just across the way from Dr. Flood.

The Chair :

I note that it's 6:30 a.m. there, so I really appreciate that you're here. I'm not a morning person, so I feel for you guys. We will carry on now and start our round of questions, with Ms. Rempel Garner for six minutes.

Hon. Michelle Rempel Garner :

Thank you. I'm sharing my time with Mr. Davies and I'll give the floor to him.

The Chair :

Okay, as you please.

Mr. Don Davies :

Dr. Flood, you recently co-authored a

chapter entitled “The Federal Emergencies Act: A Hollow Promise in the Face of COVID-19?” in the book Vulnerable: The Law, Policy and Ethics of COVID-19 . In it, you tested three case scenarios in the context of COVID-19 where, arguably, provincial steps have been insufficient, triggering the need for a national response. Could you please provide the committee with an overview of those case scenarios and the conclusions you were able to draw from them with respect to the Emergencies Act?

Dr. Colleen Flood :

Sure. We did look at the Emergencies Act very early on in COVID to understand how it works and whether or not it could be triggered, so let me give you an overview. The Emergencies Act, unlike provincial emergency legislation, can only be triggered in relatively rare circumstances. The general emergency powers at the provincial level are much broader and provide many more powers. If the federal government were to trigger the Emergencies Act, there are very prescribed areas in which it can utilize it, and that makes things more tricky.

It's not so obvious that the Emergencies Act can be used to respond to some of the problems that we've seen arise in COVID-19, such as a requirement to wear masks, for example. However, there are some particular powers that perhaps would allow contact tracing, for example, in a more generalized way, which would allow, perhaps, requirements for lockdowns. There are therefore very limited means there, Don, to permit the federal government to act, but it's fairly prescribed.

There is a question coming out of this, and I think you put it rightly to an earlier witness: What kind of emergency, if a global pandemic isn't a sufficient emergency, would you need to be able to declare a federal emergency, or is it just, as we've said, sort of a hollow promise? What more would you need than this, given 25,000 Canadians have died and the number is mounting? From a normative perspective, it's odd that Canada is one of the only developed countries in the world not to have declared a national emergency. I think we have to come back to it.

The Emergencies Act was written coming out of World War II and a concern about the internment of Japanese Canadians. It's written in a very prescribed way because of that. It's clearly not fit for the purpose of managing a pandemic or a public health emergency, as we've seen.

(1435) Mr. Don Davies :

Dr. Knight, in a recent

article you wrote:

My suspicion, too, is that this openness to responsibility was crucial in fortifying the social licence for the extreme measures the government took. In other words, the government bred legitimacy for its response through its open attitude to accountability. This speaks, I think, to an aspect of constitutional culture in New Zealand—a sense of civic virtue that predates the pandemic but one that has been rarefied throughout it.

In your view, what lessons can Canada and other nations draw from the constitutional culture of New Zealand and the way it approached accountability and openness in dealing with COVID?

Dr. Dean Knight :

For me, the value of leaning into accountability is gold. Our Prime Minister, who is very much at her best in dealing with crises and emergency, and bringing people with her, and her government have leaned into responsibility, accountability, and building, as you see, a team of five million. That's the language that's used to encourage that collective community spirit that is required to manage this pandemic. It was done in a number of different ways.

I mentioned the face-to-face explanation—just being straight up, clear, and open about the crisis that was being faced and what the government was doing, and so forth. I mentioned the fact that the government has been proactively releasing cabinet papers and minutes, with very few redactions, that showed the sense of decision-making, the analysis, and so forth. During the height of the pandemic, we had the day-to-day press conferences with the Prime Minister, director general, and ministers speaking directly to the nation, where you're trying to encourage a collective sense of precaution and health measures.

The ability to get a very high sense of social licence has been crucial, and it's helped in enforcement. It has obviated the need for heavy-handed police enforcement, because people know that they have to do the right thing, and—

Mr. Don Davies :

Thank you, Doctor. I'm sorry to interrupt you. I have to cede my time back to Ms. Rempel Garner, but thank you.

Hon. Michelle Rempel Garner :

Thank you. Mr. Chair, I move:

That, the following regularly scheduled meetings of the House of Commons Standing Committee on Health be programmed as follows:

On May 31, 2021 the Committee undertake one [or] more two hour meeting regarding Patented Medicine Prices Review Board’s Guidelines, that each political party represented on the Committee be given leave to invite two witnesses of their choosing to provide testimony on the topic for this meeting, and that upon the completion of this meeting, the analysts of the Committee be directed to commence the development of a draft report based on witness testimony and written submissions received by the Committee on this subject to date;

On June 7, 2021 that the Law Clerk and Parliamentary Counsel, the Clerk of the Privy Council Office, and Canada’s Privacy Commissioner and Canada’s Information Commissioner be invited for the duration of a two hour meeting to discuss issues related to, but not limited to, the production of documents regarding the October 26th House of Commons motion, and that the total time allotted for opening statements be limited to 5 minutes for each witness up to a maximum of 20 minutes in total to ensure adequate time for questions to be posed by committee members;

For the first hour on the meetings scheduled for June 4, 11, 14, 18, and 21, 2021, each political party represented on the Committee be given leave to invite one witness of their choosing to discuss issues related to, but not limited to, the federal government’s response to the COVID-19 pandemic, and that the total time allotted for opening statements be limited to 5 minutes by witnesses to ensure adequate time for questions to be posed by committee members;

For the second hour on the meetings scheduled for June 4, 11, 14, 18, and 21, 2021 Deputy Minister of Health Canada, the Deputy Minister of Public Safety and Emergency Preparedness, the Deputy Minister of Public Services and Procurement, the President of the Public Health Agency of Canada, the Chief Public Health Officer of Canada, the Vice President of Logistics and Operations for the Public Health Agency of Canada, and the head of the National Advisory Committee on Immunization, be invited to discuss issues related to, but not limited to, the federal government’s response to the COVID-19 pandemic, that the Minister of Health be in attendance for at least one of these meetings, that the meeting that the Minister of Health is in attendance be held on a Friday, be three hours in length, that the Minister and officials be in attendance for two consecutive hours, and that the total time allotted for opening statements by officials (and the Minister) during this portion of these meetings be limited to 5 minutes by witnesses up to a maximum of 20 minutes in total to ensure adequate time for questions to be posed by committee members

To witnesses who are here today, I want to thank you so much, particularly the World Animal Protection folks. This motion that I've just moved is just in recognition that we are almost at the end of the parliamentary session. We only have a few meetings left, and we haven't really discussed committee business in some time. Should we have to allocate another meeting to discuss business, and then adopt it in another meeting, we'd be losing two meetings in the middle of a pandemic, so the genesis of this motion was to ensure that the remaining meetings are maximized for activities related particularly to the government's response to the pandemic. I also believe that the

schedule that has been presented here will also allow the clerk enough time to give witnesses headsets. My understanding is that most political parties here have already identified their witnesses for the PMPRB study and that headsets have already been distributed. There should be no reason that we can't proceed as suggested. This motion would also give officials a full week before they next appear in front of committee—and, again, this is designed for us to maximize our time. The other thing I'll say is that I think this is very fairly written.

It gives every political party here leave to determine their own witnesses. There's really no partisan language in this motion at all. It's just to ensure that, prior to the end of session, the committee is focusing its efforts on scrutiny of the government's response to the COVID-19 pandemic, particularly given that I understand that there will be a gap at the end of June in which the House of Commons IT staff will be undertaking regularly scheduled maintenance, and meetings may not be possible, so we want to make sure that we're getting as much work done as we can, Chair, before Parliament rises.

(1440) I hope there is agreement among parties that we can proceed in this fashion. It gives a lot of flexibility. I seek the support of all of my colleagues on this committee for proceeding as follows.

The Chair :

Thank you, Ms. Rempel Garner. It is your purview to move this motion. We have notice of it. I'm wondering if you might consider moving it at the end of our witness testimony and our questions.

Hon. Michelle Rempel Garner :

I think, just for the sake of time, I'd like to move it now, because I noticed that we didn't get a second round of questions for the first panel. I would like to proceed.

The Chair :

Mr. Don Davies :

As a point of order, Mr. Chair, could I maybe ask, if we have the agreement of all committee members, that we not move any other motion so that we can deal with Ms. Rempel Garner's motion at this meeting? If we have that agreement, then we can finish at least one quick question round with the witnesses in respect of [ Technical difficulty—Editor ].

Mr. Tony Van Bynen (Newmarket—Aurora, Lib.) :

No, I don't agree.

The Chair :

Sorry, I missed a little bit of your remarks, Mr. Davies. I think I have a power glitch here. You went dead for a while, figuratively speaking. I'm thinking the matter has been responded to by Mr. Van Bynen, so we have to either go ahead with this motion now or trust on faith that we will be able to deal with it after the witnesses.

Mr. Don Davies :

I'm sorry, Mr. Chair. My screen froze right after I spoke, so I don't know what happened after I said my piece.

(1445) The Chair :

Technology is so wonderful. As you were speaking, my power glitched and I missed your whole speech. I believe Mr. Van Bynen has responded with a “no” to your request. I still think it would be appropriate, if we could, to deal with this matter after our witness panel.

Mr. Don Davies :

I'm sorry to interrupt. What I missed was Mr. Van Bynen, on behalf of the Liberals, saying no to my request that we deal with this at the end and agree to hear from the witnesses.

The Chair :

Sorry, just hang on. What you're asking for, Mr. Davies, would require unanimous consent. Mr. Van Bynen said no, so we have no unanimous consent. We go now to Ms. O'Connell. Is that...? I'm sorry, I didn't quite hear who interjected.

Ms. Jennifer O'Connell (Pickering—Uxbridge, Lib.) :

Yes. Just to clarify, Mr. Chair, I think it is incredibly unreasonable to have asked witnesses, in particular from New Zealand, to appear here and our not at least having the ability to hear their testimony. If we can deal with this motion at the end, that's fine. But, Mr. Chair, I can't commit, and I don't think it's reasonable for any member to commit, to tying their hands by our dealing with a motion procedurally. I think the intentions are that we can deal with this at the end, but I don't think we can make any commitment. Given the level of disrespect to these witnesses as well as our own members' question times, to interject like this is completely unreasonable.

The Chair :

Very well. Are there any more comments on this particular point of order?

Mr. Don Davies :

Yes, Mr. Chair, I have my hand up.

The Chair :

Is that on the point of order?

Mr. Don Davies :

It's just to provide clarification in answer to Ms. O'Connell's point. I'm asking that we have two more rounds of questions. We have the Liberals' round and then we have the Bloc's round and then my round. All I'm asking is that, if we can all agree, none of us will move another motion substantively to deal with business so that we can ensure that we deal with Ms. Rempel Garner's motion at the end. Then we can proceed to hear from the witnesses as Ms. O'Connell wants to do. That's not tying anybody's hands. That's just making a commitment that we can get to that motion at the end of the meeting, because if Ms.

Rempel Garner lets go of her motion now, and then the Liberals in five minutes move their own motion, and we lose the witnesses, then that's an unjust result. What I'm asking my colleagues to do is this. Let's listen to the witnesses, finish the question round, and agree to deal with Ms. Rempel Garner's motion at the end of this meeting so that we can do justice and respect the witnesses. It just means the Liberals, the Bloc and I, in the next 15 minutes, don't move another substantive motion. Why can't we agree to that?

The Chair :

Thank you, Mr. Davies. I understand you're asking that no one will move a substantive motion during their question slot for witnesses. Is that correct? Yes. Mr. Van Bynen, your hand is up.

Mr. Tony Van Bynen :

Thank you, Mr. Chair. I have a right to put forward a motion, and I don't want to compromise that. To agree to not putting forward a motion, I think, is unrealistic as an expectation, and I will do that at an appropriate time, as Ms. Garner has done at her appropriate time.

The Chair :

Thank you, Mr. Van Bynen. Ms. Rempel Garner, please go ahead.

Hon. Michelle Rempel Garner :

Thank you, Chair. I believe my motion is in order, and it's on the floor for debate. I know we've had issues when you've suspended at the end of meetings when we've moved motions before, and so I'd like to proceed with debate. It is in order. It's routine proceedings, two witnesses. We're just trying to make sure that we have the program set, because we've sort of run to the end of the universe of our program prior to the end of session. Thank you.

The Chair :

Yes, I've already said that it's in order, and you have the right to move it at this time. I was just asking if we could deal with this after our witness testimony, but I don't think we're going to get to that point. We have Mr. Van Bynen again.

Mr. Tony Van Bynen :

I'd like to hear from Mr. Powlowski. I'll speak after him.

The Chair :

Okay. Dr. Powlowski, go ahead.

Mr. Marcus Powlowski :

Since this has moved into debate, I want to apologize to the witnesses, particularly the people from New Zealand who got up very early in the morning to be with us. I would also like to wish Colleen Flood's son a happy birthday from Canada and from all of us here in Parliament. I am sorry that we didn't manage this.

(1450) The Chair :

May I have the consensus of the committee on whether we should release the witnesses at this time with our apologies and our thanks? I'm seeing agreement on that. To the witnesses, once again, I apologize. This is the way it works sometimes in Parliament. Motions get moved and motions have to be dealt with when they get moved. On behalf of the committee, I really do appreciate your time today and your offering to help us with our inquiries.

If you have any further communication you wish to convey to the committee, I would invite you to please direct it to the clerk of the committee, and the clerk will ensure that it gets properly translated and distributed to the committee. Thank you, all, and with that I would invite you to leave if that is your will to do so. Having said that, we will now continue with the debate on Ms. Rempel Garner's motion. Mr. Van Bynen, your hand is up.

Mr. Tony Van Bynen :

Thank you, Mr. Chair. I'd like to take this opportunity to remind my colleagues of a couple of things that were said during our meeting of May 14, starting with Mr. Davies:

I think what I'm getting from this on all sides is that we need a better process for determining our agenda going forward. I think it does speak to the less than optimal functioning of our subcommittee. We do have a subcommittee on agenda, which I think, with great respect, falls under the authority of the chair to call. I'm going to put that bug in the chair's ear to maybe use that. All parties are represented on it, and I think that we should be meeting on some sort of regular basis to deal with issues.

Then, as our meeting was coming to a close, Mr. Chair said:

I would advise the committee that I am planning to do a subcommittee meeting following the end of Mr. Davies' portion of the study and just prior to the PMPRB last two meetings, so that we can plan what we're doing following those meetings and so we'll be able to bring witnesses in, should that be our intent.

It seems to me that the crumb was indeed planted in the chair's ear, because it's my understanding that this subcommittee has been scheduled for next Monday, a little less than 75 hours from now, to discuss the committee's work plan moving forward. Now, the first phase of this study is completed. The motion we are currently debating, introduced by Ms. Rempel Garner, 11 days after our chair advised the committee of this plan as quoted above, completely undermines our ability to collaborate and work together in a respectful manner.

While there haven't been many, I have been proud of the moments when we could collaborate and be respectful to one another, because that's when we are most productive. I am not proud, however—or thankful for that matter—of motions such as this one that undermine our ability to work collaboratively as a team while respecting each other. Most importantly, I want to highlight how disrespectful we have been to our witnesses today, especially those joining us from New Zealand, and at a very early hour.

I personally think that hearing from them would have been incredibly important, and I was looking forward to hearing what they had to say. That being said, I move that debate be now adjourned.

The Chair :

Thank you, Mr. Van Bynen. A motion to adjourn the debate is on the floor. It is non-debatable so I will ask the clerk to call the vote. (Motion negatived: nays 6; yeas 5)

The Chair: Very well. We will carry on with this debate. Mr. Davies, I see your hand is up. Go ahead.

Mr. Don Davies :

I'm going to speak in support of this motion. I do want to say to Mr. Van Bynen, and I say this with great respect, on several occasions over the past year I have urged the committee chair to make use of the subcommittee to

schedule business. Today is Friday, May 28, and as of my coming to this meeting, there was no subcommittee meeting called. This is the last day of the first round of topics of our COVID study. This motion was submitted by Ms. Rempel Garner more than two days ago. Everybody on this committee has had an opportunity to look at the motion. What it does is it simply seeks to make productive use of the remaining seven or eight meetings that we have. With great respect, I raised this issue of calling a subcommittee meeting two weeks ago and it was not called.

For a subcommittee meeting to be called today for Monday means that were we to accede to that, we would lose a committee meeting on Monday and then we would lose another meeting on Friday, because the subcommittee would meet, come to a decision, hopefully, and then that proposal would have to be adopted by the full committee. We would lose approximately 25% of the meetings that we have left before the House rises on June 23. That is not an effective way to deal with committee business.

I'm going to be a little more strenuous in my objection at the lack of effective and efficient scheduling and the use of the subcommittee on this basis. If the committee chair is not going to call subcommittee meetings to plan the business of this committee, one can hardly fault the members of this committee for taking the bull by the horns and doing it themselves, which Ms. Rempel Garner has done. This motion is written very objectively. For the record, I want to state what it does. It schedules our PMPRB meeting on Monday, as Mr. Thériault is entitled to.

It proposes that we have eight witnesses instead of four so that we effectively have the final two of the four meetings, which Mr. Thériault proposed and this committee passed, completed on Monday. We finish the committee business on PMPRB. Starting on Friday of next week, and on every successive meeting but the following Monday, for the first hour of each meeting each party is allowed to submit one witness as they see fit on any issue under COVID. You can't get more egalitarian than that. In the second hour of each of those meetings, the deputy ministers will come to answer questions.

I think this is an excellent way to structure the meeting because we are allowed to hear the witnesses as each party wants to call them, whether it's on long-term care or mental health, which I know is a priority of Mr. Van Bynen's. I know long-term care is a priority that Ms. O'Connell has mentioned. On whatever issue anybody wants, we can have those witnesses appear in the first hour and then, if questions or issues emerge, we can put them directly to the deputy ministers from health, from the Public Health Agency of Canada, from procurement, and the chief public health officer.

I think that's a very important way to proceed because were we not to come up with this process, we would have to then proceed with the next first priority of the Liberals. That's where we'd go back and we would never get to the next priorities of the other parties. We have the benefit right now of stopping at this point, having heard the number one priority from each of the four parties and having four meetings on each.

You can't get more egalitarian than that and because we can't then go to the second choice of each party and hear from each of those in a fair way by the end of June, it's a very natural stopping point for us on how we are going to handle the final seven or eight meetings. This way allows every party to get the witnesses they want before each one of those meetings. Finally, the other piece of it is that the meeting a week from Monday is the only other meeting that departs from the process I just described. This would be a meeting to hear from the law clerk and the Clerk of the Privy Council.

I am going to make some pointed remarks about this.

(1455) Last October, the House of Commons—no less—passed a motion compelling—not asking—the government to produce documents in prescribed form on a number of subjects set forth in that motion. That was passed by the majority of the members of Parliament in the House of Commons. We live in a democracy. That is the democratic will of the House of Commons. In that motion... at the time, my Liberal colleagues said they had resisted it because there would be over one million documents. By the way, I never understood how they got to that number. I think it was pulled out of thin air.

Nevertheless, it was confirmed in writing by the Clerk of the Privy Council to this committee that they had in their possession over one million documents related to the motion that we called production for. To date—seven months later—this committee has received just over 8,000 documents, while 992,000 documents remain in the possession of this government. Not only that, but this government refused to translate those documents, in my view, in direct violation of the law and of their obligation to provide documents in both official languages.

This government dumped that responsibility onto the law clerk, who has no resources to do translation and had to use his budget to hire people specifically for the purpose of translating documents that this Liberal government refused to put in both official languages. Not only that, but the first tranches passed over to the law clerk were a series of the most innocuous documents you could imagine—press releases and documents well in the public sphere. I'll tell you my thesis. This government is deliberately stalling and withholding production of documents.

There is no other conclusion any reasonable person can come to. In seven months, the law clerk has received 8,000 documents out of one million. Moreover, I will say that this government, by the terms of the motion, does not have any right or responsibility to vet those documents, so they can't say they're doing any work on them. Their job is to identify the documents and fire them over to the law clerk. We, specifically, in the House of Commons, said that the law clerk has the responsibility of doing the redacting and vetting according to the criteria we gave them.

We did that specifically so that the government wouldn't hold up the process by redacting documents in advance. The government doesn't have to redact and they don't have to review. Their job is to find the documents and turn them over to the law clerk. The law clerk will then do the redacting according to the instructions. I think it's entirely appropriate to have a meeting on Monday to hear directly from the law clerk and from the Clerk of the Privy Council about what the heck is going on. Parliament is supreme in our system—not the government, not the cabinet and not the Liberal caucus.

Parliament is supreme, Parliament has demanded production of these documents, and we're not getting them. To wrap up, this motion gives us the PMPRB study conclusion that this committee has already passed. It provides a fair structure for us to hear on a completely egalitarian basis from witnesses from each party on COVID, which is what Canadians want us to focus on. It calls the deputy ministers responsible to come and be answerable to this committee, as they should be. It provides one meeting so that we can deal with the issue of production of documents, which I believe is bordering on contempt of Parliament.

Finally, it asks the Minister of Health to come to one meeting of her choosing on one of the Fridays between now and June 25. How could anybody on any side of this committee object to that? To say, “Oh, no, we don't want to vote on this. We're going to filibuster or talk this out. I know, let's have a subcommittee meeting on Monday”, on Friday and then to waste two meetings the next week on it is, frankly, irresponsible.

Other committees might have their own business, but this is the health committee and we're in the middle of the biggest global health crisis that this country and this globe have seen in a century. We can't afford to miss meetings. I think this motion is well structured, it's fair and it gives a very prescribed system for dealing with the last seven or eight meetings of this committee. I can't imagine anybody on this committee having a single valid objection to it. I will be supporting it.

(1500) The Chair :

Thank you, Mr. Davies. I should clarify that the notice for the subcommittee meeting went out Wednesday morning. It appeared in my inbox at 10:22 a.m. Pacific time. That was done by the clerk in response to a request earlier in the week, and also, to follow through on my commitment to do so in our previous meeting. We'll go now to Ms. Sidhu. Ms. Sidhu, go ahead.

Ms. Sonia Sidhu (Brampton South, Lib.) :

Thank you, Mr. Chair. First of all, I'm extremely disappointed with this motion. I have some important questions for the witnesses from New Zealand. I strongly believe it is important to have their perspective studied. I'm very disappointed that my turn was next and the opportunity has been taken away from me. Mr. Davies just said that questions should be offered equally, but this motion personally took my time away today. We agreed to a subcommittee meeting, following the NDP topic in our work plan as agreed by all members.

Letting the witnesses go despite the agreement on the scheduled subcommittee meeting has been disappointing. Is this what we are showing our friends in New Zealand? They woke up at 5 a.m. and have spent hours preparing their testimony, and we are doing this. It's unbelievable. As I said, you had mentioned that a subcommittee meeting would be held next week after we completed Mr. Davies' study. We had also adopted an earlier subcommittee report in March that said we would have two more PMPRB meetings and proceed to report writing. This motion is worded in a very confusing way.

I'm very concerned about how much time the fourth

section of the motion has asked for public officials, these high-ranking public servants, to be on standby for an hour on two different days every week, in the middle of the day, while they are in the middle of managing our response to a global pandemic. It is just asking for two hours. Like everyone, they need to prepare for these meetings. They need to defer other meetings. They're accountable to us, but it is not their job to be grilled with unnecessary questions for multiple hours a week so that an opposition member can get clips for social media.

More than any of that, I'm concerned at this point about the lack of respect that this motion shows for this committee. We have repeatedly said that we should be discussing these things as they grow. As Mr. Van Bynen said, we had the same discussion about the last Standing Order 106(4) meeting, and the quote from Mr. Davies pretty much sums up how this committee should be functioning. This motion would be in complete contradiction to the spirit of co-operation that Mr. Davies spoke about. This motion by the Conservatives is designed to render the subcommittee meaningless.

How is it respectful of this committee if its intention can force the cancellation of a subcommittee meeting where the parties could all work together, off the record, to plot a good way to move forward? I'm reminded of when they claimed that Canadians were at the back of the lineup to receive vaccines and would not get doses until 2030, but just today NACI recommended the earliest administration of the second dose due to an increased availability of the vaccines. If I may remind, this plan had been made available to the entire country very early on, last year, in 2020. On a recent podcast, Mr.

Davies spoke about how inconsistent the Conservatives had been in their criticism of the government. He said they remembered how critical they had been of the government for being too slow to close the borders, and now they criticize the government for hotel quarantine rules and border control measures. They think we should reopen the economy. I cannot really tell what their positions are. We should not be rewarding this behaviour by wasting public servants' time and inviting them for no reason in particular.

If the opposition members would like to take the weekend to think about the topics they would like to discuss with these officials and the most efficient

schedule to do that, I'm sure the subcommittee could come to an agreement. This motion should not pass. The subcommittee should meet on Monday as planned, at which point you and the co-chair, along with Mr. Davies and Mr. Kelloway, can settle the agenda for the remaining meetings. Thank you.

(1505) The Chair :

Thank you, Ms. Sidhu. We'll go now to Mr. Kelloway. Mr. Kelloway, please go ahead.

Mr. Mike Kelloway (Cape Breton—Canso, Lib.) :

Thank you, Chair. Thank you, colleagues. When I first received the notice of the motion, I was a little surprised as I was looking forward to meeting with my colleagues from the opposition at our upcoming subcommittee meeting. I agree with Don's comments from the last meeting that we need to utilize the subcommittee as a tool to plan out our upcoming meetings and get a sense of what the committee will look like in the short term, and it would seem to me that putting a motion out like this defeats the purpose of that meeting entirely, but perhaps I'm wrong.

I've heard almost every member of this committee talk about the importance of working together. I've said it at the past couple of meetings, and I've gotten to know many of you. I believe that you do want that as well, but, Mr. Chair and colleagues, let's use the subcommittee on Monday to talk about what MP Rempel Garner proposed in her motion, to hear from the government side on what we'd like to see and to get our input. For me, that would be truly a way of moving forward together. Frankly, Mr. Chair, it's a little frustrating that we're having this discussion again for the second Friday in a row.

Last week MP Rempel Garner brought forward a Standing Order 106(4) meeting, as she can do, as anyone can do, to discuss a motion she wanted to see passed at this committee, joined and signed by three other fellow Conservative members at this committee. Here's the thing, Mr. Chair. All members of this committee voted in favour of that motion, because we all agreed on its contents, and I think it was maybe 30 minutes. However, Ms.

O'Connell and I both took the time to make it clear that we were frustrated with the Conservative members of this committee using Standing Order 106(4) to call a meeting to discuss the motion rather than doing so collegially through a discussion of ideas on the committee's future business with other parties on this committee, namely the NDP, the Bloc Québécois and, of course, the Liberals. Because of this procedural tactic to move a Standing Order 106(4) meeting last week, a very important meeting that had already been scheduled for last Friday ended up having to be moved to today.

This meeting was originally scheduled at the request of our NDP colleague on this committee, who wanted to call witnesses to study his subject matter area of interest at this committee. As a reminder, Mr. Chair, to my Conservative members opposite, the entire committee, them included, agreed that the committee's area of study would alternate among the different officially recognized parties represented at this committee with four meetings to be held per each party's area of interest.

That aside, we pressed ahead with voting for the Conservative motion last week, because we wanted to give the Conservative MPs on this committee the benefit of the doubt that they would constructively, with all their colleagues on this committee, plan for areas of study in the future. In fact, we've all agreed that, in the spirit of working together in good faith, the subcommittee would need to discuss the committee's agenda going forward as a committee. Mr. Chair, the subcommittee meeting is already scheduled for this upcoming Monday, May 31, and the plan was to work together on a road map going forward.

My NDP colleague on this committee stated last week that we need a better process for determining our agenda going forward, and I agree with Don. He also reiterated that all parties are represented at the subcommittee, and that “We should be meeting on some sort of regular basis to deal with issues”. As I previously said, I agree with the comments, these comments in particular. I have made that clear to my colleagues on this committee at many meetings.

When we deal with things in this hasty and unco-operative manner, it does lead to dysfunction and to this committee's never finishing the work it's already agreed to work on. The member already knows that, because Don specifically pointed this out last week, in saying, “Luc has been waiting for the last two meetings of his PMPRB study for months”. In fact, the member for Montcalm 's PMPRB study was last before this committee on December 11, 2020. That was six months ago.

We haven't had a chance to complete the two meetings still required for that study because of the continuous disregard by some members of this committee for any of their colleagues from other parties on this committee. With this proposed motion, which only proposed to convene one of the two remaining meetings required to complete the PMPRB study, it means that Luc's study likely won't be tabled before the summer, and perhaps Luc is okay with that, I don't know.

While I'm discussing the specific contents of this motion in front of us, I would be remiss to not realize the obligations that this motion puts on some of the busiest public servants in Canada right now, who are working around the clock to guide Canada safely out of this pandemic. They have been working around the clock since early 2020.

(1510) Again, it seems as though there is little consideration given to the fact that, for officials appearing at this committee, there is a lot of time and effort in the preparation work to come here to answer questions from us here at committee. Just last week, officials appeared at this committee for three hours and some only received a couple of questions during the entire time they were here. Officials have repeatedly appeared at this committee and various other committees to answer questions. I crunched some numbers. At HESA alone, officials have answered questions for almost 40 hours.

When you consider their appearances at other committees as well, they have answered questions for over 70 hours, collectively. Nothing in the Conservative motion, Mr. Chair, even indicated that there are any new topics that have not yet been comprehensively answered. As I said last week—and I think this is important—I will always welcome the opportunity to hear from these folks. After all, they are the ones leading the charge and, as the health committee, we should be able to ask them questions. We all know there is no shortage of questions to be answered. Mr. Chair, let us think about this for a moment.

The deputy ministers of Health Canada, Public Safety and Emergency Preparedness, and Public Services and Procurement; the president of the Public Health Agency of Canada; the chief public health officer of Canada; the vice president of logistics and operations for the Public Health Agency of Canada; and the head of the National Advisory Committee on Immunization are the very officials who are actively responding to the COVID-19 pandemic in real time. They are responding to surges and emergencies across this country. They are in constant contact and hav