Overview pieces: Standing Committee on Health—April 15, 2020

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Opening statement

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Opening

Thank you for having me here today to discuss Public Services and Procurement Canada’s role in the government’s response to COVID-19.

Before we begin, I would like to thank the people behind the scenes that are working to make this meeting possible, including language interpreters who continue to play an exceptional role in ensuring Canadians have the latest information.

With me are Michael Vandergrift, Associate Deputy Minister; and Arianne Reza, Assistant Deputy Minister, Procurement Branch.

Our department is the central purchaser for the Government of Canada, and is responsible for procuring the goods that will help see us through the COVID-19 pandemic.

Specifically, we are helping to equip Canada with personal protective equipment and medical supplies, now and into the months ahead.

It is no secret that we are operating in a highly competitive global environment.

The entire world is scrambling to get the same materials from a finite number of suppliers, many of which are located in China. This is resulting in a complex and unpredictable supply chain. Add to this border restrictions, and you end up with a highly unstable marketplace where orders don’t always materialize into immediate deliveries.

Procurement strategy

I can tell you that our procurement experts are working day and night, aggressively buying from all available suppliers and distributors here at home and abroad.

In support of Canada’s frontline health care workers, we buy supplies on behalf of the Public Health Agency of Canada, which consolidates requests of provinces and territories and also maintains our national stockpile.

I thought it might be helpful to share our procurement strategy with the committee. I must stress that this strategy continues to be fine-tuned while circumstances evolve as we are dealing with global markets such as we have never seen.

Mr. Chair, I am sure that members are aware of the importance of personal protective equipment (PPE). Given the global scale of the crisis and the importance of China from a PPE production standpoint, we are dealing with a situation where many jurisdictions are competing for scarce supplies. At the same time, industry is trying to scale up to meet the demand, which means new players are emerging rapidly. Normally, we would be procuring these goods exclusively through Canadian distributors, but given the rapidly changing market conditions, a different approach was and is necessary.

Our procurement approach is 3-pronged. The first part of our buying was to buy existing inventory where we could. As you can imagine, given the pandemic, these goods were in short supply—but were important to obtain while we put in place the second part of our strategy.

Part 2 of the strategy was to place large orders to create a steady stream of receipt of goods over a number of months.

One of the benefits here is that big orders are more commercially attractive in a competitive marketplace—ordering collaboratively with provincial and territorial partners allowed us to develop those larger orders in the hopes of gaining the attention of industry.

We have also made the deliberate decision to order aggressively, or stated another way, consciously over-order. This was and is a deliberate move given the uncertainty around timeliness of receipt of goods.

As you can imagine, close collaboration with provincial and territorial governments is imperative to our success. To that end, our minister has established a federal/provincial/territorial ministerial table on procurement, which is helping to bring even greater coordination to identifying and meeting supply needs.

We are also challenging Canadian companies to step up to the plate and provide solutions.

The third prong is domestic. Under the leadership of Minister Bains, Innovation, Science and Economic Development Canada launched discussions with industry to identify opportunities to develop domestic capacity.

Many companies from across Canada have answered the call, with some manufacturers completely shifting their production lines to meet the urgent need.

My department’s role is to establish contracts with these companies, and we’ve already done so, which I will get into in a moment.

Challenges

Mr. Chair, I would be misleading committee members if I left anyone with the impression that procuring in this environment is issue free. There are many risks.

We are buying products that are new to us, and from unfamiliar suppliers, which can present challenges around quality.

Limited availability of many of those products is resulting in buyers overbidding, and established orders are often redirected to those willing to pay the most. On top of this, we are seeing additional export controls and requirements for medical supplies, particularly in China.

Successfully navigating this environment requires significant support on the ground. This is an area where we have had to adjust our strategy to better align with reality.

Given the emergence of new players, and the shortage of supply, we can no longer rely solely on Canadian distributors to obtain product. Our officials are working closely with partners in other countries, including embassies.

The on-the-ground support and expertise is proving invaluable as diplomatic staff and external partners assist in vetting companies in advance to better ensure quality. This is in addition to on-the-ground support to ensure product delivery, as well as logistics and warehousing expertise that help to secure our shipments and bring them to Canada.

This support includes receiving product as it comes off production lines, quickly inspecting for quality, arranging for shipment to a warehouse we have secured at the airport and actively securing customs clearance.

Through all of this, we have had to significantly accelerate our procurement processes by making quick decisions and streamlining contracting steps. Contracts that usually take several months to finalize are being put into place in days, if not hours.

Traditional competitive approaches would mean that the product would be sold to another buyer before a decision was made, all in an environment where prices are increasing rapidly and rules and regulations can change overnight.

But even after our shipments arrive in Canada, the Public Health Agency must first inspect purchased supplies and then get them to where they are needed across the country. The same is true for the supplies we produce in various regions at home.

To help us with this effort, we have contracted Amazon Canada—one of the companies that answered our call to action.

Amazon is providing the Public Health Agency with use of their online business platform to help manage the inventory and allow provinces and territories to directly order supplies online. Canada Post and Purolator will handle the domestic warehousing and delivery to health authorities and hospitals.

This is all about moving supplies from where they are manufactured into the hands of our doctors, nurses and health care professionals—as fast as possible. Public Services and Procurement Canada is helping its partners do just that.

Update: Orders, deliveries and contracts

Let me now turn to the latest numbers in terms of orders and deliveries.

As of April 13, we have managed to secure more than 293 million surgical masks and more than 130 million N95 respirators—a key piece of protection for health care workers. To date, we have received deliveries of more than 17 million surgical masks and just over 609,000 N95 respirators. This does not include recent shipments received over the weekend of approximately 2.5 million N95 respirators that are currently being assessed by the Public Health Agency.

To help meet longer-term supply needs, we are working to establish a domestic manufacturing contract with Medicom, of Pointe-Claire, Quebec, for these masks.

Like all of the equipment countries are seeking, ventilators are in short supply. Despite this situation, we have managed to secure orders of more than 32,000 ventilators from various companies, including Canadian companies Thornhill Medical, CAE, Starfish and FTI Professional Grade.

In addition, we have ordered more than 20 million litres of hand sanitizer—delivery has already started and will continue over the coming months. This is supported domestically in part by an agreement with Fluid Energy, a Calgary-based company.

And we have ordered over 900 million pairs of gloves, of which we have received nearly 5 million to date. We have also ordered 17 million face shields. This includes an agreement with Bauer, which is shifting its hockey skate production lines to make those face shields that are so important to frontline medical staff.

When it comes to test kits, supplies are being delivered, including hundreds of thousands of swabs, and we continue to work to secure more.

I would note that there is a global shortage of reagent, which is an important chemical used in testing. It’s something we are aggressively seeking out and ordering, and we continue to monitor the situation as we do with the availability of all global supplies. I would also note that Health Canada and the Public Health Agency of Canada are accelerating regulatory reviews of new tests and other products so that more products are available to support our response.

Here at home, we have awarded a contract to Spartan, an Ottawa-based company that will provide rapid test kits to test more than a million Canadians for the virus. This is on top of the millions of test kits already being used in provinces and territories.

These are just some of the things we’ve procured and a handful of the Canadian companies that are rising to the challenge. We are constantly adding to our orders and identifying new needs.

Other supporting initiatives

In addition to procurement, our department is supporting Canada’s fight against COVID-19 in other ways.

For example, through our Translation Bureau, we are supporting the communication of COVID-19-related information to Canadians. This includes sign languages, official language, and Indigenous language interpretation for government officials, ministers and the Prime Minister.

And I should mention that we manage one of the largest portfolios of real estate across the country. We are currently exploring how best to provide communities with secure accommodations, by working with local government to put our vacant properties to good use, if needed.

Closing

Of course, the most important role we play is in the urgent purchasing of vital supplies.

These are unprecedented times and the government is taking unprecedented measures to get equipment to the front lines.

While we are making significant progress, we are operating in a hyper-competitive market and we must continue to be vigilant.

We know that we may be dealing with spikes in COVID-19 infections in Canada for months to come, and we need to be prepared for all scenarios.

On behalf of our health officials, my department will continue to seek out and secure the supplies our health care professionals need to keep themselves and Canadians safe.

Thank you for your time, and I am happy to take your questions.

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News releases

Prime Minister (PM) news release details work with companies like Fluid energy, Stanfield, Arc’teryx, Canada Goose, Medicom and more—April 7, 2020

Canadian companies are answering the call to protect our health care professionals with made-in-Canada solutions. This is exactly the kind of innovative, collaborative thinking we need to respond to this rapidly evolving pandemic. By increasing our support for secure, Canadian sources of needed materials and equipment, we will be able to help our health care workers protect themselves, treat patients, and slow the spread of this virus.

Justin Trudeau, Prime Minister of Canada

Our first priority is getting equipment and supplies into the hands of our frontline healthcare workers. This crucial task is made more challenging by the highly competitive global environment in which we are operating. Canadian industry is stepping up in a big way to support these efforts and Canadians can be assured that we are working around the clock to ensure Canada has what it needs—made at home and abroad—as we fight COVID-19.

Anita Anand, Minister of Public Services and Procurement

Public Services and Procurement Canada (PSPC) ministerial news release to announce contract with Amazon—April 3, 2020

The government is taking an aggressive, proactive procurement approach to ensure our front-line healthcare workers have the equipment they need. To date, we have already made a number of bulk purchases to secure key items like masks and ventilators, which are in high global demand. This partnership with Amazon, with support from Canada Post and Purolator, will help to ensure that these life-saving products make it into the hands of healthcare workers across the country as quickly as possible.

Anita Anand, Minister of Public Services and Procurement

PM news release detailing contract with Thornhill Medical, Medicom, and Spartan—March 31, 2020

Canadian companies are answering the call to provide critical support to our health care workers, who are on the front lines of our country’s fight against COVID-19. As the situation continues to evolve, the Government of Canada will be there to work with Canadian industry to find solutions that will support our medical professionals and protect the health and safety of all Canadians.

Justin Trudeau, Prime Minister of Canada

We are taking an aggressive, proactive procurement approach to secure life-saving equipment and supplies. Industry has answered the call and we have successfully tapped into both existing and new supply sources. As a result, we have placed orders for millions of essential supplies in the fight against COVID-19.

Anita Anand, Minister of Public Services and Procurement

Quotes from news conferences

Transcript: Prime Minister Justin Trudeau—April 10, 2020. PM highlights contract with Fluid Energy for hand sanitizer

Right Honourable (Rt Hon.) Justin Trudeau: We've had thousands and thousands of Canadian companies step up and offer to be part of supply chains for essential services, for essential equipment and medications. We are working with all of them as quickly as possible. There have had to be choices as to who we could move quickest with, who was furthest along, but we will continue to work with all companies who put up their hands to be helpful, to figure out ways they can best help. […]

“We're helping companies join in the effort. Look no further than Fluid Energy from Alberta. They will produce over a million liters of hand sanitizer each month, with shipments starting as early as next week. We've invested in this large-scale production as part of our plan to have enough vital supplies produced right here at home.” […]

The procurement challenge is not necessarily a challenge in terms of purchasing power or costs. Costs are rising. The reality is that the different provinces and even different hospitals themselves have connections with producers around the world, and they are using those contacts, those connections, to try to get the equipment they need, in addition to all the efforts that the country and the provinces are making.

Transcript: Government of Canada officials—April 8, 2020. Deputy Prime Minister (DPM) discussed 3M masks coming in from US, integrated supply chain, bilateral relationship with US and how the Government of Canada is able to help provinces

Chrystia Freeland: […] There may be other purchases by provinces and hospitals, but I do want to assure you and tell you right now that -- and tell all provinces and hospitals that the federal government is here to help the provinces and help our hospitals in making these purchases outside the country. We are moving ahead. We have excellent ambassador in the US, in China, across the world and we're working in close collaboration with provinces and even certain hospitals to make these purchases. With respect to the United States, and the issue of purchasing medical supplies from the US, this is an issue we are currently discussing and resolving. All Canadians now know that we did have issues around the purchase of the 3M masks, but we are resolving many other specific issues as well. I would like to emphasize that we have had and are continuing to have a conversation on several other levels with respect to this issue with our American partners. We've explained that when it comes to medical services, like all of the relationships, various relationships we have with the United States is a reciprocal relationship. It is a relationship that is truly interdependent. We need the United States, but at the same time, they need us, too. And I must also have emphasize how important the premiers and the provinces' role is. This is an issue we're all working together on as team Canada. […]

With respect to 3M's masks, the first batch of masks arrived in Canada last night at 11:20 pm. Those masks are now here in Canada. We are now organizing the distribution of those masks across the country… These masks are so important and necessary for them... when it comes to medical supplies, we have a very complex relationship in that area, just like every other industry. It's not just an issue of finished products, it's about all of the required elements to produce a mask. […]

There might be orders done by provinces or hospitals that I'm not aware of, but we've been encouraging provinces and hospitals to get in touch with the federal government if they're having any concerns, any issues in the United States or anywhere in the world. […]

We are delighted that the first part of Canada's order from 3M has been resolved and those 500,000 masks are here in Canada. […]

Thus far, we have been met with real comprehension from our American partners, both in the administration and also at the business level, because American businesses really understand the extent to which the supply chains are interdependent.

Transcript: Prime Minister Justin Trudeau—April 7, 2020. PM explains global need for personal protection equipment (PPE), our own procurement items and companies the Government of Canada is contracting

Rt Hon. Justin Trudeau: We're working with Thornhill Medical, CAE, Ventilators for Canadians, and a group led by StarFish Medical to produce up to 30,000 'Made in Canada' ventilators. These purchases will help increase our capacity to make sure these life-saving machines are made right here at home. We're also working with Nobel Prize winning researcher Doctor Art McDonald, who is leading a team of scientists to develop ventilators that are easy to make. […]

And to produce medical gowns and establish new supply chains right here in Canada, we're teaming up with over 20 companies, including Arc'teryx, Canada Goose and Stanfields. One thing that is particularly inspiring to see is just how many companies are not just producing these goods, but innovating. For example, AutoLiv is looking to make medical gowns out of material they'd normally use to produce airbags. […] En même temps notre gouvernement continue d'acheter des masques pour protéger nos professionnels de la santé qui font un travail extraordinaire. On a commandé des millions de masques chirurgicaux auprès de plusieurs compagnies canadiennes, et on appui l'entreprise Medicom qui va augmenter sa capacité de production de masques N95. On achète également du désinfectant pour les mains, et Santé Canada a autorisé la vente de plus de 85 de ces produits aux canadiens.

While we're working to secure critical equipment from Canadian sources, we're also in touch with other suppliers around the world who want to sell to Canada. We're expecting 500,000 masks from 3M tomorrow and we're working as fast as we can to get them to our frontline workers. From the outset, our priority has been the health and safety of all Canadians. So, whether you're making medical gowns, delivering ventilators or treating a patient with COVID-19, we have your back.. […]

Over the past few weeks almost 5,000 Canadian companies have stepped forward to help fight COVID-19. To keep our frontline workers safe and care for Canadians with COVID-19, we need a stable supply of these products, and that means making them at home. With our plan to mobilize industry, we're helping companies retool, repurpose and innovate to fight COVID-19. We've already signed letters of intent with a number of partners to produce the things we need, and today we have more good news to share. […]

I think we're seeing right now that the entire world was unprepared to have as much PPE as needed. Some places are facing far greater shortages than Canada. We have worked extremely hard to step up both on our procurement of PPEs, but mostly on increasing the Canadian production of personal protective equipment and materials like ventilators and testing kits. […]

So, we have told these companies across the country who have put up their hands to go ahead and get building ventilators as quickly as possible and as many as possible in case we need them in Canada. We certainly hope that we won't be needing all those ventilators, but we also know that there are countries around the world where they are not able to tool up local production to create more ventilators. They're going to be reliant on a global supply that's already stretched thin, and if we end up making more ventilators than Canada needs because Canadians continued to stay social distancing, continued to follow best health advice, that will be great news, and we will have ventilators to share with other countries that are facing more difficult circumstances. For us, doing more right now and doing 'quicker' right now is really the only option. […]

Transcript: Government of Canada officials—April 7, 2020. Public Services and Procurement Canada Minister’s opening remarks and questions and answers along with DPM outlining procurement efforts, diplomacy and agreement with Amazon

Anita Anand: […] Public services and Procurement Canada is aggressively and proactively buying in bulk from all available suppliers and distributers. (Speaking French). As the Prime Minister mentioned, there was a delivery from China yesterday. We received approximately 8 million surgical masks and orders made directly by Nova Scotia and Quebec who were also on board. We are expecting more deliveries in the days and weeks to come. The reality is that we are operating in a highly competitive global environment and international logistics are challenging. We are working closely with our partners around the world including embassies, as well, with on-the-ground logistics to ensure that supplies can move from source to where they are needed in Canada right here, right now. With hundreds of millions of pieces of equipment ordered, this is a complex undertaking, even as those supplies arrive in Canada. As the Prime Minister announced late last week, we have entered into an agreement with Amazon Canada which will use its Canadian distribution network including key partners, Canada Post and Purolator to manage the distribution of personal, protective equipment and supplies purchased by the government. As part of our efforts to ensure these supplies are delivered absolutely as fast as possible when they are ready to ship, Amazon is providing these services to Canadians at cost without profit. (Speaking French). When it comes to collaboration between jurisdictions, I can confirm that last Friday I held my first call of the federal provincial territorial meeting. This is essential to securing as many supplies as possible in highly competitive markets and we are working collaboratively together and it is truly heartening to see. I would also like to note that we are working closely with all provinces and territories to offer space on our cargo flights in order to help them bring their shipments back to Canada. The orders from Nova Scotia and Quebec yesterday are examples of that collaborative shipping approach. As an update on equipment ordered, including this order delivered yesterday, we have sourced more than 230 million surgical masks to support the response, over 16 million have been delivered to date. We have also roughly 75 million N95 masks on order. We expect to have roughly 2.3 million masks in Canada's possession by the end of the week. Among other suppliers, we have also ordered over 113,000 liters of hand sanitizer, most of which is expected to be delivered this month. We have received 20,000-liters in the past 24 hours and are expecting another roughly 10,000 liters this week alone. On ventilators, as the Prime Minister mentioned, we have relationships with CAE, Ventilators for Canadians and StarFish Medical for thousands more of these life-saving machines. […]

In terms of your question relating to supplies and timelines, ordering, of course does not guarantee a delivery. Ordering means that we have placed an order and contract for products that we need to make sure find their way back to Canada. And in order to make sure that goods find their way back to Canada, we are taking very serious steps on the ground, in to make sure it meets the requirement that countries have before they leave the jurisdiction. For example, in China, we have engaged our embassy on the ground in efforts to ensure our orders are delivered on schedule and those parties are also identifying new opportunities for us. We are also engaging directly with manufacturers on the ground in China. We are also engaged with private firms who are assisting us with quality assurance, opportunities in country logistics, arranging transportation and, for example, assisting us in leasing a warehouse in Shanghai that can store goods once they are sourced and ready to export. Finally, we are arranging our own transportation from Canada. You've been told that 2 planes have already left China and landed here successfully. And we have another one coming this week. And you can see these supply chains are complex, but we are taking every effort to make sure that we get those goods back to Canada and in the hands of front-line healthcare workers. […]

It is difficult, but I will say we are working on short-term and long-term timelines. And we have 2.3 million N95 masks arriving in Canada by the end of this week. So we are seeing progress on that front. […]

So when a situation crops up with regards to supplies coming into Canada, whether it be from the United States or any other country diplomatically and ensuring the supplies make their way back into Canada and that's why I described that situation with China and Chrystia has done a great job. We are determined to make sure supplies get back to Canada once they are ordered and procured and that is our main task, we didn't and we won't stop until we get it done. […]

Let me start off by saying that talking about the supply chain and the stresses on the supply chain at the current time requires us to be sanguine about the numbers but also realistic. I can assure you that now, that the 3M shipment is coming across the border and will arrive tomorrow. I can also assure you we have a plane that will leave China this week with another shipment of N95 masks on it. Apart from that, I won't be able to and I'm sure people here will agree with me that we are in an era of volatility in global markets. And so every step of the way, we are making sure that the supply chain can function as it should. And where we see shortfall, we will be definitely relying on domestic supply chains to be ramped up and providing equipment to Canadians so that we have complimentary supply chains operating at the same time, both domestic and international. […]

I would say when we ordered masks, we had to ensure that the goods will actually arrive. So it's not just a question of ordering. It's a question of getting them in.

Chrystia Freeland: (Speaking French, voice of translator) Yes, of course, there are other American companies that are major suppliers for Canada. And we are continuing to work on a case-by-case basis to work with those suppliers and, obviously, with the American government. […]

3M has received clear assurances from the government of the United States that shipments to Canada will continue unimpeded. As the Prime Minister said, we are expecting a shipment very soon of 500,000 masks and more shipments from 3M to come. We have other pending shipments from other sources in the United States and we are working collaboratively with our American partners to be sure that those shipments also can make it to Canada. Just as our American partners are working collaboratively with Canada to make sure the medical supplies and services that the United States' services depends on from Canada can continue to flow to the United States. […]

We truly did find a good solution with 3M and I want to thank 3M and our American partners and neighbours and all of the team in Canada who worked on that. With regard to the future, we told our American partners that we have a mutual relationship that is very balanced when it comes to medical care and services. We are interdependent and the best results for Canada and for the United States is to continue to work together. […]

It is a reciprocal relationship and both countries do best when we work together and that's why we were able to achieve a win-win outcome. That will be the argument that we continue to make and advance in our relationship with the United States in these truly difficult and complicated times.

Transcript: PSPC Minister Anand COVID-19 interview — Power & Politics—April 7, 2020. Minister references procurement efforts, evaluation of products, and China

Anita Anand: […] We are facing a very tight international market at the current time, meaning that demand for PPE and the N95 in particular is very high, and in addition, the market is very volatile so once we order a good, it's always important for us to keep our eye on that good and make sure that it makes its way to Canada, so what do we do? We work very closely with teams on the ground in the country where we are doing the procurement to ensure that that product is going through the bureaucratic channels and then ultimately making its way via air transport or otherwise back to Canada. In China, for example, we are working closely with Ambassador Barton and his team to make sure that goods get to warehouse. We have a warehouse in Shanghai that we have made sure is available for goods there. We are also working with private companies in China to evaluate the goods, to assist us through the bureaucratic process, and ultimately, we're sending planes over to China to make sure those goods get back to Canada. Already this week, 2 planes have come back to Canada with goods and we're expecting another one this week. […]

The bulk of masks this week, yes, are coming from China and in addition, we have masks, as you know, coming from the United States via that 3M order, so 500,000 masks coming via the border with the United States which should arrive here in Canada this evening or tomorrow. […]

What's so important to remember is that this is procurement like we've never done it before. We are working 24/7, using all diplomatic channels to make sure that goods that we have ordered and procured make their way back to Canada. In the case of 3M, we worked very closely with the American government on launching a full court press to make sure that those goods came back to Canada and we are prepared to do that again with other corporations and other suppliers in the United States and outside of the North American continent if need be. […]

In China, for example, we have retained firms to ensure that we have quality control on the ground in China, then once the goods get back to Canada, the Public Health Agency of Canada has the responsibility to go through the goods, to make sure that they are up to speck before they are distributed out, so it's really a 2-tier process to make sure that we are able to meet speck and get those goods out to front-line health care workers in good form. […]

Let me start by saying that we are running, at the same time, complementary channels of supply. That is, we are seeking international procurements at the same time as domestic procurements and so, on ventilators, on masks, on gloves and gowns, we are working very hard with multiple suppliers, leveraging existing supply change and meeting up and contracting with new suppliers so that we can make sure we have luminous goods to distribute to the health care system. On the subject of the 3 companies that are going to be making ventilators for the Canadian market, we are very confident that in the short and the long term, we will be able to rely on these firms for ventilators. The timeline is evolving but Minister Bains, this morning, put a very short timeline on that being weeks and months, so we're very hopeful that these negotiations and contracts can continue to yield positive benefits so that we can run domestic and international supply change in tandem to make sure that we get the goods back home where they need to be. […]

What we have to remember is that there is an existing stock of ventilators in Canada at present and that number is at about 5,000. In addition to that 5,000 number, we also have international procurement contracts for the supply of ventilators and so this domestic re-tooling, building up domestic capacity, is in addition to what we already have, and so we have to remember that there are multiple supply chains operating at once and we are doing our level best to get things completed and out to front-line health care workers as soon as possible.

Transcript: Prime Minister Justin Trudeau—April 6, 2020. PM discusses relations with US to procure medical equipment

Rt Hon. Justin Trudeau: […] We continue to have constructive and productive conversations with officials in the American administration who understand that essential services and supplies are very much a 2-way street between Canada and the United States. We are interconnected and interlinked in so many ways, from primary resources flowing to American companies to make the equipment that is so desperately needed both in North America and around the world, to actual shipments of products that go from Canada to the United States and that go from the United States to Canada. We will continue to work together. We're going to make sure that goods and services that are essential continue to flow, and I expect those shipments to come in soon. […]

We have recognized over the past weeks a number of situations in which shipments coming from different countries around the world have been delayed; haven't arrived with as many products as we were hoping to see. This continues to be an ongoing problem, but specifically with the United States, we are working with them to ensure that the orders that Canada has placed get delivered. We expect those shipments to come. […]

We recognize that it is a reality around the world that some shipments have less equipment than we would have liked, or have been delayed because of actions by different countries around the world. But we will continue to work to ensure that Canada receives everything it needs.

Transcript: Government of Canada officials—April 6, 2020. DPM discusses working with US to procure medical equipment

Chrystia Freeland: [Speaking French, voice of interpreter] We are very committed to working with all the provinces. We are working hard with the US administration to ensure that all the masks that we've purchased will be exported to Canada. And we did have positive conversations, and we continue to work to solve this situation, which is so vital to our country, with respect to the situation with health services in general. All provinces are working very hard, as is the federal government, of course the situation in Ontario is one that we know very well. There's very good communication with the provinces, with Ontario, with the premier. And we are going to continue to work very hard to ensure that people who are doing essential work to protect us at our hospitals do have the necessary equipment that they need. So we are very aware of the situation that Ontario experienced with some masks it had purchased in the United States and having some trouble getting them across the border. I spoke about that with Premier Ford just a few minutes before this press conference. And immediately called Ambassador Hillman who is now very seized of the issue also. More broadly, we have been working throughout the weekend very, very hard with our American neighbors to ensure that medical supplies can continue to flow across the Canada/US border. And let me emphasize, as we emphasized in our conversations with our American neighbors, that that flow is a 2-way street. The relationship when it comes to medical supplies, when it comes to healthcare between Canada and the United States is, like all aspects of our economic relationship, very balanced, very reciprocal. […]

It's in the interest of both countries to continue supporting each other when it comes to healthcare. Let me just add. I also spoke to the global chief executive officer (CEO) of 3M, Mike Rowman, who has been doing a great job. The company is taking a very, very responsible position. They understand the very special place they are in right now. And I would really like to commend the company for its approach and for its very constructive relationship with Canada. […]

As Patty pointed out at one of these press conferences last week, it is really a wild west when it comes to buying medical supplies right now. This is a global pandemic. And every country in the world is doing its best in a truly fierce competition to get medical equipment. […]

And it is also why I am so grateful to all of the Canadian manufacturers right across the country who are stepping up to figure out ways that we can make the medical equipment the testing equipment that we need here in Canada. So it's a two-pronged approach. We are working hard. But it is absolutely very, very tough right now. […]

[Speaking French, voice of interpreter]: It's not up to a company to ignore their country's laws. It's up to a country to solve its issues in this respect. As for 3M, we had a constructive conversation. 3M's approach, while I appreciate it greatly, they have been very responsible, and we discussed what 3M needed from the US administration to continue to export its masks to Canada. We also had discussions with 3M about a central point, and that is there are mutual dependency. We have our 2 countries depend on each other.

Transcript: Prime Minister Justin Trudeau>—April 5, 2020. PM discusses working with the US to procure medical equipment

Rt Hon. Justin Trudeau: We continue to know that we have to get the necessary equipment and PPE to our frontline health workers. There is a global shortage right now, where people are trying to get as much as they can, and we are continuing to work with all our traditional suppliers and new suppliers to make sure that we're providing the equipment needed for Canadians. That's why we've ramped up domestic production as well and look to have the ability to fill all of our needs domestically within the coming weeks. At the same time, the conversations continue with the American administration in terms of solving this issue because, as I've said, both sides of the border benefit tremendously from the flow back and forth of essential supplies, and of medical goods and services, and that is the point that we're making to the administration. I am confident that we're going to be able to solve this, and I look forward to speaking with the president in the coming days. […]

There was a... many of the shipments are a blend of surgical masks and N95 masks, I'm not entirely sure which particular proportion was in that shipment, but we can get the... more answers to you soon.

Transcript: Prime Minister Justin Trudeau—April 4, 2020. PM Trudeau talks about masks shipment from China, and how the Canadian industry is shifting its production to develop PPE to cover our needs

Rt Hon. Justin Trudeau: At the same time, we're working around the clock to get Canada the resources we need. In the next 48 hours we will be receiving a shipment of millions of masks by a chartered cargo flight. We're also working with provinces to transport their medical supplies when possible. Items ordered by Quebec will be on this flight. Our government has also leased a warehouse in China to help collect and distribute these items as quickly as possible, and going forward, the flights we're chartering to get the materials here include Canadian companies Cargojet and Air Canada. […]

No, these are masks that will come from China. We're working to make sure that China's supply chains continue to function, and these masks are from that order. […]

Yes, all the different essential materials and goods and services that move across the border in both directions have been highlighted at many levels. We do not want to start restricting our exports or the services we send to the United States. We understand that our two countries are in much better situations if we continue to rely on each other, and I am confident that we will be able to find a solution to this situation. […]

As we've said, we have been working day and night to source medical supplies for Canadian frontline workers. We have shipments coming in in the next 24 hours, we've received shipments over the past days; we continue to work with suppliers around the world to ensure that we do get the medical equipment that we need, and we have more coming in regularly. […]

We are also, of course, turning towards Canadian manufacturers as the tremendous effort that Canadian companies are putting in to develop 'Made in Canada' products—PPE equipment and medical supplies that is going to actually not just supply Canada, but be there to supply other countries who need them as we meet our own needs. […]

We know that there is a global competition for these products. Every country in the world needs more of them. That's why Canada is shifting over so much of its industrial production to develop these masks, these solutions, these equipment, so that we can cover our own needs over the medium and long term and be there to help other countries as... at a point where we have enough for ourselves as we manage the spread of COVID-19. At the same time, in the short term we're continuing to procure the necessary equipment that our women and men on the frontlines need right now.

Transcript: Prime Minister Justin Trudeau—April 3 2020. PM announces the agreement with Amazon Canada

Rt Hon. Justin Trudeau: Before we get into things, I have 2 pieces of news to share with everyone. The first one is about the distribution of critical equipment to provinces and territories. For the past few weeks our government has been working closely with industry to produce the supplies our healthcare workers need, like masks, face shields, gowns, ventilators and test kits. Well, today I can announce that our government has signed an agreement with Amazon Canada to manage the distribution of this equipment to the provinces and territories. […]

Transcript: Prime Minister Justin Trudeau—April 2 2020. PM announces shipment of masks to Hamilton, Ontario, and the plan to mobilize the industry

Rt Hon. Justin Trudeau: […] Last night, we received a shipment of over a million masks to a Hamilton warehouse. I know the people there have been working overnight to validate these supplies. This is in addition to the 10 million masks that have come in over the last days and are being distributed to the provinces and territories as quickly as possible. […]

And this team Canada effort goes beyond government. About 2 weeks ago, we launched Canada's plan to mobilize industry to fight COVID-19. Since then, we've spoken to almost 3,000 companies, helping us secure millions of pieces of vital equipment. And I want to share a quintessentially Canadian example of this collaboration: our government has ordered hundreds of thousands of face shields from Bauer, the people who make hockey gear. They're creating shields to protect nurses and doctors against COVID-19. This is exactly the kind of innovative, collaborative thinking we need right now. And I know we're going to see more of it in the coming days. […]

I have seen, and am greatly concerned about, this report, which suggests that the equipment might have been diverted. We are very concerned about that, and we will follow up. I understand the concern of Premier Legault and others. We will follow up with Minister Garneau and Minister Blair, the ministers responsible, to find out what happened, and especially to ensure that the equipment intended for Canada arrives in Canada.

Our goal is to ensure that, once we have moved past this period where there is no production in Canada of this essential equipment, or not enough production, we reach a point where Canadian production is enough for the entire country, and would even be enough, once we have enough for us, to share with other countries in the world that need it.

Transcript: Ministers and Government of Canada officials—April 1 2020. DPM explains that Canada has discussions with the US on a regular basis about trade issues and the health situation in both countries

[…] Question: Yes. Hello. I would like to come back to the age of masks in Quebec. Mr. Trudeau said right now, in a very short time masks would be delivered to Quebec from Ottawa’s stockpile. But a few minutes ago, Minister Hajdu gave a more nuanced answer. Will Quebec receive masks from Ottawa in the next few days?

Chrystia Freeland: I can confirm yes. […] We discussed the relationship between the United States and Canada daily. We discussed trade issues between Canada and the US every day. And we discuss the health situation in Canada and in the United States on a daily basis.

Transcript: Prime Minister Justin Trudeau—April 1 2020. PM talks about working with provinces and the Defence Production Act

Rt Hon. Justin Trudeau: […] In this situation, we can’t guarantee anything. We’re working extremely hard to meet the various needs, to ensure that the necessary equipment that is coming from overseas is properly distributed across the country, that we will be able to develop solutions here in Canada to replace the equipment that we are using every day to save lives, to keep our health care workers healthy. We will continue to work with the provinces, with the different jurisdictions, to meet these needs, but a lot depends on the choices that citizens are going to make, on how people behave today and in the weeks to come, on the choices that they make, to be able to keep this pandemic under control and to be able to continue to protect the people who are working to protect us. […]

Yes, absolutely. The federal stockpile is there to help Canadians where they need help. I’ve spoken directly with Premier Legault, who informed me of the challenges they are facing in Quebec, and we will work very hard to meet these needs. We are waiting for equipment to arrive soon, and more will continue to arrive; we are looking at the various resources that there are across the country. […]

The Defense Production Act that we've seen in the United States is about forcing and ordering companies who might not otherwise do it, to step up and produce the necessary equipment for a wartime or crisis situation. Here in Canada, what we've seen is companies across this country putting up their hands and asking to do it; offering any help they can right across the country to switch their manufacturing over to necessary goods, necessary equipment. We, so far, have seen such an overwhelming response from businesses that we have no need of bringing in at this point a similar act, but of course we'll always keep an eye on what we need to do in future situations, or how we can adjust. And the federal stockpile has been ensuring over the past weeks that there is enough equipment across the country to respond to the needs that the provinces have asked us for. […]

For example, our embassy in China is working extremely diligently to follow up, to receive the material that we have ordered. This is a problem in that so many countries around the world are trying to obtain the same equipment, but we are working and doing everything we can to ensure that there are no shortages anywhere in the country; however, there is still a lot of work to be done. […]

I can tell you that we are expecting to receive deliveries very, very soon, in the next few days if not before.

Transcript: Prime Minister Justin Trudeau—March 31 2020. PM announces agreements with Canadian companies to make medical supplies

Rt Hon. Justin Trudeau: From coast to coast to coast, businesses are retooling to produce face shields, ventilators, hand sanitizers and other supplies our healthcare professionals need. To make it easier for companies to help out during this critical time, we launched Canada's plan to mobilize industry to fight COVID-19 a little over a week ago. In the time since, we've spoken directly to almost 3,000 companies who have reached out to offer their help. […]

When we announced our plan to mobilize industry, we said that we were close to reaching agreements with Thornhill Medical, Medicom and Spartan Bioscience. Today we're announcing that we have moved forward with contracts with these 3 Canadian companies to make medical supplies such as ventilators, surgical masks, and test kits. […]

We've also signed letters of intent with 5 other companies: Precision Biomonitoring, Fluid Energy Group, Irving Oil, Calko Group and Stanfield's. We know that the demand for critical equipment and supplies will grow in the coming weeks, so we need a sustainable, stable supply of these products; and that means making them at home. And we're optimistic that they will be available in the coming weeks.

So today I'm also announcing that our existing Next Generation Manufacturing Supercluster will be leading companies in developing and scaling up new technologies to test and treat Canadians. Demand for these goods is going up, so we're making sure Canada is ready to keep up. That's why our government is also allocating $2 billion to purchase protective personal equipment, including for bulk purchases with provinces and territories. This includes things like more masks and face shields, gowns, ventilators, test kits and swabs, and hand sanitizer. […]

And on the second question, yes, on procurement. The entire world is trying to get its hands on the various equipment needed to fight this virus. That is why we know that it will be important to be able to have 'Made in Canada' solutions, and I am incredibly, incredibly proud of Canadian companies, Canadian suppliers and manufacturers who are stepping up and saying, we want to help, we will help make ventilators, we will help make masks and gowns, and all the things that we are going to need in the coming weeks. […]

We are trying to speed up all these processes, but we recognize that it will take some time; it will likely be several weeks before the equipment arrives from our Canadian manufacturers. This is why we are continuing to accept and receive shipments of equipment from all around the world. […]

I think that there are many things that we have to be mindful of in this situation. We are working with our embassies abroad to ensure the supply of other equipment. We expect to receive some in the coming days too. We will continue to be there to accept deliveries to Canada. But at the same time, this is why it is so important to create an industry that will create these measures, this equipment, here at home, that we have supply chains entirely within Canada; and this is exactly what we are doing. […]

We are facing... looking at a global demand for these supplies that is unprecedented. Countries around the world are trying to get more of these supplies. We are expecting to see some shipments coming in very shortly that will help in Canada; we're continuing to work on more shipments in the coming weeks, and we are also working on tooling up our own production so that we can have 'Made in Canada' solutions for the coming weeks and perhaps months if that's how long this lasts. […]

We are offering all the help that we possibly can to all provinces, particularly Ontario and Quebec that are facing difficult situations in terms of supplies. I can tell you that we are going to be receiving shipment very soon of necessary equipment, and there are more to come in the coming days and weeks as well.

Transcript: Ministers and Government of Canada officials—March 31, 2020. Minister Anand announces contract agreements with Medicom, Spartan and Thornhill Medical

Anita Anand: […] As part of these efforts, Public Services and Procurement Canada is aggressively buying in bulk from all available suppliers and distributors. To date, we have ordered millions of swabs, gloves, masks, and other vital equipment. I'll take a moment now to highlight additional progress that we are making. [Speaking French, voice of interpreter] We have signed a contract with Medicom to provide an important supply of surgical masks. [End of translation] Including this order, we have now managed to secure more than 157 million surgical masks to support the response. To date, we have also ordered more than 60 million N95 masks, a key piece of protection for healthcare workers. Delivery of these will begin this week. [Speaking French, voice of interpreter] We are also working with Spartan, the Ottawa-based company that will provide kits. [End of translation] This will allow us to test many more Canadians over and above the millions of tests we have already ordered. On ventilators, we have a significant order through Thornhill Medical in Toronto, part of the 1,570 ventilators that we have ordered from companies in Canada, Europe, the United States, and overseas. We are working to secure upwards of 4,000 additional ventilators and very possibly more. Canadians have always risen to the occasion in times of challenge. The companies with whom we are working from every region in Canada and abroad are clear examples of this important point. I also want to thank Suncor and Home Depot for stepping up with generous donations of personal protective equipment. [Speaking French, voice of interpreter] We know that this type of equipment is very important in order to fight against COVID-19. We will be investing $2 billion additionally in terms of purchasing PPE. As well as bulk purchasing in coordination with the provinces and territories. [End of translation] We know how important these supplies are to the fight against COVID-19. […]

[Speaking French, voice of interpreter] I have reached out to my provincial and territorial counterparts to assure we have strong and established lines of communication with regard to procurement in addition to the work being done by ministers of health. [End of translation] Extraordinary measures are required in these extraordinary times.

Transcript: Prime Minister Justin Trudeau—March 26 2020. PM indicates that Canada will also take care of other countries as this is a global issue

Rt Hon. Justin Trudeau: […] This is a global pandemic, and it requires global responses. Canada understands that helping others is a way to help ourselves. But I can reassure Canadians that first, we have always been able to meet the provinces’ equipment needs that they have communicated to us, and in the coming days we will receive millions of additional medical equipment and supply items to meet all needs. We are also seeing that Canadian companies are manufacturing equipment and coming up with solutions. We will have the necessary equipment to keep Canadians safe, while doing our part internationally, because it is a global crisis.

Transcript: Prime Minister Justin Trudeau—March 23 2020. PM talks about the callout to industry on Buyandsell

Rt Hon. Justin Trudeau: […] Minister Bains has also sent a call to action to every university, college, polytechnic and college of general and vocational education (CEGEP) in the country. Their labs have the resources and expertise to be part of this fight. We’ve asked them to identify equipment they've got, like masks and ventilators. At the same time, we’re looking at innovative solutions they can be part of, including 3D printing of medical supplies. Many institutions have already stepped up, and many more will do the same. If you need more information, please go to buyandsell.gc.ca. We need all hands on deck.

Transcript: Ministers and Government of Canada officials—March 20, 2020. Minister Anand talks about the success of the callout on Buysandsell

Anita Anand: We have actively promoted this to industry associations and circulated it to all parliamentarians and together we have had over 5,800 submissions from companies offering goods or services to combat COVID-19. […]

Our goal is to be over prepared. We are planning for the future by considering both current and anticipated needs as much as possible. For example we have been able to secure 11.3 million N95 masks which is over and above the order we received for 7.3 million with deliveries beginning immediately. […]

Through the success of the callout and our existing relationships with suppliers we have been able to purchase a broad range of personal protective equipment and supplies including gloves, masks, gowns, hand sanitizers, wipes, ventilators and thermometers among many others. Certain supplies have already been delivered while others will follow.

In many cases we are securing any available supply including smaller quantity purchases to ensure we have what we need. Nous avons fait des progrès importants mais nous savons que la demande mondiale pour ces produits continuera d’augmenter. Des questions comme les restrictions aux frontières autour du monde peuvent affecter les chaines d’approvisionnement. […]

Exactly Nav, the most important point there is these are complementary strategies. We are working together to ensure we are leveraging our relationships with existing suppliers. We’re also working additional supply chains and developing new supply chains because we know that this is an era of global demand and we want to be ready.

Transcript: Prime Minister Justin Trudeau—March 19, 2020. PM talks about solutions we will need to consider to do what is necessary

Rt Hon. Justin Trudeau: […] Yes, we are considering using any measures necessary to ensure that Canadians and our healthcare systems have the supports they need. We’ve already been engaged with industry on production and ramping up capacity to build and create more equipment. We will, of course, look at military procurement as a solution as well. There’s a range of things that we can do and we will do what’s necessary.

Transcript: Ministers and Government of Canada officials—March 19, 2020. DPM talks procurement efforts and indicates that Minister Anand will speak about procurement at Cabinet Committee

Chrystia Freeland: […] So let me—did you want to answer—let me just say when it comes to procurement, Minister Anita Anand will be speaking about that at our Cabinet Committee on Coronavirus this afternoon. As you've heard from Minister Hajdu, from Patty and from Dr. Tam, and indeed from Minister Miller and from Dr. Wong, this is an area that we are very urgently focused on and we are looking at every single option, every single possibility, whether it is, as Patty mentioned yesterday, the possibility of making some of this stuff at home, whether it is, you know, various really extraordinary procurement efforts around the world that we are engaged in and also in being sure that we know what everyone has so we are able to manage surges across the country.

Key themes from health economics and statistical analysis section

In this section

This document summarizes witness testimony and outlines key points raised by members by theme at recent Health Economics and Statistical Analysis Section (HESA) meetings on March 31, April 7 and April 9. Main themes include personal protective equipment (PPE), national emergency stockpile, testing and vaccines, drug shortages and refills, border security, emergency legislation and mental health concerns.

Witness testimony overview of March 31, 2020 meeting

Witnesses

Public Health Agency of Canada (PHAC): Tina Namiesniowski, President, and Cindy Evans, Acting/Vice-President, Health Security and Infrastructure Branch

Department of Foreign Affairs, Trade and Development: Heather Jeffrey, Assistant Deputy Minister, Consular, Security and Emergency Management

Canada Border Services Agency: John Ossowski, President, Canada Border Services Agency and Denis Vinette, Vice-President, Travellers Branch, Canada Border Services Agency

Department of Health: Stephen Lucas, Deputy Minister

Follow-ups from March 31

Witness testimony overview of April 7, 2020 meeting

Witnesses

Canadian Association of Emergency Physicians: Dr. Alan Drummond, Co-Chair, Public Affairs Committee and Dr. Howard Ovens, Member, Public Affairs Committee

Canadian Federation of Nurses Unions: Linda Silas, President

Canadian Medical Association: Dr. Sandy Buchman, President

Canadian Pharmacists Association: Barry Power, Senior Director, Digital Content and Shelita Dattani, Director, Practice Development and Knowledge Translation

Witness testimony overview of April 9, 2020 meeting

Witnesses

As an individual: David Dingwall, President and Vice-Chancellor, Cape Breton University

Canadian Public Health Association: Ian Culbert, Executive Director

Fédération interprofessionnelle de la santé du Québec (FIQ): Linda Lapointe, Vice-President

William Osler Health System: Dr. Naveed Mohammad, Executive Vice-President, Quality, Medical and Academic Affairs

Question and answer period by theme: March 31, April 7 and April 9 meetings

Personal protective equipment

The Bloc Québécois (Bloc Q) asked about fast-tracking of projects for development of personal protective equipment (PPE) from entrepreneurs.

Mr. Luc Thériault (Bloc Q): I don't want to know if we're communicating with multiple suppliers. I'm talking about the war effort of every one of our entrepreneurs in the field. How can these people get answers quickly so they can contribute?

Ms. Tina Namiesniowski (PHAC): In addition, we have many efforts under way in the federal government to work with local suppliers to do exactly what the member who asked the question was requesting. There are various efforts under way at the industry, science and economic development department, for example, as well as at Public Works and Government Services, where anyone who believes that they can contribute is asked to contact those 2 organizations.

Bloc Q asked about how many companies have converted to produce PPE.

M. Luc Thériault (BQ): How many have been converted as we speak?

Dr. Stephen Lucas (DM, Health Canada): Today and in recent days the Prime Minister has announced a number of companies that are producing equipment. Thornhill Medical, Medicom and Spartan are 3 examples. Others are being looked at to ramp up production, from ventilators to masks. We're certainly happy to provide further information as it becomes available. All opportunities are being looked at aggressively. In particular, where they're ready to go to production, we will secure production orders and procure those products.

Bloc Q asked the Fédération interprofessionnelle de la santé du Québec at what point they realized that there was a lack of adequate protection (PPE) and if that could explain some of the community spread in some of the facilities today.

M. Luc Thériault (BQ):

First of all, allow me to point out how clear your presentation was. You have almost answered all of my quests. I still have some, but you have given me an update, and I am very happy with that. Allow me also to commend all members of the FIQ and to recognize their courage and goodwill in these difficult times. The virulence of this pandemic is quite incredible. On March 13, when Quebec issued the emergency protection order, that decision was made when there were 17 cases of infection and no deaths. About 25 days later, last night at 8:38 p.m., there were 10,031 cases and 175 deaths in Quebec. No one saw a virus of such virulence coming. However, you point out that all the relevant SARS recommendations were more or less acted upon. At what point, Ms. Lapointe, did you realize there was a problem with the stockpile of personal protective equipment? You said that people have to be able to do their jobs with equipment, but are you aware of anyone in your organization having to work without adequate protection? Could this explain some of the community spread that we’re seeing today in some CHSLDs?

Linda Lapointe (Vice president, Fédération interprofessionnelle de la santé du Québec): Thank you for the question. Yes, the lact of supplies was noticed quite quickly. That is what made us a little angry. In all of his press briefings for two weeks, Mr. Legault was reassuring. He said that there was enough personal protective equipment. However, in the front lines—we represent 76,000 healthcare professionals across the province—that wasn't at all what we were seeing. Also, we had been told that very restrictive management was in place. We thought there might be enough equipment, but that management was tight in anticipation of a possible shortage. In fact, patients and visitors were stealing masks. We were not sure. Over time, Mr. Legault had come to recognize that only three to seven days' worth of equipment remained. We had pointed that out. We had been warning the department for two or three weeks. I would send them the names of suppliers who were contacting us at the Fédération. Since we are a union, it's not up to us to provide the equipment, it's up to the employers. It reached the point that, this week, we had 100,000 masks delivered to the government, and we're expecting another 500,000 next week. We bought them to thumb our noses at the Legault government, even though it has done some good things and implemented some good measures. How is it that a union could procure over half a million masks in seven to ten days when we had no supply statistics? If the government knew exactly how much personal protective equipment it had in its possession for three weeks, why weren't those orders made before? Your second question was whether healthcare professionals had worked without personal protective equipment. The answer is yes, absolutely. We're not surprised that there have been outbreaks of this magnitude in CSHLDs. Our members were crying out to us about this need. The FIQ website includes a page called “Je dénonce”, where reports on working conditions can be found. Home care and CHSLDs are the two settings where the needs are most pressing and where people did not have equipment. Home care workers would go out to see 12 patients with only one mask. In CHSLDs, there were no masks at all, unless the patient had tested positive for COVID-19. But there may be a period before diagnosis when it is possible to spread the virus. So yes, it has been a problem.

The New Democratic Party (NDP) asked about need to determine provincial and territorial needs, bulk purchasing of supplies.

Mr. Don Davies (NDP): I'm going to ask my first question to Mr. Lucas of Health Canada. On March 9, Deputy Prime Minister Freeland wrote to the provincial and territorial premiers, asking them to inform the federal government of any critical gaps in supplies or in their capacity to deal with the COVID-19 pandemic, things like ventilators, N95 masks, testing equipment, face shields, etc. I'd like to know what the major gaps identified to the federal government were. Can you give us an approximation of the size of those gaps, please?

Dr. Stephen Lucas (Deputy Minister, Health Canada): We have had an ongoing process supported by the Public Health Agency of Canada to understand the needs of provinces and territories and to contribute to the bulk purchases the Government of Canada is making on their behalf.

The NDP asked the Canadian Medical Association whether the federal government had communicated the status of the arrival of new PPE equipment so hospitals can avoid rationing.

Don Davies (NDP): Dr. Buchman, you're quoted as saying, “We want to know the availability of what's coming down the pipeline and when it will arrive. If we know we're going to receive an adequate supply of (PPE) equipment in a certain period of time, it allows us to plan and decide how much we have to ration. It buys us some time, and as we're trying to flatten the curve—which is the goal here—so that we don't reach the surge that will overcome the health care system's capacity to handle it.” Has the federal government responded to your request as of yet?

Dr. Sandy Buchman (Canadian Medical Association): No, I haven't heard any response as of yet, but we do know that what we requested is being considered very highly. Just to reiterate your point, what has not been clear to physicians and other front-line health care providers is what PPE is coming down. How can we plan appropriately? As a result, the experience of anxiety is considerable. It also has other implications, like everything we're seeing about the resterilization of personal protective equipment like N95s. In an ordinary time we wouldn't even consider this kind of alternative because we just don't know. We really are requesting the full information and full transparency of that information. To this point in time it really hasn't arrived, but I'm confident that the government is aware of our concern and our ask.

The Conservative Party of Canada (CPC) asked about the large amount of PPE sent to China and asked if any was sent to other countries.

Mr. Matt Jeneroux (CPC): On top of all this, on February 4, the government sent 16 tonnes of medical supplies to China. This was after medical supplies were selling out here in Canada and after the health officials told Canadians that there would inevitably be more cases in Canada, so there are reasons why Canadians are worried.

Response inaudible

CPC asked about lack of masks for flight attendants and Canadian Blood Services workers. Focussed on surge capacity, shortages of PPE and safety protocols in hospitals.

Mr. Len Webber (CPC): I'm shocked that the Canadian Blood Services (CBS) does not mandate the use of masks in their blood collection facilities, and I'm wondering why. Is it because we are in such a short supply here currently? Should they not be wearing masks at the CBS? Also, I've been contacted by flight attendants who live in my riding… Why are they not wearing masks? Is it again because we're in short supply? Should they not be wearing masks?

Dr. Stephen Lucas (DM, Health Canada): Thank you for the question, Mr. Chair. We have been working with the Canadian Blood Services and the council of federal-provincial-territorial deputy ministers to ensure that they are aware of and follow the guidelines in terms of the use of personal protective equipment. I have indicated that they are working in terms of means of ensuring physical distancing, and we will continue to work with them to ensure that they are supported on this essential service for Canadians, to ensure that our blood supply continues, and that the workers involved have the necessary protections as per the guidelines. In terms of other areas, the Public Health Agency of Canada, working with provinces and territories through the Pan-Canadian Public Health Network, has developed and publicly posted guidelines for the use of personal protective equipment for essential services. There is work under way to ensure that people are aware of those, as well as guidelines for the use in health care settings. I'd be happy to provide those to the committee if you wish.

The Liberal Party of Canada (LPC) asked about status of bulk purchasing of masks and ventilators. Securing supplies for front line workers.

Mr. Marcus Powlowski (LPC): Mr. Lucas, in a response to an earlier question, you said that provinces sought help from the federal government with respect to bulk purchases of N95 masks and ventilators. Where are we with that now? I know Ms. Namiesniowski in her earlier remarks said something about the number of ventilators, but the line was very poor and full of static, and I didn't really catch that. Could you give us some specifics on what we're doing with N95 masks and the ventilators? Are the purchase orders in, and if so, what kind of ventilators, how many ventilators and how many N95 masks are we talking about?

Ms. Tina Namiesniowski (PHAC): Certainly, as I referenced in my opening remarks, there has been incredible effort from early on to work with provinces and territories to come together and, on Canada's behalf, to work the international marketplace to secure needed product for front-line health care workers. As everybody has underscored throughout today's conversation, it's critically important that we're able to equip those individuals who are working on the front line, who are so essential to our ability to be successful in the context of COVID-19. Certainly from the point of view of which items are being prioritized for purchase, very early on—even in advance of potentially getting requests from provinces and territories—the federal government focused its efforts on key items that we knew would be necessary, including the N95 masks and ventilators, among other things. Those orders are in and have been in for some time. Our colleagues at Public Services and Procurement Canada (PSPC), are working incredibly hard around the clock on behalf of everybody to secure supplies in a global marketplace that has many actors who are also looking to do the same thing. In addition to the international marketplace, as we've highlighted during this conversation, there are efforts under way also to make sure that we are taking full advantage of domestic capacity and looking to see how, domestically, we can also produce products locally, taking advantage of the exceptional entrepreneurial spirit we have in Canada and using companies, their knowledge and their know-how to also produce product in Canada. That includes ventilators, for example. There has been a lot of effort expended to ensure that we are able to secure the supply that's necessary.

The LPC asked the Canadian Medical Association about which jurisdictions are of the greatest concern.

Darren Fisher (LPC): Is there a particular jurisdiction or jurisdictions that you're more concerned about than others?

Dr. Sandy Buchman (Canadian Medical Association): Yes, we're concerned about the jurisdictions where the magnitude and the rate of rise exponentially of the number of COVID-19 cases is happening, particularly in Ontario and Quebec. I think, with the lens of looking at the amount of PPE as we try to import more PPE, as we try to manufacture our own domestic supply, we think it is clearly important to have coordination at the federal level, so between the federal government and the provincial governments as well as through the different regional health authorities in order to be able to deploy the equipment to the areas of the country that need it the most. Right now we're seeing the greatest rapid rates of rise in Ontario and Quebec and I think it's really important to see the appropriate distribution in those places. If the curve is a little flatter in other jurisdictions they may have a little more time and they may not exceed their capacity to handle the number of patients who are presenting, so as more PPE is manufactured or is imported, equipment can be then distributed appropriately to those regions as well.

The LPC asked for the Canadian Medical Association’s opinion on the mobilization of Canadian businesses to help with PPE production.

Darren Fisher (LPC): What are your thoughts on the Primer Minister's update today on Canada's plan to mobilize Canadian industry to fight COVID-19 to help provide that vital made-in-Canada protective gear and medical equipment?

Dr. Sandy Buchman (Canadian Medical Association): Well we're encouraged. We've been encouraged all along by the efforts that the federal government has taken to procure the equipment, to work with businesses, to repurpose manufacturing facilities to produce PPE. If we start seeing physicians, nurses and other front-line care workers get sick or become emotionally or mentally exhausted and drop out, it leaves increasing burden on the remaining health care workers on the front lines, so we can't state this with more urgency, that the development and the manufacture of this PPE has to occur now

The LPC referenced lessons learned from previous outbreaks and what will be learned from the COVID-19 as it relates to PPE.

Darren Fisher (LPC): We know we've talked about what we've learned from SARS, we've talked about what we've learned from H1N1. Are we going to be able to suggest that we had some lessons learned from this as well?

Dr. Sandy Buchman (Canadian Medical Association): I think there will be lessons learned and I think the first and foremost one is that we were caught flat-footed, that we didn't have adequate supplies of personal protective equipment available for health care workers, and that we have drug shortages, as has been mentioned. I think, in particular, that we don't have enough ventilators and other necessary equipment and beds. They were cut short in our health human resource planning. As mentioned, we don't have adequate number of emergency physicians or others and other health care workers who are available, particularly if they get sick or burnt out or, might I add, refuse to go into work, which is their right if they are put in harm's way without their personal protective equipment. I think there are a lot of lessons that we didn't learn from SARS or H1N1 in appropriate planning. But I also think this was a global problem. I don't think there is a health care system in the world that's been adequately prepared for the magnitude and the rapidity with which this pandemic has fallen upon us, so yes, I think we've already learned some of those lessons for the next time around and I hope for dealing with the second and even a third wave of COVID-19 that is likely to come.

National emergency stockpile

The CPC asked the CMA if the national emergency stockpiles (PPE and drugs) were sufficient.

Tamara Jansen (CPC): I was just wondering, one of the recommendations in the document was that we needed a better emergency preparedness response system, which would include a national emergency stockpile system. In your survey of the 5,000 physicians, it showed that your information regarding that stockpile was pretty scarce. Would you say that this national emergency stockpile system is inadequate?

Dr. Sandy Buchman (Canadian Medical Association): As we've heard, there are significant shortages. I'll give you an example. I'm a palliative care physician, and we're trying to ramp up our response in palliative care because no patients should be abandoned if they are not suitable for a ventilator or they're not going to survive on a ventilator. We know there's a procedure called “palliative sedation” which would allow a patient to be sedated and pass away comfortably and peacefully. But we know that some of the medications, in particular one called “Midazolam” now is in short supply, as are some other ones, including another one, for example, called “Methotrimeprazine”. As a result, it's just an example—a very small small but important clinic example—that we have these drug shortages on an ongoing basis, as has been previously referred to, and that we see them—but to my knowledge we don't have adequate stockpiles or emergency medicines.

The CPC asked if the national stockpile could have been in better shape and referenced the shipping of 16 tons of PPE to China.

Mr. Matt Jeneroux (CPC): We saw that the minister was advised in a February 10 memo to only work with the provinces and advise the provinces on stockpile information if asked. February 10 was past the date on which I believe it was that 16 tonnes of PPE material were shipped to China. Could you comment on perhaps where there could maybe have been better planning, or maybe the optics of that doesn't look so good when you're speaking of having the stockpile in better readiness for when it eventually did hit in Canada?

Mr. Ian Culbert (Canadian Public Health Association): First, I don't think the national emergency stockpile was ever imagined to be able to supply all of Canada in this kind of an outbreak, keeping in mind that SARS was limited to Ontario and B.C. predominantly. H1N1 was a different kind of outbreak, so the types of supplies required were different. First and foremost, we have to rethink what the national emergency stockpile should look like in the future because of the evolution of a pandemic. At that point the shipment was made, I believe it was ascertained that the risk to Canadians was still very low and that this was a way of moving the front line of the pandemic outside of Canada. If we were able to stop transmission in China, we might be able to reduce the numbers here. That's what public health policy tries to do, we keep that containment circle as large as possible. In hindsight, was it the best decision? Possibly not, but I think it was made in goodwill, with the best information available at the time

Bloc Q also focused on national emergency stockpile.

Luc Thériault (BQ): Especially with regard to the rationing of personal protective equipment, how do you explain the fact that after the SARS crisis we were unable to cope with the pandemic, with our national stockpile deplete? What role did your association play, from the SARS episode to the present day, to put us in such a situation?

Ian Culbert (Canadian Public Health Association): Certainly, many of the lessons of SARS have been learned and I think we would be in a much worse situation if we had not followed those recommendations as closely as we had. We do have the Public Health Agency of Canada that is really doing a tremendous amount of work and the coordination work that they're doing is incredible. Have those lessons been learned— [Français].

M. Luc Thériault: Is everything really going according to plan with respect to the shortage and the availability of equipment in the national emergency strategic stockpile?

Ian Culbert: Absolutely not. I would say that the national and emergency stockpile is probably the largest failure, as far as our response goes to date. As I mentioned, it is one of those things that requires much greater collaboration between the federal government and the provincial and territorial governments.

Medical equipment and supplies, intensive care units

The CPC asked about peak times across the country and about the number of available beds for COVID-19 patients.

Mr. Matt Jeneroux (CPC): Do you expect the country to peak all at once or will individual provinces peak at different times? How many beds are currently available across the country for COVID-19 patients?

Ms. Tina Namiesniowski (PHAC): Regarding the question as to whether we will have the same thing happening all across the country at the same time, based on what is transpiring across the country, there are differences that can be seen from an epidemiological perspective. At this point things are different in different jurisdictions, and even within jurisdictions things are different depending on where you may be within any particular jurisdiction. Our expectation is that it will continue in the same way it has in relation to other countries that are experiencing the same crisis. In response to the questions asked about the availability of beds, and hospitals converting and making more room available, and whether or not there are additional steps being taken to add capacity at a local level, from the conversations that are taking place with all of our provincial and territorial partners, all jurisdictions are definitely planning and taking steps to ensure there's a level of readiness. Each jurisdiction has a plan that's in place, and they're in the process of actually implementing their plans.

The CPC asked about hospital surge capacity and field hospitals.

Mrs. Tamara Jansen (CPC): At our last meeting, Dr. Alan Drummond said there was a lesson that we absolutely haven't learned. We started out talking about the surge capacity, and I think you've made it clear that surge capacity was created in your area by cancelling other medical procedures. Dr. Alan Drummond mentioned the fact that we're actually cancelling cancer surgeries in order to make way for that surge capacity. I'm kind of wondering. The lesson he felt we hadn't learned was the idea of field hospitals in order to be able to take care of COVID-19 patients separately from the regular needs. I wonder if you could speak to that because you obviously have a field hospital, but you are actually creating surge capacity by cancelling regular and necessary health procedures.

Dr. Naveed Mohammad (William Osler Health System): I'll answer it in 2 parts. Surge capacity is not a new problem in Canada, or in Ontario or certainly in our region here in the Central West local health integration network (LHIN). This is being highlighted right now because of the COVID-19 crisis, but every year during the influenza season, or during the flu season, hospitals across Canada and across the US suffer significant surge issues, which is where hallway medicine comes from. So I think that's a lesson. If we can use this opportunity to learn that lesson I think it'll be great. If we control COVID, we're still going to have surge capacity issues next year during the fall, during the flu season and the year after.

The CPC asked about isolation measure being taken by hospitals to separate COVID-19 patients from others.

Mr. Len Webber (CPC): It's regarding the separation of fever and infection patients from the general population in the emergency room (ER) and in the intensive care unit (ICU)s. Is there separation of these patients with the other general population?

Dr. Howard Ovens (Canadian Association of Emergency Physicians): Yes, as we mentioned, our hospitals and our provinces have taken extreme measures to create adequate capacity in our hospitals at the expense of a lot of people who've had their care delayed, but it has been successful and most of our emergency departments are very efficiently being emptied of new case. There are infection-control procedures right from when you enter the hospital and go to the emergency triage desk through to admission to the wards or ICU. The proper isolation techniques, I believe, are the norm and are being followed. The concern, if we're unable to flatten the curve, is that as our hospitals fill our ability to do that well may become compromised. But as of today, I think everywhere in Canada we have the capacity to this point to be able to do proper spacing.

The NDP asked about gaps in medical supplies.

Mr. Don Davies (NDP): […] I'd like to know what the major gaps identified to the federal government were. Can you give us an approximation of the size of those gaps, please?

Dr. Stephen Lucas (DM, Health Canada): Thank you, Mr. Chair. We have had an ongoing process supported by the Public Health Agency of Canada to understand the needs of provinces and territories and to contribute to the bulk purchases the Government of Canada is making on their behalf. Certainly, President Namiesniowski can speak to that further. From the information in the letters coming in that you referred to, we have reinforced areas where the provinces have been seeking additional support in the form of N95 masks and ventilators, and we have moved proactively to order those from all available suppliers, as well as have been noted in the comments already made, and to work with Canadian businesses either on existing production or in areas where they can create new production to address those needs. We are monitoring this on a day-to-day basis and are in constant dialogue, on a daily basis, with provinces and territories to understand those needs and to work to address them. In addition, provinces and territories have provided information on other areas of focus including support for Canadian unemployed workers and businesses, and those have been addressed through measures announced to date and with work under way.

The NDP asked whether a backlog in testing has caused a spike in the numbers.

Mr. Don Davies (NDP): On March 27 in The Globe and Mail, Dr. David Naylor, professor of medicine at the University of Toronto, wrote the following:

However, we could be far better informed. Our rate of testing has accelerated, but the coverage is still well below that needed to give an accurate picture of the epidemic. Thousands of test results have been backlogged at various times, leading to intermittent and confusing spikes in case counts, even as tardy delivery of provincial case reports to the Public Health Agency of Canada has blurred our view of national outbreak demographics. This was written 4 days ago. To the Public Health Agency of Canada, is that an accurate assessment by Dr. Naylor?

Ms. Tina Namiesniowski (PHAC): Mr. Chair, in response to the question, at the federal level we have been working with all of our provincial and territorial partners on the issue of testing within Canada. I think there is broad recognition of the importance of testing and the need to ramp up testing across the country. There is a commitment that collectively there will be increasing numbers of tests taken to enable us to have a fulsome picture of the state of COVID-19 within Canada. It's hard for me to speak to what may be happening within a particular jurisdiction, which is really a question better directed to a jurisdiction. I can say that we have collective commitment to ramp up testing overall, and as we have every single day, we are making increasing efforts at testing and ramping up our overall approach across the country.

The NDP asked a question about separate facilities for COVID-19 patients.

Mr. Don Davies (NDP): Mr. Lucas, does the Government of Canada have plans in place to establish separate facilities for COVID-19 patients? I would specifically ask that in the context of delivering service to Indigenous communities in this country as well.

Dr. Stephen Lucas (DM, Health Canada): As I noted, we are working closely with the provinces and territories on managing their health care systems. A number of them have established COVID-specific parts of hospitals as well as alternate facilities, to allow patients to move out of those hospitals, so they can focus efforts in the ICU on COVID-19 patients. This is critical, as you noted, to ensure that the risk of infection from donning and doffing protective equipment as health care workers move between wards is minimized to the greatest extent possible. Additional assets are being defined in terms of facilities to help support efforts as needed, including working through Indigenous Services Canada's first nations and Inuit health branch to ensure the supports needed for Indigenous People. I'll stop my response there, Mr. Chair.

The LPC asked if hospitals had access to the National Emergency Strategic Supply and how were they procuring medical supplies.

Ms. Sonia Sidhu (LPC): I want to ask you about the hospitals that are already running at overcapacity, that have been accommodating and treating all patients during COVID-19. How can they get access to the national emergency stockpile? Can you update us on procurement efforts for medical supplies in Canada?

Ms. Tina Namiesniowski (PHAC): Regarding how we've been working with provinces and territories, we do not deal directly with every single health care institution in the country. We do deal directly with provinces and territories, who in turn, within their own jurisdiction, are interacting with all of the institutions that might exist in a particular jurisdiction. It's through that interaction that a province or territory would have an understanding of what might be necessary and whether inventory shortages or gaps might exist. Following the analysis done by jurisdictions, we get requests from those who have chosen to come to the federal government, who seek to join us collectively to do bulk procurements. Mr. Chair, that's generally how the approach works.

Testing and vaccine

The CPC asked about diagnostic testing kits.

Mr. Robert Kitchen (CPC): At our last meeting, on March 11, I asked the minister how many test kits we had in Canada. Both the minister and Dr. Tam were unable to give me a number, although Dr. Tam's answer was that we have the capacity to do at least 2,400 tests a day and that ramping up, the estimate is that we can do 16,000 a day. Are we doing the estimated 16,000 tests per day? If we're not, is that due to the lack of availability of the testing kits and the agents, etc., that we need to provide in creating those kits?

Dr. Stephen Lucas (DM, Health Canada): The actual testing rate in Canada, as was noted, is that we're up to over 225,000, or about 6,000 per million population, which is very much in the very top tier, testing globally. We want to continue to improve on that.

In terms of the testing, it varies day to day but it is on the order of approximately 15,000. Some days it's higher. Work is under way with provinces to expand that lab capacity further. As noted, we are working on multiple solutions to manufacturing in Canada, and on import of those test kits, as noted via supply arrangements that have worked to contract to ensure we can continue to increase our level of testing.

The CPC enquired about ramping up testing for those with COVID-19 and healthcare workers and the value of immunity testing.

Robert Kitchen (CPC): A lot of discussion going on right now and, the reality is, as we start to hopefully flatten that curve and try and transition out of that, get Canadians back out into the public and get the economy back rolling, what measures and steps are going to be needed to make certain that the public is actually out there, have developed immunity such that they can be out in the public? I guess my question to you is this: Do you see value in the expansion of more of the immunity testings as well as the testing right now that we're doing in determining whether somebody has the virus?

Dr. Sandy Buchman (Canadian Medical Association): Yes. Our ability and capacity to test is absolutely critical to responding to this pandemic. It's really the testing that allows us to know who is potentially infectious or who is immune and will therefore guide the public health response of what we should do. We are seeing our testing capacity increasing day by day. Again, that's kind of where we got cut short as well, but we're seeing it increase now day by day as we sort of—it also reflects the increasing numbers of positive cases. Yes, I'm encouraged actually by the recent announcement about the government's actions, but we're not where we need to be yet. We should really ramp up our testing as much as possible. We should also get serological testing. We need to know what our level of immunity is out in the community, and that will help guide the public health measures that we need to take.

The CPC asked about standardization across the country.

Mr. Robert Kitchen (CPC): The minister stated that the Public Health Agency of Canada is working closely with provinces and territories to ensure that there is a consistent, evidence-based approach to addressing this crisis. If this is the case, why are we seeing varying protocols from province to province? Why is there no standardized testing across the country? What steps did the Public Health Agency take to ensure that every hospital in Canada, no matter where it is—local, in rural areas, urban areas, etc.—had in place protocols and procedures to be followed from the very moment this happened?

Ms. Tina Namiesniowski (PHAC): Mr. Chair, in relation to the question that was just asked, since the outset the National Microbiology Laboratory has been working extremely closely with all provincial health labs across the country. From the very beginning they have been worked together to ensure that there was a common approach across the country in terms of a commitment to testing, and quality assurance around the nature of the test that was being undertaken. Members may recall that at the beginning the approach required the National Microbiology Lab to actually confirm the results of tests done at a provincial laboratory level. Since then there has been enough advancement to allow a number of jurisdictions that have the capacity not to have to refer samples to the National Microbiology Lab to be certified as being positive. That now has taken place, and in that context, there have been efforts at a provincial level to allow for tests to happen at a more local level and down to a hospital level. There has been considerable effort expended from the outset to ensure a common approach across the country so that collectively we have a good line of sight as to what is happening at a local level in terms of transmission and level of COVID-19 in various locations across the country.

The NDP asked about blood serum test kits manufactured in Canada.

Mr. Don Davies (NDP): My question is on blood serum test kits. I understand that these kits are manufactured in Canada, and they produce very quick results and can at least confirm positively if someone has been exposed to the virus. I understand that they have been approved by the US and the European Community (EU), and are actually in use in many countries, but I understand that Health Canada has yet to approve the use of these test kits in Canada. Should we be making these serum-based home test kits more widely available, so that we can get more accurate figures on who's been exposed to the virus in Canada?

Hon. David Dingwall (President and Vice-Chancellor of Cape Breton University): I can't respond to the specifics that you're raising, but the World Health Organization is a very reliable and sophisticated partner as it relates to health throughout the world. It would seem to me that this is probably something that the committee would want to take under advisement and get some specifics from Health Canada as to why they're not, and what conditions would need to exist for them to adopt that. I know from previous experience that our senior officials in Health Canada are a pretty reputable group of men and women who adhere to very high standards. I think we would want to hear an answer from them to as to why not, and how could they go to that kind of testing. Rapid testing for me is the most important issue.

The LPC asked PHAC if we were close to a vaccine.

Mr. Mike Kelloway (LPC): In terms of vaccines, I know we're doing a lot of work both in-country and globally with research and development with respect to vaccines, but do we have any sense of how close we are to a vaccine, understanding that it is a process and that it's trial and error and a lot of testing and whatnot?

Ms. Tina Namiesniowski (PHAC): Thank you, Mr. Chair. Again, I think this is an answer that will involve both a response from me and a response from my colleague at Health Canada. At the federal level, we have been working very closely together with key organizations that are involved in research and development, which involves both our National Microbiology Laboratory and other federal players, including another member of the health portfolio beyond Health Canada—the Canadian Institutes of Health Research (CIHR)—and some of our colleagues at the National Research Council, to name but a few. Certainly in the context of different initiatives, there are efforts under way to support researchers in Canada and abroad in the context of the development of a potential vaccine for COVID-19. This question has come up a couple of times at committee in the past, and I think we all recognize that it will take a number of months before any vaccine may be developed, trialed, proven to be successful, and then potentially produced and rolled out for the general population. I think when Dr. Tam was asked that question, which I think was the first time we were at committee together, she talked about an 18-month window. Perhaps I will ask my colleague from Health Canada if he would like to add anything.

Dr. Stephen Lucas (DM, Health Canada): I would simply note that efforts are being made on a broad number of fronts in Canada, from working with firms and research labs that have potential vaccine candidates, to providing support to researchers not only to do the research but to ensure that we can participate in clinical trials, and then to ensure that we have a rapid process to approve clinical trial designs as well for the different phases of candidate vaccines as they emerge, to ensure their safety and effectiveness. All of these efforts are being co-ordinated through work between federal agencies, as noted. That timeline of 12 to 18 months for a vaccine is what is being discussed globally, but there is no certainty on that, which is why every effort is being made not only on vaccine development in Canada and Canadian participation as candidate vaccines emerge globally, but also on the development of treatments or therapies that can help manage the symptoms. The solidarity trial that was noted is important in that regard as well, as is work by Canadian firms and researchers across the country.

Hospital protocols and lessons learned and reporting of data

The CPC highlighted protocols that were developed after SARS and asked how often health care professionals are being asked to review protocols.

Mr. Robert Kitchen (CPC): I'll throw this to Dr. Mohammad. Before COVID-19 began to spread across the world, I'm wondering if you or your hospital were aware of the processes and the protocols that had been previously developed. I recognize that yours is a bigger hospital than a lot of ones across Canada, but how often are the health care professionals in your jurisdiction required to review these protocols? And how often do you do simulated tests and procedures to make certain that your hospital—and I ask this from your point of view—but also across Canada with the smaller hospitals, how often are those being implemented? Are they done yearly, weekly, monthly?

Dr. Naveed Mohammad (William Osler Health System): Thank you for your question. I can tell you what we do at Osler. Granted, we are a larger organization with more staff and more bandwidth, but we have a pandemic plan that our emergency preparedness committee is in charge of, and it is reviewed on an annual basis. The pandemic plan not only includes the work that needs to be done inside a hospital but also the partnerships that need to be developed outside with EMS (emergency medical services), regional governments and the ministry of health when such a pandemic strikes. We do it annually, and we review it annually. As I mentioned, we may be at a bit of an advantage because of our proximity to the airport, but we do have simulation exercises with the local fire departments, local police and our Greater Toronto Airports Authority for various types of issues, whether it be an airplane crash, major trauma, or an issue like this where we may have an infectious agent at risk. I think with smaller hospitals, and I have worked in towns of 1,600 and towns of 2,000 in the past, it all depends on the administrative bandwidth that they have. Being an accreditor for Accreditation Canada, I often accredit hospitals across the country, and I find that in smaller hospitals, just with the workload that they have, they may not be reviewing this on an annual basis or even every 2 or 3 years and may just be acting on it when things like this happen.

The NDP asked if PHAC should mandate standardized information reporting across the country.

Mr. Don Davies (NDP): In your view, should the Public Health Agency of Canada mandate that standardized information reporting for all public health authorities across the country be made a reality?

Mr. Ian Culbert (Canadian Public Health Association): Thank you for your question. It would be tremendous if the agency had the authority to mandate that, but unfortunately they do not. That is one of the calls that we are making in this request for federal legislation that would give the federal government a greater role in coordinating public health efforts across the country. The lack of streamlined epidemic data across the country is an ongoing issue. We know alcohol sales the next day, but we don't know the impact of alcohol, for example, for 10 years out. It's the same idea with the COVID-19 outbreak. There's a lack of consistency and we're seeing that as to why the federal government had to wait until today to release its modelling figures.

Border security

The LPC asked about screening at borders and enforcement measures.

Mr. Darren Fisher (LPC.): My question is for the Canada Border Services Agency… Maybe you could give me a bit of a rundown. I know you talked about assessments in your opening remarks, but what exactly is “screening”? What are we doing and what don't we do?

Mr. John Ossowski (CBSA): I'll describe the process for the air mode so that people can understand the continuum here. First of all, the air carriers are being asked to prevent anyone who is symptomatic from getting on the flight. During the flight, if somebody is identified as becoming symptomatic, they're identified before the plane lands in Canada so that we can segregate them immediately upon arrival. Those people would immediately be turned over to Public Health Agency officials to assess their situation. That's our hand-off point with them.

For the rest of the travellers, for the asymptomatic people, they would proceed into the customs hall, where if you've travelled internationally recently you would see our primary inspection kiosk (PIK) machines. These are our primary inspection kiosk machines. The advantage we have with these machines is that they ask the questions in 15 different languages, so we're able to carry a very broad spectrum of travellers into the country. After answering the questions about whether they have a cough, a fever or other symptoms, they also acknowledge that they are subjecting themselves to mandatory isolation for 14 days upon arrival in the country. As they're in the baggage hall, there are additional border service officers roving and looking for people who are displaying symptoms. We have referred people through these functions to the Public Health Agency. Upon departure from the customs hall, they're all given forms about how to conduct themselves should things happen after they leave and to acknowledge once again that they're being subjected to mandatory isolation. It's very layered. It's very complete. It covers more than just French and English. You're right in your point about the temperature scans. People are expecting different things, but we've not been advised by public health officials that it's something we need to do at the border. We are guided in all of these actions by the advice of the Public Health Agency of Canada on the efforts it wants us to deliver at the border on its behalf.

The LPC asked about advice and services being provided by Global Affairs Canada (GAC) to Canadians abroad.

Mr. Tony Van Bynen (LPC): […] My question is for the Deputy Minister, Heather Jeffrey. Your team has been doing great work to help Canadians come home, and as you mentioned in your earlier comments, the reality is that it's not possible to facilitate everyone to come home. What advice is being given to those Canadians remaining abroad, and what services are being made available to them?

Ms. Heather Jeffrey (ADM, Foreign Affairs, Trade and Development): I think the unique demands of quarantines and lockdowns require a different approach, and we saw this with Canadians who were in Wuhan, and again those to whom we were providing consular services during the Diamond Princess quarantine in Japan. They require assistance in making the right contacts with local governments; they require support with interpretation sometimes in making themselves understood with foreign doctors; and they need to know where to reach out for help, and what kind of help is available to them. We're providing instructions on preparedness, things that you can do, which are similar to what public health officials are telling Canadians here at home: to make sure that you have adequate supplies, that you have prescription medication you might require, that you are able to sustain yourself and that you have a local SIM card and a phone. There are a lot of very practical tips in our material. Also, there is information on who you can reach out to at the embassy, the things that should cause you to reach out, for example, if you become ill or believe you might be sick. There is also information on the local restrictions and what will happen to you in different circumstances and on how to reach out to us 24-7. Then if and when people are hospitalized or need medical care, it's about facilitating their communications with their families. It's about trying to make sure, even in environments where isolation and quarantine are necessary, that they can receive the essential goods and things they need. It's a different kind of consular service for someone who is required, by quarantine, to be at a distance, but we're equipping our missions to be able to provide those services in situ. At this stage it's really about preparedness, just as it is here in Canada, to get through a few weeks of mandatory isolation until the quarantines are lifted around the world.

The CPC asked about border agents being quarantine officers where non available (referencing Quebec).

Mr. Pierre Paul-Hus (CPC): Is there no way to designate border services officers as quarantine officers, as the Government of Quebec has done for Sûreté du Québec officers?

Mr. John Ossowski (CBSA): We have worked out with Public Health a way to make sure that their agents, who are better placed than our officers, are available either by telephone or in person to assess the health of these individuals. It depends on the port of entry and the volumes we're working with. So far we're satisfied that people are getting the right medical advice with respect to the symptoms they are speaking about with the public health officials.

Emergency legislation

The NDP asked why the Emergencies Act was not appropriate for this pandemic.

Mr. Don Davies (NDP): We know that the Emergencies Act is not just a modernized War Measures Act, but actually deals with broader emergencies, like a public welfare emergency. I'd like to read the definition of that. A public welfare emergency is defined under the act as an emergency that is caused by a “real or imminent”...“disease in human beings” and that “results or may result in a danger to life or property, social disruption or a breakdown in the flow of essential goods, services or resources, so serious as to be a national emergency.” The act defines a national emergency as an “urgent and critical situation of a temporary nature that (a) seriously endangers the lives, health or safety of Canadians…” what part of the definition does not apply, in the government's view, to the current COVID-19 situation? If COVID-19 is not a public welfare emergency, when would there be one?

Ms. Tina Namiesniowski (PHAC): Perhaps I will start and my colleague from Health Canada may wish to add. I think it's important, as we consider the Emergencies Act, that we also consider the context in which it is something a government may wish to choose to trigger, which is really in the event where we would need additional powers beyond what we potentially already have from a legislative perspective and/or where we are getting significant requests from provinces and territories for the federal government to come in directly and intervene in support of a request for assistance. At this point, I think we have the authorities we need to deal with the situation that is currently before us. Maybe I will just stop my answer there, but I would ask my colleague from Health Canada if he has anything to add.

Dr. Stephen Lucas (DM, Health Canada): I would just note briefly that critical to this work is ongoing collaboration with provinces and territories and other key partners who can supply needed materials and resources to help address the pandemic. That collaboration is essential, given that provinces and territories run the health system and have tools in their jurisdictions to manage emergencies. As was noted, critical to this is ensuring that all the federal tools and those provincial and territorial capabilities are utilized. There is ongoing engagement with provinces and territories about what is needed to address the pandemic at all levels, and it's in that context that if it were to come to it, the Emergencies Act could be considered, but that requires consultation and assessment of steps taken. That's why we're working in strong collaboration with provinces and territories and other partners now to use the tools that we have to take all steps necessary to address this pandemic.

The Bloc Quebecois questioned what more could be done if provinces were placed under Emergency Act.

Luc Thériault (BQ): What would you have done in addition to what we have already done in Quebec, with emergency measures legislation? How would an emergency measures act contribute to the problem?

Dr. Howard Ovens (Canadian Association of Emergency Physicians): Our concern is, at a time of great demand, that we—If we look at what's happened internationally, we can see the danger if we don't have a coordinated approach in Canada. Just as we've seen in the US, where governors have been competing with each other for available supply and driving up the cost, or where one jurisdiction—as the US tried to do to Canada—prevents export, imagine if Ontario said that its businesses could not sell masks to Quebec, or Quebec could not sell gowns to Nova Scotia, or the supply chain became interrupted because of provincial boundaries. I think that would be a tragedy under the circumstances. It's that type of maximum co-operation that I think is in the best interests of our country. Once again, I'm not trying to criticize anybody. I think even Quebec would benefit if Ontario, and Nova Scotia and other jurisdictions on your boundaries were as aligned as possible. In fact, at one point we were asking that the rest of Canada align with the excellent steps that were being taken earlier and more stringently in Quebec. The question is not who's right or who's wrong. The question is, how can we all get to the safest place together?

Mental health

The NDP asked about funding and support for mental health.

Mr. Don Davies (NDP): […] I heard a reference to setting up a phone line, but Mr. Lucas, will the government be committing any additional resources to an expedited implementation of a Canadian mental health strategy, in light of the COVID-19 stress on Canadians?

Dr. Stephen Lucas (DM, Health Canada): Indeed the government is certainly committed, as indicated in the mandate letter of Minister Hajdu, to support and work with the provinces and territories and other partners to increase the financial support and resources to help Canadians get mental health services and, indeed, develop standards so they know what to expect. That commitment stands. The government will work forward on that, building on the investment of $5 billion through bilateral agreements going back to 2017 providing direct support to provinces for things such as increased support for children and youth. In addition, the immediate focus now is ensuring that the resources are available and accessible to Canadians as they stay at home and self-isolate if they are symptomatic. In that regard, as I noted, we will be launching soon, working with a consortium of companies, a mental health app that provides access to needed services.

The LPC asked about how the government is addressing long-term care homes.

Ms. Sonia Sidhu (LPC): […] Last weekend we also heard about 9 deaths in one seniors home last week in Ontario, which has since risen to 13 deaths in long-term care homes. Clearly this is a tragedy in the community. How are we addressing this issue of long-term care home outbreaks? Are there any extra precautions?

Ms. Tina Namiesniowski (PHAC): In response to that question, certainly in the context of the discussions that are taking place among the chief public health officers, the Canadian chief public health officer and all of Dr. Tam's colleagues across the country, there is widespread recognition of the vulnerability of older Canadians, particularly those with underlying medical conditions, and the importance of trying to prevent any kind of introduction of the virus within a setting such as a long-term care home, given what could potentially happen. The tragedy that happened in the nursing home in Ontario is one that we all feel terrible about in the sense that it is not what anybody would ever want to see for elderly loved ones, or anyone at all for that matter. We have had a few instances, across the country, of clusters of patients within long-term care homes. In that context, there was work very early on among the chief public health officers to establish guidelines around infection prevention and control, which is a critical piece when it comes to dealing with those types of institutions.

In terms of the broad national guidance that obviously is taken by each jurisdiction and also interpreted by the kinds of institutions you would find within every single jurisdiction, right down to the level of an institution such as a long-term care home, which also would have plans and protocols in place for what should be done from the point of view of infection prevention and control, it is something that is discussed regularly in an effort to ensure that all are putting the necessary emphasis on trying to prevent those types of incidents that were described. Perhaps I'll ask my colleague at Health Canada to see if he has anything he would like to add.

Dr. Stephen Lucas (DM, Health Canada): It's just to emphasize the critical importance of all jurisdictions and all of these facilities working very carefully to ensure that all of those measures that were noted are put in place. It is critical to protect the residents and to ensure that the workers in those facilities are healthy and that strong infection, prevention and control measures are in place. This is certainly an area that has been emphasized by Dr. Tam in her comments, and the provincial medical officers of health. We strongly support that and see the urgent need to continue that messaging and, when there are residents who are infected, take all the necessary steps to stop any spread within those facilities.

Other issues

The CPC asked if messaging on refills was consistent and clear and if there were any exceptions to the 30-day refill limit for medications.

Matt Jeneroux (CPC): We spoke a little about the limited refills for one month. Are there any exceptions being considered, particularly in rural and remote communities where we know it is often hard and more difficult for individuals to get the medication?

Dr. Barry Power (Canadian Pharmacists Association): Absolutely. They are in the recommendations and in many of the directives that have come out from any of the colleges that we've seen. There is a recommendation that the pharmacists exercise their clinical judgment. Absolutely, if people have to drive 2 hours to get to a pharmacy, it's not reasonable. They could be provided with a larger quantity if somebody has an extreme immune deficiency, for example, as well. They could be provided with an additional quantity. It really is intended to be an individual decision. For the broad majority of Canadian public, however, we strongly recommend that there be a 30-day limit.

The NDP asked if pharmacists would consider lowering dispensing fees since refills had to be done every month.

Don Davies (NDP): Is there any talk in the Canadian Pharmacists Association about adjusting dispensing fees to help seniors who are on fixed incomes in light of the requirement to get their pills more frequently?

Dr. Barry Power (Canadian Pharmacists Association): Thank you for the question. We are exploring a number of options for helping these people. We are working with the provinces and payers, and we're having discussions within the profession as well as to the best way to approach it. We knew that it was going to be a difficult situation for a lot of people. We had to make a decision quickly due to the incredible spike that we saw. We're now starting to have discussions with a number of stakeholders both to figure out when we can roll back the recommendation to go with 30 days and also ways to help people. That’s a discussion that would have to happen with the pharmacy owners, but it's a discussion that we can entertain with some of the stakeholders within our community.

The Bloc Quebecois asked about if what options and/or substitutions for drug shortages were being explored.

Luc Thériault (BQ): What are our options for dealing with raw material supply issues? We talked about hydroxychloroquine. Are there options? Are there any alternatives to it? Can you tell us about the situation in order to reassure people?

Dr. Barry Power (Canadian Pharmacists Association): We still don't have a good timeline in terms of when the supplies are going to start flowing into Canada, but we are hopeful that it will pick up over the next coming weeks. In terms of hydroxychloroquine, there is another drug chloroquine that can be used. Most of the focus has been on hydroxychloroquine but they're both anti-malaria drugs and may have similar effects. The supply for that will really depend on the ability of various companies around the world to supply the ingredients for hydroxychloroquine tablets to administer to patients. We're definitely in a situation where there's an increased global demand for hydroxychloroquine and chloroquine as a result of all of the focus on COVID, and we do need all governments to encourage increased production of these medications for that reason alone. To date the data are still somewhat questionable as to whether or not hydroxychloroquin, has a clear benefit in COVID-19. Some of the research that has come out is promising, but it is not clearly showing that it has a major effect in improving the outcomes for people infected with it.

The LPC asked about supply chains and identification of drug substitutes and alternatives.

Ms. Helena Jaczek (LPC): It relates to the fact that while we're in the midst of this pandemic, of course life goes on, and people are sick with many other health issues. We're hearing about elective surgery here in Ontario being deferred.

I would like to hear from Health Canada how they are looking at the supply of prescription over-the-counter drugs and medical devices. Are there any supply disruptions? What does Health Canada do in the face of potential shortages?

Also, we've heard from south of the border about some of the potential therapies like chloroquine, hydroxychloroquine. I'm sure there are patients on Plaquenil for arthritis who are very anxious about shortages, so could you please address what Health Canada does?

Dr. Stephen Lucas (DM, Health Canada): We have an ongoing challenge with drug shortages, exacerbated now given the pandemic situation and the impact on global supply chains. To that end, we have a team dedicated to working on this. They work with a network of people in the provinces and territories—industry, distributors and patient groups—to make sure we have a line of sight as far in advance as possible on shortages. We are co-operating with regulators in the United States, Australia, Europe and other places to identify where there are potential disruptions in supply chains of active pharmaceutical ingredients and other key elements in producing needed medicines and medical equipment. In addition, steps are taken to find substitutes and to allow for the importation of other products that can help address it with an ability, through interim orders, to look at alternative labelling requirements to ensure that the needed medicine can get to Canadians. In addition we are working with manufacturers here in Canada on moving to producing pharmaceuticals if we need to. The powers provided last week through the bill will further enable that to help manage shortages and to have domestic production if we need to, to ensure that the needs of Canadians are met.

Ms. Helena Jaczek: Could you address the Plaquenil situation, the potential shortages, specifically, of chloroquine and hydroxychloroquine, because of some therapeutic merit that is being touted?

Dr. Stephen Lucas: On that, we are working actively to secure additional supply and to look at opportunities to produce in Canada.

The LPC asked if there was a manner for pharmacists to be better utilized.

Mike Kelloway (LPC): Do you feel that pharmacists could be better utilized in the fight against COVID-19? If so, how?

Shelita Dattani (Canadian Pharmacists Association): Absolutely, as I alluded to in my remarks earlier, pharmacists are doing everything they can and working to their full scope of current practice across the country, which is unfortunately quite fragmented. In our province of Alberta, pharmacists there are being immensely utilized. They are able to prescribe for many conditions, they are able to extend therapy, they're able to do a lot of different things in terms of scope of practice. As primary care environments are more and more burdened, pharmacies are going to start becoming almost the sole universally available primary health care provider. Being able to help patients and fill those gaps in primary care right now, obviously still in a collaborative way and interacting with our physician and nursing colleagues, but having the ability to exercise some of those things more independently, is very much needed in a harmonized way across the country.

The LPC asked the Canadian Pharmacists Association to elaborate on the guidance on 30-day supply guidance.

Mike Kelloway (LPC): You referenced recently released guidance to pharmacists to only fill prescriptions for one a month at a time. Can you go a little deeper as to why you decided to issue this guidance?

Dr. Barry Power (Canadian Pharmacists Association): The situation in Canada is that we get about 80% of our prescription drugs from China and India, with the bulk of them coming from China. China has been in shutdown since January and the manufacturing processes and the shipping of medications into Canada has pretty much come to a standstill. As a result, we're getting double the volume we had in March, or we had double the normal volume in March and we've seen drains on the warehouses and the stockpiles of medications we have in Canada. We already have a system that's very fragile. We have drug shortages and we were very concerned about pharmaceuticals going the way of toilet paper and hand sanitizer, with those very constituents having to go from pharmacy to pharmacy to try to fill a prescription, so we had to make a decision quickly. We decided that 30 days would give people enough prescription drugs to allow them to shelter in place for two full 14-day quarantine periods and we would be able to deliver any subsequent deliveries to them. We did reach out immediately to drug plans, provincial drug plans and private payers to try to get them to come onboard as part of the COVID-19 response in Canada to cover some of the co-pays that people are seeing. We absolutely recognize that this is a burden on people and we continue to advocate for all payers to help offset some of the costs that people are being faced with.

Committee member biographies

In this section

Committee members from the Liberal Party of Canada

Ron McKinnon (Chair)

Ron McKinnon

Political affiliation: Liberal Party of Canada

Constituency: Coquitlam—Port Coquitlam, BC

Elected: 2015 and 2019

Current role: Member of the Standing Committee on Health

Committee experience: Standing Committee on Health (2016 to 2019), Standing Committee on Justice (2017 to 2019)

Biography

As a member of the Standing Committee on Justice and Human Rights, and the Standing Committee on Health, worked on legislation related to medical assistance in dying and the Cannabis Act, and participated in a number of studies, such as Pharmacare, human trafficking, access to justice, support for jurors, and antimicrobial resistance.

Introduced Bill C-224, the Good Samaritan Drug Overdose Act which became law in May 2017 after receiving unanimous all-party support.

Considerations

Darren Fisher

Darren Fisher

Political affiliation: Liberal Party of Canada

Constituency: Dartmouth—Cole Harbour, Nova Scotia

Elected: 2015 and 2019

Current role: Parliamentary Secretary to the Minister of Health

Committee experience: Environment and Sustainable Development, National Defence (2016 to 2019)

Biography

Elected to Halifax Regional Council in 2009 and 2012 and elected by peers to represent them as Deputy Mayor. Advocated on mental health awareness, recycling, literacy, poverty, and national Pharmacare. Appointed by the Prime Minister on December 12, 2019 to serve as the Parliamentary Secretary to the Minister of Health.

Considerations
Riding specific

As part of its value proposition commitments under the National Shipbuilding Strategy (NSS), Irving Shipbuilding is investing $4.52 million in the newly established Centre for Ocean Ventures and Entrepreneurship (COVE), located in Dartmouth.

Mike Kelloway

Mike Kelloway

Political affiliation: Liberal Party of Canada

Constituency: Cape Breton—Canso, Nova Scotia

Elected: 2019

Current role: Member of the Standing Committee on Health

Committee experience: None

Biography

Prior to his election in 2019, he was a special project administrator at the Nova Scotia Community College. Prior to being elected, he was community innovation lead for Cape Breton and North Eastern Nova Scotia.

Considerations

Dr. Marcus Powlowski

Dr. Marcus Powlowski

Political affiliation: Liberal Party of Canada

Constituency: Thunder Bay—Rainy River, Ontario

Elected: 2019

Current role: Member of the Standing Committee on Health

Committee experience: None

Biography

Former physician in the emergency room at Thunder Bay Regional Health Science Centre.

For several years, he worked as a consultant in health legislation for the World Health Organization. He also volunteered on a medical project in Ethiopia.

Considerations
Riding specific

Sonia Sidhu

Sonia Sidhu

Political affiliation: Liberal Party of Canada

Constituency: Brampton South, Ontario

Elected: 2015 and 2019

Current role: Member of the Standing Committee on Health

Committee experience: Standing Committee on Health (2016 to present), Standing Committee on the Status of Women (2018 to 2019), Special Committee on Pay Equity (2016).

Biography

Before politics, Ms. Sidhu worked as a healthcare professional for 18 years. She is the chair of the All-Party Diabetes Caucus. She serves as the general-secretary of the Canada-India parliamentary friendship group and executive member of both the Canada-Poland and Canada-Portugal parliamentary friendship groups.

Considerations
Riding specific

Tony Van Bynen

Tony Van Bynen

Political affiliation: Liberal Party of Canada

Constituency: Newmarket—Aurora, Ontario

Elected: 2019

Current role: Member of the Standing Committee on Health

Committee experience: None

Biography

Prior to his career in politics, he had a 30-year career in banking as a branch manager. He was elected as a city councillor in Newmarket in 2000, and served as mayor of Newmarket from 2006 to 2018.

Considerations
Riding specific

Committee members from the Conservative Party of Canada

Matt Jeneroux (Vice-Chair)

Matt Jeneroux

Political affiliation: Conservative Party of Canada

Constituency: Edmonton Riverbed, Alberta

Elected: 2015 and 2019

Current role: Member of the Standing Committee on Health

Committee experience: Standing Committee on Health (2020), Industry, Science and Technology (2018 to 2019), Transport, Infrastructure and Communities (2018 to 2019), Access to Information, Privacy and Ethics (2016 to 2017), Public Accounts (2017)

Biography

Served as a member of the Legislative Assembly for Edmonton-South West, where he implemented compassionate care leave legislation within the province of Alberta. Before being appointed as Shadow Minister for health, Mr. Jeneroux served as Shadow Minister for Ccience. He has also worked on encouraging freedom of speech on university campuses and protecting Net neutrality in Canada.

Considerations

Robert Kitchen

Robert Kitchen

Political affiliation: Conservative Party of Canada

Constituency: Brandon—Moose Mountain, Saskatchewan

Elected: 2015 and 2019

Current role: Member of the Standing Committee on Health, Deputy Shadow Minister of Health

Committee experience: Vice-chair of Veterans Affairs Committee (2016 to 2017) and the Subcommittee on Sports-Related Concussions of HESA (2018 to 2019), Member of the Standing Committee on Canadian Heritage (2017 to 2018).

Biography

Mr. Kitchen has represented the riding Brandon—Moose Mountain since 2015 and was most recently named the Deputy Shadow Minister of Health.

Considerations

Tamara Jansen

Tamara Jansen

Political affiliation: Conservative Party of Canada

Constituency: Cloverdale—Langley City, British Columbia

Elected: 2019

Current role: Member of the Standing Committee on Health, Deputy Shadow Minister for Labour

Committee experience: None

Biography

Prior to being elected, Ms. Jansen and her husband built a multinational agricultural business.

Considerations

Len Webber

Len Webber

Political affiliation: Conservative Party of Canada

Constituency: Calgary Confederation, Alberta

Elected: 2015 and 2019

Current role: Member of the Standing Committee on Health

Committee experience: Vice-chair of Standing Committee on Health (2016 to 2017), member of Standing Committee on Health (2016 to present)

Biography

Prior to being elected to the House of Commons in 2015, Mr. Webber served 3 terms as a member of the Legislative Assembly of Alberta, including as Minister of Aboriginal Relations, Minister of International and Intergovernmental Relations, deputy government whip, and parliamentary assistant for energy.

Considerations

During the HESA briefings on the coronavirus, the member has asked questions about domestic work being done on developing a vaccine, the usage of Canadian Forces Bases, and temporary care structures.

Committee members from the Bloc Québécois

Luc Thériault (Vice-Chair)

Luc Thériault

Political affiliation: Bloc Québécois

Constituency: Montcalm, Québec

Elected: 2015 and 2019

Current role: Critic for health and medical assistance in dying; democratic institutions.

Committee experience: None

Biography

Member of the Ethics Committee of the Maisonneuve-Rosemont Hospital Center and the Jeanne-Le Ber CHSLD from 2000 to 2003. Elected to the National Assembly of Québec (Parti Québécois) between 2003 to 2007. House leader of the Bloc Québécois from 2015 to 2019.

Considerations

Committee members from the New Democratic Party

Don Davies (Vice-Chair)

Don Davies

Political affiliation: New Democratic Party (NDP)

Constituency: Vancouver Kingsway

Elected: 2008, 2011, 2015 and 2019

Current role: Health Critic

Committee experience: HESA committee member since 2015

Biography

Davies has been representing the riding of Vancouver Kingsway since his election in the 2008 federal election. He was named as the NDP Health critic for the 42nd and 43rd parliaments.

Considerations

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