President of the PHAC before the Standing Committee on Health: Canadian response to the Novel Coronavirus (January 29, 2020) 

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Opening remarks

Ottawa, Canada
January 29, 2020

Introduction

Mr. Chair,

Thank you for the opportunity to address the Standing Committee on Health regarding the Public Health Agency of Canada’s efforts to prepare for and respond to the arrival Novel coronavirus in Canada, which is an evolving situation. I’m here today with Dr. Theresa Tam, Canada’s Chief Public Health Officer and Dr. Stephen Lucas, Deputy Minister, Health Canada. Our objective is containment – limiting the virus’ impact and controlling its spread. Includes managing existing cases and managing miscommunication to reduce fear. Key is consistency in our approach federally, provincially and locally – collaboration is absolutely critical. Experience to date in responding to cases in Canada is evidence of a high level of coordination across governments; demonstrating the system is working as it should. We have learned, not only from SARS, but also from the H1N1 pandemic and more recently, the Ebola outbreak in Democratic Republic of Congo. Key improvements:

  • The creation of the Public Health Agency of Canada to provide clear federal leadership during a response
  • Enhanced federal/provincial/territorial collaboration through a formal network of public health experts, the Public Health Network Council
  • Established a Chief Public Health Officer – role born out of the SARS experience to ensure an authoritative voice to all Canadians during a public health event

Situation Update

Federal Response to Date
Border Measures

Mobilizing the Health System

Monitoring and Reporting

Contract Tracing and Quarantine

Research and Vaccines

Communications

Conclusion

Questions and answers

Meeting of January 29, 2020
3:30pm to 5:30pm

1. You say the overall risk of spread in Canada is low, how likely and how quickly could this change? 

Risk is determined by taking into account both the likelihood and impact of the illness. Key factors that are considered include geographic spread, how easily the illness spreads, and the severity of the illness.

Risk could increase from low to moderate or high, should we see localized outbreaks within Canada/North America, increased spread from person to person or more severe illness and increasing numbers of deaths.

Currently, the illness is mostly localized outside of Canada/North America, with very few travel-related cases reported outside of China, and limited human to human spread. Given this, the overall risk to Canadians continues to be low.

2. How are you working with Provinces and Territories with respect to this outbreak?

It is important that we ensure a coordinated F/P/T response to this event. As with any significant public health event, provinces and territories will look to the federal government to lead the overall coordination of the response and may also request specific assistance from the federal government.

The Public Health Agency of Canada (PHAC) is closely monitoring the outbreak of respiratory illness caused by a novel (new) coronavirus (2019-nCoV). This is an emerging and rapidly evolving situation.

PHAC, as co-chair of the Pan-Canadian Public Health Network (PHN), the preeminent forum for collaboration amongst federal, provincial, territorial senior public health officials, has been actively monitoring, coordinating and responding to this situation from the beginning.

On January 28th, the Public Health Network activated a Special Advisory Committee (SAC) on Coronavirus as per the conditions under the FPT Public Health Response Plan for Biological Events. These conditions include the need for consistent approaches to border screening, contact identification and follow-up, as well as public and professional communications.

The Special Advisory Committee, consisting of senior public health officials and the Council of Chief Medical Officers of Health (CCMOH), is leading coordination on monitoring and reporting on cases, public health policy, technical guidance and communications across jurisdictions to support response related to this outbreak.

PHAC will continue to work closely with partners domestically and around the world, including the World Health Organization (WHO) to respond to this outbreak.

3. How are you cooperating with the Chinese authorities with regards to this outbreak?

Like Canada, China has also learned much from the SARS outbreak. Chinese public health authorities are making every effort to contain the virus and are working very closely with the WHO authorities.

This includes limiting transportation into, out of and within the affected area (Hubei province), and setting up a quarantine and treatment centre. China was quick to share information, including the virus genetic sequence as soon as it was available which allowed for the rapid development of diagnostic capacity internationally.

4. What is Canada’s current level of engagement with international partners?

The Public Health Agency is working very closely with the World Health Organization (WHO) and other international partners, such as, the US Centers for Disease Control and Prevention (CDC), and members of the Global Health Security Initiative, as well as Australia. These international collaborations are an important means through which the impact of public health events can be minimized.

This includes:

  • sharing early warning information, risk assessments and technical guidance
  • collaborating on travel/border health issues and laboratory diagnostics
  • sharing best practices, tools and resources.

PHAC is also in close contact with Global Affairs Canada, as well as the Canadian embassies in Beijing and Geneva, to share information and stay up to date on developments.

We are actively engaging with the Centers for Disease Control and Prevention (CDC) in the United States (U.S.) to mutually share information about our screening, messaging and border measures as well as obtaining information around the U.S. confirmed cases. We are confident that the current measures that PHAC has taken are appropriate for the current risk level based on the available evidence.

The cases in the U.S. have been isolated and are being closely monitored. At this time, there are no additional measures needed in Canada to prevent the spread from the cases being reported in the U.S. Hospitals are already on high alert as Canada is in peak influenza season. Standard practice is to maintain strict infection prevention and control procedures at all times to manage all types of respiratory infections.

5. Are there vaccine and antivirals available for this virus? Are there plans to develop one?

Currently, there is no approved vaccine that protects against this virus in humans.

A vaccine aimed to provide short-term protection (similar to a pandemic influenza vaccine) to respond to an outbreak of this virus could potentially be developed.

As part of the federal response, we are mobilizing federal research capacity to support efforts to respond to this outbreak. Through Global Affairs Canada’s broader investments, Canada is funding a global alliance (CEPI) that is coordinating the early international efforts for vaccine development.

Domestically, the Public Health Agency of Canada is working with existing partners (e.g. Vaccine and Infectious Disease Organization in Saskatchewan) to pursue research studies to characterize the virus, develop animal models, and explore candidate vaccines that can contribute to international vaccine development efforts.

6. Are masks recommended as a way of preventing transmission?

For those who become ill, masks may be appropriate to prevent the spread of the illness to others. In particular, symptomatic patients may be asked to wear a mask to protect visitors and other patients in triage and health care settings, while they are waiting for or receiving treatment.

However, it is not recommended that healthy Canadians wear masks while travelling abroad or otherwise as it may actually increase risk as people may touch their face with unwashed hands more often as they adjust their mask.

The most important precautions are those already recommended during the seasonal flu season including frequent handwashing with soap and water and avoiding touching the face or eyes. Canadian travelling abroad should also avoid contact with animals or high-risk areas (such as farms, live animal markets and areas where animals may be slaughtered).

7. Are we taking measures to protect federal employees, including at the border and in affected countries?

Health Canada’s occupational health experts are working closely with departments to ensure the health and safety of employees in the federal public service.

We are communicating to federal workers and federally regulated employers with information on occupational health and safety.

An occupational health advisory has been sent to departments and agencies in the core public administration for federal workers and at airports of entry, with recommendations on precautions. This includes raising awareness of employers and employees of federally regulated workplaces of key sources of information and advice regarding protective equipment for front line workers.

Health Canada is also working closely with Global Affairs Canada to ensure that federal employees in affected countries have all of the occupational health information they require.

8. What is the government’s plan for enhanced screening capabilities for the Coronavirus?

We have multiple measures to alert travellers from the affected regions about what to do if they suspect that they have the illness. We have trained our CBSA officers to ensure that they have the tools they need to support people who may be ill. We have worked with partner airlines to ensure that there’s information on flights. We will continue to monitor the situation and add additional measures as needed.

9.What vulnerabilities have been identified and what mitigation approaches are being considered?

Since SARS, Canada has made important gains in terms of our capacity to respond effectively to the public health challenges of serious infectious disease outbreaks.

Following the recommendations of the National Advisory Committee on SARS and Public Health, a number of foundational cornerstones for public health emergency response were put into place or enhanced. These included the creation of the Public Health Agency of Canada (PHAC) and the establishment of a FPT Public Health Network and Council (PHNC) as a forum for collaboration, coordination and governance. The PHNC, together with the Council of Chief Medical Officers of Health, can rapidly form a Special Advisory Committee (SAC) to coordinate and manage national public health emergencies or events. All of these networks have been actively engaged throughout the current outbreak of 2019 Novel Coronavirus.

A number of measures have already been put in place to help mitigate the spread of the 2019 novel coronavirus in Canada. For travelers coming or returning to Canada, messaging on arrival screens at the Toronto, Montréal and Vancouver international airports reminding travellers to inform a Border Services Officer if they are experiencing flu-like symptoms, and an additional health screening question on electronic kiosks used by international travellers. Canada's National Microbiology Laboratory has developed a real time test that can diagnose the 2019 novel coronavirus from clinical specimens and is working collaboratively with provincial public health laboratories to ensure there is additional testing capacity in multiple jurisdictions. Technical guidance and protocols have been developed and disseminated to partners in the provinces and territories, and the transportation sector.

We continue to work closely with all our partners, here in Canada and internationally, ensuring that we are making decisions and providing guidance based on the most current information available.

Although we can never be too prepared and ongoing work is still needed, much has improved in Canada’s public health emergency preparedness and response capacity.

We must recognize that public health threats that go unchecked anywhere in the world have the potential to very rapidly become a Canadian public health threat. Support that we provide to other countries, to build capacity globally to detect, report, contain and treat public health threats also allows us to build essential international partnerships and response know-how while actively protecting our own best interests.

Friendly questions

1. How is the Government better prepared to respond to a viral outbreak than in the past? 

The 2003 SARS outbreak exposed global vulnerabilities in the management of international public health emergencies, including the lack of a global co-ordination or collaboration framework. Since then, Canada has made great strides with respect to preparing for and responding to public health threats. We have learned not only from SARS, but also from the H1N1 pandemic in 2009 and more recently, the Ebola outbreak in Democratic Republic of Congo.

Some important improvements include:

  • The creation of the Public Health Agency of Canada to provide clear federal leadership during a response
  • The establishment of a Chief Public Health Officer as an authoritative voice to all Canadians during public health events
  • Enhanced federal/provincial/territorial collaboration through a formal network of public health experts, the Public Health Network Council
  • Strengthened coordination within the federal government, including through the creation of the Government Operations Centre
  • Increased investments in our National Microbiology Lab which is recognized internationally and is an incredible asset when dealing with an infectious disease outbreak.

As a result, Canada is better equipped to respond to this type of public health event as we now have multiple systems in place to prepare for, detect and respond to the spread of serious infectious diseases into and within Canada.

2. What specific steps have been taken since cases have been confirmed in Canada to address the public health impacts of this virus? 

The Government of Canada has been working with provincial and territorial health authorities on preparedness procedures. These have been deployed to identify and limit the spread of the virus:

  • F/P/T protocols are in place for surveillance and reporting
  • P/Ts, including hospitals, are implementing response protocols to be ready
  • F/P/T public health experts are working closely to update/develop technical guidance

Interdepartmental coordination is being enhanced through the Health Portfolio Operations Centre, and the Government Operations Centre.

Actions taken regarding the recent three cases demonstrate that our collective preparedness efforts with PTs and health professionals are working as they should.

3. What is being done to address misinformation in the media/ social media online?

An effective, proactive, risk communication strategy is a critical element of our response.

It is important that we reassure Canadians by continuing to provide a counterbalance to some of the mainstream and social media sensationalism we are seeing here and abroad. Specific actions we are taking include:

  • CPHO as primary public spokesperson with communications messages and activities coordinated with PTs and public health authorities
  • Regular technical briefings for media (including ethnic press) and ongoing stakeholder engagement and information sharing
  • Comprehensive social media engagement across multiple Government of Canada accounts
  • Centralized web content on Canada.ca/coronavirus including up-to-date travel health advice on travel.gc.ca
  • Messages on airport screens, information sheets for returning travellers (English, French and simplified Chinese)
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