THE STANDING SENATE COMMITTEE ON SOCIAL AFFAIRS, SCIENCE AND TECHNOLOGY
OTTAWA, Wednesday, February 9, 2022
The Standing Senate Committee on Social Affairs, Science and Technology met with videoconference this day at 4 p.m. [ET] to study Bill S-209, An Act respecting Pandemic Observance Day.
Senator Ratna Omidvar (Chair) in the chair.
The Chair: Honourable senators, I am Ratna Omidvar, a senator from Ontario and chair of this committee.
We are beginning our review of Bill S-209, An Act respecting Pandemic Observance Day.
I would like to introduce our first witness, our colleague the Honourable Senator Françoise Mégie from Quebec, sponsor of the bill. I invite Senator Mégie to make her presentation. In order to keep us all on track, I want to share with you that you will only have five minutes for your presentation. If you see me raising my hand like this, it means that you are close to the 10-second mark and I will then ask you to conclude your remarks. I don’t necessarily like to interrupt, so please do watch out for my raised hand. Thank you, Senator Mégie. Over to you.
The Honourable Senator Marie-Françoise Mégie, sponsor of the bill: Good afternoon, fellow senators. I’m pleased to see you again, even virtually, as Parliament returns. Thank you for considering the bill to establish pandemic observance day. Bill S-209 has three purposes: recovery, remembrance and preparation. The bill designates March 11 as the date because March 11, 2020, is when the COVID-19 epidemic was described as a “pandemic” by the World Health Organization, or WHO.
As of today, Johns Hopkins University has recorded over 400 million cases of COVID-19 worldwide and nearly six million deaths from COVID. In Canada, there have been over three million cases and almost 35,000 deaths.
Pandemic observance day would be a useful way to recover. Our governments are making tremendous efforts to do so by supporting the public and businesses, researching treatments, preventing transmission and providing mass immunization.
We’re fortunate in Canada to have high immunization levels. I hope that this bill will encourage us to continue the discussion, on a regular basis, about the most effective ways to control transmission, and perhaps even to eradicate COVID-19—in other words, to recover.
Pandemic observance day would be needed for remembrance purposes. In 2021, the Government of Canada, following the lead of the WHO, also designated March 11, 2021, as a national day of observance to honour the people who lost their lives and to acknowledge the significant impact of COVID-19 on us all.
By designating March 11 as pandemic observance day, Bill S-209 will ensure that the observance takes place each year. This will acknowledge and honour the courage, selflessness and dedication of essential workers, who work in all sectors of the health care system and who make enormous sacrifices, sometimes even at the expense of their own lives. We should also remember the essential workers in other areas such as transportation, security and food service, and the volunteers who contribute to the collective effort.
With this in mind, the Canadian Taxi Association supported Bill S-209.
In addition, pandemic observance day will provide an annual opportunity to remember the people affected by the pandemic and to remember the people who died, sometimes alone in senior care facilities, and the bereaved families.
The Quebec ombudsperson recommended the following in her report:
that there be an annual day of commemoration for the COVID-19 victims and those who worked with them directly or indirectly, in order to remember what they went through ...
Honourable senators, this report shows the importance of taking the action proposed in this bill. The impact of the pandemic will be felt for a long time. Its impact on our societies will last for generations. The effects have already resulted in the severing of family bonds, the dehumanization of professional relationships and the isolation of the most vulnerable members of our society.
We, like the other people going through the ordeal of COVID-19 and also as parliamentarians, have a duty to observe and remember.
The pandemic observance day would help prepare for the next pandemic. Professor Denis Goulet’s book, A Brief History of Epidemics in Quebec: From Cholera to COVID-19, teaches us that pandemics are cyclical. The question is not if but when the next pandemic will occur.
As a result, we have a duty to prepare for it by developing the best strategies to face it again. Canada’s public health agencies were created during the Spanish flu pandemic. Hopefully, this pandemic will give us the opportunity to improve our processes for any health emergency.
Lastly, I hope that the Senate will pass this bill by March 11.
Thank you for your time today and for your attention to the pandemic observance day bill. Thank you.
The Chair: Thank you, Senator Mégie. You came in well under your time. It’s really good to see you, even virtually.
We will now proceed to questions from senators. As is our practice, I would like to remind each senator that you will have five minutes for your question, and that time includes the answer. If you wish to ask a question, please use the raise hand function in Zoom. If you are in the room, then please signal to the clerk with the “raise hand” button.
Senator Verner: I don’t really have a question for Senator Mégie. I think that her remarks speak for themselves. I’ll simply make a comment.
In Quebec, where the majority of deaths have occurred, particularly among our seniors, I hope that, in anticipation of other pandemics—which we don’t want to experience, but which we may go through on a cyclical basis—we’ll learn to take care of our vulnerable people and particularly our seniors. Once again, in Quebec, during the fifth wave, seniors are the most affected. That was just a comment. Congratulations, Senator Mégie, on your initiative.
Senator Mégie: Thank you for your comment, Senator Verner. I completely agree with you. I think that there should be a follow-up. In terms of the report from the Quebec ombudsperson, she was responsible for reporting on the disaster that occurred during the first wave of COVID-19 in the CHSLDs.
The quotation from the report concerns recommendation no. 27, which proposes that time be set aside to commemorate the pandemic.
The Chair: Senator Bovey has joined us. Although we will not put her on the spot right away, we will revert to her later to enter with a question.
Senator Kutcher: Thank you to my colleague Senator Mégie for this important piece of legislation.
Even though the pandemic has dragged on and dragged on, we continue to see denials of vaccine efficiency and effectiveness in preventing hospitalizations and death. We continue to see oodles and oodles of misinformation and disinformation about what is effective treatment, such as ivermectin, which is clearly not. We even continue to see people deny that COVID even exists. Some of the people in the convoy outside the doors have written voluminously about it being a Bill Gates plot to inject microchips into people and control them through 5G networks. This pandemic observance day could be a great opportunity to help Canadians deal with some of the scientific misinformation and disinformation. Do you have any thoughts about how that might be realized?
Senator Mégie: Thank you, Senator Kutcher, for that question. I think that, by passing this bill, it will help in terms of continuity and the fact that the observance will be each year. There will be repetition. Every observance serves to remember what happened, including the tragic aspects or the displays of solidarity and empathy by the community. All this will be observed as a result of the bill, if it passes. It would give us the chance to look back at this event every year. Hopefully, this will convince some people, but that isn’t the purpose of the bill. The goal is to remember, to take the necessary steps to end the pandemic and to prepare for the future.
The Chair: Senator Kutcher, you are at a disadvantage because I do not have the clerk by my side to tell me how many minutes you have left. I suspect you have a little bit more time. Would you like to ask a follow-up or go on the second round?
Senator Kutcher: I think I’ll stay in the second round for right now.
Thank you very much, Senator Mégie.
The Chair: Senator Bovey, as the deputy chair, I’m going to throw it to you next.
Senator Bovey: I’m sorry I was a little late. I was really engrossed in the Minister of Health’s presentation and then needed a health break myself.
Senator Mégie, thank you for the bill. I believe that it’s a significant bill. I want to thank you for your work. I think that this will be a day for all Canadians.
I have a question, though. I appreciate that you’re saying the point of this legislation is to remember. My sense is that this pandemic is one we will never forget, so as we’re observing and remembering, what’s the primary focus? Is the primary focus to remember those who were the front-line workers? Is it to remember those who suffered greatly, bot, health-wise and job-wise, during the pandemic? I wonder if we can take the intent and be a little bit more precise.
At the same time, I’m going to ask my second question now: Is this an opportunity for us to remember pandemics past, such as the flu epidemic or the polio epidemic? I well remember as a child having friends getting polio and we all lining up at school for the injections. Is this bigger than — and I don’t want to say “just COVID” — but is this “COVID-plus” national pandemic day?
Senator Mégie: Thank you for your question, Senator Bovey. When we say “remember,” we mean remember the whole tragedy, meaning the people who were seriously ill and who suffered, the people who died alone without their loved ones, and the loved ones who suffered and who are still suffering because they weren’t able to mourn. Some funeral homes aren’t yet open. A number of people haven’t had the chance to go through a mourning ritual. All these people are suffering.
It’s also about the health care workers on the front lines, who are still taking care of people and who are exhausted. We must honour their courage. It isn’t just about the health care professionals. It’s also about all the other essential workers. As I said in my remarks, it’s about the people who work in transportation, in the food industry and in the restaurant business, and all the people who helped, sometimes on a volunteer basis, to join forces and show their solidarity to support these people. On this day, we should honour all these people and ensure that everyone closely or distantly connected to them can remember and reflect with them. That’s why it matters.
Senator Bovey: Senator, can it extend to past pandemics when people also lost loved ones, when people also suffered and when people were also on the front line?
Senator Mégie: It may be possible and we may see it. However, that isn’t the point, but if it can be useful and helpful, it’s possible.
Senator Bovey: Thank you.
Senator Patterson: Thank you, Senator Mégie.
I have some questions. The first one is that the preamble to your bill notes that March 11, 2021, was designated by order-in-council and by proclamation. My first question is this: Why do we need a bill if it’s already been proclaimed and ordered by the government in an order-in-council?
Senator Mégie: Thank you for your question, Senator.
The order-in-council was to dedicate one day, but not a day each year. It was just March 11, 2021. Bill S-209 proposes an annual day of observance.
Senator Patterson: My second question is that the bill is titled pandemic observance day, but there’s no definition of a pandemic and there’s no description of the intent. You spoke in your speech of recovering, remembering and preparing, but the bill and the preamble — which we know is not definitive — do not say recover and prepare. I would like to ask you why the intent of the bill is not outlined in Bill S-209. Is that something we should correct?
Senator Mégie: The preamble says “coronavirus (COVID-19).” It was identified in the preamble. In terms of the three components, perhaps we could check with you, at a later stage, to see whether anything can be done. Once it’s noted here, I think that we can say that, by celebrating the pandemic—not “celebrating,” but remembering—we could talk about it again, look back and continue discussing what to do so that it doesn’t happen again in later years. I’m not talking about the pandemic, but about the steps to take so that it doesn’t happen again in the future.
Senator Patterson: If I may, Madam Chair, quickly, then, as a follow-up?
The Chair: Yes.
Senator Patterson: Senator, the preamble, which you referred to, only says that it will recognize those working on the front lines and to acknowledge the serious effects, but it doesn’t talk about preparing, as you said in your opening remarks, for the future and recovering. Should the preamble at least not include those concepts that you very eloquently described: recovering, remembering, preparing? Could it be improved?
Senator Mégie: That would be something to discuss. However, ultimately, this definition has already been proposed. As you said, the discussion concerns whether something is missing. The definition of the title was proposed by both the Canadian government and by other jurisdictions. In England, something along these lines was also proposed. There wasn’t any vote, but the proposal was made as well. Several jurisdictions are proposing this, also to remember the pandemic.
Senator McPhedran: Senator Mégie, thank you for this important bill. Could you please outline how this bill, if passed, will help make systemic changes to Canada’s ability to deal with future pandemics?
Senator Mégie: We believe that any observance requires time to pause. No matter what’s being observed, it’s a time to stop and reflect on what happened and to learn lessons for the future. The lessons for the future will be useful in determining how to implement other measures, as I said in my remarks, that could enable Canada to develop different ways of dealing with a pandemic.
Since we want to promote the observance part, this day will be dedicated to that purpose. However, it won’t be used to provide information on what should be done. The governments can do what they want depending on the information gathered from the public. Maybe they’ll ask for reports or discussions. They’ll proceed based on the findings in those reports. This won’t come from the bill. Bill S-209 will be a catalyst. The day of observance may serve as an opportunity for this reflection process. The annual aspect will provide opportunities for yearly discussions.
Senator Dasko: Thank you, Senator Mégie, for your presentation today.
My question is almost a bit of a follow up to the question asked earlier by Senator Kutcher, but asked in a slightly different way. I am very enthusiastic about a social marketing campaign that might accompany the pandemic observance day. We know that in this country many days recognize different conditions and diseases and so on. I’m thinking in particular of the whole month that we devote to non-smoking. During that time, various social marketing campaigns are launched around non-smoking. I wonder if there might be a possibility for this day to be marked not just by commemoration but by a serious social marketing campaign that might promote vaccinations or other related helpful, beneficial activities. I wonder if you have any thoughts about that and whether the government might be considering that or whether you think that would be something that could be done in association with the day.
Senator Mégie: The social media campaigns, the sharing of information and all these things are ways to achieve the goals set by the government or the public. That’s part of the process. The bill gives us the opportunity to have time to think about all this. Depending on what the government or the public wants to do—because the public will also want to get together and do activities—they’ll be responsible for thinking about how to share the information, through social media or in other ways. They’ll use these methods. Bill S-209 doesn’t refer to the steps to take. We’re setting the day aside for people to reflect.
Senator Petitclerc: I have a question in the form of a comment. I wanted to speak first—
Ms. Mugny: Sorry to inform you that your microphone isn’t connected properly.
Senator Petitclerc: I just wanted to say thank you and congratulations.
Senator Mégie: Thank you.
The Chair: We will move on to Senator Bernard while Senator Petitclerc tries to fix her system.
Senator Bernard: Senator Mégie, I’m sorry I missed your opening remarks because I was late getting into this meeting, so forgive me if you’ve already addressed what I’m asking. Could you shed some light for us on how this observance day relates to other observance days that we already have in Canada? Have you done some research to look at that? Have you talked about that?
Senator Mégie: Thank you, Senator Bernard.
You know, there’s no need to make comparisons with other days. Every tragedy and every significant event can have a day of observance. There doesn’t need to be a connection.
Based on my research, England has started to brainstorm, but no legislation has been proposed yet. Nurses and health care professionals are starting to send out messages about having a day of observance. They haven’t picked a date yet at all.
Senator Bernard: One of my questions has to do with reflection, and I know that you have said this is a day for reflection, but my mind goes to action. This maybe picks up on Senator Dasko’s question; I’m not sure. I’m wondering if you have considered what actions may be undertaken as part of the observance of the day. I’m thinking particularly that we’re hearing a lot about the impact of this pandemic in terms of mental health, particularly for young people; impact on educational journeys and pathways, again particularly for young people; the impact for those who are already experiencing some form of challenge or disadvantage; and the many people who are dealing with the impact of grief and loss. Would this day lead to some sort of actions in any way? If you could give us your perspective on that, that would be appreciated. Thank you.
Senator Mégie: Thank you for the question, Senator Bernard.
That’s the richness of this bill. It leaves the door open for all groups, because the suffering of one group isn’t equivalent to the suffering of another group. When we propose this day of remembrance and reflection, each group, each person and each family can choose a way to observe it. It will depend on their level of suffering, on what they experienced, or on what the public experienced in a given group or community. That’s the richness of this bill. It leaves room for reflection and action.
The action won’t be determined by the bill. It isn’t there to say what action to take. The bill provides an opportunity for reflection. The groups and communities can make decisions. For example, health care professionals can choose to mark the day in a certain way. Students and youth, a group of people with mental health issues, can choose to observe it in a specific manner. That’s the richness of the bill. It leaves the door open for everyone who wants to observe the day to do so in their own way. There can be rituals depending on the culture of the person, so it varies. It opens the door to all that. On the contrary, the bill doesn’t set any barriers.
The Chair: Senator Mégie, whilst we are waiting for Senator Petitclerc’s technical issues to be resolved, perhaps you would entertain a few questions from me.
In your second reading speech, Senator Mégie, you said very appropriately there is only one way to emerge from this pandemic, and that is by doing so together. But let’s reflect on that, given the context of what is happening in Ottawa and other parts of our country with the “Freedom Convoy.” How do you think this bill, this remembering of the past or the present, as it may be, will help unite our country and deal with the divisiveness that is so loud today?
Senator Mégie: In life, we can see that, during a tragedy or a significant event, many people come together. It can create reasons to unite. In my humble opinion, it can open the door—the unity comes from all the people who want to mark this day since it gives them time to think about what to do. That’s where a form of social cohesion will come from, depending on what they want to do and why. It takes a while. Days go by. Things go fast. Social media sends many messages. Everything moves fast. Memories also fade quickly. In order to leave room for expressing solidarity and building social cohesion, we need a day dedicated to that purpose. The bill seeks to provide this dedicated day.
The Chair: Thank you.
Like Senator Bernard, I too am curious about how this will actually roll out. If I think about Family Literacy Day, I know what our local library does. That’s a good example of what they do. Perhaps put yourself in a hospital, which you are familiar with, being a physician, or a long-term care home. What activities would they do? How would they remember this pandemic?
Senator Mégie: The bill doesn’t say what to do. Everyone has their own way of doing things. For example, in a seniors’ residence, people are in charge of recreation. Their role is to bring people together in culturally appropriate ways. Some will pray, some will remember the deceased, and so on. Everyone will make choices according to their beliefs, their culture, and the harm suffered. This includes the harmful impact on health, but also the damage to economic health. Everyone will figure out their own approach. That’s why the bill doesn’t tell everyone what to do. It gives everyone the space to think about it and to make their own plan for how to mark the day.
Senator Kutcher: Senator Mégie, our colleagues have been talking about the importance of action, and I appreciate exactly what you’re saying — that the issue here is for people to choose actions that they would think would be most appropriate for them. I think that’s an excellent way to come at this. It’s not prescriptive; it’s supportive and promising. If you were advising a health authority — pretending you’re not a senator but a physician advising a health authority — what kinds of things would you suggest that the health authority think about doing as a commemoration of this kind of day?
Senator Mégie: Thank you, Senator Kutcher, for your trick question. Let’s say that I’m not a senator, but a doctor. It would mostly be from a health perspective. I’ll tell them to remember what was done and the lapses that took place, and to learn from all this so that we can move forward and create structures to ensure that we aren’t in a difficult position next time. This is very important. However, this doesn’t provide the opportunity for remembrance. The remembrance part would perhaps involve sitting down together—the different players, the managers—to conduct the post-mortem, to be able to come up with these ideas.
Senator Kutcher: Thank you. I appreciate that.
Senator Bovey: My question is a follow-up from Senator Kutcher, Senator Bernard and those who have been asking about action and what you can link this to. I want to have an idea of your thoughts.
We all remember when the AIDS pandemic hit the world. In my world, the art world, we globally look at December 1 as being the Day With(out) Art, doing exactly what Senator Mégie is working on with recognition, remembering and reflecting. Institutions around the world and across Canada dealt with the Day With(out) Art in quite different ways. Some closed; some draped works of art with black; some had special programs. The whole day was to celebrate the lives of those lost and to celebrate the research. We still don’t have a vaccine for AIDS, and a medical cocktail approach is being followed. The day celebrates doctors and front-line workers working with patients with AIDS, and it recognizes families of those who lost their lives. That was a day that came out of fear when no one knew what caused AIDS. We thought we knew. There are biases against certain aspects of society.
My question, Senator Mégie, is whether perhaps a Day With(out) Art is an example that you might want to look at when you’re promoting your bill as something that was celebratory, that celebrated the research, front-line workers, those who lost their lives and yet carried on looking to the future?
Senator Mégie: Thank you, Senator Bovey, for your question. You just described all the possible steps and actions. Even though the bill doesn’t set this out, it gives the public the space to think about things and to consider following up on everything that the government has already done to fight COVID-19. It can be an assessment of all this.
It can also be, as you said, a day without activities. What comes to mind—and to respond to Senator Kutcher, who asked me what I would do as a citizen—could be as simple as a day where everyone washes their hands, to learn how to wash their hands for a future pandemic. However, this wouldn’t come from the bill, but from the time the bill provides for reflection. For example, health care professionals could decide that, in their hospital and in several hospitals in the area, they would oversee hand washing. This could raise public awareness.
I’m glad that you gave me all these examples from AIDS, because it gives our committee members suggestions for possible actions. This day, when we think about it, can be used to urge the government to take action, depending on the group calling for action.
Senator Bovey: This was picked up in the case of AIDS, and it picked up quickly and very positively. It doesn’t cost much except for the black draping and special programming, but it was very simple and very direct.
Senator Bovey: I think that, in the case of the Day With(out) Art, the response was very quick and involved many people across the country. It didn’t cost anything. It was very simple.
Senator Mégie: That’s good, yes.
Senator Patterson: Senator, why was March 11 picked? What’s the significance? Does that day have a special significance in relation to the COVID-19 pandemic?
Senator Mégie: Thank you, Senator, for that question. This date is significant. March 11 is the day when the WHO declared that an epidemic had become a pandemic.
Senator Patterson: Thank you very much.
I fully appreciate the noble intent of this bill, but I’ve been in the Senate for a while now and am almost sure that there will be some honourable senators or even some people who will say, “Oh no, not yet another commemorative day. Soon there won’t be enough days left in the year.” I’ve heard that before with bills like this. Do you have any idea how many days the Parliament of Canada has already named of this kind in a year?
Senator Mégie: Thank you for the question, Senator. I think that there are many days. However, I don’t think that this detracts from the idea of giving people who suffered and people who worked hard to save lives the chance to find a space to remember and to begin to grieve. As I said, the people who suffered were the sick individuals, but their loved ones are still grieving. They need a space to grieve.
When you haven’t experienced this, maybe you think that introducing another day is overkill. This day isn’t a holiday, so it shouldn’t bother anyone on an economic level. However, the people who suffered and who are still suffering need this space.
Senator Patterson: Thank you.
The Chair: Perhaps I can get my question in, Senator Mégie. When I think of all the national days that we observe, there is one day that has seeped into our national consciousness, and it is Remembrance Day. We all wear the poppy, and there are lots of mini and macro things happening in the country. Is that your vision in your bill for your national pandemic day?
Senator Mégie: Thank you, Senator. It wasn’t just November 11. It’s the goal of observance, the goal of remembrance. As you can see, for all the commemorative days—you just told me that there are many—people often use these times to reflect. Life goes on. Everyone goes about their daily lives, but this day is dedicated to reflection.
We’ve also seen that things are quickly forgotten. The Spanish flu was devastating, but it has been a century and no one remembers it. The disaster has never been commemorated. As I said in my remarks, there were even positive effects or benefits of the Spanish flu, such as the government’s establishment of public health agencies. However, no one remembers these things because they’re in the past.
If we miss this opportunity, especially with social media, where the next day’s news is no longer news, it will quickly be forgotten. At least, if we keep this date every year, it gives people the chance to use it based on their needs.
Senator McPhedran: Senator Mégie, would you agree that we should suggest some amendments to this bill?
Senator Mégie: It depends on the type of amendment. We could look at this in committee. I’m not completely opposed.
It shouldn’t change the spirit of the bill, which is to provide the space for people to reflect, to take stock and to do what it takes to ensure that this doesn’t happen again. If the amendments don’t change the spirit, I’m open to them.
Senator McPhedran: Thank you.
The Chair: Thank you, Senator McPhedran.
I don’t think there are any other questions, so I will make an observation. The plague was a pandemic of enormous proportions. In every city, town and community in Europe, they erected a monument called the Plague Column. That’s the way they remembered it. We are beyond structures in these times, I think, so I welcome your effort, Senator Mégie, in this regard.
Continuing our hearing on Bill S-209, our next witnesses are: from the Canadian Grief Alliance, Katherine Kortes-Miller, Member of the Executive Committee; from the Canadian Medical Association, Dr. Katharine Smart, President; from the Royal Society of Canada, Tracy Vaillancourt, Professor and Canada Research Chair, University of Ottawa; Julia M. Wright, Professor, Dalhousie University; and Dr. Sharon Straus, Director, Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto.
I invite Ms. Kortes-Miller to begin her presentation, followed by Dr. Smart and then Professor Vaillancourt. In order to keep us all on track, honoured witnesses, I want to share with you that you will have five minutes for your presentations. If you see me raising my hand like this, it means that you are close to the 10-second mark and that you need to wrap up your remarks. I think we prefer that to interruption. Let’s proceed, Ms. Kortes-Miller.
Katherine Kortes-Miller, Member of the Executive Committee, Canadian Grief Alliance: Thank you and good afternoon, senators.
It is my pleasure to join you this afternoon from the traditional lands of the Fort William First Nation, signatory to the Robinson-Superior Treaty of 1850, in support of Senator Mégie’s Bill S-209 to designate March 11 in each and every year as pandemic observance day.
It is my privilege to represent the Canadian Grief Alliance as one of the core members. The Canadian Grief Alliance is a coalition of national leaders in grief and bereavement and more than 150 national and provincial organizations that are encouraging the government to adopt a proposal to address national gaps in grief services that are leaving hurting Canadians unsupported in their grief. The alliance includes front-line providers, psychiatrists, social workers, psychologists, therapists, alongside academics and organizations providing grief services from across Canada. Our group is convened by the Canadian Virtual Hospice, an internationally recognized charitable organization that serves 2.4 million users annually.
Canadians are enduring a savage pandemic. To state what might seem obvious, Canadians have suffered an unprecedented level of grief over the past two years, and COVID continues to be, as it has been described, a “perfect storm” with incredible numbers of deaths, political divisiveness, lockdowns, visitation policies, unemployment, financial ruin and now, occupations.
Not only has COVID-19 claimed the lives of almost 35,000 Canadians, but many others have died in circumstances that have left those close to them bereft, saying goodbye on an iPad, unable to hold a funeral and separated from the comforting presence and touch of family and friends. The Canadian Grief Alliance tracker on our website estimates that over 5 million Canadians have experienced the death of someone close to them during the pandemic.
Grief is a natural process from which most people recover in normal circumstances, but grief during this pandemic has been different. Never in our lifetime has Canada experienced the volume and complexity of grief that has resulted. Grief is often difficult, but the social distancing requirements of COVID-19 have fundamentally changed the ways we grieve. Professionals agree that due to the absence of important traditions that formally honour people who have died, there is a greater risk for more complex grief experiences. Moving through grief relies on human connection, the ability to bring a casserole, to hold a hand, to hug, to sit quietly with someone who is grieving, to be present. Many people in Canada have grieved in isolation, separated from their social supports, without the ability to formally say goodbye to a loved one at their bedside or during a funeral or memorial service, and those left behind may feel a sense of ambiguous or delayed grief. Delaying these important rituals creates concern in our communities that people who have died will not be properly acknowledged or honoured. Research has shown that the pandemic-related and influenced grief is more complex. It can feel as though the person has not really died, despite rationally knowing otherwise. Others may feel that they were not able to say their goodbyes.
Designating March 11 as pandemic observance day is one way to allow Canadians to acknowledge our anguish and our deep losses experienced throughout the pandemic so that we can engage in social mourning and hopefully come together and begin to heal. The Canadian Grief Alliance is in support of this bill because how we grieve matters, and this formal recognition of our collective grief experienced during the pandemic is a step in the right direction.
Katharine Smart, President, Canadian Medical Association: Thank you, chair and committee members, for the opportunity to appear before you today.
I am Dr. Katharine Smart. I’m appearing before you from the traditional territory of the Kwanlin Dün First Nation and the Ta’an Kwäch’än Council. I am a paediatrician based in the Yukon. As president of the Canadian Medical Association, it’s an honour to represent physicians and medical learners from all jurisdictions. This role is even more meaningful at a time when the country so clearly sees the impacts of the pandemic on a health care system and a health workforce that has been overstretched for years.
I am pleased to add the CMA’s support for a pandemic observance day. This is an opportunity to reflect on everything we’ve lived through, the impact it has had on every aspect of our lives and the lessons we must learn from this experience to build a better tomorrow.
The federal government has played an instrumental role in Canada’s pandemic response, with CMA staunchly supporting the many federal actions taken since the onset of the pandemic. As we enter the third year of the pandemic, we continue to look for federal leadership. This is a pivotal moment, not just to stabilize health care in Canada but to reframe it.
Patients and providers are bearing the brunt of shortages, structural issues and regulatory barriers that have long plagued our health systems. We are in the depths of a health workforce crisis. Each wave leaves us flailing under deepening levels of backlogs, with even greater workforce and systems impacts.
Physician burnout is at an all-time high. Preliminary results from the CMA’s National Physician Health Survey reveal that 53% of physicians report high levels of burnout, nearly double pre-pandemic levels. Further, 46% told us that they are either likely or very likely to reduce clinical hours in the next 24 months, with an additional 18% considering it.
The state of the health workforce will greatly impact Canadians’ ability to access the care they need, now and in the future. We know that the premiers are focused on an increase in unconditional federal dollars. The CMA is calling for more strategic federal investments to support rebuilding and reforming health care delivery in Canada.
First, we need federal leadership for pan-Canadian, integrated health human resource planning. Health workforce challenges have escalated beyond what any province can manage alone. An intergovernmental approach led by the federal government is now required.
Second, it’s time to deliver on the promise to increase patient access to family doctors and primary care teams by delivering on the $3.2 billion commitment. Scaling up collaborative, inter-professional primary care is central to increasing access to care.
Third, we need to eliminate barriers for medical professionals by enabling the adoption of pan-Canadian licensure. Medical professionals need to be able to move from province to province to help deliver care where it’s needed.
These actions by the federal government are crucial to rebuilding the foundation of health care in Canada. Whether or not they are implemented will determine how we look back on the lives we’ve affected in the coming years.
Future pandemic observance days can remember a time when we seized a moment to collectively address a systemic cascade of hardship and worked to breathe life back into health care.
We know the government cares. We rely on it to help us to supply and provide care to Canadians.
Thank you, chair.
Tracy Vaillancourt, Professor and Canada Research Chair, University of Ottawa, Royal Society of Canada: We thank you for the invitation to present to your committee.
Over the last 20 months, The Royal Society of Canada’s COVID task force has overseen nearly 30 working groups charged with developing policy briefings to support evidence-based responses to the pandemic. The pandemic has affected our health, our institutions, our economy, our education, our culture, our social interactions and even our social cohesion. The pandemic’s ripple effects will be felt for many years, if not generations, to come.
Anything that impacts public health and health affects not just how we live but also how we live together. The range of policy briefings produced by the task force reflects this interconnectedness, addressing topics from education to long-term care and from mental health to economic recovery.
Because we are also connected to our past, many of our policy briefings have reflected on the health and public health disparities that have long existed in Canada. These briefings have addressed concerns relevant to priority populations such as Indigenous people, racialized communities, older adults, children and those living in congregate settings.
Connection has also been part of how we work. The task force is multidisciplinary, including scholars in the arts, humanities, social sciences and sciences. Many of our working groups reach across categories of experts to include community representatives such as members of the public, educators, practitioners, patients and essential care partners, as well as researchers and decision makers. We have learned from this pandemic that we must work together and build bridges rather than walls. The partnerships and collaborations that we have already built must continue.
We welcome the discussion of a national day of observance as an opportunity to remember lives lost and to remember lessons learned. It is urgent that we continue to reflect, together, on what worked and what didn’t so we can honour our shared grief by doing better the next time and in the meantime. We must ensure that we collectively work on recovery and monitor our progress in the recovery process.
The task force’s first policy briefing on long-term care highlighted the failure to learn from past research and the experiences of residents and clinicians, knowledge that was gained over decades before the pandemic. This failure made the first wave so much harder than it should have been.
This has been a reoccurring theme in many of the task force’s peer-reviewed policy briefings. The pandemic has been more dangerous and more difficult than it ought to have been in Canada, in part because we have not always acted on expertise and evidence, even when faced with urgent calls to action. We have let things slide and have failed to develop nimble and flexible systems to respond to similar emergencies. We have pushed problems to the back burner and forgotten lessons of the past. We had hoped for more after SARS and the SARS commission, but still we failed to learn and so we weren’t as ready as we might have been in March 2020. We must try to be better prepared for the years ahead.
For example, school closures were experienced by 5.7 million Canadian children and youth. Although often necessary to curtail the spread of COVID-19, school closures have widened the inequality gap in Canada, thus threatening the prospects of all children and youth, but especially those who were already vulnerable to begin with. Recent estimates on learning loss point to an urgent need for education recovery and renewal strategies to help mitigate the impact of school closures on educational disengagement, attendance problems, declines in academic achievement and decreased credit attainment.
As another example, over the past 10 years, more than 80 reports and inquiries into long-term care have been conducted in Canada at a cost of tens of millions of dollars. The lack of support and inadequate infrastructure in long-term care homes was well known. We had the information to anticipate the disastrous effect of the first wave of the pandemic. Instead, efforts at the outset of the pandemic were largely focused on supporting acute care hospitals. We had to pivot quickly to support residents and caregivers in long-term care homes.
In Canada, unique research collaborations were established to help mitigate outbreak risks and support as well as involve long-term care home residents and staff. These collaborations allowed Canada to leap ahead of others in these research areas. We must not lose the ground that we have gained. We must continue to advance.
This is why the task force continues to draw together experts from across academic disciplines and beyond, to understand the problems we’ve faced, build on what we’ve learned and chart paths forward to a Canada that is more resilient. We hope to build more of these bridges so that we can more effectively learn from the past and from each other to collaborate on solutions. We must continue to build on the advances of the past 22 months, including creating new pathways for multidisciplinary research and collaborative research that engages patients, caregivers, educators, youth, policy-makers and citizens in sharing knowledge across disciplines, including effective communication.
A national day of observance is an opportunity to make sure we forget neither the lessons nor the terrible human costs of this pandemic. It can help ensure that we are all held accountable to those we lost by urging us to mark their memory with a collaborative and evidence-led movement toward a better Canada.
Thank you for your time.
The Chair: Thank you so much all. You all did well on time, and on substance, of course.
I will ask the sponsor of the bill, Senator Mégie, to ask the first question.
Senator Mégie: I want to ask Dr. Kortes-Miller and Dr. Smart the following question. Should this bill pass, how would it be viewed by your different groups and how do you think they might approach the observance of this day?
Ms. Kortes-Miller: Thank you for the question.
Canadian Grief Alliance is very excited about the opportunity for there to be social mourning in the context of remembering what we have learned, the lessons learned from the pandemic. Particularly, we would use this as an opportunity to work to increase the capacity of grief literacy within our communities. The Canadian Grief Alliance, in conjunction with the Canadian Virtual Hospice and other groups across Canada, would engage in using webinars and providing opportunities for social mourning. We would utilize web resources and community engagement to support opportunities for people to come together and remember and acknowledge the losses that they have encountered and the lessons that we have learned through the pandemic. Thank you.
Senator Mégie: Could Dr. Smart answer the same question for the Canadian Medical Association?
Dr. Smart: Thank you for the question, and thank you, Senator Mégie, for this important bill.
From the perspective of the CMA, the opportunity for a pandemic remembrance day, we believe, gives us an opportunity each year to remember the dedication and the sacrifice of front-line health care workers as they’ve cared for Canadians throughout this pandemic.
I think what’s really striking is that care has crossed so many aspects of our society: acute care in hospitals, ensuring capacity to care for people critically ill, but also in our communities, long-term care facilities, stepping up vaccination clinics, attending to people in primary care offices and making sure that people’s mental health was attended to.
I think the opportunity each year for us to acknowledge those health care professionals, the sacrifices they made to ensure that Canadians were able to receive care during this pandemic, is incredibly meaningful. Also important, as we’ve spoken about, is the opportunity to reflect on where we are at advancing the changes, the reframing and the innovation that needs to happen to keep moving our health care system forward so that it can serve Canadians.
We have the opportunity both to acknowledge our members and thank them for what they’ve done, but also to reflect on where we’re headed and the actions that we need to take and whether we have been able to do that as a nation as we move out of this pandemic.
Senator Bovey: I would like to thank all the presenters. I found that very moving and very factual and forward-looking and honest, so I thank you.
Dr. Smart, I really like the plans on actions that the CMA has put forward, and I look forward to seeing how those are going to be able to be played out.
Dr. Vaillancourt, I was fascinated that you talked about generations going forward in this remembrance. Our chair earlier referred to the Black Death. I want to say I have a medieval academic daughter, and she said there’s never been more interest in the history of the Black Death and the learnings from the Black Death than there have been in the last two years. So this will go on for generations, and we’ve got lots to give.
My question is for Dr. Kortes-Miller. You’re so right about grief. The issues have been huge, and not just for those who have lost loved ones but also for those whose lives won’t be what they were before. I really appreciate that probably the first few years of this special day will be societal mourning days and societal grief days, and I appreciate what you’ve said as to what your actions might be.
What I would like your thoughts on — as one who has suffered grief, I know how it comes back so unexpectedly at odd times — is how you think this special day will assist those individuals who are grieving and will help bring them out of that grief to that moment of better light and happy memories of the loved one they’ve lost? As well, do you think that, over the years going forward, the impact of this day will change, perhaps change from one of communal mourning and understanding grief to one of — I don’t want to say positive memories, but you know what I mean. Will it transform itself into other meanings? Because for me, that would make the day very rich. Ms. Kortes-Miller, that was a long way around to ask if you can tell us more about its effect.
Ms. Kortes-Miller: Thank you very much for your question, and I hope I can.
I can tell a short story from some research that I’ve had the opportunity to engage in, speaking with people who have experienced the death of someone close to them during COVID. One of our participants spoke of how she returned at the onset of the pandemic from a holiday to find everything locked down and how she went to her garage to grab her ladder, which she put on the back of her truck, and she drove to the long-term care facility where her mother was dying. She stood on that ladder in wintertime in Thunder Bay to be able to see her mother as she lay dying because of her connection and her desire to be present. When I mentioned to this individual that I had the opportunity to speak with you today and that there might be the creation of a day of observance, she talked about the fact that her family had made a YouTube video for the funeral. She thought a national day of observance would provide an opportunity for her to feel that social connection to her community and to the country as a whole in remembrance of this difficult time during which her mother died. To have that acknowledgment and for her to be able to connect with others during this time would be really important.
On the second part of your question, senator, and what might this day move into, I hope it will help us to recognize a time when we came together in different and unique ways to acknowledge people’s grief, to come together as a country to learn from some of our challenges and our mistakes and to grow together so that we learn that we will take care of each other in difficult times. I hope our national day of observance moves into that learning and acknowledgment.
Senator Bovey: Thank you. Again, I applaud all three of you.
Senator Kutcher: My question is for Dr. Smart and Dr. Straus, but first I would like to thank you and all of our health care providers for the selfless dedication, hard work and care that you have provided to all Canadians during this incredibly trying time. I am deeply, personally sorrowed by the attacks launched upon you and your co-workers. They are completely unacceptable. Please note that neither I nor many of my colleagues support these behaviours that threaten health care workers or anyone else who is following our public health guidelines for that matter. I just wanted to let you know that.
The pandemic has seen us experience a horrible lack of surge capacity in our health care system. No pun intended, but it’s unmasked problems that were already very well known. If you were being asked by the federal government for advice on how they could show action as well as reflection on this kind of day, what two or three concrete things would each of you suggest should be done to fix the problems that this pandemic has cast such a harsh light on?
Dr. Smart: Thank you for the question.
As we’ve heard, I think pandemic observance day provides an opportunity as a nation to remember where we find ourselves today and the sacrifices of so many people in health care, other people providing front-line services to Canadians, of Canadians themselves and, of course, of all the people who have lost their lives and loved ones. It can also serve as a call to action to the government to really be serious and committed to the collaboration and the work it’s going to take to bring our health care system back to where it needs to be.
As you said, we haven’t learned anything during this pandemic that many of us didn’t already know. I think the difference now is it is at the forefront in the minds of Canadians. Never have we seen health care on the front page of the news almost daily. I think what’s very clear is that to move forward, we need to be transparent, own the problem and really commit to that multilevel government approach and to collaborating with stakeholders to advance changes in the system.
From the CMA’s perspective, we see several priority areas where we would like the government to take action. I think what could be happening on pandemic observance day is using it as a bit of a stake in the ground to reflect on whether we have actually moved forward on these issues. As I said in my statement, from our perspective, there are a few areas.
One is human health resources. We know there’s no health care without health care workers, and we are at a crisis in this country right now in terms of the future and what that looks like. Having all levels of government commit to an integrated health workforce plan, the data to support it and then monitoring the progress we’re making on an annual basis would be very meaningful and would move us toward that long-term objective of having the human health resources our country needs. That’s one issue.
Another issue is around licensure. We’ve spoken about pan-Canadian licensure and opportunities to better deploy the human health resources we have. We know there’s a desire for this amongst other health professionals also. Again, I think we can be reflecting annually on where we are in that trajectory. Are we creating a human health resource network that has the mobility to be available to Canadians? Especially when we look at things like virtual care that is likely here to stay, taking down some of those regulatory barriers will allow us to leverage that to improve access. We can reflect on that day on whether we have made it further down the path toward that change.
Stabilizing health care funding is another aspect. I think we all recognize that right now our health care system is not adequately funded to meet the needs of Canadians. I think we need to set clear benchmarks on where we’re going, what the federal government’s role will be and how we combine that increased funding with changes in terms of how the system is designed to better meet the needs of Canadians. Again, I think this day can serve as an opportunity to benchmark that progress.
I often think the best way to commemorate the sacrifices people have made is to be committed to the change that they would want to see in a system that would better serve them, their families and their communities. I think reflecting on these benchmarks and the progress that we’re making is that opportunity.
Dr. Sharon Straus, Director, Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Royal Society of Canada: Thank you, Senator Kutcher, for the very kind words and for this opportunity. I would focus on three things.
The first is with regard to the long-term care home sector. I co-led the long-term care home report for the Royal Society, and I would really like to see that the standards that are being developed actually get implemented, that there’s going to be some accountability with regard to monitoring to make sure they are implemented and that we do actually learn the lessons of the past decades.
The second thing I would like to see is a focus on science to continue. I think everybody has talked about the importance of science literacy and adequate science communication, and I think that’s a critical factor.
The third thing is to continue to promote the multidisciplinary collaborations. I would love to see more collaboration across our tri-council funding agencies to really support the efforts across the different disciplines and to also create new pathways for people doing research in these areas. As a geriatrician who looks after older people and who is doing wastewater surveillance research with engineers and geographers, if you asked me two or three years ago if I would be doing that, it would have never happened. I would really love to see that kind of work and opportunities for students in the future to build careers and to answer these tough questions.
Julia M. Wright, Professor, Dalhousie University, Royal Society of Canada: I’m not a medical expert, but I would say as somebody who lives in a province with a chronic shortage of family physicians, and given the infodemic that we’re seeing, I think it’s really critical that we deal with the shortage of family physicians in this country. People need somebody who they trust and who they can talk to about vaccines, about their grief, about their mental health and their physical health needs and to get better advice than they can find online. I would make that a priority, personally, from the patient side of things.
Senator Moodie: Thank you to the witnesses today.
We’ve had some discussions already about what this bill means and the intent of the bill. Just listening to the three of you, it has been enlightening and enriching. You have provided a rich backdrop of what this could possibly be.
In your opinion, should Bill S-209 state the intention of pandemic observance day a little more clearly? Do you think we need to define more clearly what this day is about? Some of the thoughts and ideas that you have expressed, although very much a thread, are somewhat different. How do you see us explaining to Canadian people just what this day means for each of you? You jump right in and you know exactly what it means for you, but for the average Canadian, have we gone far enough?
I will throw the question at Ms. Kortes-Miller first because you are pretty well placed in collective grief versus delayed grief, and I understand that. However, I’m trying to understand what happens with Canadians each year and the first year. What do they do with this day? What’s your impression of that?
Ms. Kortes-Miller: For the first year, I hope it will be an opportunity for people to come together in their collective grief for that social mourning. I’m hopeful there will be groups, such as are represented here today, that will target the different communities that they serve and provide some structure to be able to come together.
I appreciate what you’re asking in terms of what happens later on, and I like the idea that there is space for Canadians to acknowledge this in the way they would like to. I think we can look at it as a time to honour our education around science and the need to be able to communicate what’s going on with a level of transparency and also have respect for our government and what is occurring.
I also like the idea that there will be time for people to talk about what they have missed as a result of the pandemic. I’m thinking of children who have missed high school graduations, proms and the first years of university, and people who have lost jobs and can talk about their businesses that have dissipated as a result of challenges with the pandemic. I think a day of observance will provide space for all of that in addition to respecting the achievements made by our health care system and recognizing what needs to improve during that time.
The Chair: Senator Moodie, would you like an answer from others?
Senator Moodie: Yes, I would appreciate the answer to the question of whether we need to put more into the bill that guides the thinking around this day.
Dr. Smart: Thank you so much for the question.
I think what’s really interesting and encouraging about something like a pandemic observation day is the opportunity to really reflect in a simple way on where we’ve been, where we are — and that will, of course, change from year to year — and where we are going.
We have heard from many of us today about the impact in our areas and the way it has impacted our communities and our country. I think it’s fair to say that the way people want to observe this day will likely be different depending on what impact the pandemic had on them. That openness to allow it to be different things, depending on what people need, is important. It can serve as an anchor point to always be asking those questions.
What we would all agree on about this pandemic is that so many things about the status quo are no longer acceptable. I hope that this day will provide us the opportunity to always ask those questions about where we are headed as a nation, what lessons we can take from this pandemic and what things we don’t want to repeat. I think that’s an amazing way to commemorate all the sacrifices people have made. What I want to see in the bill is that it’s asking Canadians to reflect on that aspect of the pandemic and use it as an opportunity to continue to grow.
Senator Patterson: I’d like to thank all the presenters for a very eloquent, compelling testimony.
I am speaking as a legislator or a lawyer. I have heard very clearly what almost all of you have said about, as Dr. Smart just said, reflecting on where we have been and where we’re going, benchmarks that we can aim to and forward-looking hopes about our distressed health system.
However, the preamble of the bill itself — there’s no intent in the body of the bill — says to honour those who have died and recognize those working on the front lines. It talks about serious effects on the health of Canada’s population. I’d like to know whether you would recommend that the bill could be strengthened by putting in, as well, these forward-looking goals that you have almost all talked about.
As the sponsor told us today, one of her hopes is that the bill would help us to prepare for the future. It seems to me that’s not really spelled out in the preamble. It’s more — and don’t let me minimize it — recognizing the health workers who have worked so nobly, the people who have died and the impacts on the population. It doesn’t talk about that forward-looking viewpoint and the lessons learned that you all seem to recommend should come out of this. Would you like to see that spelled out better in the bill to strengthen it? Thank you. That’s my question, and I will ask Dr. Smart and Dr. Straus in particular, if I may Madam Chair.
Dr. Straus: Thank you very much, and absolutely I would agree. Certainly, my interpretation — and especially when reading it — was focused on the recovery, the remembrance and the preparation for the future. That really implies looking to the future and holding us accountable for what lessons we learned. I agree that it would be terrific to have it further strengthened to make sure that that’s explicit. It’s going to be critical for us to be able to see, over time, that we have actually implemented change and that we have continued to innovate and act on the lessons that we learned. I don’t want to have to write a similar report on the status of long-term care homes in a few years with nothing changed, so I would really advocate for inclusion of that additional language in the background of the document.
Senator Patterson: Dr. Smart recommended three very laudable goals. I wonder if she would comment on whether we can put some of that kind of lessons-learned, forward-looking concept in the intent, the preamble or even the body of the bill.
Dr. Smart: Thank you for the question, and I would definitely agree with Dr. Straus. I think that would strengthen the bill. Again, as I mentioned, the real way to honour what Canadians have been through is for all of us who are still here to be accountable, as we move forward, about what changes we want to see in our system. I believe that embedding that as part of the bill — this idea of where we have been, where we are and where we’re going — and using this pandemic observance day as an opportunity to hold each other accountable to the changes we want to see would strengthen it. It would give us the opportunity not only to honour and commemorate what has been lost but also to have hope for the future. I think that will be critical for Canadians as we move into a post-pandemic recovery.
Senator Patterson: I want to say that I’m happy to see a CMA president from one of the territories. Also, I think my question really followed on the gist of what Senator Moodie had asked.
Senator Bernard: Thank you to all the witnesses. I appreciate your testimony and your time with us today.
We’ve heard a lot across the country about the shadow pandemic, which is the impact of the pandemic on those experiencing gender-based violence. We have also heard about the dual pandemic impact of racism. We’ve heard about the impact of the pandemic on those already marginalized by poverty, homelessness, those living with health conditions and those experiencing challenges.
My question really picks up on the question that Senator Moodie was asking in terms of this bill. For Canadians living with any of those realities, living with the shadow pandemic, the dual pandemics, the cracks in our society that have become more visible through the pandemic, how would they see themselves reflected in this bill? How would this bill speak to their realities, and are there things that we can add that may make such a day more impactful for them? I am also thinking about children and youth and the impact of the pandemic on their everyday realities. That can be to any of the witnesses.
Ms. Kortes-Miller: Thank you very much for the question.
As an academic, I generally appreciate detail and direction from documents that I get, but one of the things that actually appealed to me about this bill was the national nature of it and that there is room for people to observe the pandemic in the way they would choose. I liked that about the bill when I read it initially because my take is that Canadians are tired of being told what to do. I think if we make it really specific about what it is they are supposed to observe on the day of observance, we’re not going to get that collective feeling of joining and people coming together and sharing the diversity of their stories and honouring the Indigenous peoples here in northwestern Ontario that we have watched suffer. You’re mentioning people of structural and vulnerable situations who are really struggling. I think a day of observance that’s not overly specific or directive or mandated provides opportunity for people to honour the time that they have experienced during this pandemic in the way that they choose. Thank you.
Dr. Straus: I would agree. I think one of the strategies is to make sure that some of the people from these different priority populations can actually be invited to share their stories. For example, one of the populations I work with — I look after older adults — and the community that I work with in particular, we’re seeing a lot of older adults who are socially frail or who are now precariously housed because of the pandemic because they didn’t have the same supports. Often these people’s voices aren’t being heard, and I think of them being able to tell their stories and others hearing the stories we have been hearing from these people over the last two years and hearing how their lives have been affected. Over this next period of time, we’re seeing more and more older adults at risk of homelessness, more than we’ve ever seen before, and these are the stories I would like to see told. I would like to make sure we are held accountable so this doesn’t happen again and that we have systems in place in our communities to make sure that when caregivers get locked down into a particular situation, like long-term care homes, retirement homes or acute care settings, that we still have resources in the communities to look after these socially frail individuals who may not have family members. I think being able to tell those stories and hearing those stories from those individuals and have those reflected across Canada will be critically important.
The Chair: You only have one minute left, but I do see that Dr. Smart and Ms. Wright have their hands up to answer this question, so if you can get it in very quickly, please do so.
Dr. Smart: I will say one quick thing. I think your question underscores the importance of us understanding the impacts of why some people are healthy and why some people have been disproportionately impacted by the pandemic. It’s very clear that societal racism, the impacts of colonialism, all of these themes have impacted who got COVID, who is comfortable being vaccinated and who has been able to access care. Again, I think this has to be foundational, and any observance of what’s happened in the pandemic is us recognizing these societal issues and, again, holding ourselves accountable about what changes we are going to bring forward to make sure they are being addressed.
Ms. Wright: Quickly, I wonder if that excellent point might be addressed by including some phrasing along the lines of the “unequal effects of the pandemic.” I work in cultural history, and the meaning of these kinds of commemorative events changes over time. At various points in history, the Remembrance Day celebrations have been a lot more powerful as the war to end all wars than they have been at other times. The meaning of it has shifted quite a bit over the generations. I think we need to be mindful that this will as well. Inequality is unlikely to go away, alas, so I think that reminder that inequality is something for which we should continually strive to address would be urgent to put into this, perhaps, and would allow us to acknowledge the sorts of things that Senator Bernard is talking about.
Senator McPhedran: I want to thank each one of our expert witnesses for helping us with this discussion today, and I want to thank Senator Mégie, the sponsor of the bill, for her openness to allowing this committee to look at ways in which we might strengthen and clarify the intent of the bill.
I want to invite a little more specificity, if it’s possible, to the notion of referencing inequality in a potential amendment, and also including some sort of reference to systemic change. I guess my last point is that we also have available to us observations as a committee that may allow us to bring, at least in the legislative context, some greater clarity as well. The question is to anyone who wishes to answer.
Ms. Vaillancourt: I agree. I think it is going to be really important that we acknowledge that the pandemic has been particularly cruel to certain segments of the population. If we say it, then we validate their experience. I think that’s really important. I agree with your comments, and I can appreciate what Dr. Kortes-Miller was saying about it being broad, but I think in this instance there is enough evidence to support that certain individuals were disproportionately affected and that it ought to be addressed.
The Chair: I don’t see any other hands raised. I take that as being acquiescence with your response.
Senator McPhedran, you have a little more time left. Do you want to ask another question, probe deeper, or are you happy with what you got?
Senator McPhedran: I’d like to probe more deeply on some of the points that Senator Dasko made. She’s speaking after me, so I hope I’m not eating any lunch here. I really would welcome more commentary from our experts while we have this wonderful opportunity to be in dialogue with you about the kinds of messaging, the possible events and the opportunities. This very much goes to points that have been made by Senator Moodie and others about inclusion. I have particular concerns for inclusion of the upcoming generations and within that youth population of our country. As my colleagues know, I’m very worried about the fact that Canada has become an old country. As of the 2016 census, we have more older people in this country than we have younger people. All the various ways in which we can include young people in their full range of diversity is something I would love to hear more from you about.
Ms. Wright: Thank you for that question.
I think this is something we should devote time to. We have been talking about the Remembrance Day commemorations and World War I. One of the things historians have pointed out is that one of the reasons we were surprised to learn a couple of years ago about the big flu pandemic at around the same time is that it was seen as women’s history, and it was men’s history that got commemorated. Inequality was written into how history was remembered and we lost the lessons of that major pandemic. That’s one of the reasons that addressing inequality here is urgent, but also remembering the diversity of this experience.
Make no mistake, this is already being erased. If you watch television being made right now that is set in our present moment, they are not wearing masks or talking about COVID. It is being erased, and I’m hearing from people inside the industry that it is in the name of being universal and not tied to a specific historical moment. It’s urgent we learn from that mistake in our commemoration of the great flu pandemic of 100 years ago and think about the complexity of this experience across various sectors of society, sectors of work and different phases of it and really get into the nitty-gritty and make sure we remember what we have learned.
Dr. Straus: I think it would be critical to engage young people, and one message should be how schools can engage in this and how community organizations can engage and identify strategies for commemorating this and recognize the individual stories. For example, one of the outreach projects we do with kids at risk of dropping out of school is creating videos about what they did during COVID, so thinking about how that could be used to commemorate.
Dr. Smart: I appreciate your comments, especially as a paediatrician who cares deeply about the impact on children and youth. So much of the challenge of this pandemic is that the impacts on them have often been secondary to the impacts on adults because they happened in ways that are more silent, less dramatic and not as visible to Canadians. We know that there have been huge impacts on our children and youths in terms of school access, mental health and marginalized children and youth experiencing more serious impacts than others and those divides worsening. Including children and youth and what they see for the future of Canada and allowing them to reflect on their experiences and how they want our world to be different moving forward on the issues that matter to them will be critical and a source of hope for all of us.
Senator Dasko: I have two questions, and thank you, again, to our witnesses. I have learned an awful lot today. It has been really valuable.
Many of you have opened the conversation to a larger one on health care issues during the pandemic. My first question is about that. Dr. Smart and Dr. Straus, both of you have talked extensively about what you would like to see. You would like to see certain initiatives, policy directions and so on from the federal government, but I want you to briefly say whether you think we’ve made progress. We are now two years into the pandemic. At the beginning of the pandemic, many of us were talking about something that we might express as we want to build back better. Have we made improvements in any of the areas that are important to you? Dr. Straus, you talked about long-term care standards and what you would like to see. Have we made progress in this area? Are we better now than where we were? Dr. Smart, I would like to ask you that question too. You talked about integrated planning and so on. Have we made progress? That’s my first question.
Dr. Straus: It’s a great question. Absolutely. Over the last two years, we also have to celebrate what we have done well and the things that have happened. The changes that have been implemented in such a rapid pace are incredible. Some examples are the expansion of the scope of practice and the creation of task shifting teams to look after patients in different settings. I think that has been something quite remarkable that has happened fairly quickly.
The second thing is from a long-term care home perspective. There have been some changes for the positive. In particular, there is a federal initiative to create national standards, and that is a huge step forward. I think that the key thing is to make sure they get implemented and that we monitor the implementation. Similarly, there have been a lot of different initiatives focused on supporting wellness amongst the staff in long-term care homes. It’s not necessarily something that happened from coast to coast and it’s a bit patchy, but there are some great examples of initiatives to support that. Similarly, initiatives to support the essential care partners, families and caregivers of those living in long-term care homes and the engagement of those individuals in the directions of the long-term care home sector have been critical.
The other thing I wanted to highlight from the clinical research perspective is that there has been huge forward movement on things like creating national clinical platforms for large-scale trials to quickly test interventions, to look at ways of testing rapidly, new tests, for example, like some of the rapid antigen tests. There have been huge advances from a clinical research perspective that have leveraged our health care systems. I would say that’s something to be celebrated as well.
Dr. Smart: Thank you for the question. I totally agree with what we heard from Dr. Straus and I don’t want to repeat that, but I’ll highlight two other things.
What has been incredible is the way our health care systems have pivoted to meet the needs of patients during this very challenging time. One example I would highlight is the rapid adaptation of virtual care. We were talking about virtual care before the pandemic, but literally overnight thousands and thousands of physicians pivoted their clinics to ensure access for their patients and did that through virtual care. There is still a lot to learn there, but it’s incredible how willing people were to make those changes and adapt that new technology to make sure people had the care they need. That’s something we need to continue to leverage when we think about access to care.
The other space I think is very interesting is around health communication. We’ve heard throughout this discussion about the risk of misinformation, disinformation and the infodemic we are in. What’s also been really interesting over the last two years is how many doctors, nurses, scientists and other experts have stepped into the social media space to educate Canadians, to combat misinformation and to promote vaccination. I don’t think we would be where we are now without those grassroots efforts and without experts sharing their knowledge freely with Canadians across social media platforms. I think the importance of health communication going forward will be critical as well.
Senator Dasko: Ms. Kortes-Miller, we are looking toward pandemic observance day as being a positive day for the most part, but do you have any fears that this observance day will actually expose the deep divisions we’ve seen recently with respect to COVID, for example, around vaccine mandates, the fact that people have experienced lockdowns and lost jobs. You’ve talked about missing experiences for school children. There are so many negative outcomes. Do you have any fears that this observance day is actually going to highlight the difficulties and the terrible experiences that people had in a negative way? Perhaps the marchers we see outside here in Ottawa today might use this day to come forward and do this again.
Ms. Kortes-Miller: Thank you for the question.
To be totally honest, a few weeks ago, I might have said “no” because I think, as Canadians, we would use this as a day of observance of what we have learned. Yes, there are difficult things. Now, though, given hindsight and what we’ve learned from the occupation, I’m not 100% sure, but there are some very dark things we have experienced during the pandemic that require discussion, analysis and research so that we can do what the other witnesses here have spoken of in order to be able to move forward. I don’t think a day of observance that only focuses on the positive will be what happens. I think we need to feel and acknowledge some of those challenges and the darkness to be able to go forward in this.
The Chair: I have a question of my own. I will keep it short, and it’s to you, Dr. Kortes-Miller. It’s about grief. You speak very eloquently of different expressions of grief. There is social mourning, individual mourning and there is also cultural mourning. I lost my mother during the crisis, and we still have not brought closure. If this bill is passed into law and the Grief Alliance is tasked with developing a platform around it, how would you include Canada’s cultural minorities in your work?
Ms. Kortes-Miller: Thank you for your question, and thank you for sharing the death of your mother with us. That’s a really important question.
Within the Canadian Grief Alliance, we hope to be able to provide opportunities to acknowledge the differences in cultures and to learn with, from and about other cultures as we talk about social mourning. I think that a day of observance will provide an opportunity for people to reflect and to grieve their own losses in their own ways. I am hopeful we will see community groups of culture, spirituality and occupation joining together to reflect on some of these losses. Hopefully, the Canadian Grief Alliance will be able to be involved in providing space for that. Thank you.
The Chair: Let me first thank all the witnesses: Dr. Kortes-Miller, Dr. Smart, Dr. Vaillancourt, Dr. Wright and Dr. Straus. You have been brilliant and substantive. We could have talked with you for another two hours, but we cannot. We will let you go, and we will get on with our work. Our thanks to you for being present here with us today and for being present for Canadians throughout this crisis.
Colleagues, there being no further business, this meeting is adjourned. Thank you.
(The committee adjourned.)