Tag Archives: ‘greater’

Why people working snowy slopes may be at greater risk of catching COVID than skiers

Fresh air, blazing speed and spacious alpine terrain makes skiing and snowboarding low-risk activities for COVID-19 transmission, infectious disease doctors say.

But the threat is never zero during a global pandemic, they add. And people working on those snowy slopes may be at greater risk of catching the virus than those dashing down them.

Most ski hills in Ontario were permitted to reopen Tuesday, joining other mountainous resorts across the country that have remained operational through the winter.

Many have implemented extra safety precautions and operate under local restrictions, including:

  • Asking patrons to wear face coverings on lifts.
  • Cancelling classes.
  • Limiting access to indoor spaces.

While the activity of skiing is relatively safe from a transmission standpoint, experts say spread can still happen, and COVID outbreaks have been reported at larger resorts over the last couple months, mostly affecting staff members.

One outbreak in Kelowna, B.C., in December began with workers living on site before it sprawled to include more than 130 cases. Popular Lake Louise and Nakiska resorts in Alberta also reported outbreaks among staff.

‘Tale of two pandemics’

Dr. Andrew Boozary, the executive director of population health and social medicine at the University Health Network, says it’s clusters of cases like those that make ski hills concerning.

“I have no anti-skiing bias — it’s an activity that makes a whole lot of sense in Canada — but there’s a lot of people who take on risk to ensure a ski hill is operational,” he said.

“A lot of the time we rely on people who are in temporary work or who’ve been underpaid, without living wages and without paid sick leave, to take on risk so some of us can have that pleasure and leisure activity.” 

Boozary likened the recent emphasis on ski hills to that of golf courses over the summer, or to policy around cottages and seasonal vacation homes that were tailored to higher-income populations.

Skiing, like golf, isn’t affordable to everyone, he says.

And while Boozary agrees that skiing and snowboarding can provide mental health benefits of exercise in a low-risk setting, he’d like to see more emphasis on ensuring lower-income populations have safe, outdoor spaces, too.

WATCH | Ont. ski resorts welcome people back to the slopes:

Jim Hemlin, chief operating officer of Calabogie Peaks Resort, says skiers and snowboarders are excited to be back on the hill after the extended shutdown. 0:45

“We’ve seen this dichotomy, this tale of two pandemics. And we’re seeing it now with skiing,” Boozary said. “There’s an income divide on who gets access to these spaces.”

Dr. Ilan Schwartz, an infectious disease expert with the University of Alberta, says staff members at ski resorts are more likely than visitors to become infected because of the close proximity workers tend to be in.

Sometimes they share indoor spaces like lunchrooms, which aren’t conducive to mask-wearing when people are eating, Schwartz says, and “transmission thrives” in those settings.

“The likelihood of infection is going to be a function of physical proximity, the amount of time they’re in that proximity, the activities they’re doing and whether there are precautions taken to minimize transmission.”

Precautions for skiers

While skiers will generally be safe, those who wish to hit the slopes still need to be mindful of safety precautions, Schwartz says.

He added that spread is more likely to happen before or after people glide down the mountains, like when they put on ski boots in a crowded indoor area. Those spots should be avoided when possible, Schwartz says, and masks should be worn when distance can’t be maintained.

Skiers and snowboarders hit the slopes as Mount Pakenham in Eastern Ontario reopens after being closed due to the COVID-19 pandemic in Pakenham, Ont., on Feb. 11. (Sean Kilpatrick/Canadian Press)

Other factors could make trips to snowy resorts more dangerous, he added, including guests travelling from COVID hot spots and potentially bringing the virus with them into small ski towns.

The rise of new variants of concern might require more stringent restrictions on skiers as well, says Parisa Ariya, a chemistry professor at McGill University who specializes in aerosol transmission.

Ariya says while outdoor settings are far safer than indoors, spread “actually does happen outside” in some instances, and she recommends wearing a mask while skiing or snowboarding.

Winters in Quebec and Ontario make air more dense, Ariya adds, which could have an impact on how long viral particles stay in the atmosphere.

WATCH | Ski resorts walk a fine line during pandemic: 

The ski industry in the Canadian Rockies is struggling during the pandemic, with operators trying to balance COVID-19 safety and industry survival. 2:00

Dr. Sumon Chakrabarti, an infectious disease expert in Mississauga, Ont., says that while cold air may cause physical changes to aerosols “it does not translate to increased risk of disease transmission.”

He says risk of outdoor spread remains “quite low,” except for situations with large crowds in close contact, like during concerts or sporting events.

“From a public health standpoint I would much rather see 50 people skiing outdoors than a group of 10 watching TV together indoors,” he said.

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CBC | Health News

‘Your whole life is spent caring’: Clinicians over 60 stay on the job during pandemic despite the greater risk

More than one-third of Canada’s COVID-19 cases are people 60 and over. Many doctors and nurses are in that age group, which has experts considering about how best to protect them during the coronavirus outbreak, including the use of virtual care and other innovative tools. 

In a commentary published last month in JAMA about older clinicians working during the pandemic, U.S. researchers suggested that hospitals and health departments “carefully consider how best to protect and preserve their workforce, with careful consideration involving older physicians and nurses.”

Older nurses and physicians shouldn’t necessarily be precluded from direct care of patients with COVID-19, the researchers say. They said it’s worth considering that their direct duties be shifted to roles with less risk of exposure to the virus, such as consulting with younger staff, advising managers and speaking with families of patients and the public.

Dr. Fiona Smaill, 65, a professor of infectious diseases and microbiology at McMaster University in Hamilton, has treated patients with infections, including suspected COVID-19. Doctors and nurses have to assume everyone they’re seeing could be infected and to wear personal protective equipment, such as surgical masks, gloves and gowns, she said.

“I think the most challenging [aspect] is dealing with the uncertainty,” Smaill said. “You’re worried. Dealing with that … in the setting of actually providing the best care that you can is a strain — both emotionally and physically.”

Smaill said she feels well-supported by her employer. But she also sees how colleagues are struggling to respond to rapidly changing policies and procedures. And at the same time, they’re concerned about their own health — including personal risk of infection — as well as the well-being of their families.

As for the journal commentary suggesting older clinicians step away from the front line, Smaill said she sees herself as fit and active. 

“As a physician and a health-care worker, your whole life is spent caring,” she said. “You’ve got this very deep, strong professional belief that really has impacted your whole life, so that doesn’t just get turned off overnight.” 

WATCH | Doctor on ‘desperation, sadness and hope’ after putting patients on life support:

Dr. Nadia Alam of Georgetown, Ont., describes how one elderly patient didn’t want to be on a ventilator and how her children are afraid that she, too, may get sick. 10:28

Health-care workers change duties

Smaill has been following many of her patients with HIV for up to 30 years. Now, she’s making phone and video appointments to check how they’re doing and to ensure their prescriptions are up to date. 

Doctors may not normally give much thought to how disruptive it can be for patients to come to a clinic. 

COVID-19 gives clinicians and patients alike an opportunity to think about the best way to serve patients’ needs and wishes, Smaill  said. 

Douglas Staiger, the JAMA commentary’s co-author and an economics professor at Dartmouth College in Hanover, N.H., said since the publication, he’s received messages of thanks.

“When our article was published, some hospitals were already shifting older workers from jobs interacting with patients to more administrative and supervisor positions, but others were so overwhelmed and short-staffed that they had not yet had the bandwidth to plan for this issue systematically,” Staiger said in an email.

Dr. Fiona Smaill, 65, a professor of infectious diseases and microbiology at McMaster University in Hamilton, has treated patients with infections, including suspected COVID-19. ‘I think the most challenging [aspect] is dealing with the uncertainty,’ she says. (McMaster University)

The latest Canadian Institute for Health Information’s 2018 reports on physicians and nurses suggest more than a quarter of doctors are aged 60 and older, as are more than one in 10 nurses.

Embracing technology

Dr. Louis Francescutti, 66, said the pandemic is a great time to look at how to embrace technology — from virtual care and smartphone ultrasound tools — to make the health-care system more sustainable. 

He’s a professor at the University of Alberta’s School of Public Health and works in an emergency department in Edmonton. Francescutti recalled a recent example of a patient using a device to collaborate.

“I said, ‘Oh, let me check your sugar [level],'” Francescutti said. “And she said, ‘Oh, why bother? Here.’ She pulled out her phone, and she’s got a device on her that sends her the glucose reading.”

Emphasize staying healthy, not treating illness

Not everyone at the ER needs to be seen face to face, Francescutti said.

“If you can figure out ways to keep people from becoming patients, then we’re heading in the right direction,” he said.

To get there will require a greater emphasis on prevention, he said.

“There is no such thing as a free lunch, and Canadians unfortunately think that our health system is free,” Francescutti said. “It’s very costly. Then it comes at the expense of building better parks, having better education, building better housing, building better transportation, cleaning up the environment. Those are the things that make you healthy.”

To that end, health-care professionals in clinics, hospitals and long-term care are already innovating during the coronavirus crisis.

Prof. Ivy Bourgeault heads the Canadian Health Workforce Network, a group of researchers who guide governments about staffing in health care. She studies how doctors, nurses and other health-care workers, including personal support workers, can use their knowledge and skills fully and safely.

Personal support workers (also called continuing care assistants and health-care aides) feed, bathe and provide bedside care in long-term care facilities, hospitals and homes.

“The invisibility of that workforce and the invisibility of the people that they take care of — our older adults, our elders — has made them incredibly at risk,” Bourgeault said.

The deadly COVID-19 outbreaks at long-term care homes across Canada have exposed cracks in the system overall, including underfunding leading to overworked, underpaid staff.  1:50

Personal support workers also tend to be older women, Bourgeault said. But little is known about them since they aren’t registered and tracked in most provinces.

Elder advocates have long called for access to benefits and sick leave for everyone employed in long-term care so workers aren’t moving between multiple locations, potentially spreading infections.

Invaluable experience

Many dedicated clinicians over 60 are going to work during the pandemic, and their experience is invaluable, Bourgeault said.

“The physician who takes care of my mom in her long-term care centre is well into his 80s,” Bourgeault said. That’s where older doctors often shift to working as their careers wind down, she said.

Bourgeault pointed to solutions to the health-care service crunch during the pandemic, such as:

  • Equip retirees with new skills.
  • Ramp up new trainees and international medical graduates, particularly those with experience in infectious diseases.
  • Tap into and reorient the skills of laid off dental nurses, as the United Kingdom is doing, to assist with anesthesia.

In Canada, health-care delivery is more compartmentalized, Francescutti said, which can be a barrier to the re-skilling of workers.

But if it was redesigned with the best interests of the patient instead of physicians first, then it could look and function differently than it does now, such as more professionals offering anesthesia.

Francescutti gave the example of waiting rooms in clinics that are designed so that the physician doesn’t have to wait. But the priority could be flipped, he said, like at Apple’s Genius Bar. Its customers don’t need to wait long to consult a technology expert in stores. 

‘This is where we get innovative’

Dr. Sandy Buchman, president of the Canadian Medical Association, is 65. The palliative care physician in Toronto signed up to offer virtual care during the pandemic.

“This is where we get innovative,” Buchman said. “Virtual care has taken off. We’ve crossed a threshold here, and we’ll never go back.” Doctors in every province and territory are now offering the service.

Buchman said age is just one factor in how severe an outcome someone could have with COVID-19. It’s also important to consider older doctors and nurses who have other chronic illnesses, such as asthma, hypertension and asthma, he said, as well as how vulnerable others in their home are.

Staiger acknowledged people with underlining medical conditions are also at higher risk of death but said data were preliminary.

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CBC | Health News

Shia militias now a greater threat than ISIS in the Middle East, says Canadian commander

Iranian-backed Shia militias embedded alongside Iraqi security forces are now a bigger threat than the fragmented fighting power of former Islamic State extremists, a senior Canadian military commander told a House of Commons committee today.

Lt.-Gen. Mike Rouleau delivered the assessment while updating the all-party House of Commons defence committee on recent events and threats in the Middle East.

He said out of the roughly 70,000 Shia militia members under arms in Iraq, about 30,000 of them are hardcore fighters affiliated with Iran who could pose a danger.

“They are a very big concern,” Rouleau tesfied. “In fact, they’re my No. 1 concern. At the moment, relative to force protection, I am more concerned about that swath of Shiite militia groups than I necessarily am about Daesh (the Arabic term for ISIS) because Daesh has been defeated militarily.”

The remnant of the ISIS units hiding out in remote regions of northern Iraq and Syria, he said, “are reorganizing and spending time on themselves, more than they are spending time on attack planning.”

Over the last two weeks, CBC News has spoken to several senior Canadian and anti-ISIS coalition commanders who share Rouleau’s assessment and note that the militias have “yet to extract their pound of flesh” for the targeted killing of Iranian General Qasem Soleimani, the commander of the secretive Quds Forces, by the U.S. in early January.

Iranian mourners gather during the final stage of funeral processions for slain top general Qasem Soleimani in his hometown Kerman on January 7, 2020. (Atta Kenare/AFP/Getty Images)

The Iranians fired ballistic missiles into two Iraqi bases used by coalition forces, including Canadians, but have thus far taken no further retaliatory action.

The militias became highly integrated with Iraqi forces during the battles to expel ISIS from the northern part of the country, including the prolonged fight for Iraq’s second largest city, Mosul.

“These Shiite militia groups we’re concerned about are very well equipped,” Rouleau told MPs. “They have tubed artillery. They have multiple launch rocket systems and armed UAVs. They have air defence equipment.” 

Rather than being a ragtag force, the fighters are like armed as though they are “a state military,” he said.

Canada, with roughly 500 troops in Iraq alongside the U.S.-led coalition, is keeping a close intelligence eye on the various groups to determine what their intentions might be.

“They have been muted since the attack and the U.S. threats that — if a U.S. or coalition service member dies at the hands of these group — there will be an outsized response,” said Rouleau, who is responsible for all military operations, foreign and domestic.

Ongoing crises in Iran, including the COVID-19 outbreak and the fallout from punishing economic sanctions, are also helping to mitigate any possible retaliation, he added.

Conservative defence critic James Bezan said he wondered how much support there was for the Shia militias within the Iraqi government itself.

Sandra McCardell, director general of the Middle East Bureau at Global Affairs Canada, told the committee that Iraq, prior to the Soleimani killing, had been engulfed in anti-Iranian, anti-corruption protests.

“They were frustrated and resentful of the foreign influence in their country,” she testified. “I think what we’ve seen more recently, particularly since the killing of Qasem Soleimani, is that there has been pressure to again return to sectarian camps.”

After the 2003 U.S.invasion, Iraq descended into a sectarian bloodbath between Shia and Sunni Muslims.

“How we’ll go from here remains to be seen,” McCardell said.

Rouleau said that in the aftermath of the Iranian missile attack on Erbil, where Canadian special forces have conducted operations out of since 2014, consideration is being given to consolidating Canadian bases in Iraq.

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Number of coronavirus cases inside China is now greater than the 2003 SARS outbreak

Latest developments:

  • Several countries are assisting citizens who want to leave Wuhan. 
  • Virus has killed 132 people and infected more than 6,000 on the mainland and abroad.
  • Number of coronavirus cases inside of China has surpassed the 2003 SARS outbreak.
  • WHO to hold a briefing this morning with an update on the coronavirus outbreak.

Several countries have begun moving their citizens out of the Chinese city hardest-hit by an outbreak of a new virus that has killed 132 people and infected more than 6,000 on the mainland and abroad.

A Japanese flight carrying 206 evacuees home included four people with coughs and fevers. The three men and one woman were taken to a Tokyo hospital on separate ambulances for treatment and further medical checks.

The Japanese flight was bringing 20,000 face masks as well as protective gear, all in short supply as Chinese hospitals treat a growing number of patients. Wuhan is building two hospitals in a matter of days to add 2,500 beds for treatment of patients with the virus.

It wasn’t immediately known whether they were infected with the new type of coronavirus that appeared in the central city of Wuhan in December. Its symptoms, including cough and fever and in severe cases pneumonia, are similar to many other illnesses.

China’s latest figures cover the previous 24 hours and add 26 to the number of deaths, 25 of which were in the central province of Hubei and its capital, Wuhan, the epicentre of the outbreak. The 5,974 cases on the mainland marked a rise of 1,459 from the previous day, although that rise is a smaller increase than the 1,771 new cases reported on Monday.

The number of coronavirus cases inside of China has surpassed that of the 2003 SARS outbreak, which at its height saw 5,327 people infected, however, the death toll remains lower. 

Dozens of infections have been confirmed outside mainland China as well, including cases in: Taiwan, Australia, Cambodia, France, Germany, Japan, Malaysia, Nepal, Sri Lanka, Singapore, South Korea, Thailand, Vietnam, the U.S. and Canada. On Wednesday, the United Arab Emirates’ health ministry said four members of a Chinese family were infected in the first cases announced in the Gulf state, state news agency WAM said. 

A plane carrying Americans who had been in Wuhan landed in Anchorage, Alaska, Tuesday evening, where they will be rescreened for the virus. Approximately 210 U.S. citizens are being relocated. Hospitals are prepared to treat or quarantine people who may be infected. Then the plane is scheduled to fly to California.

An airplane, background, carrying U.S. citizens being evacuated from Wuhan, China, makes a refuelling stop at Anchorage International Airport in Alaska Tuesday evening. (Bill Roth/Anchorage Daily News/The Associated Press)

Canada, for its part, is still working on its plans to get Canadians out of the affected area. Foreign Affairs Minister Francois-Philippe Champagne said Tuesday that 250 Canadians living there have registered online with Global Affairs Canada, with about 126 requesting consular assistance to get home.

Italy is arranging a flight on Thursday to evacuate its citizens from Wuhan, the country’s foreign ministry said Wednesday. Around 50 Italians were stranded in the city, which has been largely isolated in an effort to prevent the spread of the virus, a ministry official said.

The United Kingdom’s health secretary Matt Hancock told the BBC Thursday that British nationals being flown back from Wuhan will be quarantined for two weeks. The U.K. is also warning against “all but essential travel” to mainland China amid the outbreak. 

German Health Minister Jens Spahn said he expects the evacuation of German citizens from China is set to get underway in the next few hours.

Hong Kong’s leader said the territory will cut all rail links to the mainland and halve the number of flights to stop the spread of the virus.

WATCH: Hong Kong closes borders as China battle coronavirus:

As China continues to battle a growing coronavirus epidemic, Hong Kong has bowed to pressure and closed its borders to reduce the flow of people coming in from the mainland. 1:59

South Korea also said it will send a plane, and France, Mongolia and other governments also planned evacuations.

China has cut off access to Wuhan and 16 other cities in Hubei province to prevent people from leaving and spreading the virus further. The lockdown has trapped more than 50 million people in the most far-reaching disease control measures ever imposed.

The sharp rise in infections recently suggests significant human-to-human spread of the virus, though it could also be explained by expanded monitoring efforts, said Malik Peiris, chair in virology at the University of Hong Kong.

Officials said on Wednesday that the virus outbreak in the neighbouring city of Huanggang city is especially severe, adding the city cannot be allowed to become the second Wuhan.

An ambulance carrying evacuees from Wuhan, China, arrives at Ebara Hospital in Tokyo Wednesday after the first group of Japanese evacuees returned. Four of the evacuees had a cough and fever and were taken to hospital. (Kyodo News via The Associated Press)

Governor of Hubei province Wang Xiaodong said during a press briefing that companies in the province should not resume work before the end of Feb 13.

Huanggang, a city of 7.5 million people, has reported five deaths and 324 cases as of end-Tuesday, the second-most in both accounts among the cities in the province behind Wuhan. 

WHO says coronavirus is ‘highest priority’

Experts worry the new virus may spread more easily than originally thought, or may have mutated into a form that does so. It is from the coronavirus family, which also can cause the common cold as well as more serious illnesses such as SARS and MERS, which both emerged in the past two decades and are thought to have come from animals.

The new virus causes cold- and flu-like symptoms, including cough and fever, and in more severe cases, shortness of breath and pneumonia. It is thought to have spread to people from wild animals sold at a Wuhan market. China on Sunday temporarily banned trade in wild animals and urged people to stop eating meat from them.

On Tuesday, Director-General of the World Health Organization (WHO) Tedros Adhanom Ghebreyesus met with Chinese leader Xi Jinping to discuss the latest information on the outbreak and reiterate their commitment to bringing it under control, WHO said in a news release.

“The National Health Commission presented China’s strong public health capacities and resources to respond and manage respiratory disease outbreaks,” the release said.

It said discussions focused on ways to cooperate to contain the virus in Wuhan and other cities and provinces and studies that could contribute to the development of medical countermeasures such as vaccines and treatments. Other WHO experts will visit China as soon as possible, it said.

“Stopping the spread of this virus both in China and globally is WHO’s highest priority,” Tedros said.

The source of the virus and the full extent of its spread are still unknown. However, WHO said most cases reported to date “have been milder, with around 20 per cent of those infected experiencing severe illness.”

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CBC | World News

Kavanaugh's 'hostile' defence won over Trump but likely put his Supreme Court hopes at greater risk

At the start of the month, Brett Kavanaugh came across as a devout Catholic with an unblemished personal record and golly-gosh stories about coaching his daughters' basketball teams. He had a mild way about him, and a near-certain chance of sailing to a confirmation to the highest court in the land.

By the end of Thursday's Senate judiciary committee hearing, the U.S. Supreme Court nominee, who is facing a handful of allegations that include sexual assault, would be shown in cable news clips snivelling, roughly flipping pages from his prepared statement, shouting during his opening testimony as he denied the allegations, and deflecting senators' questions about his alleged abuse of alcohol by challenging them about their own drinking habits.

His testimony came in stark contrast to the composed and considered testimony of Christine Blasey Ford, the California research psychologist and professor who on Thursday alleged to senators with "100 per cent" certainty that Kavanaugh tried to drunkenly rape her in the 1980s when they were both teens at a house party in Maryland.

"By everyone's account, she has been an outstanding witness … she was not evasive. She seemed forthright," said Stacy Hawkins, a professor at Rutgers Law School in New Jersey. "She was as credible as any witness could be, under the circumstances."

(Watch: Christine Blasey Ford says she's 100 per cent certain Kavanaugh sexually assaulted her.)

Senator Dick Durbin asks Christine Blasey Ford with what degree of certainty she believes it was Brett Kavanaugh who assaulted her in 1982. 0:47

Some in the gallery were reportedly brought to tears by Ford's testimony. On Fox News, host Chris Wallace commented that she sounded "extremely raw — and extremely credible."

Hawkins noted Ford offered at times to answer questions even when she could have claimed attorney-client privilege. Kavanaugh, on the other hand, appeared to be "hostile" and "extraordinarily rattled" by persistent questioning asking if he would press for a full FBI investigation into Ford's claims.

'I like beer'

When Democratic Sen. Amy Klobuchar asked the judge if he had ever drunk to the point of losing his memory, he shot back: "Have you?" 

He later apologized, but a line Kavanaugh kept falling back on probably didn't help.

"I like beer," he offered defensively.

He also said "I liked beer" and "We liked beer," and according to the transcript, declared "We drank beer" seven times.

"Do you like beer?" he asked a senator at one point.

(Watch: Kavanaugh gets combative when asked about his drinking)

U.S. Supreme Court nominee testifies that he does not have a drinking problem. 0:50

Mark Osler, a law professor at the University of St. Thomas in St. Paul, Minn., who attended Yale Law School with Kavanaugh and socialized with him, said in a phone interview that after Thursday's hearing, he believes his old peer's promotion is in greater jeopardy.

"He might be withdrawn," he said. "That's where we are right now." 

Osler was among dozens of Kavanaugh's former classmates who signed a letter of support for him after his nomination. Osler has since withdrawn his support in the wake of the allegations.

He did stress that although he did "go to parties and drink with" Kavanaugh, he never saw any behaviour matching the kind of accusations that have been made against him.

Among Kavanaugh's mistakes on Thursday, Osler said, were his sharply partisan attacks in his opening testimony. He accused Democrats of an "orchestrated political hit, fuelled with apparently pent-up anger about President Trump … and revenge on behalf of the Clintons."

Kavanaugh worked on independent counsel Ken Starr's investigation of President Bill Clinton in the 1990s, and was known to have proposed the most sexually graphic questions to be asked of former White House intern Monica Lewinsky, with whom Clinton admitted to having an "inappropriate relationship."

Kavanaugh alluding to Clinton "revenge" didn't sound to Osler like the impartial thoughts of a jurist deserving of a spot on the Supreme Court.

"More than anything, what he needs to do is establish himself as someone who's telling the truth," Osler said. "If what he's saying is related to conspiracy theories, it's going to go the other way."

(Watch: Sen. Dick Durbin asks Kavanaugh to insist on an FBI investigation.)

Sen. Dick Durbin asks Kavanaugh repeatedly if he thinks an FBI investigation should be held. 5:30

A stream of Republican senators defended Kavanaugh and ripped Democrats for what they portrayed as 11th-hour tactics to derail the Supreme Court nomination of a respected conservative judge. During Kavanaugh's testimony, Republican Lindsey Graham slammed his Democratic colleagues for carrying out what he called "the most unethical sham" he's ever witnessed in his political career.

Kavanaugh's angry indignation appeared to please U.S. President Donald Trump, who tweeted his support for the nominee and repeated Kavanaugh's "search and destroy strategy" line, calling the nomination process "disgraceful." Kavanaugh's combative testimony might also resonate with Trump's base, and Republicans have learned it may not be politically wise to cross the president.

Democratic strategist Karl Frisch said Kavanaugh's performance was an attempt to convince Trump not to pull his nomination.

"Seems clear Kavanaugh is testifying AT Trump and not the Senators in the room," Frisch wrote on Twitter. "His anger as an appeal to Trump. It is this type of outrage that really reaches Trump."

The hearing began with an unusual format that didn't seem to work very well for the Republicans.

Normally, the two parties would take five-minute turns asking a witness questions. But the Republicans opted to cede their time to Rachel Mitchell, a sex-crimes prosecutor they hired to ask questions on their behalf, apparently aware of the bad optics of an all-male, all-white group of Republicans grilling a female survivor of sexual assault.

The tactic "backfired," said Supreme Court expert Lisa Tucker, an associate law professor at Drexel University in Philadelphia.

"Their strategy of using Mitchell was terrible. Any lawyer engaged in a line of questioning gets a rhythm going with the witness. Interrupting her and telling her she had to stop every five minutes was very unexpected to her, and you could see it."

Rachel Mitchell, counsel for Senate judiciary committee Republicans, questions Christine Blasey Ford as senators Mike Crapo, Jeff Flake, Ben Sasse, Ted Cruz, Mike Lee and John Cornyn listen. (Tom Williams/Reuters) 

It was difficult at times to grasp where Mitchell's questions were heading. During the morning session, she quizzed Ford about her fear of flying, apparently attempting to cast doubt on her credibility by pointing out she has flown to holiday destinations despite her claimed aversion to air travel.

By the late afternoon, midway through Kavanaugh's testimony, Republicans abandoned the tactic of ceding their speaking time to Mitchell. Several of them took the opportunity to attack the behaviour of their committee rivals.

'Coming out screaming'

Kavanaugh seemed to set the new tone with his angry opening statement that admonished the Democrats for "destroying" his family and reputation. 

"It was not a good look to be coming out screaming," Tucker said. "I was shocked. I don't think that shows judicial temperament."

And certainly not, she said, given the portrayal of Kavanaugh in press reports as a "sloppy drunk" who could be aggressive or belligerent when inebriated.

Republican senators Lisa Murkowski and Susan Collins might have the final say on whether Kavanaugh's approach was successful. Both are considered potential swing votes, but Republicans can only afford to lose one vote to confirm Kavanaugh, given the party's 51-49 edge in the upper chamber.

Tucker believes that even if Republicans feel they'll be able to scrape together enough votes to confirm Kavanaugh, the judge's confidence has been shaken and his name tarnished.

"Whether or not Kavanaugh is confirmed," she said, "you'll never be able to Google his name without this coming up."

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Canucks see greater good in whirlwind trip for NHL's debut in China

About to turn 37 years old, Henrik Sedin didn’t sound overly thrilled about the prospect of having to fly across the Pacific Ocean to play a couple of exhibition games ahead of the gruelling NHL season.

The captain of the Vancouver Canucks at the same time also understands what getting a foothold in China, a country of nearly 1.4 billion people, could mean for both the league and its players.

“It’s a big market,” Sedin said last week in Vancouver. “If we can get that market on our side and interested in our brand and sport, it’s going to be huge for us.

“It’s a good start.”

The Canucks will meet the Los Angeles Kings in Shanghai on Thursday and Beijing on Saturday in two showcase games as the NHL makes its first foray into the country.

“You’ve just got to take it for what it is and enjoy the trip [and] make the best of the two games,” added Sedin.

Embracing the chance

The Canucks departed on a roughly 10-hour flight from Vancouver to China around noon local time Sunday and, with the 15-hour time difference, arrived in Shanghai early Monday afternoon.

While probably not an ideal scenario for a rookie head coach trying to drag a team that finished 28th and 29th in the NHL the last two seasons back to respectability, Travis Green is embracing the chance for his group to bond and experience something different.

“I’ve never been one to worry about things I don’t control,” Green said at the start of training camp. “It’s a great opportunity for guys to get together on the road and go to China — I’m going to gather that most of them have never been there — and see a part of the world you might never get to again.”

Vancouver forward Sam Gagner, who signed a three-year free-agent deal this summer, said he’s eager to get to know his teammates in a unique environment.

“It’s a positive, especially for a new guy,” he said. “You’re away from everything. It’s going to be a good experience.”

While the NHL isn’t sending its players to the 2018 Olympics in Pyeongchang, South Korea, in February, the league has a keen eye towards the 2022 Games in Beijing as China continues to invest heavily in winter sports, including hockey.

The Canucks — who along with the Kings are among a number of NHL teams that have already held youth camps for Chinese players — are looking forward to the chance to help grow the game in the world’s most populous country, which has embraced the NBA over the past couple of decades.

But what the NHL doesn’t yet have is a marquee player like former basketball star Yao Ming, meaning fans in China need an introduction to the sport in other ways to get them interested.

“It’s going to be fun,” said Vancouver centre Bo Horvat. “Hopefully we can put on a good show.”

With long road trips and cross-continental flights a fact of life playing on the West Coast, the Canucks have invested heavily in sleep science in the past. General manager Jim Benning said the club has done everything it can to ensure things goes as smoothly as possible.

‘It’s growing’

“When to leave to fly over there … when to come back to give the players the best opportunity to get their rest,” said Benning. “We’ve talked about everything from meals [and] making sure the players have some of the things they like to have.”

Fans back in Canada will have to wake up early or stay up late to see the games, with Thursday’s opening faceoff set for 7:30 a.m. ET and Saturday’s scheduled for 3:30 a.m. ET.

Apart from practising and playing, the Canucks will also get to play tourist, with a trip to the Great Wall of China among the planned outings.

“Getting to see a new culture is not something we usually get a chance to do,” said centre Brandon Sutter. “I’m sure we’ll have a couple fun days.”

But in the end, the trip is about business as the NHL looks to expand its footprint in a country seen as having vast and untapped potential.

“It’s growing,” said Vancouver forward Daniel Sedin. “It’s good for our league to get in there.”

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CBC | Sports News