Tag Archives: crisis

This Winnipeg lab confirmed Canada’s 1st case of COVID-19. Then it set to work helping manage the crisis

On Jan. 23, 2020, doctors at Toronto’s Sunnybrook Health Sciences Centre admitted a 56-year-old man with what appeared to be mild pneumonia. Two days later, he was “Patient Zero” — the first COVID-19 case in Canada.

Four days late, it was senior research scientist Nathalie Bastien’s team at the National Microbiology Lab (NML) in Winnipeg that confirmed the case.

“When you want to become a scientist, when you’re a young kid, this is what you dream of, to be part of helping people and saving lives in a way by stopping the spread of the virus,” Bastien said in a recent interview from her lab. “It’s rewarding.”


Senior research scientist Nathalie Bastien and spent years after the SARS epidemic developing a universal test that could detect any type of coronavirus, but they weren’t sure it would work on the new virus, known as SARS-CoV-2 until they got the sample last January. (Public Health Agency of Canada)

Bastien’s work is one example of 150 different COVID-19 projects at the national lab, which is is the only Level 4 lab in Canada, capable of handling the world’s deadliest pathogens. 

Many of those projects are done in collaboration with academia, industry and public health partners, and more than 50 of them are related to pre-clinical research, including clinical trials in animals, testing of antibody-based therapeutics and vaccine collaborations.

It’s all part of nearly $ 2 billion in funding the lab has received in the last year as part of Ottawa’s COVID-19 pandemic response, although the lab would not give a breakdown of how that money is spent.

“Obviously, collaborating in an environment that is fast-moving, like a pandemic response, has its challenges but the willingness to work together to achieve that common goal, which is, ultimately, to protect Canadians, has been really rewarding to see,” acting scientific general Dr. Guillaume Poliquin said in a recent interview with CBC News.


Dr. Guillaume Poliquin, centre, is the acting scientific director general of the National Microbiology Lab in Winnipeg. (Warren Kay/CBC)

For Bastien, an expert on respiratory viruses such as the flu, SARS and H1N1, Canada’s first presumed positive case of this pandemic was an opportunity to see if years of work would pay off.

After the SARS epidemic, her team had developed a universal molecular PCR lab test that they hoped would be able to detect any coronavirus.

However, they weren’t certain it would work on SARS-CoV-2 until that first sample arrived at their Winnipeg lab.

It did work. And since then, the lab has made that first-generation test even more sensitive. Those efforts have led to the standardized PCR test now used in labs across Canada.

During the early days of the pandemic, all samples were sent to the NML from provincial and territorial public health labs to confirm the presumptive results.

The NML still helps provinces and territories if their labs are overwhelmed and also supports the PCR molecular laboratory tests being done at the border to confirm or rule out active COVID-19 infections.

As well, it’s constantly doing surveillance for variants of concern.

“We’re still working like crazy,” Bastien said.

Made-in-Canada supply chain

Scientists at the lab also stepped in to solve one of the early stumbling blocks of the pandemic, a global shortage in lab supplies and equipment needed to test swabs from possible COVID-19 patients. 

This was especially true for reagents, the chemicals needed to extract the genetic material from samples.

As backlogs for testing grew, the need for a “Made in Canada” solution became apparent.

“Half jokingly, we thought: ‘Well, if we can’t buy it, can we make it?'” Poliquin said.


Allen Grolla, pictured in West Africa in 2014. Grolla has analyzed lethal pathogens such as Ebola and Marburg where outbreaks of the deadly viruses occur, including the Democratic Republic of the Congo, Angola, Kenya, Bangladesh, Hong Kong and Guandong, China. (SYLVAIN CHERKAOUI/Doctors Without Borders)

So NML managers called up biologist Allen Grolla, known as a problem-solving MacGyver. 

Grolla was enjoying his first month of retirement but agreed to return to work. 

His task was to find the right chemical cocktail to create a reagent that public health labs across the country could use to diagnose COVID-19. By April 2020, the reagent was being manufactured at New Brunswick-based LuminUltra Technologies Ltd. and shipped to public health labs across Canada.

“When we started down the pandemic road, there was a capacity to do a few thousand tests [a day]. In Canada, the latest capacity figures are over 200,000 tests per day,” Poliquin said. “Sometimes, the crisis averted is not as glamorous as the crisis solved. But at the end of the day, that’s the one that’s most important.”  

Developing vaccines

NML scientists were the ones who developed the world’s first approved Ebola vaccine, which helped save lives in Africa. So when the coronavirus pandemic emerged last year, NML scientists started developing in-house SARS-CoV-2 vaccine candidates.


Health Canada has approved four COVID-19 vaccines: Pfizer-BioNTech, Moderna, Oxford-AstraZeneca and Johnson & Johnson. (CBC)

There are currently four approved vaccines in Canada, Pfizer-BioNTech, Moderna, AstraZeneca-Oxford and Johnson & Johnson, but NML is focused on developing ones that could be effective against some of the variants of concern. There is one promising candidate that has started pre-clinical trials in animal model testing, Poliquin said.

The lab is also conducting animal tests of vaccine candidates being developed at Canadian university and industry labs to see if they’re ready for human trials.

Early warning system

Another project the lab is working on is a study with the Canadian Water Network that monitors the presence of SARS-CoV-2 in wastewater. The NML is providing technical guidance to labs across the country and helping them make reliable comparisons of data across communities.

Poliquin said that work made a difference in the Northwest Territories last December, when the lab alerted public health officials to community spread.

“They were seeing an increase in the amount of SARS-CoV-2 RNA in their wastewater in the community, where they knew of a single case that was isolated,” Poliquin said. 

“That really didn’t jibe with what we were observing. The Northwest Territories, in response, did some proactive testing and identified another five individuals that were then isolated. And from there, the signal intensity decreased. So I think that’s compelling evidence that using wastewater as an early warning system can, in fact, help avert larger outbreaks.”


The NML is providing technical guidance to communities testing their wastewater for the coronavirus. Here, researchers at the University of Ottawa test that city’s wastewater. (Pierre-Paul Couture/CBC News )

Quick investment is key

Dr. David Butler-Jones has been watching to see how his former colleagues are managing the COVID-19 pandemic.

He was Canada’s first chief public health officer between 2004 and 2014 and co-ordinated the response during the 2009 H1N1 outbreak, which resulted in 428 confirmed deaths in Canada. An estimated 40 per cent of Canadians were immunized in a national vaccination campaign that began in October 2009. 

Butler-Jones also led the Public Health Agency of Canada from its creation and directed PHAC’s efforts to build up and co-ordinate provincial public health systems.  


Dr. David Butler-Jones was Canada’s first chief public health officer from 2004 to 2014. He says Canada learned from the SARS epidemic that funnelling money quickly into research is key when a crisis hits. (Fred Chartrand/Canadian Press)

While he says he’s seen a “diminishment in funding” in PHAC and NML’s budgets since 2012, Butler-Jones is pleased one of the big recommendations after SARS has been followed — funnelling money quickly into research where and when it’s needed.

Often, it can take more than a year between concept and development to writing proposals and receiving funding.

“When you’re in the midst of a pandemic or a crisis, you need that money now and you need to do the research,” Butler-Jones said.

Not the time to celebrate

Back in Toronto, public health officials have set up a field hospital in the parking lot of Sunnybrook Hospital’s Bayview campus with 100 beds to take the stress off the intensive-care wards as they prepare for a possible third wave of the pandemic.


A mobile field hospital, pictured March 10, 2021, is being assembled in an empty parking lot at the Bayview campus of Sunnybrook Health Sciences Centre in Toronto amid fears of a third wave of COVID-19. (Patrick Morrell/CBC)

Poliquin knows his own teams have been working full-out for more than a year. He hopes they eventually get a break and the thanks they deserve.

“We’ve all been so busy,” he said. “It’s been less of a time to sit back and reflect on our successes and more of a time to put our heads down and get the work done.

“I think there will be a time and a need to celebrate everything that was achieved.… But the work isn’t done yet.”

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CBC | Health News

Power restored to more Texas residents, but water crisis persists during deep freeze

Power was restored to more homes and businesses in Texas on Thursday after a deadly blast of winter this week overwhelmed the electrical grid and left millions shivering in the cold. But the crisis is far from over, with many people still in need of safe drinking water.

Fewer than a half million homes remained without electricity, although utility officials said limited rolling blackouts could still occur.

The storms also left more than 320,000 homes and businesses without power in Louisiana, Mississippi and Alabama. About 70,000 power outages persisted after an ice storm in eastern Kentucky, while nearly 67,000 were without electricity in West Virginia.

And more than 100,000 customers remained without power Thursday in Oregon, a week after a massive snow and ice storm. Maria Pope, the CEO of Portland General Electric, said she expects power to be restored by Friday night to more than 90 per cent of the customers still in the dark.

Meanwhile, snow and ice moved into the Appalachians, northern Maryland and southern Pennsylvania, and later the Northeast. Back-to-back storms left 38 centimetres of snow in Little Rock, Ark., tying a 1918 record, the National Weather Service said.

The extreme weather has been blamed for the deaths of at least 40 people, some while trying to keep warm. In the Houston area, one family died from carbon monoxide as their car idled in their garage. A woman and her three grandchildren died in a fire that authorities said might have been caused by a fireplace they were using.

Utilities from Minnesota to Texas implemented rolling blackouts to ease the burden on strained power grids. Southwest Power Pool, a group of utilities covering 14 states from the Dakotas to the Texas Panhandle, said rolling blackouts were no longer needed, but it asked customers to conserve energy until at least Saturday night.

Drinking water affected

In Texas on Thursday, about 325,000 homes and businesses remained without power, down from about three million on Wednesday. The state’s grid manager, the Electric Reliability Council of Texas, said the remaining outages are largely weather-related, rather than forced outages that were made early Monday to stabilize the power grid.


A sign advises customers entering a convenience store that they have no running water. Residents of Arlington, Texas, were told to conserve and boil water after a potential water main break. (Tom Fox/The Dallas Morning News/The Associated Press)

“We will keep working around the clock until every single customer has their power back on,” said ERCOT senior director of system operations Dan Woodfin.

Woodfin warned that rotating outages could return if electricity demand rises as people get power and heating back, though they would not last as long as outages earlier this week.

Texas Gov. Greg Abbott warned that state residents “are not out of the woods,” with temperatures remaining well below freezing statewide and south-central Texas threatened by a winter storm.

Adding to the state’s misery, the weather jeopardized drinking water systems. Authorities ordered seven million people — a quarter of the population in the nation’s second-largest state — to boil tap water before drinking it following days of record-low temperatures that damaged infrastructure and pipes.

Water pressure has fallen across the state because lines have frozen, and many residents are leaving faucets dripping in hopes of preventing pipes from freezing, said Toby Baker, executive director of the Texas Commission on Environmental Quality. Abbott urged residents to shut off water to their homes, if possible, to prevent more busted pipes and to preserve pressure in municipal systems.

Houston Mayor Sylvester Turner said he expects that residents in the nation’s fourth-largest city will have to boil tap water before drinking it until Sunday or Monday.

Hospitals cancel some surgeries

In Austin, some hospitals faced a loss in water pressure and, in some cases, heat.

“Because this is a state-wide emergency situation that is also impacting other hospitals within the Austin area, no one hospital currently has the capacity to accept transport of a large number of patients,” said David Huffstutler, CEO of St. David’s South Austin Medical Center, in a statement.


A patient at St. David’s South Austin Medical Center is prepared for transport. Earlier on Wednesday, hospital officials said some patients at the facility would be moved over to other hospitals in the area after the building began losing heat due to low water pressure. (Bronte Wittpenn/Austin American-Statesman/The Associated Press)

Two of Houston Methodist’s community hospitals had no running water but still treated patients, with most non-emergency surgeries and procedures cancelled for Thursday and possibly Friday, said spokesperson Gale Smith.

Emergency rooms were crowded “due to patients being unable to meet their medical needs at home without electricity,” Smith said. She said hospital pipes had burst but were repaired.

Texas Children’s Hospital’s main campus at the Texas Medical Center and another location had low water pressure, but the system was adequately staffed and patients had enough water and “are safe and comfortable,” spokesperson Jenn Jacome said.

The Federal Emergency Management Agency (FEMA) sent generators to support water treatment plants, hospitals and nursing homes in Texas, along with thousands of blankets and ready-to-eat meals, officials said. The Texas Restaurant Association also said it was co-ordinating donations of food to hospitals.

WATCH | Some Texas gas stations run out of fuel:

Extreme winter weather in Texas has delayed delivery of gasoline to some fuel stations in northern Texas, leaving drivers to scramble. 0:42

Mayor resigns 

The now former mayor of Colorado City, Texas, said he had already turned in his resignation when he wrote a controversial Facebook post on Tuesday.

Tim Boyd said it was not the local government’s responsibility to help those suffering in the cold without power. “Only the strong will survive and the weak will parish,” the typo-ridden post, which was made as millions in Texas were without power following the storm, said.

Boyd also wrote that he was “sick and tired” of people looking for handouts and that the current situation is “sadly a product of a socialist government.”

Boyd deleted his post but stood by the sentiments in a follow-up message. He also wrote that his original message was posted as a private citizen, not the mayor of Colorado City.


Father John Szatkowski, left, and Deacon Bob Bonomi of St. Paul the Apostle Church in Richardson sweep water out of the church. (Tony Gutierrez/The Associated Press)

“I was only making the statement that those folks that are too lazy to get up and fend for themselves but are capable should not be dealt a handout,” Boyd’s follow-up post said.

Turtles rescued from cold

Thousands of sea turtles unused to cold temperatures have been washing up on the beaches of South Padre Island, off the southern coast of Texas.

WATCH | Hundreds of sea turtles shelter in Texas convention centre to escape cold:

Volunteers in South Padre Island, Tex., have rescued about 2,500 sea turtles who ran ashore to escape icy waters and are now being warmed at a convention centre. 1:10

Ed Caum, executive director of the South Padre Island Convention and Visitors Bureau, said the turtles are “cold-stunned.” That’s a condition where cold-blooded animals suddenly exhibit hypothermic reactions such as lethargy and an inability to move when the temperature in the environment around them drops.

Volunteers have brought some 4,700 of them to the convention centre, where they are being kept in tubs and enclosures before they can be released when the weather warms up.

Although, as this Tik Tok user demonstrated on Tuesday, fish weren’t faring much better in their indoor tanks during the blackouts.

‘An extreme challenge’ in Mississippi

The weather also disrupted water systems in several southern cities, including New Orleans and Shreveport, La., where fire trucks delivered water to hospitals and bottled water was brought in for patients and staff, Shreveport television station KSLA reported.

Power was cut to a New Orleans facility that pumps drinking water from the Mississippi River. A spokesperson for the Sewerage and Water Board said on-site generators were used until electricity was restored.

And in Jackson, Miss., Mayor Chokwe Antar Lumumba said almost the entire city of about 150,000 was without water Thursday night.


A person warms up using a combination of towels, clothes and gloves in the warming shelter at the Johnnie Champion Community Center in Jackson, Miss., on Wednesday. Some people at the shelter had lost power, water and heat at their homes following winter storms, but many are people experiencing homelessness. (Rogelio V. Solis/The Associated Press)

Crews were pumping as much water as possible to refill the city’s tanks, but there was a shortage of chemicals to treat the water, and road closures made it difficult for distributors to make deliveries, Lumumba said.

“We are dealing with an extreme challenge with getting more water through our distribution system,” he said. “This becomes increasingly challenging because we have so many residents at home.”

Drinking water was made available at fire stations throughout Jackson, and officials also planned to set up bottled water pickup sites.

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CBC | World News

Texas power outages below 500,000, but water crisis persists during deep freeze

Power was restored to more Texans on Thursday, with fewer than a half-million homes remaining without electricity, but many still were without safe drinking water after winter storms wreaked havoc on the state’s power grid and utilities this week.

Meanwhile, the Appalachians, northern Maryland and southern Pennsylvania braced for heavy snow and ice. Snow fell in Connecticut, New Jersey and New York. Little Rock, Ark., got 38 centimetres of snow in back-to-back storms, tying a 1918 record, the National Weather Service said.

More than 320,000 homes and businesses were without power in Louisiana, Mississippi and Alabama. In Tennessee, 12 people were rescued from boats after a dock weighed down by snow and ice collapsed on the Cumberland River on Wednesday night, the Nashville Fire Department said.

The extreme weather has been blamed for the deaths of more than three-dozen people, some of whom perished while struggling to keep warm. In the Houston area, one family succumbed to carbon monoxide from car exhaust in their garage. A woman and her three grandchildren died in a fire that authorities said might have been caused by a fireplace they were using.


Father John Szatkowski, left, and Deacon Bob Bonomi of St. Paul the Apostle Church in Richardson sweep water out of the church. (Tony Gutierrez/The Associated Press)

Cruz acknowledges Mexico travel

Meanwhile, Texas Sen. Ted Cruz acknowledged on Thursday that he had travelled to Mexico for a family vacation this week, leaving his home state as thousands of constituents struggled after the powerful winter storm.

The high-profile Republican, a potential White House candidate in 2024, said in a statement that he had accompanied his family after his daughters asked to go on a trip with friends, given that school was cancelled for the week.

“Wanting to be a good dad, I flew down with them last night and am flying back this afternoon,” Cruz said after The Associated Press and other media outlets had reported details of the trip.

“My staff and I are in constant communication with state and local leaders to get to the bottom of what happened in Texas,” Cruz said. “We want our power back, our water on, and our homes warm.”

The revelation drew immediate criticism from Democrats and Republicans in Texas and beyond as Cruz, a key ally of former president Donald Trump, contemplates the possibility of a second presidential run. The two-term senator’s current term expires in early 2025.

“That’s something that he has to answer to his constituents about,” state Republican Party Chairman Allen West said when asked whether Cruz’s travel was appropriate while Texans are without power and water.

“I’m here trying to take care of my family and look after my friends and others that are still without power. That’s my focus.”


Texas Sen. Ted Cruz is under fire following the revelation he travelled to Mexico on Wednesday for a family vacation as his home state struggled with extreme weather. (Erin Scott/Reuters)

Earlier, Cruz’s office had declined to answer specific questions about the family vacation, but his staff reached out to the Houston Police Department on Wednesday afternoon to say the senator would be arriving at the airport, according to department spokesperson Jodi Silva. She said officers “monitored his movements” while Cruz was at the airport.

Silva could not say whether such requests are typical for Cruz’s travel or whether his staff has made a similar request for his return flight.

The Texas senator, who once described Trump as a “pathological liar,” championed the-then president’s call to block the certification last month of Democrat Joe Biden’s election victory. That stand led to calls for Cruz’s resignation after a violent mob stormed the Capitol as Congress was affirming Biden’s win.

“Ted Cruz had already proven to be an enemy to our democracy by inciting an insurrection. Now, he is proving to be an enemy to our state by abandoning us in our greatest time of need,” Texas Democratic Party Chair Gilberto Hinojosa said Thursday. “For the 21st time, the Texas Democratic Party calls on Ted Cruz to resign or be expelled from office.”

Drinking water affected

In Texas, just under 500,000 homes and businesses remained without power, down from about three million on Wednesday. The state’s grid manager, the Electric Reliability Council of Texas, said the remaining outages are largely weather-related, rather than forced outages that were made early Monday to stabilize the power grid.

“We will keep working around the clock until every single customer has their power back on,” said ERCOT senior director of system operations Dan Woodfin.

Adding to the misery, the snowy weather has jeopardized drinking water systems throughout the state.

Texas officials ordered seven million people — a quarter of the population in the nation’s second-largest state — to boil tap water before drinking it following days of record-low temperatures that damaged infrastructure and froze pipes.

In Austin, some hospitals faced a loss in water pressure and, in some cases, heat.


A patient at St. David’s South Austin Medical Center is prepared for transport. Earlier on Wednesday, hospital officials said some patients at the facility would be moved over to other hospitals in the area after the building began losing heat due to low water pressure. (Bronte Wittpenn/Austin American-Statesman/The Associated Press)

“Because this is a state-wide emergency situation that is also impacting other hospitals within the Austin area, no one hospital currently has the capacity to accept transport of a large number of patients,” said David Huffstutler, CEO of St. David’s South Austin Medical Center, in a statement.

Water pressure has fallen across the state because lines have frozen, and many residents are leaving faucets dripping in hopes of preventing pipes from freezing, said Toby Baker, executive director of the Texas Commission on Environmental Quality.

Texas Gov. Greg Abbott urged residents to shut off water to their homes, if possible, to prevent more busted pipes and to preserve pressure in municipal systems.

Supplies run short

Grocery store shelves have gone bare in several Texas cities, including Austin and Lewisville. Frozen goods had to be disposed of after the blackouts.

Gas shortages have also hit parts of the state as people search for fuel for their vehicles and back-up generators. Some oil production facilities, responsible for an estimated three million barrels per day, remain offline.

WATCH | Some Texas gas stations run out of fuel:

Extreme winter weather in Texas has delayed delivery of gasoline to some fuel stations in northern Texas, leaving drivers to scramble. 0:42

Mayor resigns over insensitive comments

The now former mayor of Colorado City, Texas said he had already turned in his resignation when he wrote a controversial Facebook post on Tuesday.

Tim Boyd said it was not the local government’s responsibility to help those suffering in the cold without power. “Only the strong will survive and the weak will parish,” the typo-ridden post said.

Boyd also wrote that he was “sick and tired” of people looking for handouts and that the current situation is “sadly a product of a socialist government.”

The post was made as millions in Texas were without power following the storm. Utilities from Minnesota to Texas and Mississippi implemented rolling blackouts to ease the burden on power grids straining to meet extreme demand for heat and electricity.

Boyd deleted his post but stood by the sentiments in a follow-up message. He also wrote that his original message was posted as a private citizen, not the mayor of Colorado City.


A woman collects ice cream that had been thrown out because of power outages at a Kroger store in Arlington. (Tom Fox/The Dallas Morning News/The Associated Press)

“I was only making the statement that those folks that are too lazy to get up and fend for themselves but are capable should not be dealt a handout,” Boyd’s follow-up post said.

Turtles rescued from cold

Thousands of sea turtles unused to cold temperatures have been washing up on the beaches of South Padre Island, off the southern coast of Texas.

Ed Caum, executive director of the South Padre Island Convention and Visitors Bureau, said the turtles are “cold-stunned.” That’s a condition where cold-blooded animals suddenly exhibit hypothermic reactions such as lethargy and an inability to move when the temperature in the environment around them drops.

WATCH | Hundreds of sea turtles shelter in Texas convention centre to escape cold:

Volunteers in South Padre Island, Tex., have rescued about 2,500 sea turtles who ran ashore to escape icy waters and are now being warmed at a convention centre. 1:10

Volunteers have brought some 4,700 of them to the convention centre, where they are being kept in tubs and enclosures before they can be released when the weather warms up.

Although, as this Tik Tok user demonstrated on Tuesday, fish weren’t faring much better in their indoor tanks during the blackouts.

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As COVID-19 exposes long-term care crisis, efforts grow to keep more seniors at home

Lucy Fernandez volunteered in a long-term care home for 20 years.

Although she saw first-hand how much of an effort staff and her fellow volunteers made to keep the residents happy, she also saw many seniors languishing in their rooms.

“While she was still, you know, fairly cognizant, [she] expressed her desire of not wanting to go to a long-term care facility,” her daughter, Laura Fernandez, said.

Lucy, now 85, suffers from advanced Alzheimer’s disease, with limited ability to speak and move. Because she’s one of 850 people in Ontario’s High Intensity Supports at Home program, announced by the provincial government in December, personal support workers come in for several hours a day — in addition to others who work with her on cognitive development — allowing Laura Fernandez to keep her mother at home in Toronto.

“She is in her own environment, she’s happy,” Fernandez said. “Just knowing that I’m there, I know is giving her comfort.”

That’s the level and quality of home care that should be much more widely available to seniors, according to several health policy advocates, including the National Institute on Ageing and the Ontario Community Support Association.

In addition, they say, it would ultimately save governments money by keeping more seniors out of long-term care facilities, which are expensive both to build and run.  

COVID-19 put spotlight on home care

The benefit of increased home-care investment in Canada is getting long-overdue attention, now that COVID-19 has torn through long-term care homes, killing thousands of residents and exposing lethal weaknesses in the system, said Dr. Samir Sinha, head of geriatrics at Mount Sinai and University Health Network hospitals in Toronto.

“Long-term care is at a crossroads,” said Sinha, who is also the director of health policy research for the National Institute on Ageing.

“People are thinking about their futures more than ever before and saying, ‘When I age, you know, am I going to be able to age with independence? Will I have to go into one of these homes? You know, how do I actually stay in my home for as long as possible?'”

WATCH | Laura Fernandez’s mother volunteered in a long-term care home:

Laura Fernandez describes the difference it makes for her mother, who has advanced Alzheimer’s disease, to receive the care that allows her to stay at home. 1:15

Not only do most seniors want to live at home for as long as possible, more of them actually could, according to a report released by the Canadian Institute for Health Information (CIHI) in August 2020.

After reviewing the health status of people admitted in long-term care facilities in several provinces over the course of a year, CIHI concluded that across Canada, about one in nine new admissions “could potentially have been cared for at home, provided they had access to ongoing home-care services and supports.”

In Ontario, where people admitted to long-term care facilities are often quite frail or suffer serious cognitive impairment, including dementia, CIHI estimated that one in 12 new admissions could still potentially have remained at home if sufficient care were provided.

“One of the greatest reasons why people end up in nursing homes in Canada is because we don’t have enough publicly funded home care and supports … available,” Sinha said.

Although the Ontario government (under both Liberal and Conservative leadership) has increased its investment in home care and community services over the last decade, those investments haven’t kept pace with the needs of an aging population, according to the Ontario Community Support Association, which represents more than 200 not-for-profit organizations that provide home care and community support.

While long-term care homes have been struggling during the pandemic, the home-care sector could have helped lessen their load if it were funded appropriately, said Deborah Simon, the association’s CEO.


Devastating COVID-19 outbreaks in nursing homes have exposed enormous weaknesses that the Ontario government has pledged to fix, but many seniors’ experts say expanded home care should be a cornerstone of the solution. (Evan Mitsui/CBC)

Home care has also proven to be a safer option during COVID-19, Simon said, because seniors could more easily isolate in their own homes than in the congregate living setting of a long-term care facility. In addition, home-care workers use “the full gamut” of personal protective equipment.

“Care can be safely provided to people in the community who have COVID, using those very, very stringent practices around infection control,” Simon said. 

Put home care first, advocates urge

The COVID-19 crisis prompted the Quebec government to announce an additional $ 100 million investment in home care on top of the $ 1.7 billion it had already budgeted for this year.

“Home care is what people want, and they want it even more because of the pandemic,” Health Minister Christian Dubé said at a news conference in Montreal in November.

In a statement, Ontario’s Ministry of Health said it provided about $ 2.88 billion in funding to home care in the 2019-20 fiscal year. No estimate was given for the 2020-21 fiscal year.


Both the National Institute on Ageing and the Ontario Community Support Association say government funding should be prioritized so that home care is the end goal, rather than just an interim solution until seniors get a space in long-term care. (David Donnelly/CBC)

On Tuesday evening, a ministry spokesperson told CBC News in an email that “the government continues to make investments in our home-care sector for 2021-22,” citing an “additional” $ 111 million for the High Intensity Supports at Home program to help people with high needs — including Lucy Fernandez — transition out of hospital to home.

The spokesperson also cited last October’s announcement of a $ 461 million “temporary wage increase” for personal support workers in both home-care and long-term care settings during COVID-19.

In a separate statement, a spokesperson for the Ministry of Long-Term Care said it was investing up to $ 20 million for a community paramedicine program to provide services to seniors in their homes while they wait for a bed in long-term care.

But both the National Institute on Ageing and the Ontario Community Support Association say government funding should be prioritized so that home care is the end goal, rather than just an interim solution until seniors get a space in long-term care.

The Ontario Community Support Association has submitted a pre-budget consultation report to the provincial government, advocating for an investment of $ 595 million in the 2021 budget to make that happen.

The National Institute on Ageing has also submitted a proposal, co-authored by Sinha, to prioritize home care.

WATCH | Doctor says most Canadians want to age at home for as long as possible:

Geriatrics specialist Dr. Samir Sinha says boosting the level of home care and sending fewer people to long-term care facilities is both cost-effective and the right thing to do. 0:33

Both reports estimate the cost of home care to be significantly less expensive than long-term care. They also point to the Ontario government’s own estimate that about 38,000 people are currently on the waiting list for a long-term care bed.

To address that, the Ontario government has pledged to build 15,000 new long-term care beds and update 15,000 more.

That will cost billions of dollars that could be better invested — at a lower cost — in building a robust home-care system, Sinha said.

“By finding that better balance with those future investments we’re looking to make, I think we’re actually going to allow more people to age in the places of their choice,  which frankly allows everybody — the taxpayers and individuals and governments — to win.”

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CBC | Health News

Peru’s interim president resigns amid protests, constitutional crisis

Peru’s interim president resigned Sunday as the nation plunged into its worst constitutional crisis in two decades following massive protests unleashed when Congress ousted the nation’s popular leader.

In a short televised address, Manuel Merino said Congress acted within the law when he was sworn into office as chief of state Tuesday, despite protesters’ allegations that legislators had staged a parliamentary coup.

“I, like everyone, want what’s best for our country,” he said.

The politician agreed to step down after night of unrest in which two young protesters were killed and half his Cabinet resigned. Peruvians cheered the decision, waving their nation’s red and white flag on the streets of Lima and chanting “We did it!” But there is still no clear playbook for what comes next.

Congress scheduled an emergency session for Sunday afternoon to select a new president.


People in a Lima snack bar Merino announces his resignation in a televised message. (Luka Gonzales/AFP via Getty Images)

Meanwhile, ex-president Martin Vizcarra — whose ouster sparked the upheaval — called on the country’s highest court to step in.

“It can’t be that the institution that got us into this political crisis, that has for five days paralyzed Peru, with deaths, is going to give us a solution, choosing the person who they best see fit,” Vizcarra said.

Peru has much at stake: The country is in the throes of one of the world’s most lethal coronavirus outbreaks and political analysts say the constitutional crisis has cast the country’s democracy into jeopardy.

“I think this is the most serious democratic and human rights crisis we have seen since Fujimori,” said analyst Alonso Gurmendi Dunkelberg, referring to the turbulent rule of strongman Alberto Fujimori from 1990 to 2000.

Ex-president accused of bribery

Congress kicked Vizcarra out using a clause dating back to the 19th century that allows the powerful legislature to remove a president for “permanent moral incapacity.” Legislators accused Vizcarra of taking more than $ 630,000 US in bribes in exchange for two construction contracts while governor of a small province years ago.

Prosecutors are investigating the allegations but Vizcarra has not been charged. He has vehemently denied the accusations.


Martin Vizcarra speaks in front of the presidential palace after lawmakers voted to remove him from office in Lima on Nov. 9. (Martin Mejia/The Associated Press)

Merino, previously head of Congress, stepped in as interim president, but his six-day rule was marred by constant protests. The little-known politician and rice farmer promised to keep in place a scheduled vote for a new president in April. That did little to sway Peruvians who were loath to accept him.

Half of those in Congress are themselves under investigation for alleged crimes including money laundering and homicide. Polls show most wanted Vizcarra to carry out the rest of his presidential term, due to expire in July. As Peruvians took to the streets, police responded with batons, rubber bullets and tear gas.

Crackdowns ‘intensifying’

A network of human rights groups reported that 112 people were hurt in Saturday’s protests and the whereabouts of 41 others were unknown. Health authorities said the dead included Jack Pintado, 22, who was shot 11 times, including in the head, and Jordan Sotelo, 24, who was hit four times in the thorax near his heart.

“Two young people were absurdly, stupidly, unjustly sacrificed by the police,” Peruvian writer and Nobel laureate Mario Vargas Llosa said in a recorded video shared on Twitter. “This repression – which is against all of Peru – needs to stop.”

The protests rocking Peru are unlike any seen in recent years, fueled largely by young people typically apathetic to the country’s notoriously erratic politics. Protesters are upset at Congress for staging what they consider an illegal power grab as well as whom Merino had chosen to lead his nascent government.


A protester faces off with police in Lima on Sunday. (Angela Ponce/Reuters)

His prime minister, Antero Flores-Araoz, was a former defense secretary who resigned in 2009 after police clashes with indigenous protesters in the Amazon left 34 dead. Alberto Vergara, a political analyst with Peru’s University of the Pacific, said many saw the new Cabinet as “old, bitter, stale, closed to the world.”

In remarks before Saturday’s upheaval, Merino denied the protests were against him, telling a local radio station that young people were demonstrating against unemployment and not being able to complete their studies because of the pandemic. For many, that showed just how out of touch Congress is.

“We want the voice of the people to be heard,” protester Fernando Ramirez said as he banged a spoon against a pot at a protest.


Protesters hold a sign reading in Spanish ‘Murderer’ shortly before Merino announced his resignation in Lima on Sunday. (Rodrigo Abd/The Associated Press)

According to the National Association of Journalists, there were 35 attacks against members of the media between Monday and Thursday, almost all by police officers. Rights groups have also documented excessive force against protesters, the use of tear gas near homes and hospitals and the detention of demonstrators.

“We are documenting cases of police brutality in downtown Lima,” Jose Miguel Vivanco, Americas director of Human Rights Watch, wrote on Twitter Saturday. “Everything indicates repression against peaceful protesters is intensifying.”

‘Peru deserves to move forward’

If Congress proceeds with selecting a new leader, they may have relatively few options that would appease demonstrators. An overwhelming majority -—105 of 130 — voted in favour of removing Vizcarra. They are widely expected to choose among those who were against the ex-president’s surprise rushed removal.

The timing of the crisis could not be worse: Peru has the world’s highest per-capita COVID-19 mortality rate and has seen one of Latin America’s worst economic contractions. The International Monetary Fund projects a 14 per cent decline in GDP this year.


Protesters gather outside the Congress building in Lima on Sunday. (Sebastian Castaneda/Reuters)

In stepping down, Merino said he’d fulfilled his responsibility with “humility and honour” and that it was a challenge he “accepted and did not seek.” He accused unnamed actors of trying to “confuse the country” into thinking Congress wanted to kick out Vizcarra in order to delay the upcoming presidential vote.

He also took a jab at demonstrators, saying there were groups of young adults “interested in producing chaos and violence.”

“I call for the peace and unity of all Peruvians,” he said. “Peru deserves to move forward.”

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Provinces pursue OxyContin maker for $67B US in costs associated with Canada’s opioid crisis

In an effort to claw back the public health-care costs incurred by the opioid crisis, Canada’s provinces have filed a $ 67.4-billion US claim against OxyContin producer Purdue Pharma. 

The provinces are some of the more than 600,000 claimants listed in documents filed against Purdue Pharma on Nov. 5 in the U.S. Bankruptcy Court for the Southern District of New York.

OxyContin was introduced about two decades ago, marking what addiction experts recognize as the beginning of the opioid crisis. The drug quickly spread to the streets, leading to a full-blown public-health crisis involving various other opioids and eventually a devastating influx of fentanyl, which killed many of the more than 4,500 Canadians who died of drug overdoses in 2018 alone. 

British Columbia’s claim is for more than $ 9.1 billion US, while Ontario’s is $ 26.1 billion US, and Quebec’s is $ 15.3 billion US.


British Columbia’s claim against Purdue is for more than $ 9.1 billion US, while Ontario’s is $ 26.1 billion US, and Quebec’s is $ 15.3 billion US. (Douglas Healey/The Associated Press)

Reidar Mogerman is the lawyer handling the class action cost recovery litigation for British Columbia. He says this situation is comparable to past societal actions after mass public injury was caused by tobacco and asbestos.

“The Canadian number looks large and it is large because it’s a significant problem. I believe if you add in claims from U.S. entities you get numbers in excess of $ 2 trillion US. It’s really staggering,” said Mogerman.

In the United States, Purdue paid $ 634.5 million US about 13 years ago to settle litigation after being charged with misbranding OxyContin as less addictive than other prescription pain medications.

Health Canada has never investigated Purdue.

“It’s a product that we thought was useful and it turned out to be extremely dangerous. The carnage can only be addressed with society-wide tools,” said Mogerman.

Society-wide health care crisis created

He explained that as the drug maker became overwhelmed by claims related to the opioid crisis it moved to apply to the U.S. courts for bankruptcy protection, which has stalled the legal process.


Purdue paid $ 634.5 million US about 13 years ago to settle litigation after being charged with misbranding OxyContin as less addictive than other prescription pain medications. (George Frey/Bloomberg/Getty)

Mogerman says Purdue continues to sell opioids in Canada and the U.S., but the way they are used and marketed has become safer.

However, the fallout from the introduction of OxyContin has been a “society-wide health care crisis,” he said. 

Three years ago Canadian provinces seemed willing to whittle down their $ 85.5-billion Canadian claim — for everything from emergency medical care to overdose prevention sites and addiction treatment programs — to a $ 2 million share of the settlement offer. 

But outspoken Saskatchewan judges raised the alarm that the provinces were failing to protect public funds.

Purdue initially offered $ 20 million Cdn to settle a 1,600-member victim-centred Canadian class-action lawsuit that’s been ongoing since 2007.

But in the end provinces withdrew their support, after the judges’ rebuke.

In 2018 the B.C. government launched its own lawsuit against more than 40 pharmaceutical companies, including Purdue. That claim alleges they knew, or should have known, that opioids were addictive and leaking into the illegal market.

But all claims were frozen after Purdue sought bankruptcy protection in 2019.

Mogerman says patient claims began to be at odds with provincial interests — so they had to move another way.

He said B.C. takes this crisis so seriously that billions have been spent trying to solve it.

“The province needed to protect the larger public interest that it’s trying to pursue,” he said.

 “But nobody has a silver bullet. It’s not an easy thing to solve.”

He predicts a reckoning will come and pharmaceutical companies will pay B.C. and other provinces compensation or his team will pursue the company and the family who owns it.

“We will pursue the cases to the ends of the earth if we need to,” he said.

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Canada’s opioid crisis killed 4,614 people in 2018, but more loss and ‘heartache’ can be prevented

About 13 people a day in Canada died as a result of opioids in 2018, according to a new report that shines a spotlight on preventable poisonings.

Released on Thursday, the report by Parachute, a Canadian charity dedicated to injury prevention, and the Injury Prevention Centre at the University of Alberta’s School of Public Health focused on poisoning — the toxic effects of substances such as medication, cleaning products or gas vapour — on the body.

The report found that in 2018, opioids were responsible for 4,614 deaths in Canada, equating to about 13 lives lost per day, based on data from the Public Health Agency of Canada. It breaks down the top 10 pharmaceutical and top 5 non-pharmaceutical causes behind cases at Canada’s five poison control centres.

“We know that the vast majority of these are preventable,” said report co-author Pamela Fuselli, president and CEO of Parachute.

The numbers are stark, Fuselli said, with nearly half of all opioid-related poisoning deaths occurring in those aged 30 to 49, primarily men.


Pamela Fuselli, president and CEO of Parachute, a Canadian charity dedicated to injury prevention, says what sends people to hospital for poisoning varies by age group and can include over-the-counter medications such as acetaminophen, alcohol, prescription drugs, including opioids, and cleaning products. (Kelda Yuen/ CBC)

“We’re losing people who can contribute to Canada and [losing] lives … that don’t need to be lost.”

Individuals using illicit substances can be at increased risk of poisoning despite using their usual amount because of the growing degree of contamination of the drug supply with fentanyl and other ultrapotent opioids, the report said. Respiratory arrest and death can result.

The report recommends steps to prevent the loss of a family member and the “heartache” that follows, such as:

  • Harm reduction to reduce the negative effects of stigma surrounding people with a substance use disorder.
  • Offering treatment and rehabilitation services for those with substance use disorders and associated mental health disorders.
  • Expanding safe consumption sites where people can access safe needles and receive medical attention and support, including conversations on accessing treatment and rehabilitation services.
  • Clamping down on illegal drug production and trafficking.
  • Providing educational campaigns to inform people of the risks associated with use of substances.
  • Looking at what leads people to take drugs in the first place.
  • Providing naloxone to prevent deaths among people who take opioids.
  • Locking up medications and cleaning products to keep them out of reach of young children.
  • Getting rid of any medications that are no longer needed.

Fentanyl detected in majority of illicit drug deaths

Co-author and epidemiologist Kathy Belton, associate director of the Injury Prevention Centre at the U of A, said Western Canada has been hit hard, with British Columbia seeing 1,542 deaths related to illicit drug use in 2018. Of these, fentanyl was detected in 87 per cent.

When both Fuselli and Belton crunched the numbers, they said they were surprised to find that twice as many people now die of unintentional poisonings than traffic-related injuries — the leading cause of unintentional injury deaths for children and teens for nearly 20 years.

“It just jumped out at you on the page,” Belton said.

She also pointed to a 2018 study in Alberta that showed the increase in death and disease accompanying the opioid crisis was largely due to unintentional poisoning rather than intentional self-harm or suicide by poisoning.

‘Long road to go to solve poisoning’

“An overdose is really the wrong term,” Belton said, because people taking opioids to get high aren’t intending to die.

“If we start looking at that’s not the intended outcome, then we look at this whole issue of poisoning and opioid poisoning differently,” she said. “Maybe they would stop blaming the individual because addiction is a disease just like any other disease.”


Jason Mercredi, executive director of Prairie Harm Reduction in Saskatoon, says he thinks the report underestimates the scale of hospitalizations from opioids and would like to see an expansion of harm-reduction services across Canada supported with long-term funding. (Don Somers/CBC)

Jason Mercredi, executive director of Prairie Harm Reduction in Saskatoon, was not involved in writing the report, but he said he thinks it underestimates the scale of hospitalizations from opioids given how busy paramedics are in Saskatchewan.

“I think the most frustrating part of my job is when I get a call from somebody’s mom whose kid died, and they’re calling and asking what they can do to support us,” Mercredi said. “That’s backwards. It should be the opposite relationship, but they have nowhere to go to and they don’t feel like they’re being listened to.”

Mercredi said he would like to see an expansion of harm-reduction services across Canada supported with long-term funding.

WATCH | COVID-19 pandemic exacerbates opioid deaths:

There has been an unprecedented spike in opioid overdoses in Canada during the COVID-19 pandemic, with a 25 per cent increase in Ontario and a 39 per cent increase in British Columbia. 1:59

Fuselli said when it comes to other types of poisoning deaths, people may think that the problem of poisoning slowed with the introduction of child-resistant caps and blister packs for medications, but that’s not the case.

“We actually have a long road to go to solve poisoning,” she said.

What sends people to hospital varies by age group and can include over-the-counter medications such as acetaminophen, alcohol, prescription drugs, including opioids, and cleaning products, depending on how much is ingested, Fuselli said.

Belton said that as a scientist, it’s important to get more information on the circumstances surrounding an event to find out what’s the best point to intervene and stop injuries from happening.


A pair of shoes representing a life lost hangs on the Burrard Street Bridge in Vancouver as part of an art display on International Overdose Awareness Day in August. (Ben Nelms/CBC)

But that data is not collected in the same database in Canada. Instead, the report was compiled based on 2008 to 2018 data on deaths and hospitalizations in all provinces except Quebec, as well as emergency department visits in Alberta and Ontario.

The authors recommend setting up a national phone number that would allow health professionals to connect seamlessly with a poison control centre. They would also like a database similar to what’s in the U.S. and European Union to look for signs of contaminants, which could also help inform health-care providers when exposures occur.

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CBC | Health News

NFL nears COVID-19 crisis as Titans, Patriots reveal more positive tests

Tennessee will not be returning to the team’s facility Wednesday after two more players tested positive amid the NFL’s first COVID-19 outbreak, and the New England Patriots have cancelled practice amid reports that a third player has tested positive for the coronavirus.

The New England Patriots cancelled a practice scheduled for Wednesday after reigning Defensive Player of the Year Stephon Gilmore tested positive for COVID-19, according to the National Football League’s website.

Quarterback Cam Newton tested positive Saturday and is on the reserve/COVID-19 list, and the Patriots placed a defensive tackle from the practice squad on that list Tuesday. The Patriots are scheduled to host Denver on Sunday.

“WEAR YOUR MASK. KEEP YOUR DISTANCE,” Newton posted on Twitter Wednesday along with a photo of himself wearing a mask.

The Titans had no positive tests Monday or Tuesday for the first time after six consecutive days of positive results. A third straight day was necessary for the team to be allowed back in its headquarters, stopping its planned return, according to a person familiar with the situation.

Buffalo coach Sean McDermott said no one’s perfect when asked about the NFL’s stricter protocols as his Bills (4-0) prepare for a game at Tennessee that may now be in jeopardy. McDermott said no one’s perfect.

“We’re fighting an uphill battle,” McDermott said. “I think we know that there’s a challenge because of how easily this thing spreads.”

McDermott said the Bills have had no positives after beating the Raiders 30-23 in Las Vegas last week. The Raiders placed defensive tackle Maurice Hurst on the reserve/COVID-19 list Tuesday.

Instead, the Titans’ outbreak now is up to 22 cases with 20 now returned since Sept. 29, according to the person who spoke to the AP on condition of anonymity because neither the NFL nor the Titans announced the latest results.

The Titans announced they will not have any media availability Wednesday.

The new positive tests put into question Tennessee’s scheduled game Sunday against Buffalo (4-0), a matchup between two of the NFL’s six remaining undefeated teams. The NFL has rescheduled the Titans’ game with Pittsburgh from Oct. 4 to Oct. 25.


The NFL gave New England and Kansas City an extra day after Newton tested positive Saturday, and Kansas City beat the Patriots 26-10 on Monday night. But pushing the Bills’ game with the Titans back by a day will be challenging because Buffalo is scheduled to host Kansas City on Thursday night, Oct. 15.

The league is attempting to play a full schedule amid the pandemic without teams isolated in a bubble as other sports have done to protect players and staff from the virus. No games were affected through the first three weeks of the season.

Pittsburgh defensive tackle Cam Heyward said Wednesday it was “ludicrous” to think the NFL wouldn’t have positive tests and warned there would be more. He said players and teams were under pressure to minimize outbreaks.

“Things are going to change every minute now,” said Heyward, the Steelers’ player representative. “And we’ve just got to be willing to adjust. I know the NFL and the NFLPA is trying to do right by the players and the coaches, but there’s only so much they can do.”

Breaking rules could mean forfeits, fines

NFL commissioner Roger Goodell warned all 32 teams Monday that any violations of COVID-19 protocols that force schedule changes could result in punishment including forfeiting games, fines or loss of draft picks.

Pittsburgh quarterback Ben Roethlisberger said he’s allowing his wife and three children to attend the Steelers’ game Sunday against Philadelphia. The Steelers had an unexpected bye last weekend with the Titans’ outbreak affecting their schedule.

“I don’t think they’ll consider forfeiting our game, and of course we got the short end of the stick,” Roethlisberger said.

Titans last together on Sept. 27

Titans coach Mike Vrabel told reporters Tuesday he was hoping to hear more good news Wednesday morning when the latest batch of daily testing results came back. Instead, he’ll have to try to prepare a game plan with his team possibly not back into its facility until Saturday because it needs back-to-back days of negative tests.

Tennessee hasn’t been together as a team since Sept. 27, when the Titans beat the Vikings 31-30 in Minnesota. The Titans played that game after leaving outside linebackers coach Shane Bowen in Nashville following his positive test result Sept. 26, and the NFL shut down the team facility on Sept. 29.

The franchise has continued daily testing since then, and the league sent all 32 teams a memo Oct. 1 with list of new protocols for clubs to follow when dealing with a coronavirus outbreak or having been exposed to an outbreak.

The Las Vegas Raiders put their first player on the reserve/COVID-19 list Tuesday — defensive tackle Maurice Hurst. He didn’t attend the charity function last week that led the NFL to fine 10 Raiders players for conduct violating COVID-19 protocols. The list is for players who either test positive for the coronavirus or have had close contact with an infected person.

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Quebec gives police legal tools to enter homes quickly to stop gatherings during COVID crisis

Quebec Premier François Legault says police in the province’s red zones — regions where COVID-19 cases are surging — will be issuing $ 1,000 fines to those who violate newly strengthened public health rules.

With fees, those fines will top $ 1,500 and can be issued for gathering in private residences or protesting without a face covering. 

Speaking during a late-afternoon news conference on Wednesday just hours before the new rules went into effect, Legault said the negligence of a few has led to the crackdown.

“Lives are at stake. We want to keep our children in schools,” Legault said. “We also want to protect our health network”

Quebec reported 838 new cases of COVID-19 but no new deaths Wednesday. Since the start of the pandemic, there have been 74,288 confirmed cases and 5,834 people have died in the province. 

Home gatherings can lead to fines

Beyond the few exceptions, such as for caregivers or romantic relations, house guests are not allowed, Legault said.

Police are authorized to demand proof of residency and if residents refuse entry, officers will be able to obtain warrants faster through a new, virtual system that was established in collaboration with the Crown, the premier said.

“We had to give the police the means to intervene,” said Public Security Minister Geneviève Guilbault.


Public Security Minister Geneviève Guilbault says the goal is not to fine everybody who violates the rules, but instead encourage compliance to protect the population. (Jacques Boissinot/The Canadian Press)

Normally the process for obtaining a warrant can take a day or two, but that won’t work when police want to break up parties that very same evening, Legault said.

He said people who shrug off the rules and host parties are “putting the lives of other people in danger.”

Protestors to be fined for refusing to wear masks

Quebec made masks mandatory inside public spaces, like bars and shops, on July 18, but there have been several protests since.

Now, anti-maskers will have to cover up if they want to march or police will be issuing fines.

Guilbault said protesting without masks cannot be tolerated and she is not ruling out using force to disperse protests if needed.

“Eventually, we will cross that bridge when we get there,” she said.

All gatherings prohibited, travel discouraged

Legault said all gatherings will be banned, even outside in public parks — an activity that has grown more popular in places like Montreal during the pandemic. 

“Police officers will start by trying to disperse the gatherings, but if people don’t co-operate, fines can be given,” he said.


Police will again be cracking down on those who gather in public parks within Quebec’s red zones. (Graham Hughes/The Canadian Press)

Legault said people from red zones cannot travel to orange zones to eat in a restaurant or gather in a home. They will face fines if they do. 

He said restaurants will not be required to verify residency, but police can issue a ticket if they catch people violating the rules.

People should not travel between regions to pick up groceries or run similar errands, Legault said. People can go to their cottage, for example, as long as they bring their provisions with them. 


In recent months, some demonstrators in Quebec have denounced what they consider government fear campaigns over COVID-19. The new measures included a mandatory rule on wearing masks during demonstrations. (Graham Hughes/The Canadian Press)

Legault made no mention of roadblocks, something that occurred last spring. However, Guilbault said signs will be posted, warning people they are entering or leaving a red zone.

Guilbault said the idea is not to issue as many fines as possible, but to ensure people are staying in their zones and decreasing the spread of COVID-19.

She said police will try to educate and inform before resorting to tickets.

Back in the spring, hundreds of fines were issued to people who ignored the two-metre rule or threw parties at home.

WATCH | Quebec’s premier says it’s time to protect others: 

Quebec premier explains the punishments for breaking restrictions that begin at midnight . 2:17

Restrictions to take effect at midnight

The new restrictions take effect 12:01 a.m. ET on Thursday and are set to last for 28 days, until Oct. 28, in the red zones. The restrictions are: 

  • A ban on home gatherings, with some exceptions, such as a single caregiver, babysitter, tradesperson or technician, allowed per visit.

  • All bars and casinos are closed. Restaurants can offer only takeout.

  • Museums, cinemas and theatres are closed.

  • Being less than two metres apart will be prohibited. Masks will be mandatory during demonstrations.

  • Houses of worship and venues for events, such as funerals and weddings, will have a 25-person limit.

  • Hair salons, hotels and other such businesses will stay open.

  • Schools will remain open.

Libraries were on the list of buildings to close, but Legault clarified on Wednesday that libraries will remain open to borrow books only.

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The key metric that will tell us if Canada is headed for a U.S.-style COVID-19 crisis

This is an excerpt from Second Opinion, a weekly roundup of health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.


A recurring fear looms over newly reopened bars and restaurants, lurking over crowded aisles, clinking glasses and face-to-face banter enlivened by alcohol.

Are we sleepwalking toward an American-style coronavirus crisis?

As Canadian establishments reopen, it’s a worry voiced even by some people with a financial stake in the hospitality business. 

Two Montreal restaurateurs said they were aghast at behaviour they witnessed after businesses resumed operating several weeks ago.

“Frustrated. Angry. Disheartened,” is how Stephen Leslie, owner of Tavern on the Square and Monkland Tavern, describes his reaction to seeing other establishments defy safety guidelines, with too many tables and too little PPE for staff.

“You just can’t help but think that what’s going on to the south of us — Texas, Florida — how they’ve been forced to re-close is going to happen to us here if we don’t follow the rules.”


A patron enjoys a glass of wine at the bar of Lemeac restaurant on the first day after restrictions were lifted on restaurants in Montreal, on June 22. (Christinne Muschi/Reuters)

Ilene Polansky, owner of Montreal restaurant Maestro SVP, said disrespectful clients littered; stumbled into her; did not distance; refused to wash their hands; and stormed off when she declined to group tables together.

“They said, ‘One-star review for you. We’re never coming [back] here,'” Polansky recalled. 

“It’s sad that I have to tell people to follow the rules.”

Now Montreal has long lineups for testing, with infections rising and dozens of cases linked to bars, prompting new provincial guidelines

Alberta faced 41 new cases tied to outbreaks at four restaurants in Edmonton late last month. British Columbia has seen exposure to COVID-19 in bars, nightclubs and strip clubs since reopening. Ontario reopened bars and restaurants in much of the province Friday as it moves into Stage 3

The post-reopening spikes inevitably raise questions about whether Canada is simply a few weeks behind a neighbour that reopened sooner.

In the U.S., a new wave of the virus is battering virtually every region, with cases rising in most states; record spikes in several of them; and hospital bed shortages in Florida and elsewhere

To gauge whether the early signs in Canada point to a scenario similar to the one flaring up through the U.S., CBC News consulted three infectious disease experts, four public health officials, and national, state and provincial data.

One of Canada’s best-known public health experts said she lost sleep over the decision to reopen bars in B.C. — but she’s now confident in their ability to clamp down on outbreaks quickly before they spiral out of control. 

“We’ve had our restaurants and bars open for the last month now, and we haven’t had major outbreaks,” Bonnie Henry said in an interview with CBC News. “It’s not been perfect, and we’ve had to revise things.”

Henry said B.C. reopened establishments in a “manageable” way that allowed people to socialize safely, with smaller capacities, strict physical distancing and hygiene protocols, and a COVID-19 safety plan in place

“The first thing people said when we had the exposure event in a couple of the nightclubs in Vancouver was, ‘Oh, shut them down.’ But that doesn’t help,” she said, adding officials worked with the industry to minimize risk to patrons and staff.

“It just drives people underground, where we won’t hear about cases because they’re afraid to talk about it.”

‘You can’t eat and drink with a mask on’

When trouble hit the United States, it initially struck with stealth — as a series of anecdotes, unheeded warnings, contradictory news headlines, and videos of safety guidelines being ignored.

Within days the headlines took an unambiguously bleaker turn. Arizona reported its highest one-day increase in cases. Then the cases kept growing, and growing, then doubling, tripling, quadrupling


California is among the many states experiencing a surge in coronavirus cases. Pictured are cars lined up at a drive-thru testing site at Dodger Stadium in Los Angeles on Thursday. (Lucy Nicholson/Reuters)

Now Canada is also reopening what experts describe as some of the highest-risk environments — bars and restaurants.

People are indoors, in close contact, sharing food and drinking while proven infection-control measures — like physical distancing, hand hygiene and mask wearing — are also much harder to maintain.

“You can’t eat and drink with a mask on,” said Dr. Matthew Oughton, an infectious disease specialist at the Jewish General Hospital and an assistant professor at McGill University in Montreal.  

The spread of COVID-19 among bar-goers who aren’t displaying symptoms is another major risk factor.

“The risk is that you could be feeling totally fine and ready to go for a night out,” he said. “And your dining partner might be infected, or you might be infected and yet not know it.” 

Oughton said the biggest challenge for public health officials is catching those outbreaks from bars and restaurants early enough to stop them from “snowballing” into larger threats to the community. 

He said they need to focus on isolating positive cases and contact tracing to ensure the virus doesn’t spread in the community unchecked after an outbreak. 

“We are sitting in a forest that is bone-dry and there are lots of places where sparks might flare up,” Oughton said.

“So you can stomp out the first spark, you can stomp it the second spark, what worries me is if there’s 100 different sparks starting 100 small brush fires, can you actually stomp it all of them in time?”

WATCH | B.C. and Quebec hurry to trace new COVID-19 clusters

Authorities in B.C. and Quebec are racing to contain a new cluster of COVID-19 cases linked to bars and social gatherings. 2:04

But the statistic to watch, according to one U.S. epidemiologist: the percentage of people testing positive for coronavirus, and which direction it goes.

That’s a metric Jennifer Nuzzo follows closely as a leading indicator of where case totals are headed.

If it starts to move down, that’s good news; if it moves up, that’s a red flag that more cases are being missed, more people are unwittingly spreading the virus, and there’s a growing chance it might spiral out of control. 

“I pay a lot of attention to positivity,” said Nuzzo, an epidemiologist at Johns Hopkins Bloomberg School of Public Health.

“If it starts to pick up, that’s, I think, a worrisome development.”

The goal set by the World Health Organization is to keep positive test rates below five per cent.

By that standard, the U.S. is in brutal shape. A whopping 33 U.S. states had rates higher than the WHO benchmark on Thursday, with several just above or just under 20 per cent.

Canada has far lower positivity rate than U.S. 

That’s exhibit A in the difference between Canada and the U.S..

U.S. states were indisputably in worse shape when they reopened indoor social establishments: 

Arizona’s positivity rate was around six per cent when it allowed restaurants and some bars to reopen on May 11 — and has surged to a recent peak of 26.9 per cent, according to figures compiled by Johns Hopkins. The Texas rate hovered above five per cent this spring during the weeks it reopened, and is now at 16 per cent. Florida reopened restaurants in most places on May 4 and bars on June 5, a period during which test-positivity rates were between two and five per cent — and then started surging to a peak near 20 per cent.


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Canada is simply not in that ballpark. 

In Montreal, even after its latest spike, the positivity rate inched upward, from a low under one per cent to three per cent this week. Quebec overall has a positivity rate of 1.4 per cent; British Columbia and Ontario both sit at about 0.8 per cent positivity; and Alberta hovers around 1.7 per cent

More than 3.3 million Canadians have been tested for coronavirus since the pandemic began, with a positivity rate of about three per cent.


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U.S. states reopened with little regard for such metrics, said Dr. Abraar Karan, a physician and public health researcher at Harvard Medical School who is aiding the Massachusetts pandemic response. 

He said the U.S. could have avoided a spike in cases from reopening if it had simply taken its own advice: in May, the U.S. Centers for Disease Control and the White House published careful step-by-step guides to reopening based on scientific benchmarks.

“The thing is, none of those were actually implemented at the state level across the United States,” Karan said.

Right after the White House published those guidelines, however, the president of the United States was essentially brushing them off, calling on states to reopen in a series of all-caps tweets like, LIBERATE MICHIGAN!” 

That illustrates another difference between the countries: politics.

Canada has not had as vocal a chorus of coronavirus-doubters in its media and political establishments


Bar patrons attended a reopen-Florida maskless rally and dinner in Windermere, Florida, this week, illustrating the political debate over pandemic precautions even as cases surge in the U.S. (Octavio Jones/Reuters)

Attempts to lock down the U.S. have prompted armed protests; numerous lawsuits; and open defiance of efforts to shut down bars.

Even now, the governor of Georgia is preventing cities from imposing masks. 

And while the numbers are shifting, as the U.S. grapples with this ongoing wave, data collected by Google from people’s smartphones showed Canadians doing far more physical distancing than Americans in the winter and spring.

“What happened in the States is that they did a fast reopening, before they even came close to settling down their first wave. So what’s going on now is not a second wave, it’s a continuation of the first wave,” Oughton said. 

“Whereas it’s very safe to say that in Quebec — and, in fact, across Canada — we really have largely controlled it.” 


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CBC | Health News