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In face of deadly pandemic, Ontario long-term care homes continue breaking COVID-19 safety rules

Ten months into the COVID-19 pandemic, inspectors were still catching Ontario long-term care homes violating crucial infection prevention and control measures.

A CBC News data investigation has found 1 in 12 long-term care facilities in the province were caught breaking COVID-specific government directives between June 2020 and January 2021. Many infractions occurred during or after outbreaks.

“To have egregious infractions in terms of not following standard operating procedure for things like infection prevention and control, these operators need to be held to account,” said Dr. Nathan Stall, a geriatrician at Mount Sinai Hospital in Toronto.

The COVID-19 death toll in Ontario’s long-term care homes was 3,743 residents as of Feb. 26, 2021, according to the province. Of those deaths, 1,848 occurred before Aug. 31, 2020, which means the second spike in long-term care homes was even deadlier than the first.

Improper screening was a frequent issue at homes. Many were cited for not asking staff members or visitors questions or taking their temperatures, and failing to ensure they were wearing masks as they entered or left the premises. 

Some of the reports from provincial inspectors also detail long lists of infection control issues. While other companies are reflected in the data, the number of Caressant Care-owned homes with inspection violations of COVID-19 directives is high relative to the number of homes owned by the company.

WATCH | Several Ontario nursing homes broke rules meant to prevent COVID-19 outbreaks:

A CBC News investigation has revealed that multiple Ontario long-term care homes didn’t follow infection prevention rules meant to prevent COVID-19 outbreaks with some breaking the rules during or after an outbreak. 2:50

At Caressant Care Listowel Nursing Home west of Toronto, where an outbreak infected nearly every resident of the home in January, an inspector found 12 major infection control violations during the outbreak. 

“That probably explains quite a bit about how [COVID-19] got through so quickly,” said Alycia Houchen, whose grandfather, Edwin Rutherford, was one of 13 residents who died in the home, which has room for 45 people.

In all, 43 residents and 26 staff were infected during the winter outbreak at the home.

The violations included staff not being aware of the correct personal protective equipment to wear and not cleaning their hands after taking care of residents; staff working with both COVID-19 positive and negative residents; and hand sanitizer not being available in all areas of the home. 

Houchen, herself a personal support worker at a different retirement home, says the inspection report findings are “disturbing and disgusting.”

“They have had plenty of time to prepare and to do whatever they needed to do, and they obviously didn’t do it.”

Caressant Care owns 15 homes in Ontario. Four of those facilities were caught breaking COVID-19 safety directives during inspections. Like the location in Listowel, two others were found to be in violation of the infection control rules during outbreaks in December or January.

The company declined to comment for this story.

Big operator accounts for more than 20% of violations

Extendicare, one of Ontario’s largest long-term care operators, which owns or manages 69 facilities in the province, was cited for the most violations of infection control and prevention directives.

Homes owned by the company accounted for 13 per cent of the provincial total of 60 violations. When homes the company manages are included, that increases to 22 per cent of the violations. 

Other big chains such as Sienna Senior Living and Revera accounted for three and five per cent, respectively.

Inspection citations against Ontario’s long-term care homes hardly ever come with any consequences. Homes are asked to fix the problem, but even if an inspector returns and finds the same issue, there are no fines or penalties. In very rare cases, homes are barred from accepting new residents. 

Extendicare says inspectors visited its owned and managed homes almost 200 times in the past six months. 

“While some inspections do report issues related to COVID directives that require attention, these represent a small minority of the visits,” Extendicare said in a statement to CBC News. “While our goal is to have no issues, it’s important to note that in 93 per cent of the inspections, there were no COVID-related compliance issues.”

For-profit long-term care homes received 70 per cent of the violation citations despite accounting for 56 per cent of the homes in the province. An additional eight per cent of the violations were found in non-profit homes managed by for-profit companies.

Tamara Daly, director of York University’s Centre for Aging Research and Education, says research suggests conditions are better at non-profit care facilities. (Submitted by Tamara Daly)

That for-profit operators are over-represented in the findings isn’t surprising to Tamara Daly, the director of York University’s Centre for Aging Research and Education. She has been studying the differences between for-profit and non-profit care for years.

“I think, at the end of the day, the working conditions and the caring conditions have been shown to be worse at for-profit facilities and the research data backs this up, both pre-pandemic and during the pandemic,” she said.

CBC News sent the Ontario Ministry of Long-Term Care its findings from the inspection reports. It responded with a statement that said inspectors monitor for the health, safety and quality of care of residents.

“Repeated non-compliance is a serious concern and can result in escalated measures and sanctions by the ministry,” the statement says.

However, past CBC News investigations have found many homes have been cited for repeated issues without any consequences.

Inspectors spot infection control issues during outbreaks

Of the infection control and prevention violations, 52 per cent occurred in homes either during or after an outbreak.

The fact that inspectors were finding repeated violations in the same home, or violations after an outbreak, is very concerning, said Daly.

“To get those reports indicating that there’s still improper use of PPE after an incident, that concerns me greatly, because where is the learning?”

Ten homes were cited for denying entry to essential caregivers. Short staffing in homes has been well documented, and restricting family access means residents often don’t get the care they need, said Daly.

It’s also a quality of life issue, she said.

“Being in long-term care is very different than being in a hospital bed,” she said. “You’re there to live. And I think what we essentially did is we removed that part of their care, the living part, the part that makes life worthwhile.”

Infection control important after vaccinations

Even as residents at Ontario nursing homes get vaccinated, the number of infection control violations is still concerning, said Stall, the geriatrician at Mount Sinai Hospital.

“Vaccine euphoria is a good thing. We should all be excited about this,” he said.

However, he said, we don’t know definitively that the vaccines prevent transmission.

Dr. Nathan Stall is a geriatrician at Mount Sinai Hospital in Toronto. He says operators not following the rules need to be held to account. (David Common/CBC News)


The vaccine supply didn’t make it in time to help at Caressant Care Listowel.

For Houchen, the tragedy was hard to watch from the outside. 

She didn’t get to say goodbye to her grandfather, and as a personal support worker, not being able to help him in his final days made it worse, she said.

“I followed it with my heart breaking,” she said. “Every time [the deaths] climbed up, my heart was just breaking more because there’s nothing you can do, there’s nothing you can do to help.”

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New coronavirus variant may be more deadly — but more evidence is needed, U.K.’s chief scientist says

There is some evidence that a new coronavirus variant first identified in southeast England carries a higher risk of death than the original strain, the British government’s chief scientific adviser said Friday — though he stressed that the data is uncertain.

Patrick Vallance told a news conference that “there is evidence that there is an increased risk for those who have the new variant.”

He said that for a man in his 60s with the original version of the virus, “the average risk is that for 1,000 people who got infected, roughly 10 would be expected to unfortunately die.”

“With the new variant, for 1,000 people infected, roughly 13 or 14 people might be expected to die,” he said.

But Vallance stressed that “the evidence is not yet strong” and more research is needed.

WATCH | Boris Johnson discusses coronavirus variant:

While saying the variant of the coronavirus first detected in the U.K. may be associated with a higher degree of mortality, British Prime Minister Boris Johnson said it’s also putting additional pressure on the nation’s health-care system. 1:42

The findings come from a paper released on Friday by the U.K. government’s New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) on the variant known as B117.

The team acknowledged there are “important limitations to the data,” which was based on a relatively small sample size of 2,583 deaths among 1.2 million tested individuals, with 384 deaths likely tied to infections of the variant.

“It should be noted that the absolute risk of death per infection remains low,” the NERVTAG team wrote in the paper.

The researchers also did not find evidence of increased mortality tied to the variant for hospitalized individuals specifically.

The variant has spread to several countries around the world — including Canada, where chief public health officer Dr. Theresa Tam said on Friday there have been 31 confirmed cases. Tam said there have also been three confirmed cases of the variant first found in South Africa.

In Ontario, local public health officials are concerned by the presence of an unidentified variant among an outbreak at the Roberta Place Long-Term Care Home in Barrie — where more than 90 per cent of residents have tested positive for COVID-19.

Infectious disease specialist Dr. Dominik Mertz, who is based out of McMaster University in Hamilton, agreed the paper is just a first step and requires more confirmation.

“To my knowledge, this is the first study that suggests a higher mortality with the B117 variant, while previous data suggested no difference,” he said, noting the study’s limited sample size. 

“Hence, we remain uncertain whether B117 results in more severe infections.”

Dr. Isaac Bogoch, an infectious disease physician in Toronto and a member of Ontario’s vaccine distribution task force, agreed the uncertainty makes it difficult to draw conclusions on the increased deadliness of the variant.

“Other preliminary data did not demonstrate that this was the case,” he added. “Regardless, it’s best to be cautious and ensure we take steps to limit the transmission of this in Canada.”

In contrast to that uncertainty, Vallance said, there is growing confidence that the variant is more easily passed on than the original coronavirus strain. He said it appears to be between 30 and 70 per cent more transmissible.

Maria Van Kerkhove, the World Health Organization’s technical lead on COVID-19, said studies were underway to look at the transmission and severity of new virus variants.

She said so far “they haven’t seen an increase in severity” but that more transmission could lead to “an overburdened health care system” and thus more deaths.

British officials say they are confident that the vaccines that have been authorized for use against COVID-19 will be effective against the new strain identified in the country.

But Vallance said scientists are concerned that variants identified in Brazil and South Africa could be more resistant to vaccines, adding that more research needs to be done.

WATCH | An inside look at the U.K.’s mass vaccination program:

CBC News gains access to a unique inoculation site in the U.K., where vulnerable groups are being prioritized. 1:51

Concerns about newly identified variants have triggered a spate of new travel restrictions around the world. Many countries have closed their borders to travelers from the U.K., which itself has halted flights from Brazil and South Africa.

Prime Minister Boris Johnson said there could be further restrictions.

“We may need to go further to protect our borders,” he said.

Similarly, Bill Blair, Canada’s Minister of Public Safety, said Friday that the variants are a concern and one of the reasons the government requires all international travellers to be swabbed within 72 hours of departure to Canada. 

Blair said further options to discourage people from making unnecessary trips include:

  • More restrictions on international travel.
  • Additional quarantine measures.
  • Greater enforcement.

“A loophole frankly does exist because the Americans previously had not placed any restriction on international flights coming into the U.S.,” Blair said. “We’ll be working with the Americans on developing new reciprocal measures that can further protect Canadians.*

The U.K. has recorded 95,981 deaths among people who tested positive for the coronavirus, the highest confirmed total in Europe.

The country is currently in a lockdown in an attempt to slow the latest surge of the coronavirus outbreak. Pubs, restaurants, entertainment venues and many shops are closed, and people are required to stay largely at home.

The number of new infections has begun to fall, but deaths remain agonizingly high, averaging more than 1,000 a day, and the number of hospitalized patients is 80 per cent higher than at the first peak of the pandemic in the spring.

Johnson, who has often been accused of giving overly optimistic predictions about relaxing coronavirus restrictions, sounded gloomy.

“We will have to live with coronavirus in one way or another for a long while to come,” he said, adding that “it’s an open question” when measures could be eased.

“At this stage you’ve got to be very, very cautious indeed,” he said.

Vallance agreed. “I don’t think this virus is going anywhere,” he said. “It’s going to be around, probably, forever.”

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Boeing 737 MAX back in the air, nearly 2 years after being grounded by deadly crashes

Commercial flights with Boeing 737 Max jetliners resumed Wednesday for the first time since they were grounded worldwide following two deadly crashes nearly two years ago.

Brazil’s Gol Airlines became the first in the world to return the planes to its active fleet, using a 737 MAX 8 on a flight from Sao Paulo to Porto Alegre, according to the flight tracking website Flightradar24.

The company’s own announcement didn’t specify the route of the flight.

Gol is set to start regular service on Dec. 18, according to aviation data firm Cirium, with several daily flights between Sao Paulo and other major Brazilian cities.

Customers will be able to exchange their tickets if they don’t want to fly on a 737 Max, a Gol spokesperson told The Associated Press in an email.

Gol, the country’s largest airline with 36 million passengers annually, owns seven 737 Max aircraft, according to Cirium. It is the only Brazilian company with the model in its fleet.

“The MAX is one of the most efficient aircraft in aviation history and the only one to undergo a complete recertification process,” Gol’s chief executive officer, Paulo Kakinoff, said in a statement earlier this week.

Canada yet to clear 737 Max to fly

The Boeing plane was grounded globally in March 2019, shortly after a 737 Max crashed in Ethiopia. A prior crash in Indonesia involving the model occurred in October 2018. In all, 346 people died.

Brazil’s aviation regulator lifted its restrictions on the 737 Max in November, clearing the way for the plane to resume flights in Latin America’s biggest country.

Similar restrictions have been lifted in the U.S. and Europe, where commercial flights with the plane are expected to resume soon, likely starting with American Airlines on Dec. 29.

WATCH | Canada holds off on clearing Boeing 737 Max 8 to fly:

U.S. aviation authorities have cleared the Boeing 737 Max 8 to return to active service more than two years after a pair of crashes killed 346 people, but Transport Canada is holding off, despite assurances from the U.S. Federal Aviation Administration and Boeing that the troubled MCAS computer system has been fixed. 2:00

In Canada, Transport Minister Marc Garneau’s office told CBC News last week that no final decision on validating changes to the aircraft had been made yet and that the “commercial flight restrictions” remain in effect. 

That came after Canadian families of crash victims say they took part in a video call with officials from the department who told them it could soon take the first step toward potentially clearing the aircraft to fly again.

Transport Canada has been working with the U.S. Federal Aviation Administration and received a directive listing changes to the aircraft.

Transport Canada’s safety experts have been doing their own independent review of those proposed changes to determine if the aircraft is safe to fly again.

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OxyContin maker Purdue Pharma pleads guilty, admits to role in deadly opioid epidemic

Purdue Pharma pleaded guilty Tuesday to three criminal charges, formally admitting its role in an opioid epidemic that has contributed to hundreds of thousands of deaths over the past two decades.

In a virtual hearing with a federal judge in Newark, N.J., the OxyContin maker admitted impeding the U.S. Drug Enforcement Administration’s efforts to combat the addiction crisis.

Purdue also acknowledged that it had not maintained an effective program to prevent prescription drugs from being diverted to the black market, even though it had told the DEA it did have such a program, and that it provided misleading information to the agency as a way to boost company manufacturing quotas.

It also admitted paying doctors through a speakers program to induce them to write more prescriptions for its painkillers.

The guilty pleas were entered by Purdue board chairperson Steve Miller on behalf of the company. They were part of a criminal and civil settlement announced last month between the Stamford, Conn.-based company and the U.S. Justice Department.

Members of the Sackler family, who own the company, have also agreed to pay $ 225 million US to the federal government to settle civil claims. (Seth Wenig/Associated Press)

Hundreds of thousands of deaths attributed to opioids

The deal includes $ 8.3 billion US in penalties and forfeitures, but the company is on the hook for a direct payment to the federal government of just a fraction of that, $ 225 million. It would pay the smaller amount as long as it executes a settlement moving through federal bankruptcy court with state and local governments and other entities suing it over the toll of the opioid epidemic.

Members of the wealthy Sackler family who own the company have also agreed to pay $ 225 million to the federal government to settle civil claims. No criminal charges have been filed against family members, although their deal leaves open the possibility of that in the future.

“Having our plea accepted in federal court, and taking responsibility for past misconduct, is an essential step to preserve billions of dollars of value for creditors and advance our goal of providing financial resources and lifesaving medicines to address the opioid crisis,” Purdue said in a written statement after pleading guilty.

“We continue to work tirelessly to build additional support for a proposed bankruptcy settlement, which would direct the overwhelming majority of the settlement funds to state, local and tribal governments for the purpose of abating the opioid crisis,” the statement read.

Purdue’s plea to federal crimes provides only minor comfort for advocates who want to see harsher penalties for the OxyContin maker and its owners.

The ongoing drug overdose crisis, which appears to be growing worse during the coronavirus pandemic, has contributed to the deaths of more than 470,000 Americans over the past two decades, most of those from legal and illicit opioids.

Purdue has admitted that it impeded efforts to fight the deadly opioid crisis and paid doctors to prescribe more of the painkillers. (Craig Chivers/CBC)

Opposition to settlement

There were an estimated 16,364 apparent opioid-related deaths in Canada between January 2016 and March 2020, according to the Public Health Agency of Canada. 

Cynthia Munger, whose son is in recovery from opioid addiction after being prescribed OxyContin more than a decade ago as a high school baseball player with a shoulder injury, is among the activists pushing for Purdue owners and company officials to be charged with crimes.

“Until we do that and we stop accusing brick and mortar and not individuals, nothing will change,” said Munger, who lives in Wayne, Pa.

The attorneys general for about half the states opposed the federal settlement, as well as the company’s proposed settlement in bankruptcy court. In the bankruptcy case, Purdue has proposed transforming into a public benefit corporation with its proceeds going to help address the opioid crisis.

The attorneys general and some activists are upset that despite the Sacklers giving up control of the company, the family remains wealthy and its members will not face prison or other individual penalties.

The activists say there’s no difference between the actions of the company and its owners, who also controlled Purdue’s board until the past few years.

Last week, as part of a motion to get access to more family documents, the attorneys general who oppose the deals filed documents that put members of the Sackler family at the centre of Purdue’s continued push for OxyContin sales even as opioid-related deaths rose.

Company tried to ‘supercharge’ opioid sales

The newly public documents include emails among consultants from McKinsey & Corp., hired by the company to help boost the business.

One from 2008, a year after the company first pleaded guilty to opioid-related crimes, says board members, including a Sackler family member, ” ‘blessed’ him to do whatever he thinks is necessary to ‘save the business.’ “

Another McKinsey internal email details how a mid-level Purdue employee felt about the company.

It offers more evidence of the Sacklers being hands-on, saying, “The brothers who started the company viewed all employees like the guys who ‘trim the hedges’ — employees should do exactly what’s asked of them and not say too much.”

The documents also describe the company trying to “supercharge” opioid sales in 2013, as reaction to the overdose crisis was taking a toll on prescribing.

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Cuba braces for storm Eta after deadly toll in Central America

Hundreds of thousands of Cubans began evacuating their homes on Saturday as Tropical Storm Eta neared the Caribbean island’s southern coast, threatening torrential rain and flooding after killing dozens in Central America.

The storm is expected to make landfall in central Cuba overnight, the Cuban meteorology’s office said, warning of winds of 90-110 kkm/h, a storm surge and heavy coastal flooding.

Inundations could be a problem more broadly, it said, given that Cuba was already waterlogged in the wake of recent heavy rains, and Eta could potentially dump more than 30 centimetres of water on the country. Already, outer bands of rain had unleashed 9.5 centimetres of water on eastern Cuba.

Cuban authorities, who are known for preparedness in the face of natural disaster, said that farmers were moving their livestock to secure locations and harvesting as much crop as possible before the storm hit.

The U.S. National Hurricane Center said damaging tropical storm-force winds, with hurricane-force winds possible, were expected from Sunday night in the Florida Keys and parts of southern Florida.

A soldier helps a person to cross a flooded street after passage of Eta in La Lima, Honduras, on Saturday. (Jorge Cabrera/Reuters)

Heavy rainfall could also spark flash flooding there, it said.

One of the fiercest storms to hit Central America in years, Eta struck Nicaragua as a Category 4 hurricane on Tuesday with winds of 241 km/h before weakening to a tropical depression as it moved inland and into neighbouring Honduras and Belize.

Across swaths of the mostly poor countries wedged between Mexico and Colombia, high winds, torrential rains and catastrophic flooding caused deadly mudslides and damaged hundreds if not thousands of homes.

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Deadly day, lasting impact

Every year on Oct. 22, former House of Commons security guard Maurice Montpetit makes a solemn pilgrimage to the National War Memorial before heading to Parliament Hill.

He stands at the spot where Cpl. Nathan Cirillo, 24, was gunned down in 2014 before the sentry’s killer, armed with a rifle and a long knife, raced up the Hill and stormed Centre Block.

That day, Montpetit spent hours locked down in the antechamber and lobbies outside the House of Commons, comforting the MPs and others hiding there. Sometimes Montpetit carried a handgun, but on that day he was unarmed.

“There were MPs who were scared. An MP had her baby with her. Some MPs wanted to get out through windows and construction scaffoldings. I kept telling them, ‘We don’t know what is outside. Stay inside,'” he recalled six years later.

Montpetit, seen here in a still from a video taken the day of the shooting, was among about 30 House of Commons guards on duty when the gunman burst through the doors of Centre Block and began firing. The next day, he returned to his post ‘as if nothing had happened,’ he said. (Radio-Canada)

Confusion reigned. At one point, Montpetit heard over his radio that there could be as many as 13 gunmen on the building’s roof.

The fallout was long-lasting.

“For three years, I comforted people. There wasn’t a day that went by that I didn’t talk about the shooting.”

Breakdown came 3 years later

Eventually, that took its toll on Montpetit. One morning in November 2017, more than three years after the attack, everything came to a crashing halt.

“Usually, I would have gone for coffee, stopped at the gym, but I did not do any of these things. I went to my locker to get ready. It took me about three hours to get dressed,” Montpetit recalled. The intense fatigue he suddenly felt was tinged with terror.

“I was afraid I would see something coming out of a corner. I felt that I was totally out of control. I finished my day and then I cried, because I knew I wasn’t coming back the next day.”

Radio-Canada has learned that out of the approximately 30 House of Commons security guards on duty when the shooting occurred, at least 13 have since suffered serious psychological problems. One has taken his own life.

Montpetit said he wishes all the guards had been convened for a debrief following the attack. Instead, he said he returned to work the next day “as if nothing had happened.”

Louis Létourneau was decorated with the Star of Courage for his part in stopping the gunman, but later began experiencing severe anxiety. ‘It’s a pressure that is there, that stays there, no matter what you do or what you’re thinking about.’ (Emilien Juteau/Radio-Canada)

‘The Hill is a bad place for me now’

While returning regularly to the scene of the shooting has been an important aspect of Montpetit’s therapy, his former colleague Louis Létourneau can’t bring himself to go back.

“I try to avoid Parliament Hill,” the Gatineau resident said. “My psychologist is in Ottawa. Technically, it would be shorter to drive near Parliament Hill. But I make a detour. The Hill is a bad place for me now.”

I emptied my cartridge. Fifteen bullets. I didn’t give him a chance to shoot back at me.– Louis Létourneau, retired Parliament Hill security guard

On Oct. 22, 2014, Létourneau was standing in the Hall of Honour, between Centre Block’s main entrance and the Library of Parliament, when he heard a boom. He turned his head to see the assailant at the top of the stairs, rifle in hand.

“I said to myself, ‘There is no way you’re going to stop me from seeing my kids tonight,'” Létourneau said. “He didn’t stop running. I emptied my cartridge. Fifteen bullets. I didn’t give him a chance to shoot back at me.” 

He reloaded and shot twice more. Bullets from Létourneau’s gun were among the 31 that struck the attacker. Létourneau was later decorated with the Star of Courage by the former governor general for his part in that day.

Létourneau shakes hands with then-governor general David Johnston after receiving the Star of Courage at Rideau Hall in Ottawa on Feb. 8, 2016. (Justin Tang/Canadian Press)

Haunted by flashbacks

Létourneau’s retirement, forced by post-traumatic stress disorder, became permanent just a few weeks ago. Vivid flashbacks still haunt him.

“The first gunshot, when he enters the main door, and probably the end of the event, when I see him on the ground with the blood coming out — those are the images that always come back.”

Like Montpetit, Létourneau felt fatigued, but in his case it happened about two months after the shooting.

“I would be at work, and as soon as I had a 30-minute break, I would go to the constables’ room and take a power nap. That’s something that had never happened to me before. I could do 13-, 15-, 16-hour days without having to lie down.”

About 30 House of Commons security guards were on duty when the gunman stormed Centre Block. (Radio-Canada)

Létourneau’s demeanour took a dark turn. “I would blow up for no reason,” he said. He first left his job in 2015, one year after the shooting. He tried to return in stages the following year, but it didn’t work out and he left again.

He still has difficulty concentrating and suffers bouts of depression, but said the anxiety is the worst symptom. “Anxiety is the toughest thing. It’s like a ball in here,” Létourneau said, pointing to his chest. “It’s a pressure that is there, that stays there, no matter what you do or what you’re thinking about.”

Suffering widespread

According to the president of the Union of Officers of the Parliamentary Protective Service, Létourneau and Montpetit are hardly alone.

“The great majority of officers in the Parliamentary Precinct buildings on duty that day have suffered at different levels from the events,” said Roch Lapensée.

That includes the guard who took his own life a little over three years after the attack. According to the man’s sister, he was never the same after the events of Oct. 22, 2014.

Eight months after the attack, the House of Commons and Senate security services were merged into the Parliamentary Protective Service (PPS), under the direction of the RCMP. (Simon Lasalle/Radio-Canada)

Radio-Canada has interviewed several guards and supervisors, and has identified at least 13 House of Commons security guards who suffered serious mental health problems. Every interviewee agreed the way they were treated after the attack only contributed to their stress.

Following the shooting, the government of then-prime minister Stephen Harper moved quickly to reform Parliament Hill security.

Eight months after the attack, the House of Commons and Senate security services, which were in charge of security inside the Parliament Buildings, and the RCMP unit that was in charge of security on the Hill were merged into the new Parliamentary Protective Service (PPS). Management of this new service’s operational matters was handed over to the RCMP.

“The guys felt like they had been shoved aside,” Létourneau said. “‘You did a good job, but now we’re the ones in charge.'”

‘Heroes to zeros’ 

Security guards who had never carried a weapon suddenly had to undergo firearms training. The new “protection officers” were expected to perform a job similar to that of RCMP officers, but for less pay.

In 2017, the PPS reprimanded guards who wore hats with the word “respect” as a sign of protest.

“We went from heroes to zeros,” said Jean-Louis Franchi, another former security guard who was on duty the day of the shooting, and who has also suffered from psychological problems.

“When there is a suicide amongst your security guards, you’d think that as a boss you would ask yourself questions. The employer will tell you it offered psychological support to the employees, but where is the moral support, the respect? The guys did heroic acts and you reprimand them because they are asking for better salaries and respect?”

Some PPS officers were reprimanded for wearing hats with the word ‘respect’ on them. ‘The guys did heroic acts and you reprimand them because they are asking for better salaries and respect?’ asked one former guard. (Simon Lasalle/Radio-Canada)

PPS responds

In a statement to Radio-Canada, PPS wrote: “We take mental health issues very seriously. We have initiated a series of mental health and wellness activities for all our staff. Our goal is to make sure our staff have access to the proper mental health support they need.”

The labour dispute lasted until the end of 2019, when the Federal Public Sector Labour Relations and Employment Board granted the officers a wage increase.

Létourneau said psychological help was offered on the evening of the shooting to the small group of guards who had been directly involved, but he believes their employer should have done a better job watching for mental problems surfacing long afterward.

In his case, it came down to colleagues telling him he didn’t seem well and recommending he seek help.

For some of the Parliament Hill security guards on duty on Oct. 22, 2014, the trauma of the day has had a lasting impact. 2:49

Oct. 22 remains a painful anniversary for Létourneau and Montpetit, but they are learning to cope with the horror of that day thanks to the professional help they sought.

“It saved my life,” Létourneau said. “It’s something you have to do for yourself first, and for your family.”

“You will hit the bottom and even beyond before you go back up. It’s normal,” said Montpetit, who now tries to find peace of mind by doing what he likes best: music and camping.

Now, the two men have agreed to share their stories to encourage others who are struggling with similar issues to seek psychological help.

Need help? Here are some mental health resources:

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Deadly DRM: Right to Repair a Life-or-Death Problem During the Coronavirus Pandemic

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Up until now, so-called ‘right to repair’ legislation was a topic that touched on important questions, like whether or not farmers could repair their own tractors, or if end-users were allowed to repair their own electronics goods, but wasn’t viewed as a literal life-or-death issue. Now, however, the question of whether or not people and companies are allowed to fix hardware they’ve purchased has a real chance of becoming one.

The advocacy group US Public Interest Research Group has released a report detailing the results of interviews it conducted with 222 biomedical repair professionals. It writes: “Nearly half reported they had been denied access to ‘critical repair information, parts or service keys’ since March.”

Manufacturers claim these lockouts and other hoops are in place to protect patient safety, but such claims fly in the face of an FDA report, written in 2018, which found no evidence that third-party repair carries any risk whatsoever after reviewing 2.1 million medical device failure reports submitted over the past decade. Manufacturers are already supposed to provide “schematics, wiring diagrams, mechanical layouts, and other pertinent data for the appliance,” as well as, “preventative and corrective maintenance, inspection, and repair procedures.” According to US-PIRG, these standards are not being upheld.


Some of the survey quests asked by US-PIRG

According to multiple biomedical repair professionals, repairs in the time of coronavirus require a heavy reliance on online forums, because manufacturers will not distribute training and repair manuals adequately. In one case, the head of a biomedical college engineering program deliberately requires students to attempt to obtain repair manuals as part of their training in order to illustrate how difficult it is and how much begging they may have to do in order to get the documentation. US-PIRG also details how manufacturers have attempted to use copyright claims and legal threats to force websites to remove repair manuals. Steris, a company that manufacturers sterilizers, has requested iFixit remove manuals from its website.

Manufacturers, of course, want to handle these repairs themselves. The problem is, in some cases, quarantine protocol prevents hospitals from allowing random service technicians from entering the buildings. In others, manufacturers are no longer sending technicians out due to the pandemic. Both situations cause the same problem: Broken equipment no company-certified technician is going to be fixing any time soon.

In at least one case, a manufacturer booby-trapped an ultrasound machine to require software calibration if anyone removed the outside cover. This was not disclosed to the hospital, who attempted to troubleshoot the piece of equipment and found themselves locked out of it as a result. GE has only recently begun waiving the requirement that technicians complete an in-person, four-day training course to receive any documentation on its ventilators. Siemens refuses to allow already-trained colleagues to train co-workers under any circumstances.

According to one biomedical technician, an unnamed manufacturer charges $ 28,000 to train one technician in how to repair one device. The actual cost of the device? $ 35,000. Another manufacturer initially attempted to de-certify all of a hospital’s technicians due to their failure to complete a bi-annual recertification requirement during the pandemic, when the manufacturer was offering no recertification courses of any kind.

According to the survey results, 30.4 percent of technicians had equipment in their facilities they could not use, due to limited access to parts or training manuals, while 91.8 percent stated they had been denied service information for life-saving, critical equipment. 88.7 percent reported that manufacturers have refused to sell spare parts (4.5 percent “Most of the time,” 36.2 percent “Somewhat frequently,” and 48 percent reporting “Sometimes, but infrequently.”)

In the COVID-19 epidemic, you’d expect manufacturers to be prioritizing ventilator repairs above all else. You’d also be wrong. 69.5 percent of the 222 engineers and repair people surveyed are responsible for ventilator repair. Of that group, 29.2 percent report they have ventilators they cannot use due to a lack of either spare parts or servicing information. 24.2 percent of technicians have been denied access to information since March. 51.9 percent of technicians have ventilators on-site they cannot service or repair if they break.

A month ago, it might have been tempting to think such issues were receding behind us and would not need to be dealt with in the future. The current state of the pandemic in the United States belies such pleasant dreams. Technicians need permission to repair life-saving medical equipment the instant it breaks. They need to be able to purchase repair parts as soon as possible. If the pandemic continues to worsen, and America’s stockpiles of emergency medical equipment are stretched nationwide, these sorts of failures could start leading to deaths.

However much revenue device manufacturers might lose off repairs, we suspect they’ll lose more if people start dying because local, qualified technicians weren’t allowed to read a frickin’ manual.

DRM is a lot of things. It’s not supposed to be a death sentence. If it starts becoming one, device manufacturers will have bigger problems than just their profit margins to consider. iFixit has published a database of medical device repair information, if you are looking for manuals.

Feature image shows a NASA/JPL-designed ventilator, whose design is specifically intended to be easy to maintain, cheap, and repairable in the field. 

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Mexico City police chief injured in deadly shooting blamed on cartel

Mexico City’s chief of police was shot and injured and two of his bodyguards killed in a dramatic assassination attempt early on Friday that he quickly blamed on one of Mexico’s most powerful drug gangs, the Jalisco New Generation Cartel (CJNG).

The city’s public security chief Omar Garcia Harfuch suffered three bullet wounds as he and bodyguards came under heavy fire around dawn in an upscale Mexico City neighbourhood, where the attack was captured on security cameras.

Some three hours later, apparently from his hospital bed, Garcia sent out a message on Twitter blaming his injuries and the death of two bodyguards on a “cowardly attack” by the CJNG, a gang notorious as one of the most violent in Mexico.

A 26-year-old woman travelling in a car with relatives to sell street food nearby was also killed in the gunfire that ripped through the Lomas de Chapultepec neighbourhood. The area is home to many wealthy people and has ambassadorial residences.

President Andres Manuel Lopez Obrador and Mexico City Mayor Claudia Sheinbaum said the attack showed that authorities were putting pressure on criminal gangs in the capital, which has rarely witnessed such brazen outbreaks of violence.

A forensic investigator collects cartridges at the scene where the Mexican capital’s police chief was attacked by gunmen in Mexico City on Friday. (Rebecca Blackwell/The Associated Press)

“There will be no turning back,” Sheinbaum told a news conference.

Grainy security camera footage broadcast on Mexican television showed a group of heavily armed men in an open-backed truck disguised as a work vehicle, and an SUV blocking off a road to open fire on Garcia’s automobile.

Separately, fast-arriving police could be seen shouting and moving toward the high-calibre gunfire that rang out for several minutes just after 6.30 a.m. local time.

Television footage of what was apparently Garcia’s armoured SUV showed a vehicle riddled with bullets roped off by police.

Garcia was wounded in the shoulder, collarbone and the knee, Security Minister Alfonso Durazo told a news conference.

Relatives of a passerby killed in Friday’s shooting mourn at the crime scene in Mexico City. (Pedro Pardo/AFP via Getty Images)

The assassination attempt served as a warning that “nobody is off limits” and was reminiscent of previous attacks on officials during Mexico’s drug war, said Gladys McCormick, a security analyst at Syracuse University in New York.

It fit the CJNG’s modus operandi “to a T” and had the hallmark of the cartel staking out its turf, she said.

Led by a former police officer and based in the western state of Jalisco, the CJNG has been blamed for fuelling record levels of violence in Mexico during its battles to eliminate rivals for control of drug trafficking and crime rackets.

Omar Garcia Harfuch is seen during a news conference at the Mexican embassy in Guatemala City in April 2017. (Moises Castillo/The Associated Press)

Lopez Obrador took office 19 months ago vowing to pacify the country, but homicides hit a new high last year and are on track to be higher still in 2020.

The shooters fled. Mexico City attorney general Ernestina Godoy said 12 suspects were arrested.

Police recovered military-grade long guns including a Barrett rifle from the crime scene, authorities said.

Videos posted on the internet by the CJNG have featured gunmen brandishing high-performance weapons used by the gang in its bloody feuds with other outfits, notably the Sinaloa Cartel of captured kingpin Joaquin “El Chapo” Guzman.

That the CJNG may have carried out the attack was one of various lines of investigation, Security Minister Durazo said. A week ago, threats were made against some security officials and authorities would see if they were linked to Friday, he said.

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China scolds India after rare deadly confrontation in Himalayas

China’s foreign minister demanded Wednesday that India punish those behind deadly border clashes between their forces this week, and warned New Delhi not to underestimate Beijing’s determination to safeguard what it considers its sovereign territory.

Wang Yi’s comments came in a telephone call with his Indian counterpart, Subrahmanyam Jaishankar, two days after soldiers from the two sides engaged in fighting along their disputed border in the Himalayan mountains.

Twenty Indian troops were reportedly killed, while it was not clear whether China suffered any casualties. Wang said China demanded India conduct a thorough investigation and “harshly punish” those responsible.

“The Indian side would best not make an incorrect judgment of the situation, would best not underestimate China’s strong determination to safety its sovereign territory,” Wang said in a statement issued by the foreign ministry.

He repeated China’s claims that India was solely responsible for the conflict, saying its forces had crossed the Line of Actual Control that divides the thousands of troops from the sides deployed in the area.

Indian army trucks move along a highway leading to Ladakh on Wednesday. India’s Prime Minister Narendra Modi praised the soldiers who died in the confrontation earlier this week. (Danish Ismail/Reuters)

The statement said Jaishankar explained India’s position, but gave no details, and said New Delhi was committed to talks on reducing tensions.

Indian security forces said neither side fired any shots in the clash in the Ladakh region late Monday that was the first deadly confrontation on the disputed border between India and China since 1975. Some officials said the soldiers were carrying anti-riot gear instead of weapons.

China has not said if any of its troops were injured or killed.

India’s Prime Minister Narendra Modi said the country would be proud that the Indian soldiers died while fighting.

“Their sacrifices wouldn’t go to waste. For us, the unity and sovereignty of the country is the most important. India wants peace but when provoked, it is capable of giving a fitting reply be it any kind of situation,” he said.

India’s Defence Minister Rajnath Singh tweeted that the loss of soldiers in the Galwan Valley is “deeply disturbing and painful.”

A group of protesters gathered near the Chinese Embassy in the Indian capital condemning the killing of the soldiers and demanding a ban on Chinese goods. They carried placards with photographs of Chinese President Xi Jinping, his face crossed out, and the Chinese army.

A small group of retired Indian army personnel also marched close to the embassy with placards reading “Chinese army down down,” but they were detained by police.

Zhao, the Chinese spokesperson, repeated Chinese claims that the clashes erupted after Indian forces “provoked and attacked Chinese personnel, which lead to fears, physical confrontation between the two sides’ border troops and resulted in casualties.”

Long-standing border tensions

An official Communist Party newspaper said the clash occurred because India misjudged the Chinese army’s strength and willingness to respond. The Global Times, which often reflects nationalistic views within the party’s leadership, said China did not disclose whether it had casualties in the skirmish to avoid comparisons and prevent further escalation.

While experts said the two nations were unlikely to head into a war, they also believe easing tensions quickly will be difficult.

“This will likely be a watershed moment in India-China relations and the geopolitics of the Indo-Pacific,” said Abraham Denmark, Asia program director at The Wilson Center.

“We’ve already seen the deadliest clash on the China-India border in over 50 years, both countries are led by men who have embraced nationalism, and both countries are facing tremendous domestic and international upheaval as a result of COVID-19 and other long-standing problems.”

The main questions now are if either side can find a path to de-escalation and whether India’s allies such as the United States will help.

“It is a highly volatile and dangerous situation between two nationalistic, nuclear powers at a time when American influence has badly diminished,” Denmark said.

The editorial published in the Global Times on Wednesday said India’s reaction was largely due to encouragement from the U.S., China’s chief strategic rival which has been steadily building relations with India’s military.

“The arrogance and recklessness of the Indian side is the main reason for the consistent tensions along China-India borders,” the editorial said. China “does not and will not create conflicts, but it fears no conflicts either.”

China claims about 90,000 square kilometres of territory in India’s northeast, while India says China occupies 38,000 square kilometres of its territory in the Aksai Chin Plateau in the Himalayas, a contiguous part of the Ladakh region.

India unilaterally declared Ladakh a federal territory while separating it from disputed Kashmir in August 2019. China was among the handful of countries to strongly condemn the move, raising it at international forums, including the UN Security Council.

Thousands of soldiers on both sides have faced off for over a month along a remote stretch of the 3,380-kilometre Line of Actual Control, the border established following a war between India and China in 1962 that resulted in an uneasy truce.

Manner of death still unclear

The Indian army said three soldiers died initially. The 17 others died after being “critically injured in the line of duty and exposed to sub-zero temperatures in the high-altitude terrain,” it said in a statement Tuesday that did not disclose the nature of the soldiers’ injuries.

The troops fought each other with fists and rocks, Indian security officials said on condition of anonymity because they were not authorized to disclose the information.

After the clash, the two sides “disengaged” from the area where the the fighting happened, the Indian army statement said.

The United Nations urged both sides “to exercise maximum restraint.”

“We are concerned about reports of violence and deaths at the Line of Actual Control between India and China,” UN associate spokesperson Eri Kaneko said. “We take positive note of reports that the two countries have engaged to de-escalate the situation.”

Michael Kugelman, a South Asia specialist at the Wilson Center, said the two countries were unlikely to go to war because they cannot “afford a conflict.”

“But let’s be clear: It beggars belief to think that they can magically de-escalate after a deadly exchange with such a high number of fatalities,” he said. “This crisis isn’t ending anytime soon.”

The tense standoff started in early May, when Indian officials said that Chinese soldiers crossed the boundary in Ladakh at three different points, erecting tents and guard posts and ignoring verbal warnings to leave. That triggered shouting matches, stone-throwing and fistfights, much of it replayed on television news channels and social media.

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Pandemic worsens Canada’s deadly opioid overdose epidemic

An epidemic of fatal drug overdoses across Canada is on the rise amid COVID-19 pandemic restrictions that harm-reduction workers and doctors say exacerbates the toxic supply.

Overdose prevention sites continue to run but physical distancing guidelines mean fewer people are able to use the services. For example, a site in Toronto that previously averaged more than 100 visits a day now sees fewer than half that.

From March 2019 to May 2020, Ontario’s coroner reported a 25 per cent increase in fatal overdoses, based on preliminary estimates for all substances.

Nick Boyce, director of the Ontario Harm Reduction Network, said the increase is significant.

“It matches anecdotally what I’ve been hearing from the front-line workers we work with around the province,” Boyce said. “They’re all saying deaths are going up. But to hear that number and to see that number, I was not expecting it to be that high.”

Last year, fentanyl directly contributed to about 75 per cent of opioid-related deaths in Ontario.

More than 14,000 Canadians have been killed by opioids in the last four years, according to federal data

“Laws actually incentivize drug dealers and suppliers to come up with new and different drugs,” Boyce said. “We learned this lesson in the 1920s with alcohol prohibition when people switched from drinking beer to toxic moonshine. We’re seeing that with the opioid drug supply now.”

Nick Boyce says front-line workers report overdose deaths are going up across Ontario and a safer drug supply would help reduce the problem. (Melissa Haughton/CBC)

Stimulant-related deaths have also increased in Ontario.

British Columbia saw a 39 per cent jump in overdose deaths in April compared to the same month last year.

And in Alberta during the pandemic, the number of opioid-related calls to EMS increased from 257 in March to 550 this May.

Dr. Theresa Tam, Canada’s chief public health officer, has pointed to similar overdose trends across the country.

Back when COVID-19 was first declared a pandemic in March, a woman CBC News is calling Lisa to protect her identity was living in a tent in downtown Toronto. When people were ordered to stay inside, she said there were few places to go. Her struggle with street opioids deepened.

“I OD’ed three times and woke up alone because I was using alone,” Lisa said, referring to overdoses.

Lisa relies on overdose prevention sites; her health-care provider worked with a pharmacist to offer methadone or Suboxone as well as safe supplies as part of harm reduction services.

“I see a lot more deaths in my circles,” Lisa said.

‘Disaster of epic proportions’

Guy Felicella, a peer clinical adviser at the BC Centre for Substance Use in Vancouver, blames increasingly toxic street drugs, usually laced with fentanyl or its analogues, for the increase in deadly overdoses. The direct relationships users  had to get drugs from dealers were cut off in the pandemic.

“You add COVID into the mix, I mean it’s just a disaster of epic proportions,” Felicella said.

In pandemic prescribing, Felicella said a medical version of a drug is offered to users instead of the tainted street version. But that doesn’t address what most people who use substances are seeking in order not to feel sick from withdrawal, he added.

Dr. Jennifer Brasch leads addiction psychiatry at St. Joseph’s Healthcare in Hamilton, Ont. She’s heard from patients that it is harder to access their substance of choice during COVID-19.

“It’s very stressful to be socially isolated and fearful of catching COVID-19,” said Brasch, who also works at the Hamilton Clinic, a medical service provider. “When people are stressed and anxious, they may use more substances in order to cope.”

Health Canada has temporarily eased restrictions on some medications used for treatment of addictions. Brasch said some doctors are also prescribing slow-release morphine with methadone to protect patients from fentanyl in street supplies.

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