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How approval of Johnson & Johnson’s ‘one and done’ COVID-19 vaccine could change Canada’s vaccination game

A one-dose COVID-19 vaccine is now approved for use in Canada — and vaccine experts say the shot from Johnson & Johnson could give a major boost to countrywide vaccination efforts while offering a “real solution” to hasten the end of the pandemic.

Health Canada authorized its use and released details during a Friday morning announcement.

The vaccine, made by a subsidiary of Johnson & Johnson, is a non-replicating viral vector option and, unlike the three other vaccines previously approved for Canadian use, was tested during clinical trials as a single shot. 

So far, Canada is expecting 10 million doses, with options to purchase up to 28 million more if necessary, with most of those shots set to arrive by the end of September.

From a logistical standpoint, Toronto-based infectious disease specialist Dr. Isaac Bogoch said the benefits are clear.

“You can vaccinate more people in a shorter period of time,” he said. “You don’t have to clog up the vaccine centres with people getting their second dose — it’s one and done.”

The storage requirements are also less stringent than the early freezer requirements for the two mRNA-based vaccines from Pfizer-BioNTech and Moderna, with Johnson & Johnson estimating its single-dose option should remain stable for two years at -20° C — and can be stored for at least three months in most standard refrigerators.

Wondering how each of the leading coronavirus vaccines compares? Click here for a closer look at the vaccines Canada is betting on to stem the spread of COVID-19.

“You can way more easily get a vaccine like this into primary care clinics and pharmacies, which means that you can distribute it so much more broadly,” said Bogoch, who is also a member of Ontario’s vaccine task force.

That’s good news in this country and beyond, said Dr. Zain Chagla, a Hamilton-based infectious disease specialist and professor at McMaster University.

“In remote areas of Canada, it’s a big vaccine in that sense that it’s easy to transport and get around, and it’s big for the rest of the world,” he said. 

“This is a vaccine that could go into mass vaccine clinics in low- and middle-income countries that could be stored on the back of a motorcycle to make it into a very, very remote setting. That is very, very different than anything we have in that sense.”

WATCH | J&J vaccine good for less accessible, marginalized communities, doctor says:

As a single dose COVID-19 vaccine, the Johnson & Johnson product will be especially helpful for people who sometimes have difficulty accessing health care, says Dr. Lisa Bryski, a retired ER doctor in Winnipeg. 1:23

85% effective at stopping severe disease

But where the vaccine excels at convenience, it may fall short on overall efficacy — though there are a lot of factors at play, and it’s crucial to note the shot is proving highly effective at reducing cases of serious illness.

According to February briefing documents from the U.S. Food and Drug Administration, Johnson & Johnson’s shot was both safe and effective in clinical trials, where it reduced the risk of COVID-19 and prevented PCR-test confirmed cases at least 14 days after vaccination.

A month earlier, the company had announced its vaccine was 66 per cent effective in preventing COVID-19 against multiple variants in a global trial involving nearly 44,000 people.

That effectiveness varied from 72 per cent in the United States to 66 per cent in Latin America and 57 per cent in South Africa, where a new variant has spread.

In January, Johnson & Johnson announced its vaccine was 66 per cent effective in preventing COVID-19 against multiple variants in a global trial involving nearly 44,000 people. (Phill Magakoe/AFP/Getty Images)

That’s in contrast to the even more powerful protection witnessed in clinical trials for the Moderna and Pfizer-BioNTech vaccines, which showed efficacy levels — in terms of preventing symptomatic COVID-19 infection — of 94 per cent and 95 per cent respectively after two doses.

Those trials, however, took place before the rise of several concerning variants of this virus. Each company also tested for slightly different outcomes, meaning the efficacy levels aren’t apples-to-apples comparisons.

On Friday, Dr. Bob Wachter, chair of the department of medicine at the University of California, San Francisco likened it to comparing the scores of golfers who teed off during a calm moment to those who teed off when “winds were howling.”

“While it’s hard to make precise adjustment,” he said in a tweet, “it’s clear that equally good play will result in different scores.”

WATCH | Doctor who helped create Johnson & Johnson vaccine talks about its efficacy:

Dr. Dan Barouch, director, Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center, says the Johnson & Johnson vaccine he helped to create is highly effective against COVID-19 and new variants of concern. 5:11

Crucially, Johnson & Johnson’s one-dose option did prove 85 per cent effective overall when it came to stopping severe cases of the disease specifically.

The company’s main study also showed that 28 days or more after vaccination, the shot 100 per cent prevented hospitalizations and deaths.

“I think people discount how much practicality means to this vaccine rollout,” Chagla said. “You do see severe illness going down with this vaccine. You see hospitalizations coming down with this vaccine.”

One-dose could offer ‘real solution’

Virologist and vaccinologist Alyson Kelvin, who is working on Canadian COVID-19 vaccine development at the University of Saskatchewan’s VIDO-InterVac research institute, said for all vaccine developers, a safe and effective single-dose option has been the ultimate goal.

“Because people will be more interested in taking a vaccine if they don’t have to go back for their second shot, and which means that a vaccine will be more effective at getting to that community immunity that we need,” she said.

Like Chagla, she’s not alarmed by a slightly lower overall efficacy level.

“The goal of the vaccine is to protect people. Keeping them out of hospitals, keeping them from succumbing to disease,” she said.

And Chagla stressed that ultimately, this one-dose option could offer a “real solution” that helps countries like Canada tackle this year-long pandemic and alleviate the current burden on the health-care system from a virus that’s still widespread.

“It may not be the final strategy for vaccination,” he said. “But it’s a pretty good ‘right now’ strategy for vaccination.”

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CBC | Health News

Why Canada’s vaccine rollout is slower than other countries — and what can be done to fix it

Canada is falling behind in its initial rollout of COVID-19 vaccines at a critical time in the pandemic, and experts say our most vulnerable populations are being left at risk.

Despite having months to prepare for the deployment of the initial shipment of vaccines to those most threatened by COVID-19 in long-term care facilities, a consistent rollout plan has yet to fully materialize on the ground.

“It just seems to be chaos right now,” said Alyson Kelvin, an assistant professor at Dalhousie University and a virologist at the Canadian Centre for Vaccinology evaluating Canadian vaccines with the VIDO-InterVac lab in Saskatoon. 

“We know who is a vulnerable population, so we need a strategy of actually vaccinating them.”

Long-term care residents were largely left out of Canada’s initial rollout of the Pfizer-BioNTech vaccine, which requires storage temperatures of –80 to –60 C, in favour of waiting for the more easily transportable Moderna vaccine and vaccinating health-care workers first.

But once thawed, the Pfizer-BioNTech vaccine can be used for up to five days at basic refrigeration temperatures — meaning it could be taken out of distribution hubs across the country and brought into long-term care facilities directly during that window of time. 

A registered pharmacy technician prepares COVID-19 vaccines in Toronto on Dec. 15. (Evan Mitsui/CBC)

“We treated the Pfizer vaccine with as much care and respect as possible and that really created all these hub sites,” said Dr. Zain Chagla, an infectious diseases physician at St. Joseph’s Healthcare Hamilton and an associate professor at McMaster University. “And I think that did hinder some of the innovation and the ability to do things elsewhere.”

Fragmented rollout across Canada a ‘failure’

The federal government has deployed almost 500,000 doses of both the Pfizer-BioNTech and Moderna vaccines to distribution sites across the country since mid-December, but the actual rollout of vaccinations is up to the individual provinces and territories. 

Quebec took the bold step of actually putting its vaccine distribution centres inside long-term care facilities, making it easier to inoculate residents as quickly as possible.  

While British Columbia made the decision to move the Pfizer-BioNTech vaccine from its distribution sites almost immediately into long-term care homes to inoculate residents and staff upon receiving its first doses.

Andy Yoon, 77, of Abbotsford, B.C., became the first long-term care resident in the Fraser Health region to receive the COVID-19 vaccine on Dec. 24. (Submitted by Fraser Health)

Yet Ontario decided against bringing the Pfizer-BioNTech vaccine directly into long-term care homes initially, despite other provinces doing so, and is only now doing so more than three weeks after receiving its first shipment. 

Dr. Vera Etches, Ottawa’s medical officer of health, announced Tuesday the city would be transporting the Pfizer-BioNTech vaccine out of its distribution hub at the Ottawa Hospital and directly into long-term care residences, after vaccine-handling criteria from Pfizer were changed.

Despite receiving 53,000 doses of the Moderna vaccine last week, which is much easier to bring into long-term care residences, only 3,000 doses have actually been administered in Ontario as of Tuesday.

Ontario has pledged to vaccinate all residents, health-care workers and essential caregivers at long-term care homes in the hardest hit regions of Toronto, Peel, York and Windsor-Essex by Jan. 21, but has not set a deadline for the rest of the province. 

To date, fewer than 1,000 long-term care residents have been vaccinated in Ontario.

“The provincial health-care systems aren’t experts in newly emerging viruses, brand new speedy vaccine platforms and pandemics,” said Kelvin. For that reason, ongoing communication from the federal government to the provinces and territories and local level is essential, she said.

“To leave each province and territory to have to come up with their own plan, when they’re not experts in this, I think is a failure.” 

Kelvin said putting experts with relevant backgrounds in long-term care at the helm of vaccine rollouts across the country could have mitigated some of the missteps made so far.

“We need somebody who’s knowledgeable about long-term care facilities in Canada and their current functioning states,” she said.

WATCH | Vaccination lessons from around the world: 

Canada’s COVID-19 vaccine rollout has gotten off to a sluggish start, but there could be lessons to learn from countries such as Israel, which has vaccination clinics operating around the clock. 3:11

Chagla said Ontario could have either proactively opened up more vaccine distribution centres, or used the five-day model of thawing the Pfizer-BioNTech vaccine and getting it directly into long-term care facilities in order to vaccinate those most at risk sooner.

‘Rules are made to be broken’

Dr. Allison McGeer, a medical microbiologist and infectious disease specialist at Toronto’s Mount Sinai Hospital who worked on the front lines of the SARS epidemic in 2003, says provinces need to be much more flexible in how they roll out the vaccines. 

“You want to do what got done in studies, because you know what the outcome of studies were,” she said, referring to the clinical trial data for both COVID-19 vaccines. 

“However, this is a pandemic and rules are made to be broken.” 

Quebec and Manitoba decided not to reserve second doses for those who had received their first shot in an effort to speed up their vaccination campaigns, while Ontario has asked Health Canada to “look into” the possibility of providing Moderna’s vaccine as a single dose.

Both the U.S. Food and Drug Administration and the Public Health Agency of Canada advise against administering only a single dose of the vaccine.

McGeer said Canada should be focused on the most effective way to use the vaccines it has in hand, as opposed to letting them sit in freezers, even if that doesn’t always line up entirely with the usage guidelines.

WATCH | Weighing the pros and cons of going ‘off label’:

In order to distribute more COVID-19 vaccines faster, some jurisdictions are looking at using different vaccine doses, vaccination schedules and possibly mixing and matching vaccines. Experts say these choices are about weighing the risks of going ‘off label’ and the potential rewards. 2:01

She said that includes being open to the possibility of administering more initial doses to people as quickly as possible and spacing the second doses differently over a longer period of time.

“While we have to be careful with messing with what we’re doing with vaccines, we also really want to be focused on the most protection for the largest amount of people in the shortest period of time,” she said.

“And that definitely means being open to half doses, spreading doses further apart, mixing vaccines.”

Chagla agrees there are ways to pick up the pace that could be considered, including prioritizing giving people their first dose without reserving their second. 

“But I don’t think we’re even at that point yet,” he said. “We just need to start getting the logistics up, and again, using the supply we have before we start reconsidering.”

The U.K. has come under fire for its decision to stretch the interval between doses to up to three months, as opposed to the recommended three to four weeks, and for opening the door to giving a person doses of two different vaccines.

Israel has made the decision to use up its initial supply of COVID-19 vaccines as quickly as possible in order to vaccinate as many people with the initial doses it has, with more than two million people set to get a shot by the end of the month. 

“We need to be open to the concept that the way [the vaccines] were studied is not necessarily the best way to use them in the middle of a pandemic,” said McGeer.

“In Ontario, it actually doesn’t matter, because we’re so far behind in delivering vaccine that we could give second doses to everybody that’s had a first dose and we wouldn’t make a dent in our vaccine supply.

“So it’s actually become irrelevant.” 

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CBC | Health News

Donald Trump gets no political obituary. He, and his legacy, aren’t done

On that fateful day in June 2015 that he rode down a gilded escalator into the world of electoral politics, Donald Trump’s critics saw a pastel-faced buffoon destined to melt away after an attention-seeking stint in the political sun.

How wrong they were. 

Trump will never truly go away. A closer-than-expected election makes it only that much clearer that defeat is but a prelude to Trump’s next act as a permanent fixture on the American political scene. 

It’s not just that his thirst for the stage has allies predicting that he’ll run again in 2024, and that in the meantime, he’ll keep doing rallies and act as the leader of the opposition.

It’s that Trump has already left an indelible mark on the nation he leads, revealing several truths about it in the process.

WATCH | Americans cheer and denounce Biden victory: 

Voters gathered in cities across the United States to celebrate and decry the election of Joe Biden as president. 4:43

The elements of Trumpism

There have been countless newspaper columns, books and academic studies asking what drove Trumpism: Was it economics? Was it racism? A new nationalism? Nostalgia? The joy of an unpredictable carnival?

It was all of the above.

If several years of talking to his supporters has illustrated anything, it’s that human beings can hold multiple overlapping feelings at once.

Take Chip Paquette, for instance.

In the five years since he rolled down the escalator at Trump Tower on June 16, 2015, to announce his presidential bid, Trump transformed U.S. politics. (Brendan McDermid/Reuters)

Early on in the Trump phenomenon, at a 2016 primary rally in New Hampshire, the retired police officer chuckled at the candidate’s antics, elbowing his seat neighbour as if at a comedy show. He howled with laughter when Trump referred to Sen. Ted Cruz as a “pussy.”

In a conversation with a reporter later, he said he missed the good old days — back when a cop could punch a suspect, without controversy.

He questioned the wisdom of free trade and expressed a desire for more tariffs on imports: “We’re losing jobs,” he said.

Then, finally, he casually brought up something else he liked about Trump: “I like the idea of him banning the Muslims.”

The Trump campaign’s proposed Muslim ban evolved after he took office, becoming a travel ban on mostly Muslim countries. It underwent other iterations, amid legal disputes, and triggered protests from people disgusted that this campaign promise ever saw the light of day in a country with religious freedom stamped into its founding DNA. 

Trump smashed enough norms that he’ll be studied by future generations in political-science departments around the world.

Trump drew massive crowds to rallies. And he kept doing it during a pandemic, as here on Oct. 31 in Butler, Penn. (Carlos Barria/Reuters)

He also revealed things about the modern-day U.S. — and some of those lessons hold implications far beyond American territory, touching every nation.

The first is that the U.S. will be a less-predictable partner. 

Trump’s policy legacy stretches far beyond U.S.

There’s no guarantee agreements with one U.S. administration will survive a change in government. That unpredictability stretches beyond Trump to past examples such as Bill Clinton’s signing of the Kyoto climate accord and George W. Bush shunning it.

Trump announced in the middle of a global pandemic that the U.S. would leave the World Health Organization, stalled the World Trade Organization, questioned the point of NATO, abandoned the Iran nuclear deal and reversed a diplomatic thaw with Cuba.

“This egg can’t be unscrambled,” wrote Trump critic and Nobel Prize-winning economist Paul Krugman last month in a New York Times column titled “Trump Killed the Pax Americana.”

“No matter how good a global citizen America becomes in the next few years, everyone will remember that we’re a country that elected someone like Donald Trump, and could do it again.”

Trump’s tougher attitude to international issues caused tensions with allies but also led to the renegotiation of NAFTA in 2018. (Sean Kilpatrick/The Canadian Press)

Trump turned the page on a chapter of American history written after the Second World War, in which a young superpower helped build new global institutions in the hope of creating a long-lasting peace.

It’s unclear what the postscript to the postwar era would look like.

Trump did shift attention to a new geopolitical challenge: China. His administration struck a more aggressive posture, and accused China of breaking its promises to the West.

There’s a huge audience for this message. 

Passionate devotion equals continuing power 

One Republican operative said whether or not he runs for president again, Trump’s policies on China, trade and immigration will have a lingering effect.

“We don’t know what Trump’s role in the party is going to be going forward, [and] is he going to be keeping open the option of perhaps running again in 2024,” said Matt Mackowiak, a party organizer and consultant.

“I do think he’s changed the party in significant ways.”

Trump’s message not only drew record turnout from working-class white Americans, but he also made inroads in his second race among groups that rarely vote Republican.

Trump performed better with Black men, Latino and Asian-American voters this year than he did four years ago.

To be clear, he still won only a small percentage of minority voters. But some were among his staunchest defenders.

Sylvia Menchaca, a Mexican restaurant owner near Phoenix, applauded Trump for putting his country first and wanting immigration limits.

Business owner Sylvia Menchaca, seen here working in her Arizona restaurant, is a huge Trump fan. And she thinks the polls will soon look foolish — again. (CBC News)

She told CBC News she felt sorry for migrant children separated from parents at the border, but, she said, the country needed to get immigration under control. 

“I love him,” said Menchaca, who described herself as a religious woman. “Trump is similar to one of the kings in the Bible. Nobody in the Bible is perfect.… But some of them were blessed by God to run a country.”

Nothing would ever rattle her support for him, she said.

WATCH | Trump supporters in Arizona react to Biden win:

In spite of widespread projections for a Joe Biden win, Donald Trump supporters at a pre-planned gathering site in Phoenix, Ariz., Saturday insisted Biden is not the next president and repeated Trump’s unproven allegations of voter fraud. 2:12

Trump sounded real — even when he was lying

One reason Trump engendered uncommon devotion was he didn’t sound like a politician — he sounded real while other politicians relied on scripts and talking points.

Yet his telling-it-like-it-is effect was chronically undermined by one uncomfortable truth: He lied. He lied a lot.

This is different from most politicians who will often exaggerate, and frequently obfuscate, while generally avoiding flat-out lies.

Trump operated on another level. 

When it came to spouting untruths, he pivoted from one to another with the same painless strokes reminiscent of his supporter, Bobby Orr, gliding across a hockey rink.

President Donald Trump walks away after speaking at the White House, Thursday, Nov. 5. (Evan Vucci/Associated Press)

Half the country fumed; the other half brushed it off.

He left Americans split on an uncommon range of issues: COVID-19 mask-wearing; Black Lives Matter; voting by mail. They all became litmus tests of political loyalty. 

You were with him or against him, right down to the end, when the polarizing question became whether or not you would support his attack on the accuracy of a U.S. election.

WATCH | Voters with opposing views of Donald Trump converge on Atlanta after 2020 election is called:

Pro-Trump and anti-Trump protesters are gathering and, at times, jeering each other on an Atlanta street in the open-carry state amid projections for a Joe Biden presidency from major networks. 5:41

The polarizer-in-chief

These constant battles divided families, and it’s no exaggeration to say he even had a polarizing effect on mating rituals. Trump fans, and people abhorred by Trump fans, split off into separate dating sites, with names such as Donald Daters and Trump Singles.

One Florida widow said people just simply want to know, before investing time in someone, whether their values are compatible, and she sees Trump support as a test of values.

She was no fan. She said Trump has stoked the country’s divisions and made people angrier, and she didn’t vote for him despite being a Republican.

“Politics used to be a part of your life, but it didn’t consume your life,” said Arlene Macellaro. “But now it seems like the thing to do in my Republican Party is to be angry.”

People in her Florida retirement community tell stories you often hear in the U.S. these days — of old friendships suspended over differences on Trump.

WATCH | Florida voter Arlene Macellaro reflects on how Trump changed Americans’ engagement with politics:

Arlene Macellaro lives in a staunchly Republican retirement city in Florida called The Villages, but says she won’t be voting for Donald Trump this election. 0:31

One final and perhaps most fundamental truth the Trump era exposed is that democracy may be more fragile than assumed  — that the rules protecting it may exist primarily on paper but are, in the end, enforced by a civic spirit.

In a bitterly polarized era pitting the blue team versus the red team, old norms were occasionally discarded.

Trump called elections stolen, called for opponents’ arrest, pardoned friends, used federal regulators to punish unfriendly media and ignored the constitutional rules for how to appoint cabinet members. 

WATCH | Trump accuses Democrats of trying to ‘steal the election’:

Republican presidential candidate Donald Trump said Thursday that Democrats could ‘try to steal the election from us’ if ‘illegal votes’ cast after election day were counted. There is no evidence that ballots were cast after Nov. 3. 0:40

Ask a foreign government to investigate Joe Biden? It’s what got him impeached. And there were no real-time consequences. 

He lost precisely one Republican in the impeachment vote: Mitt Romney, and for that act of alleged betrayal, the former Republican presidential nominee was quickly shunned by party grassroots members.

Trump became the first impeached president to lead his party into another election.

WATCH | Did Trump deliver on his 2016 promises?:

From boosting manufacturing in the United States to building a border wall, Donald Trump made a lot of promises during his first presidential campaign. CBC News’s Paul Hunter checks in on whether he delivered on them. 6:00

He talks, Republicans follow

And had a few votes broken the other way in a few swing states, had he gotten better control over the coronavirus pandemic, he might have won.

Instead, he’ll be gone from the White House in 11 weeks. It’s unclear he’ll ever concede he lost, or ever follow the tradition of extending grace to his successor.

His niece, a psychologist, author and now a critic of him, wrote a book suggesting he has a pathologically delicate ego and lives in terror of not being admired.

He enjoyed the granite-hard support of the conservative base. 

It was illustrated by what happened last week when his son, Don Jr., issued a warning to Republicans: if they had any future aspirations to lead the party, they had better start fighting the election result.

A virtual stampede ensued. 

Possible members of the 2024 field, Nikki Haley, Tom Cotton, Josh Hawley, Ted Cruz and others started complaining about the process. 

Sen. Lindsey Graham went on Fox News and promised to donate $ 500,000 US to the president’s legal fund for fighting the result.

No matter what the president does next, he’ll remain a kingmaker in the Republican Party, and those party members will keep courting his support.

If, however, he chooses to run again in a primary four years from now, he’d probably beat them — barring some unforeseen twist, such as legal troubles in New York, his former home state.

So there are no political obituaries this weekend, not even for an election loser. Because you can’t eulogize what’s not dead.

WATCH | ‘Let’s give each other a chance,’ Biden tells Trump supporters in victory speech:

President-elect Joe Biden spoke directly to Americans who didn’t vote for him during his victory address in Wilmington, Del., saying it’s ‘time to listen to each other again’ and to stop treating opponents like enemies. 1:42

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CBC | World News

Why COVID-19 cases are surging across Canada and what needs to be done

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.

Six weeks ago, Prime Minister Justin Trudeau said the country was at a “crossroads” in the COVID-19 pandemic. 

Now, with cases spiking in regions that were practically untouched by the virus in the first wave, it appears we’ve taken a wrong turn. 

There have been more than 100,000 new cases of COVID-19 and over 1,000 more deaths in this country since Trudeau made those comments.

The percentage of COVID-19 tests across the country that have come back positive has also grown by more than 235 per cent — from 1.4 per cent in mid-September to 4.7 per cent in the past week. 

So where did Canada go wrong? 

Experts say a mix of insufficient public health measures and complacency brought us to where we are today and we need to act quickly to turn things around — or at the very least prevent them from getting worse. 

Canada ‘failed’ to follow lessons 

South Korea taught us that by building up a robust test, trace and isolate system, it’s possible to control the spread of the coronavirus without subjecting your population to large scale lock downs. 

New Zealand locked down quickly, then shifted to a South Korean model focused on building up testing, tracing and isolating cases.  

But Australia learned the hard way in the second wave that, if you let the coronavirus spread unchecked for too long, tough action is needed to keep it under control through further lockdowns and strict public health measures.  

“The lesson across all of the world is that the places that do the best are the ones that act hard and early,” said Raywat Deonandan, a global health epidemiologist and an associate professor at the University of Ottawa. 

“That’s where we failed.”

Experts say Canada, comparatively, has seemingly not yet learned these lessons. 

“In Canada, we never set clear goals and so we opened up without having built a solid test, trace isolate strategy,” said Dr. Irfan Dhalla, vice-president of physician quality at Unity Health in Toronto. 

“We didn’t follow the indicators closely enough and now we’re paying the price. The good news is we’re not paying nearly as bad a price as people in some other countries are paying, but it would be a big mistake to compare ourselves to the worst countries in the world.”

Ontario ‘highly unstable’ 

In Ontario, there are currently almost 150 outbreaks in long-term care homes, the seven-day average of cases has grown to nearly 1,000 and the largest number of COVID-19 deaths in a single day happened this week. 

“The situation we find ourselves in right now is highly unstable,” said Dhalla, who is also an associate professor at the University of Toronto who sits on provincial and federal committees related to the COVID-19 response. 

“It wouldn’t take much to put us on a path towards the kinds of outcomes we’re seeing in Belgium, Switzerland, the United Kingdom, many American states.” 

But with over half of Ontario’s cases with no known link to previous cases and community transmission running rampant, experts say the province doesn’t have a clear enough view of the situation. 

“We don’t understand how many people are infected. We know that it’s a lot, but we really don’t know the magnitude,” said Dr. Andrew Morris, a professor of infectious diseases at the University of Toronto and the medical director of the Antimicrobial Stewardship Program at Sinai-University Health Network. 

“If this were an iceberg, we don’t know how much is above or below water.” 

Despite this, Ontario is moving to ease restrictions on much of the province, even without hitting its full testing capacity and contact tracing and isolation of cases not functioning in hot spots like Toronto due to the sheer volume. 

“We know in Ontario that 1,000 cases per day is not a sustainable situation. We have too many outbreaks in hospitals, we have too many outbreaks in long-term care homes,” he said. 

“We have to bring the number of cases down from 1,000 a day back down to something like 50 or 100 per day. And when we get back down there, we need to have a test, trace, isolate strategy that works.” 

WATCH | Ontario’s restrictions system under fire:

Ontario has announced a new tiered system for triggering COVID-19 restriction, but critics say the sky-high thresholds won’t stop the virus from spreading across the province. 1:59

Manitoba suffered from ‘complacency’

Manitoba went from one of Canada’s shining examples of how to successfully manage the spread of the coronavirus, to facing its single worst outbreak

“Some of us lost our way, and now COVID is beating us,” Premier Brian Pallister said Monday. “Perhaps we were cursed by our early success.”

It was that early success that caused the province to let its guard down, leaving it vulnerable to a surge in cases when the virus re-entered the community. 

“We had a very good proactive response in early spring. We shut things down very quickly, everybody seemed to be quite on board and cases receded,” said Jason Kindrachuk, an assistant professor of viral pathogenesis at the University of Manitoba in Winnipeg and Canada Research Chair of emerging viruses.

“And that, probably, in some ways, fed a complacency across all levels.”

Kindrachuk said that because Manitoba didn’t bear the brunt of COVID-19 that other regions of the country had, it lost focus on the need to prepare for the future. 

“Then everything hit at the perfect time — we had exponential growth, we had community transmission, we likely had superspreading events, we had outbreaks that occurred in long-term care facilities,” he said. 

“The worst of the worst that could have happened, did happen.” 

Alberta faces ‘tipping point’ 

Alberta shattered COVID-19 records on Thursday, recording what health officials described as “about 800” new cases after specific numbers were unavailable due to technical problems with the province’s reporting system. 

It’s another province that saw low case numbers slowly rise after a lull in the summer, but waited to act on imposing stricter restrictions and now faces the prospect of a worsening second wave. 

Dr. Lynora Saxinger, an infectious diseases specialist and an associate professor at the University of Alberta’s faculty of medicine, called the situation “profoundly disturbing.” 

“You can have things simmering along, and then it just starts to boil over — there’s a tipping point, and it starts to change,” she said. 

“And when that happens, what we’ve seen across the world, is the actions in that early phase make a really big difference.” 

Alberta Premier Jason Kenney rejected the call for stricter public health restrictions this week, the same time a record 171 people were hospitalized with COVID-19, 33 of them in ICU, and nine more people died. 

“We’ve seen other jurisdictions implement sweeping lockdowns, indiscriminately violating people’s rights and destroying livelihoods,” Kenney said Friday, rejecting the call for further measures to curb the spread of the virus.

“Nobody wants that to happen here in Alberta.”

Saxinger said Alberta should look at emulating a “circuit breaker” model of controlling the virus from the U.K., focused on brief lockdowns that can interrupt transmission and reverse rising case numbers quickly if rolled out successfully. 

WATCH | Stop gatherings in homes, Kenney urges Albertans:

Premier Jason Kenney is calling on Albertans to not host parties or large family dinners and is expanding the 15-person limit on social gatherings to all communities on the province’s COVID-19 watch list. 2:42

“There’s a certain part of the population that’s just not really paying attention as much anymore,” she said. “So you might need to have that short, sharp, lockdown that’s visible to actually really get the whole population re-engaged.” 

Saxinger said she’s worried Alberta is past the point of “targeted” restrictions due to rising community transmission and inadequate contact tracing and is being “surged under” by new cases and hospitalizations

“I’m really afraid that it could take off in a really bad way,” she said. “A lot of us are very anxious right now and the hospitals are already stressed.”

Record numbers in B.C.

British Columbia was praised for its vigorous test, trace and isolate approach and became a global model for how to effectively control the spread of the virus, but could risk jeopardizing the progress it’s made if it doesn’t regain control of a surge in cases. 

The province hit a record high COVID-19 case numbers two days in a row this week, with 425 on Thursday and 589 on Friday adding to the 3,741 active cases in the province currently. 

Unlike Quebec, which saw its cases surge a month after school started and has been struggling to regain control, B.C. has largely seen outbreaks in community settings.

“Most of the transmissions are through gatherings … superspreader-type events that happen with lots of people in a room,” said Dr. Srinivas Murthy, an infectious disease specialist and clinical associate professor in pediatrics at the University of British Columbia.

“I think our lack of attention to that, and how we can target where we know those large-scale transmission events happen, was probably not as rigorous as it could have been.” 

Murthy said new public health restrictions focused on limiting the size of gatherings, mandating masks in health-care facilities and threatening businesses with closures for not following guidelines will hopefully drive down the numbers and avoid lockdowns — but it will take time. 

“So far we’ve been able to, with pretty rigorous data collection, follow up and trace and isolate most of the cases in the superspreading events that have happened,” he said. 

“But if there is an increased, unlinked case number in the community that’s unable to be traced and isolated — then obviously large-scale social distancing would be probably the next step.”

Atlantic bubble needs vigilance

The Atlantic bubble, a success story for curbing COVID-19 spread, is another model that other parts of the country can learn from. 

The four Atlantic provinces imposed tight restrictions on points of entry, moved quickly to clamp down on new outbreaks of COVID-19 and focused on aggressive contact tracing and isolating.  

But epidemiologist Susan Kirkland said the recent surge in cases in parts of Canada that weren’t hit as hard in the first wave is a stark reminder of the need for the region to avoid letting its guard down. 

“We have to be constantly vigilant,” said Kirkland, head of public health and epidemiology at Dalhousie University in Halifax. “As long as COVID isn’t introduced, we’re OK. But the minute it is, the environment is rife for it to spread very, very quickly.” 

The Atlantic provinces have so far avoided rampant community spread of the virus with unknown origins, but Kirkland says rising numbers across the country show it could happen anywhere — even the North. 

Nunavut confirmed its first case of COVID-19 on Friday and while health officials say contact tracing is currently underway in the community, the territory’s rapid response team is “on standby to help manage the situation should it become necessary.”

WATCH | No sign of bubble bursting:

Like an extended family, the four Atlantic provinces have walled themselves in, creating measures to restrict outsiders and COVID-19 cases. So far, it’s worked and there doesn’t seem to be much of a rush to burst the Atlantic bubble. 5:09

Kirkland said Atlantic Canada has much more in common with the North than it does with more populous provinces like Ontario and both regions face an uncertain future. 

“Part of the reason that we’ve done so well is because we are isolated,” she said, adding that they have also benefited from strong public health messaging and a compliant public. 

“But the minute we have community spread, we’re again in that situation where we’re putting ourselves at big risk. So it’s hard to be complacent.”

To read the entire Second Opinion newsletter every Saturday morning, subscribe by clicking here.

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Boris Johnson’s big win may ‘get Brexit done’ but damaging fights loom

Boris Johnson has broken Britain’s deadlock over leaving the European Union with a dramatic election win but the victory could lead to new and potentially damaging confrontations with both Scotland and Northern Ireland.

Johnson, with his trademark floppy white hair and a reputation for making off-colour remarks, was dismissed by opponents — including many in his own party — as untrustworthy and something of a buffoon. But as the results began trickling in early Friday morning, it was clear his victory had dramatically redrawn the U.K.’s electoral map.

“What happens with elections is if you win, all the sins get washed away. He is at the pinnacle of his power,” said conservative commentator Craig Oliver,  who served as communications director for former Conservative prime minister’s David Cameron.

The Conservatives are on track to take at least 364 seats, giving Johnson’s party a healthy majority and handing the Labour Party its worst defeat in more than a generation.

“Just utterly devastating,” tweeted well-known Labour commentator Owen Jones,  “Brexit just smashed us. Keeping together an electoral coalition of “Remainers” and “Leavers” as the country bitterly divided just became impossible.”

Britain’s opposition Labour Party Leader Jeremy Corbyn waits for the General Election results of the Islington North constituency to be announced. His party lost big on Thursday night. (Hannah McKay/Reuters)

Labour Leader Jeremy Corbyn spoke only briefly after being proclaimed the winner in his riding of Islington North.   

In his speech, Corbyn said while he would be stepping down as leader, it might not happen right away. Corbyn suggested he planned to stick around through what could amount to a long a transition period.

Labour loses big in longtime strongholds

The Conservatives made deep inroads into traditionally Labour seats, especially in northern England,  as the vote appeared to polarize over Brexit.

“I want to thank Boris,” said winning Conservative candidate Ian Levy, whose surprise win in Blyth Valley early in the evening signalled the kind of night it would be for Labour.

No Tory had been elected there in almost 80 years. 

Nearby in Sedgefield, the seat of former Labour prime minister Tony Blair swung Conservative in a stunning upset.  And in Bassetlaw, a previously safe Labour seat near Sheffield, the Labour vote utterly collapsed.

“Brexit had been this dividing issue since the referendum was called and it seemed that [Brexit] cut across the traditional Labour-Conservative, left-right divide,” said Tim Durrant, associate director of the Institute for Government in London.

“People voted in terms of the party’s Brexit policy, as opposed to party loyalty.”

Scotland ‘flatly’ rejects Johnson’s plan, SNP leader says

But just as vast swaths of rural England turned Conservative blue, Scotland was painted with the yellow colour of the Scottish National Party. 

The SNP is on track to win to win an unprecedented 48 of Scotland’s 59 seats — a 13-seat increase. The major gains position Scottish First Minister Nicola Sturgeon as a major voice of opposition as Johnson moves forward with plans to break away from Europe. 

Scotland strongly backed the bid to remain in the European Union in the 2016 referendum.

Scottish National Party Leader Nicola Sturgeon celebrates as she hears her party has unseated Britain’s Liberal Democrat Leader Jo Swinson. (Andy Buchanan/AFP/Getty Images)

“Boris Johnson’s argument to Scotland has been flatly and completely rejected,”  Sturgeon told the BBC in the early hours of Friday morning.   

“There is no doubt that I have a mandate to offer people that choice.”

Johnson is on the record as saying he will not agree to another referendum so soon after the last vote in 2014, which sets up an epic confrontation between two leaders with large majorities behind them.

The 2014 referendum on Scottish independence saw 55 per cent of voters cast their ballots to stay in the U.K. That vote was sanctioned by Westminster, whereas a future unsanctioned vote would be legally dubious.    

But Johnson, who will face major decisions and negotiations around Brexit even after securing his majority, will be in a difficult position politically if Sturgeon moves toward holding another referendum.

‘Northern Ireland is the one to watch’

The other major upset of the night came in Northern Ireland, where parties that favour strong ties with the rest of Britain were overtaken by those with more nationalist leanings.

“Northern Ireland is the one to watch,” said Durrant, noting that the election of 11 nationalist MPs there marks the first time ever that so-called unionist parties have been in the minority there.

“Northern Ireland voted to remain in the EU, and there’s been a lot of disappointment in Northern Ireland about the way the DUP (Democratic Unionist Party) supported the Conservative government.” 

If Scotland votes for a referendum, Durrant said it will no doubt intensify debate in Northern Ireland about whether its future lies inside or outside of the U.K.

‘We don’t really know him fully,’ analyst says

Johnson — a former journalist who has been in or around politics virtually his entire life — has long faced criticism for adopting and then shedding political positions with little apparent intellectual discomfort.

His hard opposition to Europe during the Brexit campaign surprised many Conservatives, as did his intense push over the last few months to take Britain out of the EU without a deal.    

Durrant said with a comfortable majority behind him and the need to appeal to all those first time Conservative voters,  Johnson’s thinking may yet evolve again.

“The thing with Boris Johnson is that we don’t really know him fully,”  he told CBC News in an interview.   

Voters headed out in dreary weather Thursday to cast their ballots in a rare December election. (Carl Recine/Reuters)

“He was London mayor for a long time and [London] is socially liberal and anti-Brexit.  And he took a different tone as mayor to some of his stances while as a conservative backbencher in Theresa May’s government and now PM.”

In the immediate future, Johnson is expected to assemble his MPs and to have a modest cabinet shuffle as early as Monday. Brexit legislation is expected to go for a vote before the end of January.

While most of London remained a Labour stronghold, Johnson’s win — and the promise of movement on Brexit — was taken as positive in the financial district, with the pound trading higher.

There was no such rejoicing, though, from Labour backers and anti-Brexit campaigners. The Labour supporting Daily Mirror put a big photo of Johnson on the front page with the caption: “The Nightmare before Christmas.”

For conservatives, however, a big majority and clear path ahead for Brexit is nothing short of a dream that only a few months ago seemed unattainable. 

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Trump tells U.K. to divorce EU without a deal if they can’t ‘get it done’

U.S. President Donald Trump has said Britain should refuse to pay a $ 50 billion European Union divorce bill and “walk away” from Brexit talks if Brussels does not give ground.

Trump told the Sunday Times newspaper ahead of a state visit to Britain, which starts on Monday, that Britain’s next leader should send arch-Brexiteer Nigel Farage to conduct EU talks.

Once Britain leaves the EU, which Trump said must happen this year, then he would go “all out” to agree to a trade deal.

“They’ve got to get it done,” he said in the interview. “They have got to get the deal closed.”

British Prime Minister Theresa May will step down shortly after this week’s Trump visit, having failed to win backing for the Brexit divorce deal she negotiated with the EU.

Trump said her successor should pursue a “no-deal” Brexit if he or she could not get more concessions from Europe by the end of October, when Britain is due to leave.

Trump said Theresa May’s successor should pursue a ‘no-deal’ Brexit if he or she could not get more concessions from Europe. (Pablo Martinez Monsivais/Associated Press)

“If they don’t get what they want, I would walk away,” he said. “If you don’t get a fair deal, you walk away.”

The 13 candidates already in the leadership race are split between those willing to accept a “no-deal” and those opposed.

In the “no deal” camp are former foreign secretary Boris Johnson, whom Trump praised in an interview with the Sun newspaper on Friday, along with former Brexit minister Dominic Raab and interior minister Sajid Javid.

Trump said the United States could work “very, very quickly” on a trade deal if Britain was not constrained by a transition period agreed with Brussels.

Concerns about U.S. agricultural standards

The U.S. ambassador to Britain, Woody Johnson, said any such trade deal would include agriculture and healthcare.

“In a trade deal, all things that are traded will be on the table,” he told the BBC on Sunday. Asked if that included healthcare, he replied: “I would think so.”

Concerns have been raised in Britain about accepting U.S. agricultural standards, notably chlorine-washed chicken, and about opening up its state-funded healthcare system to U.S. companies as the price of a trade deal.

“American products would come over, and be allowed to come over,” Johnson told the BBC’s Andrew Marr Show. “You give the British people a choice, if they like it they can buy it, if they don’t want it, they do not have to buy it.”

Trump backs Farage 

Trump said it was a mistake for the Conservatives not to involve Farage, the Brexit Party leader, in negotiations with Brussels after his success in European Parliament elections.

“I like Nigel a lot. He has a lot to offer — he is a very smart person,” Trump said. “They won’t bring him in but think how well they would do if they did. They just haven’t figured that out yet.”

Farage, who led the unofficial campaign to leave the EU in the 2016 Brexit referendum, wants to leave the bloc without any agreement.

His new Brexit Party swept to victory in the United Kingdom’s European parliament election last month, prompting him to demand a seat at Brexit negotiations.

However, none of the candidates seeking to replace May are expected to offer an olive branch to a longstanding rival who has the potential to split the right-wing vote in Britain.

Trump also said he would have “to know” Labour opposition leader Jeremy Corbyn before authorizing U.S. intelligence to share its most sensitive secrets with a hard-left government.

He said Britain must be careful not to jeopardize intelligence-sharing by letting Chinese firm Huawei into its 5G mobile phone network.

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The Raptors are nearly done making history — now the challenge is repeating it

For now, all of the history is in the past. I mean, obviously. But bear with me.

The Toronto Raptors made their first Finals, and won their first Finals game (118-109 over the two-time defending champion Golden State Warriors, just to remind you).

Between quarters, the team nodded to its 24-year existence with a parade of ex-players, all welcomed with applause. Game 1 was a celebration of basketball in Toronto and in Canada — rightfully so.

But the time for pageantry is over. The only bit of history left to make is a championship. How can the Raptors repeat their solid Game 1 victory three more times?

Speeding Siakam

After the game, Golden State coach Steve Kerr zeroed in on one major Warriors weakness: transition defence. The Raptors picked their spots to pierce the Golden State defence with quick buckets through hit-ahead passes and run-outs. At the centre of it all was Pascal Siakam, the fastest player on the court. Siakam blitzed up and down, surprising two-time defensive player of the year Draymond Green with his straight-line speed and funky array of finishes.

The Raptors scored 24 fast-break points to the Warriors’ 17. That’s a huge win against a team that built its dynasty on the backbone of quick strikes. Game 1 didn’t feel comfortable until Kyle Lowry’s late three-pointer because the Warriors are known for their two-minute offensive outbursts. That the Raptors beat the Warriors at their own game is promising. Siakam may not shoot 83 per cent again, but the fact that he can is a massive development.

(Relatively) Quiet Kawhi

The Warriors sold out to stop Kawhi Leonard. At times this post-season Leonard was the main reason the Raptors were winning. The worm began turning in the conference final as Fred Van Vleet and Kyle Lowry began knocking down shots, but Leonard remained the epicentre of Toronto’s success.

WATCH | Raptors run over Warriors for Game 1 win:

Pascal Siakam set a postseason career best with a game-high 32 points in Toronto’s 118-109 win over Golden State to begin the 2019 NBA Finals. 2:08

It only followed that the Warriors, then, would do everything in their power to turn off Kawhi’s faucet. They switched Leonard’s defender on pick-and-rolls and doubled him late in the shot clock. But on the biggest stage, Siakam took the reins, Marc Gasol got aggressive, Danny Green found his shot and the load on Leonard’s shoulders eased. The Raptors superstar made just five field goals in Game 1. If there’s anything non-repeatable about Game 1, it’s probably just that. He still scored 23 points and added eight rebounds and five assists, by the way.

Steph & Klay, Dray & ‘Dre…

With Kevin Durant ruled out of Game 2, Curry, Thompson, Green and Iguodala remain the Warriors’ core. The Splash Bros. were solid in Game 1, but a combined 16-for-35 performance leaves lots of room to improve for two of the greatest shooters ever. Forty-six per cent shooting wasn’t enough to carry the short-handed Warriors on a night where Green and Iguodala connected on just five of their 16 shot attempts.

It’s a bit startling to see the lack of depth on the Warriors. Ex-Raptors 905er Alfonzo McKinnie was on the court during crunch-time. McKinnie couldn’t crack Toronto’s rotation last season. Still, Golden State piled on 109 points. An above-average performance by Steph and Klay or a return to form for Dray or ‘Dre would change the calculus on the court.

…And Drake

The least repeatable part of Game 1 is Drake’s elite trolling. His signed Raptors Dell Curry jersey is tough to beat. His non-scuffle with Green after the game can only exist after a Raptors victory. His subsequent Instagram post was the perfect finish to the three-course meal. The Warriors won’t let Drake live in their heads rent-free. They’re too good for that.

And so perhaps the most encouraging part of Game 1 was the Raptors’ matching poise and intensity. Toronto has plenty of players who’ve played in plenty of big games, but The Finals is a different beast. Nick Nurse outcoached eight-time NBA champion Steve Kerr. You know the Warriors’ bounceback is coming — regardless of a certain rapper.


On offence: Game 1 was ideal for the Raptors: 50 per cent from the field, 40 per cent from three, 84 per cent from the line. A heavy dose of clean looks contributed to the pretty percentages, even with Leonard and Lowry missing 10 “wide-open” shots (as classified by NBA.com) between them. So the Raptors probably won’t change a tonne going into Game 2. But they will try to get Leonard going through mismatches. One way to do this is to have Lowry screen for Leonard to force a smaller player (probably Curry) into a one-on-one situation with the Raptors superstar. From there, it’s clear out and let Leonard do work.

On defence: Play smartly aggressive, but also play aggressively smart. The Warriors shot 31 free throws in Game 1, including 14 for Curry. Those are automatic. The Raptors did well in forcing 17 turnovers with their aggression, but some smarter decision-making when Curry has the ball rising to the shot would be beneficial. That will limit opportunities from the charity stripe, and creating more transition chances off of the ensuing misses.

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Blac Chyna Reveals She Had Her Breasts Done 4 Times and Got Lipo After Birth of Dream

Blac Chyna Reveals She Had Her Breasts Done 4 Times and Got Lipo After Birth of Dream | Entertainment Tonight

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‘We are not monkeys’: Inuit speak out about skin grafts done without consent in 1970s

After years of keeping silent, Inuit from Igloolik, Nunavut, say they want answers about medical tests performed on them in the late 1960s and early ’70s.

Nearly 50 years ago, the hamlet of Igloolik was the site of a boom in scientific research, all part of a larger project called the International Biological Program. While the program was aimed at answering a wide array of scientific questions, much of the work in Igloolik focused on Inuit.

“We would do all these different kinds of things for a researcher,” said former Nunavut premier Paul Quassa, who grew up in Igloolik.

In the early ’70s he was a young man, spending his days going to school and hunting. He remembers researchers being in the community and doing experiments — he says some were merely inconvenient and annoying, but others were more invasive.

Quassa remembers being taken to a research building with his uncle and his cousin. There, they were told to roll up their sleeves.

Three Inuit show scars from skin graft procedures they say were done by researchers in the 1960s and 1970s. The photos were taken about a month ago; CBC News has agreed not to identify the people pictured. (Submitted by Steven Cooper)

“They took pieces of our skin, from another person, and then they put into ours,” said Quassa.

“They had a little circular knife or blade, and they would just start twisting it and then you could see the skin being cut in a circle.”

The scars from the skin graft are still visible on his forearm.

We are not animals, we are another human being that deserves respect.– Paul Quassa

He described another instance where he had been out hunting one February, wearing caribou clothing. When he got back, researchers made him stand outside for 20 minutes before letting him inside. Quassa suspects they were testing his ability to withstand the cold.

Quassa says he never gave his consent to be experimented on; he says Inuit were very compliant and trusting back then, and they did what they were told.

‘It was really unfair’

The International Biological Program was a large-scale multi-year project aimed at co-ordinating research among scientists worldwide. It looked at everything from pest control to pollution and how people adapted to their environments.

A 1970 article on the program published in Science said studies on “Eskimos, South American Indians, migrants and populations living at high altitude … include not only the health of these populations but also social conditions, nutritional patterns [and] biological rhythms.”

I was grafted with part of the skin of my sister.– Lazarie Uttak

It’s estimated that researchers did the skin grafting experiment on more than 30 Inuit from Igloolik, including Lazarie Uttak.

“I was grafted with part of the skin of my sister,” said Uttak. “I feel like we were being used.”

Uttak, 67, still lives in Igloolik and says at least 15 of the people who were experimented on are still alive in the hamlet today.

“We talk about this sometimes,” he said. “It was really unfair. We never got any information from them about why this was happening and the reason why they did it. I never found out.”

Quassa points to a scar left by a skin graft performed on him. (Kieran Oudshoorn/CBC)

2005 book outlines tests

The experiments in Igloolik are outlined in the 2005 book Beyond the Hippocratic Oath: A Memoir on the Rise of Modern Medical Ethics by Dr. John B. Dossetor, a celebrated Canadian physician who was inducted into the Order of Canada in 1994.

In it, Dossetor describes participating in the large research mission, travelling to Igloolik in 1972 and performing a series of skin grafts on Inuit.

Dossetor and his colleagues were studying why some skin grafts work while others fail, and they wanted to test their theories on an isolated human population.

Dossetor was a professor of medicine at the University of Alberta at the time. He went on to become an expert in medical ethics.

Igloolik has a population of about 1,600. (CBC)

In his book, Dossetor writes that his research in Igloolik received “community consent,” which he claims was granted by elders via a non-Inuk translator.

The doctor confronts the ethics of his research in the book, ultimately concluding that his team had not done enough to secure meaningful consent, though Quassa and Uttak say he never made any attempts to reach out or apologize to those he experimented on.

Dossetor is in his early 90s, living in Ottawa. He declined an interview request.

Memoir is ‘sickening’

Representatives from the federal Department of Indigenous Services and from Health Canada both declined to comment.

In an email, the director of the University of Alberta’s Research Ethics Office, Susan Babcock, said the university did not have a formal research ethics review process in 1972. It wasn’t until 1978 that the Medical Research Council of Canada put together the first framework for ethical requirements for human participation in research.

“The research conducted by Dr. Dossetor in the early 1970s would be reviewed and undertaken differently now,” wrote Babcock.

The university’s ethics office has no record of anyone expressing concerns about Dossetor’s work.

Quassa says the details revealed in Dossetor’s memoir are “sickening.”

Quassa shot back at the doctor’s concept of “community consent.” He questions what details were actually shared with locals in Inuktitut, and dismissed the idea that elders could unilaterally grant consent for invasive medical procedures.

“I’ve heard of scientists doing experiments on monkeys — they use animals to do a lot of experiments for the betterment of humankind,” he said.

“We are not monkeys, we are not animals, we are another human being that deserves respect.”

Quassa, Uttak and other Igloolik Inuit are considering their legal options. They are working with an Edmonton-based law firm to potentially seek an apology and damages.

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‘A tsunami to get this done’: How New York finally accepted congestion pricing

When New York state lawmakers voted earlier this month to accept a new plan to charge drivers a fee to come into Manhattan, Assemblyman Jeffrey Dinowitz found himself doing something that a decade ago would have seemed unimaginable: He voted “yes.”

Ten years ago, when then-Mayor Michael Bloomberg first proposed a congestion charge as a way of easing gridlock on the city’s busiest streets, Dinowitz rallied the opposition in his Bronx district, angry that drivers there would bear the brunt of the new tax.

“It was a horrible idea at the time and it would have had very negative effects on a lot of people,” Dinowitz said.

The turning point had more to do with what was happening below city streets than on them. In recent years, New Yorkers watched the transit system, particularly the subway, fall into a state of crisis. Overcrowding and delays, combined with a rise in rideshare apps, lead to a decline in ridership.

Between 2012 and 2017 subway delays more than tripled, in part because of overcrowding. The system was a victim of its own success. Ridership went from around four million users daily in the 1990s to more than six million clogging the system. A report by the New York City comptroller found that delays were costing the New York City economy $ 389 million US annually.

Unreliable transit drives away riders

As users turned away from the unreliable service, the decrease in revenue left a gap in funding for critical repairs and upgrades. In June 2017, New York Governor Andrew Cuomo declared a state of emergency over transit to speed up repairs.

New York State Assemblyman Jeffrey Dinowitz is a reluctant supporter of the congestion tax, despite leading opposition to the idea a decade ago. He says the benefits that come from fixing transit outweigh the added costs to drivers in his district. (Steven D’Souza/CBC)

Dinowitz watched it unfold as chair of the state committee overseeing New York City’s transit system, which has been under control of the state government since 1969.

“It was almost as if service deteriorated suddenly, but in fact it was coming for a long time,” Dinowitz said.

Faced with a desperate need for funding, Dinowitz and others reluctantly agreed that congestion pricing was a necessary, if flawed, option.”I still have mixed feelings on it.”

How it will work

While the plan has been approved, the details, and there are many, still have to be worked out. Vehicles entering Manhattan anywhere below 60th Street will pay the congestion charge. The cost to drivers hasn’t been worked out, but it’s estimated it will be between $ 12-14 US for cars, and around $ 25 for trucks. Prices will change depending on the time of day and on weekends.

A panel of transportation officials will determine the final fees, as well as contentious issues such as exemptions. Among those being debated include exemptions for residents in the congestion zone, the disabled, and emergency services.

The congestion pricing plan states that the expected $ 1 billion raised annually will be dedicated to help improve transit. That money would be leveraged to rise $ 15 billion in bonds towards fixing the beleaguered system.

Stars align

“I always said congestion pricing would happen when the stars aligned,” said Bruce Schaller, former deputy commissioner for traffic under Mayor Bloomberg.

He wrote the original congestion plan and says it took a perfect storm to create the political climate for the idea to win support.

“The sense of crisis, the sense of need, was more intense this time,” Schaller said. “It wasn’t that people who opposed it before got convinced or were given something or made a deal, there was just this tsunami to get it done this time.”

Former New York transportation official Bruce Schaller says the overwhelming need to repair the city’s crumbling transit system is what dragged the opposition on board with the idea of a congestion tax. (Steven D’Souza/CBC)

But he says the devil is still in the details. The state has mandated that the congestion charge raise around $ 1 billion. Schaller says, if too many exemptions are handed out, then the fee for drivers may end up being higher. Too many exemptions could also dilute the actual effect on alleviating congestion.

Schaller says it’s too early to know if the plan will decrease traffic in Manhattan’s central business district, but says European cities like London and Stockholm saw an almost immediate 15-20 per cent decrease in traffic after introducing a congestion tax.

“It’s pretty clear if you increase what people pay to drive into Manhattan, some people will decide not to drive in,” Schaller said. 

Opposition remains

For business owners like Peter Petino, the congestion pricing plan is a cash grab that he worries could be the end of his delivery business. He has around 20 employees on delivery on a given day with many going in and out of Manhattan.

“I’m looking at a possibly decreasing the business or going out of business completely because of it,” Petino said. 

Petino also worries that congestion pricing won’t address Manhattan’s brutal traffic. He points to the 80,000-100,000 extra cars that have hit New York streets in recent years driving for rideshare apps like Uber and Lyft.

Peter Petino says his delivery business may crumble under the weight of new congestion charges and worries that the plan doesn’t do enough to address the nearly 100,000 extra cars that have hit New York streets driving for rideshare services like Uber and Lyft. (Steven D’Souza/CBC)

He says the new plan will do nothing to lessen the presence of those vehicles. “It is ludicrous and it is unreasonable unless the city told all these app cars not to come into the city to begin with,” Petino said. 

But Schaller says the city has already moved to cap the number of rideshare vehicles and has begun levying a congestion surcharge for those rides. He says solving the riddle of congestion takes more than one approach. 

“It’s congestion pricing, it’s managing the growth of Uber and Lyft, it’s managing trucks and deliveries — there’s not one thing you can do that by itself will reduce congestion, it’s a combination of things.”

The lessons from New York

As New York embarks on North America’s first foray into congestion pricing, Schaller knows the eyes of politicians, planners and commuters in the U.S. and Canada are focused on the results.

He says other cities must tailor their congestion pricing plans to their unique situations, and shouldn’t wait for a crisis to act. For example, he says Los Angeles would have to look at congestion on the highways rather than in its downtown core.

Dinowitz preaches caution for other jurisdictions looking at New York’s congestion pricing model. He says it will be several years before a verdict can be reached on the program.

“I think other cities that may want to look at this should carefully examine whether it’s accomplished the purposes it was intended to in New York City,” Dinowitz said.

On the key purpose of improving transit, Dinowitz has a long list of improvements he wants to see in his district, from better bus service to more accessible subway stations. 

“Getting agreements on those issues certainly made it a lot easier to not oppose congestion pricing.”

New York will become the first U.S. city to impose congestion pricing, seen as a key weapon against global warming, following lawmakers’ approval of a state budget to fund the plan. 2:50

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