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Everything you need to know about the Blue Jays this year

This is an excerpt from The Buzzer, which is CBC Sports’ daily email newsletter. Stay up to speed on what’s happening in sports by subscribing here.

The Toronto Blue Jays open the 2021 baseball season Thursday at 1 p.m. ET at Yankee Stadium. Here’s a quick catchup on Canada’s only major-league team:

They’re not coming back to Canada any time soon

The Jays announced Wednesday that they’re extending their stay in Dunedin, Fla., through at least their May 14-24 homestand. They still want to return to Toronto at some point this year. But if Canadian government pandemic restrictions don’t soften, they’ll continue playing their home games in the United States — either in Dunedin or, if Florida gets too hot and humid, in Buffalo.

2 key new players should bolster the lineup

Toronto’s big off-season catch was slugging centre-fielder George Springer, who it lured from Houston with the richest contract ($ 150 million US over six years) in team history.

The 31-year-old leadoff man won the World Series MVP award in 2017 and averaged 31 home runs in the last four full seasons. But he’s out for a bit because of an oblique strain.

WATCH | CBC Sports’ Jamie Strashin joins John Northcott to preview Jays’ season: 

Jamie Strashin of CBC Sports joins John Northcott on CBC News Network to talk about the kick-off to the Toronto Blue Jays season today. 3:18

New second baseman Marcus Semien, 30, will be in the opening day lineup and looking to recapture his form from 2019, when he hit 33 homers for Oakland and finished third in American League MVP voting.

Springer and Semien join a talented young team

Corner outfielders Lourdes Gurriel Jr., and Teoscar Hernández are both coming off excellent seasons and are still on the right side of 30. Ideally, 22-year-old Alejandro Kirk can soon take over at catcher after hitting well in his cameo appearance last year.

But the Jays’ future — and present — hinges on their three core young guys.

A big year by a smaller Vladimir Guerrero Jr. would be huge for the Jays. (Maddie Meyer/Getty Images)

Shortstop Bo Bichette, 23, should be a line-drive machine again after a knee injury sapped him of his power last year. Cavan Biggio, 25, is a good hitter who can steal bases and play almost anywhere on the field.

Vladimir Guerrero Jr., though, could ultimately be the make-or-break guy. The 22-year-old hasn’t lived up to the massive hype yet. But he’s still very young, very talented and he’s in better shape now. If Guerrero becomes the all-star-calibre slugger everyone expects, he can push the Jays to the next level.

The pitching looks a little shaky

Opening day starter Hyun Jin Ryu is a legit ace who finished third in American League Cy Young voting last year. Behind him are a lot of journeymen and question marks.

The Jays hope prospect Nate Pearson can become the No. 2 guy after he showed flashes as a rookie, but he’s hurt again (strained groin).

The bullpen is pretty deep, but Toronto’s gamble on closer Kirby Yates went bust. The one-time 41-save man suffered a season-ending elbow injury in spring training, leaving the job up to a committee that could be led by Canadian righty Jordan Romano.

Another post-season trip is in reach

Last year’s appearance by the Jays in the post-season was a product of the field temporarily expanding from five teams to eight in each league.

The added randomness of a 60-game season may have helped, too, as the Jays gave up more runs than they scored.

But they’re a good, young team that made some solid additions, and there are objective reasons to think they can make the playoffs in a normal season.

Fangraphs’ projection model has Toronto finishing 88-74 — seven games behind the Yankees in the AL East, but good enough to claim the top AL wild-card spot from a tightly packed handful of contenders.

The Jays are also trendy in the betting market, which has them as the No. 3 favourite to win the AL pennant, behind the Yankees and White Sox.

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CBC | Sports News

COVID-19 exposes need for more collaborative, community-based health care

When Adil Butt’s body started to ache, he immediately isolated himself in a small bedroom for a month to keep his young family safe from COVID-19.

The 42-year-old lives in Thorncliffe Park, a tightly knit community of apartment buildings in Toronto’s east end. Neighbours have been hit hard by the coronavirus.

Butt phoned to inquire about testing at a local pop-up site on Saturday, Dec. 5, got tested and received his positive result the following Monday.

He went above and beyond public health guidelines to avoid passing on the virus to his wife and children, ages 10, seven, six and three.”Nobody got it,” he said. “It was very hard, especially [for] my small kid.”

This week marks the one-year anniversary of the first quarantine measures to control COVID-19. When CBC News canvassed some doctors and scientists across Canada on what’s fundamentally changed in health care during the pandemic, what stood out was the need for more collaborative care similar to what Butt received.

Adil Butt said staying away from his young children was especially difficult after he received a positive test result. (Submitted by Adil Butt)

Primary care providers help prevent people from coming to hospital with damaging and costly complications of diabetes or infections.

Deaths and policy failures 

Dr. Andrew Boozary, executive director of social medicine at Toronto’s University Health Network, said community health centres such as where Butt was tested offer a one-stop shop of services, including prescription medications, healthy foods and connections to housing and jobs for people living on the margins across Canada.

“There’s actually systemic discrimination in the way we pay for primary care and the way we fund our health-care system,” he said.

Boozary said the pandemic has exposed public policy failures, not only in long-term care homes but also in neighbourhoods where essential workers, many who are racialized, bear a disproportionate burden.

The Black Creek Community Health Centre, in Toronto’s Jane and Finch neighbourhood, serves an area with high case rates of COVID-19 but few resources. (Evan Mitsui/CBC)

“Our failure or lack of policy has really determined who lives and who dies,” Boozary said. “When you go back to look at things like primary care, if you put the map of where primary care funding was and the map of where COVID was, there’s a complete mismatch.”

Boozary draws hope from community health centres, which he said have been a leader for decades in gaining patients’ trust by working with them regularly where they are.

Caring for all to stop coronavirus

Cheryl Prescod, executive director of Black Creek Community Health Centre in the city’s northwest, said their service is priceless and underestimated.

“Throughout this past year, I believe we saw our value,” she said.

Asked about the need for stable funding beyond the pandemic, Prescod said, “We feel invisible compared to larger hospitals or larger health-care institutions. The small community health centres are the distant cousins.”

Cheryl Prescod said small community health centres are seen as distant cousins of hospitals. Their value to the health-care system, however, is priceless, she said. (CBC)

But the coronavirus that causes COVID-19 will not discriminate between someone who earns a high income and someone who doesn’t.

WATCH | Community volunteers ease vaccine roll out: 

Several community and religious groups in British Columbia are armed with computers and phones, ready to help local seniors sign up for COVID-19 vaccinations. 2:03

“The virus will not be stopped unless we take care of everybody,” Prescod said.

Paulina Aghedo works as one of the centre’s community ambassadors, sharing safety tips to stop the spread in her neighbourhood.

Paulina Aghedo hands out flyers promoting COVID-19 testing for the Black Creek Community Health Centre in Toronto. Her efforts helped a woman get tested so she could return to work. (CBC)

Now, Aghedo hands out flyers and sparks conversation, all to raise awareness of testing sites in apartment complexes, lobbies and parking lots. It’s home to many personal support workers and grocery clerks who work long hours and may still struggle to make ends meet.

She recalled knocking on doors in her crowded building to distribute flyers when a friend called to say someone needed to know about testing right away.

“She is just coughing in her working place and they told her if she doesn’t bring that COVID-19 test [result] she shouldn’t come back to work,” Aghedo said.

The flyer reached the woman, who tested negative and no longer feared losing her job.

“I was very happy I could help someone,” Aghedo said.

For his part,  Butt gave up his job as an Uber driver during COVID-19. He temporarily lost his sense of smell, even for perfume that was pungent to his wife, as well as sense of taste.

During self-isolation, the food delivery volunteer relied on friends from his neighbourhood to return the gesture. For Butt, seeing neighbours helping each other to cope and recover resembles how doctors and nurses care for patients in hospitals.

“He [a friend] was bringing the food for me and leaving it outside my door and this is how we survived,” Butt said of his neighbour.

Butt’s fever broke after a few days and he’s fully recovered.

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CBC | Health News

Trudeau says Canada-U.S. relations need to rebuild. Just how bad did it get with Trump?

When Justin Trudeau met virtually with U.S. President Joe Biden this week, the prime minister suggested that relations between the two countries had taken a significant hit during Donald Trump’s administration, noting that “there’s a lot to rebuild.”

Tensions over trade culminated in tariff battles during Trump’s term in the White House, and his use of Twitter to blast the prime minister certainly put a chill on their relationship.

However, despite the often-tense relationship between Trudeau and Trump, tough deals were still forged, including a revamped NAFTA agreement, while the countries continued to co-operate on longstanding issues.

“The relationship between the United States is so deep and so broad that you can’t characterize it simply in terms of whether or not an individual president and a prime minister get along” said David MacNaughton, Canada’s ambassador to the U.S. from 2016 to 2019.

“Having said that, I think it is of huge value if they do,” he said. “There are times when having that kind of close personal relationship can make a difference. So I think it’s desirable, but it’s not essential.”

Yet MacNaughton said the reality was that Canada and U.S. continued to have a constructive relationship on the meaningful files.

David MacNaughton was Canada’s ambassador to the U.S. from 2016 to 2019. (Graham Hughes/The Canadian Press)

For example, the military and intelligence relationship between the two countries continued to be very strong, he said.

While negotiations for the new NAFTA agreement — the Canada–U.S.–Mexico Agreement (CUSMA) — were tough, an agreement was still hashed out, MacNaughton said.

“And frankly, I’m not sure if we were renegotiating NAFTA today, we would have an easier time with [the Biden administration].”

As well, key figures from Donald Trump’s administration were able to forge strong relations with Canada and members of Trudeau’s team. Sonny Perdue, the U.S. secretary of agriculture was a “great friend,” while former treasury secretary Steven Mnuchin and former finance minister Bill Morneau “got along really well,” MacNaughton said.

Governors and premiers

And as CBC’s Aaron Wherry chronicled in his book Promise and Peril: Justin Trudeau in Power, Trudeau’s chief of staff, Katie Telford, built a rapport with Trump’s son-in-law, Jared Kushner, who was also a senior adviser to the president.

Even Trump’s controversial chief strategist Steve Bannon had said he had developed a good relationship with Trudeau’s Gerald Butts, Trudeau’s principal secretary from 2015 to 2019.

Then there are the on-going Canada/U.S. relationships between governors and premiers, MacNaughton said. On a regular basis, the Atlantic, Western and Great Lakes premiers get together with their New England, Great Lakes and Western governor counterparts.

Steven Mnuchin, right, treasury secretary in the Trump administration, and Bill Morneau, who served as Canada’s finance minister from 2015 to 2020, were said to have had a good relationship despite tension between Trump and Trudeau. (Pablo Martinez Monsivais/The Associated Press)

As well, there are bilateral mayoral, business and union relationships, he said. 

“So to say the relationship was broken is putting too much emphasis on Donald Trump’s M.O.”

Chris Sands, director of the D.C.-based Wilson Center’s Canada Institute, said so much in the Canada/U.S. relationship is managed by unknown bureaucrats who continued working behind the scenes and were “getting important things done.”

That Canada was able to make a deal to keep the border restricted but not closed following the COVID-19 pandemic was a testament to the co-operation and trust we have [for] the Canadians,” he said.

‘Knows how to get things done’

“I don’t want to say that it was magic, but it was really good and it was a sign of a relationship that knows how to get things done,” Sands said.

“There were a lot of things that weren’t fun but they did get done in the Trump era and they’re still getting done now.”

Still, relations “did get pretty bad” as “trust was eroded over the last four years, particularly on the Canadian side toward the U.S,” said former American diplomat Scotty Greenwood, who spent four years as chief of staff of the U.S. Embassy in Canada.

“I do think that the relationship suffered. I do think the relationship between the leaders matters,” she said. “While there’s a certain inevitability of Canada/U.S. relations, there are still times when you really benefit from a good working relationship at the top to solve thorny issue or to create big opportunities.”

Some of the tension between Trump and Trudeau seemed to be sparked by Trump’s ire with Canada/U.S. trade deals and what he saw as Canada having an unfair trade advantage. (Sean Kilpatrick/The Canadian Press)

On that front, relations at the top were at times tumultuous with the president. 

And some of that, at least, seemed to be sparked by Trump’s ire with Canada/U.S. trade deals and what he saw as Canada having an unfair trade advantage.

In 2017, Trump called Canada a “disgrace” for policies that he said hurt American farmers and would tweet a year later that “I love Canada but they’ve taken advantage of our country for many years!”

What eventually followed was the tense renegotiation of NATFA. But before that, Trump in June 2018, in the days leading up to the G7 leaders summit in La Malbaie, Que., slapped tariffs on Canadian steel and aluminum imports.

This prompted a reportedly tense call between Trudeau and Trump over the tariffs. Trump reportedly at one point asked: “Didn’t you guys burn down the White House?” — a reference to the War of 1812.

‘Dishonest and weak’

The rhetoric became more heated after the summit, when Trump got word that Trudeau had said the tariffs were insulting and that Canada wouldn’t be pushed around. Taking to Twitter,  Trump lashed back that the prime minister was “very dishonest & weak.”

Later, Trump’s trade adviser, Peter Navarro, remarked there was “a special place in hell” for Trudeau, while Trump’s chief economic adviser, Larry Kudlow, said Trudeau had “stabbed us in the back.”

Such level of diplomatic vitriol prompted former prime minister Brian Mulroney to observe he had “never seen language like this. Least of all from subordinates of the president directed at the prime minister of their greatest friend and ally.”

WATCH | Trudeau caught complaining about Trump’s lateness:

PM Justin Trudeau, France’s Emmanuel Macron, UK PM Boris Johnson and other VIPs shared a few words at a Buckingham Palace reception Tuesday – and seemed to be talking about U.S. President Donald Trump’s lengthy impromptu press conferences earlier in the day. 0:25

A year later, however, there was another flareup. At a NATO summit reception in Buckingham Palace in London, Trudeau was caught on video complaining to British Prime Minister Boris Johnson and French President Emmanuel Macron that Trump was late because “he takes a 40-minute press conference off the top.”

Trump would later respond that while Trudeau was  “a very nice guy,” he’s “two-faced” and was just upset that he had challenged the prime minister to make a greater financial contribution to NATO.

WATCH| Trump responds to Trudeau:

U.S. President Donald Trump says PM Justin Trudeau ridiculed him last evening because he was upset that Trump called him out over low NATO spending. 0:41

Weeks later, Trump would take another shot at Trudeau when he learned his cameo in the film Home Alone 2: Lost In New York had been edited out of CBC’s broadcast. (CBC said it had cut the scene before Trump was president and did it to make way for commercials.) 

“I guess Justin T doesn’t much like my making him pay up on NATO or Trade!” Trump tweeted.

21-second pause

The relationship would come into focus again in June 2020 when Trudeau made headlines for his 21-second pause after being asked about Trump’s threat to use military force against protestors in the U.S.

WATCH | Trudeau’s 21-second pause:

Asked about U.S. President Donald Trump threatening the use of military force against protestors in the United States, Prime Minister Justin Trudeau paused for 21 seconds before saying “we all watch in horror and consternation.” He did not comment on Trump. 2:59

Relations would be tested a few months later when Trump again slapped a tariff on Canadian aluminum, only to back down after Canada was set to impose retaliatory measures.

Yet despite these tensions, Trudeau was still able to work out and maintain a relationship with Trump, said former Canadian diplomat Colin Robertson.

“It was difficult, but every Western leader had difficult relationships with Mr. Trump.”

Robertson said while other Western leaders gave up, Trudeau kept trying.

Most important relationship

“He had to because it’s our most important relationship,” Robertson said. “The one relationship our prime minister has to get right is the relationship with the United States.”

Greenwood, the former diplomat, said in an ironic twist, Trump’s threats to tear up NAFTA and his disruption of the system made the U.S. much more aware of the importance of Canada.

“What happened was the awareness of the economic relationship between the United States is maybe at an all-time high in Congress,” she said. 

Greenwood, however, wondered if the new U.S. administration will be able to build from this new awareness.

“It seems to me the question is how will the prime minister, the president seize on the kind of awareness that now exists in the U.S … where policy makers appreciate more than ever our interconnectedness with Canada.”

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CBC | World News

Why we need to rethink COVID-19 risk as the weather warms up

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.

It’s been almost a year of “Stay home. Do nothing. Save lives.” And people are tired. 

Pandemic fatigue has turned to pandemic restlessness as the weather shows signs of improving and vaccines gradually roll out across the country.

Hope is on the horizon, but if last spring is any predictor of what lies ahead we can expect to see Canadians flocking outdoors in search of safe ways to gather as temperatures rise. 

And with good reason. 

After a surge of cases after the holidays, Canada has seen a significant decline in COVID-19 levels across the country following lockdowns in hard-hit regions — even with frigid temperatures driving people indoors and more contagious variants spreading.

As more people get vaccinated, cases (hopefully) continue to decline and society slowly reopens, it may be time to shift our messaging away from strict one-size-fits-all public health guidelines.

There’s no doubt people will want to congregate more as the weather improves, and experts say we should transition from an abstinence approach to one of harm reduction. (Evan Mitsui/CBC)

Allow small risks to counter fatigue

Experts say officials need to start to shift their messaging and set out realistic parameters for socializing safely over the next few months or risk losing the room — or worse, pushing people to more dangerous behaviour.

Dr. Zain Chagla, an infectious diseases physician at St. Joseph’s Healthcare in Hamilton, Ont., says guidelines need to shift in Canada to educate people on how to see their friends and family safely. 

“Now that transmission is down, we need to start making some discussions on the trade offs,” he said.

“Can you really realistically think that people can wait it out at home without any interactions outside of their household for another three months? Or can you at least start prioritizing and building in low risk stuff, so that you give people the sense of normalcy?” 

Chagla says recent negative reactions to outdoor activities like tobogganing and skating rinks mirror concerns at the start of the pandemic, when outdoor gatherings in places like parks were seen as dangerous even with no evidence of transmission occurring. 

In Ontario, reservations for provincial parks have surged in anticipation of warmer months ahead, nearly doubling in the first few weeks of this year. Cottage rentals are also in high demand, with bookings at levels never seen before.

Finding practical ways to alleviate pandemic fatigue and allow for some level of safe interaction in the coming weeks and months will be essential to keeping Canada on a downward trajectory with COVID-19 levels. (Evan Mitsui/CBC)

There’s no doubt people will want to congregate more as the weather improves, and experts say we should transition from an abstinence approach to one of harm reduction. 

“If you gave people that opportunity to do things appropriately outside, how many cases would you then save from indoor activity?” said Chagla.

“If you allow them to take that small risk, you’re preventing the people that are going to fatigue and say, ‘Well, I’m just going to have my family over, we’ve been fine, we’ve been isolating for weeks, I deserve this,’ and then have COVID transmission that way.”

Outside is better than inside

Finding practical ways to alleviate pandemic fatigue and allow for some level of safe interaction in the coming weeks and months will be essential to keeping Canada on a downward trajectory with COVID-19 levels. 

“People are tired of the sacrifices they’ve made, and for their mental health and physical health want to see other people and want to socialize,” said Linsey Marr, an expert on the airborne transmission of viruses at Virginia Tech.

“Doing it outdoors is very low risk if you avoid face-to-face conversation with people, maintain your distance and avoid crowds.” 

Prof. Linsey Marr says going for a walk side-by-side, taking an exercise class or even having a beer with friends are all relatively safe outdoors when more than two-metres of space is maintained. (Ben Nelms/CBC)

Marr says going for a walk side-by-side, taking an exercise class or even having a beer with friends are all relatively safe outdoors when more than two-metres of space is maintained. 

New research from the U.S. Centers for Disease Control and Prevention shows the risk of indoor activities when proper precautions aren’t taken. 

In Hawaii, 21 cases were linked to a fitness instructor during a class where physical distancing measures were in place, but masks weren’t worn and airflow wasn’t prioritized. 

A similar situation occurred in Chicago, where 55 people were infected with COVID-19 after attending indoor exercise classes despite physical distancing and some mask use. 

The missing element in both of those outbreaks was ventilation. 

“We should be opening up park spaces, we should be encouraging outdoor activities where people can gather and gather safely and converse and talk and just be with people,” said Bromage

“Recognizing that there is a small risk associated with it — but it’s better than the alternative.” 

‘Get creative’ with public health messaging

Timothy Caulfield, a Canada Research Chair in health law and policy at the University of Alberta in Edmonton, said public health officials are walking a “tightrope” in communicating public health guidelines in the coming months. 

“We have to figure out ways that we can allow people to live their lives, while still making sure that we’re reducing the risk,” he said. “And I think we need to engage people as part of the solution.”

A recent research article published in SAGE surveyed several hundred Italian and French citizens under strict lockdown and found there was significantly less adherence to public health guidelines when people’s concern about COVID-19 was waning, along with their trust in officials.

WATCH | Dealing with stress in this leg of the pandemic:

Physical distancing may save lives and protect people’s health in a pandemic, but it has its own health impacts. With isolation and apprehension comes sleeplessness and stress. And the advent of new virus variants and the slow progress of vaccinations are making things even worse. 2:01

The World Health Organization released guidelines for fighting pandemic fatigue, focused on understanding people, allowing them to live their lives while reducing risk, engaging with them to find a solution and acknowledging the impact of the pandemic on their lives.

Caulfield says officials need to evolve their messaging with emerging scientific research and avoid being tuned out by the public by setting realistic guidelines for safely interacting. 

“We need to recognize that we’re really getting to a point where there’s going to be profound complacency,” he said.

“There is profound fatigue, and not just fatigue about the lockdown. I think there’s fatigue about the messaging — people are sick of hearing about this stuff. So I think we need to get creative.” 

Variants make noncompliance higher risk

Erin Bromage, a biology professor and immunologist at the University of Massachusetts Dartmouth who studies infectious diseases, said he’s concerned transmission could soon skyrocket due to increased interactions with warm weather amid the spread of variants. 

“We’re heading into March very soon, and March is when the pandemic really took off last year,” he said. “I’m holding my breath, just sort of hoping that it’s not a repeat of 2020 given the changing mobility that comes with the weather.”

COVID-19 levels have risen by about five per cent globally in the past week, after significant declines since the beginning of the year, with recent upticks in parts of Canada and the U.S. concerning officials.

“What comes next is really uncertain. Do we roll back up again? Do we just stay at this level?” said Bromage. “Nobody really knows.”

Chagla says we need to give people more low risk activities to do together in the near future, or risk people hiding their interactions with each other behind closed doors. 

“A Zoom call versus seeing a very close friend with a mask in the park is slightly higher risk,” he said. “But I think using it to allay fatigue is probably a whole lot better than the implications of just keeping people at home.” 

WATCH: The impact of stress, a year into the COVID-19 pandemic:

A physician and psychiatrist talk about the impact that stress is having on mental and physical health a year into the COVID-19 pandemic and what the longer-term effects might be. 6:10

Caulfield says officials need to re-evaluate public health messaging and explain clearly to people what’s safe and what isn’t. 

“I do want to see recommendations on what they can do outside now and how they can enjoy the weather,” he said. “Let’s put a positive spin on this, letting them know that there are steps that can be taken.”

With the emergence of variants, Chagla says the risk of people letting their guard down now is incredibly high. 

“You’ve got to get people on your side for the next few months,” said Chagla. “And realistically offering things to them, rather than taking things away, is going to be the way to do it.”

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

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CBC | Health News

Americans need late goal to scrape past Canada at SheBelieves Cup

Substitute Rose Lavelle scored in the 79th minute to help the U.S. defeat Canada 1-0 Thursday on the opening day of the SheBelieves Cup.

It was a gritty performance by a Canadian side missing captain Christine Sinclair and other top players.

While the top-ranked Americans dominated play at Exploria Stadium, they failed to convert until late when Canada didn’t clear a ball in the box and Lavelle hammered a shot through traffic. The Canadians thought there had been an infraction on the play but to no avail.

The Canadian women, tied for eighth with Brazil in the FIFA world rankings, had their hands full with the Americans who spent much of the game in Canada’s end.

WATCH | Lavelle scores late goal to secure U.S. win over Canada:

The United States defeats Canada 1-0 with Rose Lavelle’s goal in the 79th minute. 1:04

The Americans kept coming but could not finish. Canada had a few chances of its own with a Shelina Zadorsky header going just wide in the dying seconds

The game marked the debut of 34-year-old Bev Priestman as Canada coach. The English native, who worked for Canada Soccer from 2013 to 2018, took over last November when Kenneth Heiner-Moller took a coach job in his native Denmark.

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CBC | Sports News

Threat of vaccine nationalism reinforces global need for better pandemic planning

Protectionism has been a recurring theme throughout the COVID-19 pandemic as countries scrambled to secure valuable resources. With delays already impacting vaccine supply chains, experts warn that so-called vaccine nationalism will cause long-term harm in the global response to the pandemic.

Concerns over countries limiting the export of vaccines in the name of keeping inoculations for themselves were renewed on Friday when the European Union said it would use emergency Brexit measures to restrict exports of COVID-19 vaccines from crossing the Irish border into the United Kingdom. The EU reversed course later that night following outcry in Northern Ireland, London and Dublin — but the situation raised fears of vaccine delays in Canada.

“What we’re seeing is not surprising,” said Steven Hoffman, professor of global health law and political science at York University in Toronto and director of the Global Strategy Lab. 

“This is just the latest example of [export controls] being used in a way that is not helpful for solving the global dimensions of this pandemic that we all face,” Hoffman said, citing former U.S. president Donald Trump’s attempt to prevent 3M from honouring its Canadian deals for N95 masks in April.

World Health Organization director general Tedros Adhanom Ghebreyesus said on Friday that vaccine nationalism could exacerbate inequalities lower-income countries already face in terms of acquiring doses.

“Vaccine nationalism might serve short-term political goals. But it’s ultimately short-sighted and self-defeating,” Tedros said. “We will not end the pandemic anywhere until we end it everywhere.”

On Saturday, Canadian International Trade Minister Mary Ng received assurances from European Commission executive vice-president and commissioner for trade Valdis Dombrovskis that Canada would not be impacted by proposed export controls on vaccines.

“In their regulation, there is absolutely consideration for advance purchase agreements that have been made, like that of Canada, with the vaccine makers, and our expectation is that there is no disruption or delay,” Ng said in a Sunday interview on Rosemary Barton Live. “I was given assurances that Canada’s vaccines should not be affected.”

WATCH | Minister told EU vaccine export controls won’t affect Canada:

International Trade Minister Mary Ng said in an interview with Rosemary Barton Live that she’s received assurances from her European Union counterpart that the EU’s proposed export transparency mechanism will not affect Canada’s COVID-19 vaccine shipments. 7:25

For Hoffman, vaccine nationalism is another example of how unprepared the world was to confront a pandemic that people in the public health community considered inevitable — and not likely to be the last one.

“We need to figure out and have a global agreement about how we do these things before a pandemic strikes, before a vaccine is developed and ready for deployment, because after the fact, it’s too late,” he said.

Hoffman referred to an article he wrote in the Global Challenges journal following the Ebola outbreak in 2014 entitled “How Many People Must Die From Pandemics Before the World Learns?” to reiterate the need for collaborative action going forward.

“I hope that this ends up being that shock that will bring us the kind of global governance system that we need in order to address 21st-century threats,” he said. “Now that we see how bad it can be, the hope is that we’ll be able to change our structures in the future so that we’re better prepared next time.”

WATCH | How COVID-19 exposed Canada’s innovation weak spot:

Dan Breznitz, co-director of the University of Toronto’s Innovation Policy Lab at the Munk School of Global Affairs and Public Policy, warns that Canada cannot rely on its allies and that the national security risks from losing manufacturing should be a wake-up call. 7:04

‘Co-operative solution’ best course, lawyer says

Mark Warner, an American and Canadian trade lawyer, said the situation with the EU and the U.K. is messy to unpack, particularly with regards to the AstraZeneca vaccine. He likened COVID-19 vaccine production to car manufacturing in North America, where parts can cross borders multiple times before the product is finished.

“Despite the bark from the European Union, they don’t have really an effective remedy, it seems to me, other than moral suasion,” said Warner, principal counsel at MAAW Law in Toronto. He said what the EU did was a message to vaccine developers to “be very careful in what other contracts you’re filling before you fill ours.”

“We’re all going to be better off if we choose a co-operative solution,” he said.

Warner, who has experience helping a pharmaceutical company send its antiretroviral drugs around the world during the AIDS epidemic, said the notion that the rollout would proceed without issue was misguided.

“I think there was a period because of the pandemic and its effect on people and everybody wanted hope,” he said, adding that people were looking for a “happy science story.”

“The rest of the world has seemed to catch up to what I think people like me have unfortunately thought was going to happen, which is supply chains and competition and trade issues, and that’s where we are.”

Domestic production a complicated prospect, experts say

Despite assurances from Canadian officials, the notion of manufacturing COVID-19 vaccines domestically has emerged as a way around potential dilemmas. Both Warner and Hoffman agree that it’s not a cut-and-dried solution.

“I think the reflexive reaction on the part of a lot of Canadians is ‘let’s do it here,’ which makes sense,” Warner said. “But even the Germans with BioNTech — Germany is a pretty big country — they couldn’t do it. They had to go and find Pfizer, one of the biggest pharmacy companies in the world, to commercialize it.

WATCH | Virologist discusses why Canada should start making its own COVID-19 vaccines:

Virologist Dr. Earl Brown says the government should support local drug-makers to retool infrastructure as vaccine nationalism abroad could have consequences for Canada. 6:59

“Oxford University develops their vaccine [and] they had to join up with AstraZeneca, a British and Swedish multinational pharmaceutical, to go for it.”

Hoffman said there isn’t enough incentive for any country to build manufacturing capacity that wouldn’t be used in a non-pandemic scenario. “Maybe the question is why would Canadians expect there to be large-scale vaccine manufacturing in our country when nearly every country doesn’t have it?” he said.

Instead, Hoffman said there should have been a global effort to pool resources to build a facility that could serve an international demand for vaccines and act as an insurance policy.

“But as a world, we decided not to do that. It’s an expensive insurance policy,” he said. “We might now regret that decision, realizing that the costs without that insurance policy are even greater than the costs if we had pursued it.”

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Why the U.S. isn’t in desperate need of the Keystone XL pipeline

Ramped up domestic oil production and alternative supply routes have lessened the U.S.’s need for the hundreds of thousands of barrels of oil that would have been pumped daily through the now-cancelled Keystone XL pipeline, some industry experts say.

On Wednesday, not long after being sworn in as president of the United States, Joe Biden fulfilled a campaign promise by signing an executive order scuttling the 1,897-kilometre pipeline expansion as part of the administration’s effort to fight climate change.

The project, first announced in 2005, would have carried 830,000 barrels of crude a day from the oilsands in Alberta to Nebraska and connected with the original Keystone pipeline that runs to Gulf Coast refineries.

“I really don’t think that this works out to be a major, significant change to American oil supply right now,” said Warren Mabee, director of Queen’s University’s Institute for Energy and Environmental Policy. 

“The flow of oil out of Canada … is now a much smaller part of any big U.S. energy strategy. They’ve got the capacity in the States to be able to make up for that. They’re not really counting on the additional capacity, the growth that Keystone XL would bring.”

A ‘gut punch’

Prime Minister Justin Trudeau said he was disappointed with Biden’s decision, but Alberta Premier Jason Kenney called it a “gut punch” and federal Conservative Leader Erin O’Toole described it as “devastating.”

U.S. President Joe Biden signs executive orders on his first day in office. He wasted little time cancelling the Keystone XL project. (Evan Vucci/The Associated Press)

While supporters of the project north of the border say the decision represents a major loss for Canadian jobs and oil production, it likely won’t have a similar negative impact on U.S. oil supply, some experts say.

And that makes the prospect of changing the administration’s mind even more unlikely.

“A decade ago, we were integral,” Mabee said. “In fact, the United States would think of Canada as part of the United States when they were looking at their energy supply. And I don’t think that’s the case anymore.”

As well, there was no guarantee that adding 800,000 barrels a day of capacity would lead to 800,000 barrels a day of additional production in the oilsands, said Mabee.

With Canada already moving 500,000 barrels a day by rail to the U.S., Keystone XL may have just picked up the slack from the rail system, he said.

Weaned off imports

In the years since Keystone XL was first proposed, the U.S. significantly increased its oil production through the hydraulic fracturing of shale. This resulted in a 230 per cent surge in U.S. crude production, or an extra 6.9 million barrels a day, said Michael Tran, managing director of global energy strategy at RBC Capital Markets. Total U.S. crude imports have dropped significantly as well.

According to the U.S. Energy Information Administration, in 2019, the U.S. produced about 19.25 million barrels per day and consumed about 20.4 million barrels. 

Since the 1990s, Canada’s share of total crude oil imports to the U.S. has increased, accounting for 56 per cent of the supply in 2019.

However, by that time, total U.S. crude oil imports were down by about one-third compared to 2005 volumes.

“So the U.S. has just really weaned its way off of global imports in a really big way during that period,” Tran said. “The domestic shale revolution has completely altered the U.S. landscape and its dependency on foreign oil. 

“The U.S. need for Canadian oil is not to the same urgent degree as it has been in the past.”

(CBC News)

David Braziel, CEO of RBN Energy, an energy markets consultancy based in Houston, Texas, said that when the Keystone XL project was first announced, back in 2005, the U.S. was certainly in need of the additional capacity that would have been produced. 

But as the project continued to stall, the industry found alternative supply chains. Producers began relying more on rail to transport oil supplies while other pipelines expanded incrementally to help move those additional barrels to U.S. markets, Braziel said. 

The U.S. is also counting on the expansion of the Trans Mountain Pipeline, which heads west from Alberta to B.C. and connects with a pipeline to Washington state, and Enbridge Line 3, which also begins in Alberta and crosses Minnesota to Superior, Wis.

In late July, the Trump administration approved the existing Keystone pipeline to ship 29 per cent more Canadian crude into the U.S. Midwest and Gulf Coast.

“So, there’s a lot of additional capacity that could come on to fill the gaps. If the Keystone XL was there, [we would] definitely use it, but if it’s not there, then there are other ways to get to market,” Braziel said.

WATCH | Kenney on Biden’s decision to scrap Keystone XL: 

Alberta Premier Jason Kenney says the federal government ‘folded’ in response to U.S President Joe Biden’s decision to revoke the Keystone XL pipeline. 2:14

Andrew Lipow, CEO of Lipow Oil Associates, a petroleum consulting firm based in Houston, Texas, said the Keystone XL pipeline certainly could have been used to increase crude oil production that ultimately would have been delivered to U.S. refineries, many of them on the Gulf Coast, displacing imports from other parts of the world.

“And those other imports that the Gulf Coast relies on come from areas of the world that may be politically unstable or have other supply issues,” he said.

Major exporter

As well, while shale production has resulted in the U.S. becoming a major exporter of crude oil, that oil is of the “light sweet variety,” Lipow said. And many U.S. refineries are configured to prefer the heavy sour crude that comes from Alberta.

“The Canadian crude is actually less expensive than the light sweet crude coming out of the shale producing regions [in the U.S.],” he said.

Still, while the U.S. refineries would prefer Alberta crude pumped through Keystone XL, they can still use U.S. crude oil, he said.

Meanwhile, U.S. motorists are unlikely to see any spike in gas prices as a result of the Keystone XL decision, Mabee said.  

“It’s not going to leave Americans paying three times as much for their gasoline,” he said. “It probably won’t affect their price at all.” 

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Canada won’t receive any Pfizer shots next week — here’s what you need to know about the vaccination campaign

Canada’s vaccination campaign is off to a slow start — and news this week that deliveries of the Pfizer-BioNTech product will be reduced dramatically over the next month has further complicated the national rollout.

Maj.-Gen. Dany Fortin, the military commander leading vaccine logistics at the Public Health Agency of Canada (PHAC), has said Pfizer will not ship a single vial of its highly effective vaccine to Canada next week as the pharmaceutical giant retools its production facility in Puurs, Belgium to boost capacity.

The announcement is already prompting some provinces to warn that they will have to curtail appointments in the weeks ahead as they direct the existing supply of the two-dose Pfizer-BioNTech vaccine to patients who need their second shots.

Why is Canada getting less vaccine than anticipated?

Pfizer is grappling with unprecedented global demand for its vaccine as the world scrambles to inoculate patients against the deadly novel coronavirus.

While the company had projected it could manufacture up to 1.3 billion shots this year alone, it is now shifting gears to pump out even more.

The company is making upgrades to its Belgian plant so that it can manufacture up to 2 billion doses this year to meet the insatiable demand. In order to complete those upgrades, some production lines will have to be idled and Pfizer won’t have enough vials to go around in the short term to meet its previously promised delivery schedule.

“Pfizer and BioNTech are working relentlessly to support the further rollout of the vaccination campaigns worldwide by not only expanding their own manufacturing capacities but also by adding further suppliers as well as contract manufacturers to increase total manufacturing capacity,” the company said in a news release announcing the disruptions.

A driver pulls his truck out of the Pfizer plant in Puurs, Belgium on Monday, Dec. 21, 2020. (Valentin Bianchi/AP Photo)

Fortin has said that, starting next week, Canada’s deliveries will be reduced by up to 50 per cent over a four-week period, punting as many as 400,000 doses to a later date.

While the company has another manufacturing facility in Kalamazoo, Mich., the Belgian plant alone is supplying Canada, the European Union and the United Kingdom. U.S. deliveries will continue uninterrupted.

Will Canada, the EU and the United Kingdom be equally affected by these disruptions?

No. Announcing the delays last week, Public Services and Procurement Minister Anita Anand said she expects Pfizer will treat all countries equally as it reduces shipments with an eye to restoring service in February.

But Pfizer isn’t treating every customer the same way. While Canada will receive zero doses next week, the company said it “will be back to the original schedule of deliveries to the European Union beginning the week of January 25.”

Pfizer has promised the EU that it will then “increase delivery beginning week of February 15, resulting in our ability to deliver the fully committed quantity of vaccine doses in the first quarter and significantly more in the second quarter.”

Public Services and Procurement Minister Anita Anand and Maj.-Gen. Dany Fortin look on as Prime Minister Justin Trudeau responds to a question during a news conference in Ottawa on Dec. 7, 2020. (Adrian Wyld/Canadian Press)

When asked why Pfizer will not make the same commitment to Canada, Anand said that she expects the company to treat all countries equitably — but could not say why Canada has been singled out.

“This was very disappointing and I spent the weekend on the phone with Pfizer executives and my team. We reiterated firmly the importance for Canada to return to our regular delivery schedule as soon as possible,” she said at a press conference Tuesday.

Pfizer did not respond to specific questions about why it is showing more favourable treatment to the EU. In an emailed statement, the company said the details of its agreements with governments are “confidential.”

“Multiple countries around the world will be impacted in the short term in order for us to quickly enable increased production volumes afterwards,” the spokesperson said. 

The U.K. delivery schedule is less clear. The government there has said it is “in close contact” with all suppliers so that it can achieve its target of immunizing all those over age 70 by February 15.

So how many doses will Canada receive over the next number of weeks?

It’s hard to say for sure. Fortin had said Canada would see a 75 per cent drop next week in deliveries — but then had to correct that forecast after learning Canada wouldn’t receive a single dose.

Just last week, Fortin had been expecting delivery of 208,650 doses to the provinces every week for the rest of this month. Fortin also said Canada is expected to receive 366,000 Pfizer doses per week in February.

Speaking to the press this week, Fortin conceded those numbers are no longer accurate.

“Those numbers remain to be confirmed by Pfizer Canada. In fact, we have regular conversations with them and we hope and we expect to have clarity on those numbers,” Fortin told reporters at a public health briefing.

Is Canada still on track to get 4 million doses of the Pfizer product by the end of March?

The government has said yes. While the deliveries may change, the government insists its medium-term targets are more certain.

By the end of the first quarter, Canada is expecting four million doses from Pfizer and another two million doses from Moderna — enough to vaccinate some 3 million Canadians with these two-dose products.

WATCH | Canada affected by Pfizer-BioNTech vaccine production delay in Europe:

Federal Procurement Minister Anita Anand made the announcement to reporters in Ottawa on Friday. 2:38

But these delays mean that many people will be kept waiting much longer for shots than they originally anticipated. While deliveries might return to a more normal flow, it will be difficult for provinces to pump through hundreds of thousands of patients in a short timeframe to reach vaccination targets.

The delivery hiccup also could push off the vaccination campaign for the general population, which had a start date of April 1.

Pharmacies have said they could vaccinate as many 2.5 million people per week if all 11,500 community pharmacies in this country are mobilized, but the lack of supply has delayed their participation in the effort.

Data released by PHAC Thursday suggest 10 million more people could be fully vaccinated between April and June, for a cumulative total of 13 million people inoculated since the start of the campaign.

And if other vaccines apart from the Pfizer and Moderna products are approved over that time period, 10 million more patients could complete the vaccine regime by the end of June, for a combined total of 23 million.

The PHAC data also suggest that 36 million Canadians can be vaccinated by the end of September, if all goes well and there aren’t any significant delivery disruptions in the interim.

What is Prime Minister Justin Trudeau doing about this Pfizer delay?

While the prime minister of Israel has had more than a dozen calls with the CEO of Pfizer, and the president of the European Union has personally reached out to the company’s leadership, Trudeau has said that Anand is the lead on this file.

“I can assure you that Minister Anand is talking almost daily with Pfizer and the other vaccine companies to ensure that we get as many doses as possible, as quickly as possible, and that work will continue,” he said. “We will not rest, we will not slow down.”

Israeli Prime Minister Benjamin Netanyahu, center, and his Health Minister Yuli Edelstein, second left, attend the arrival of plane with a shipment of Pfizer coronavirus vaccines at Ben Gurion Airport, near the city of Lod, Israel, on Jan. 10, 2021. (Motti Millrod/AP Photo)

When pressed by Vassy Kapelos, host of CBC’s Power & Politics, to state whether Trudeau has personally contacted Pfizer to ask for more doses, Anand would only say that she has been in “close communication” with the prime minister.

Some observers have said Trudeau should ask U.S. President Joe Biden to temporarily float Canada some vaccines from the Michigan plant as a sign of goodwill — especially after Biden rescinded the presidential permits for the Keystone XL pipeline.

So how are the provinces reacting to all this?

Not well. Ontario Premier Doug Ford has said the delivery delays will be very disruptive. The province also has said the temporary stoppage could mean its goal of immunizing all long-term care residents in the province by Feb. 15 won’t be achieved.

“If I was in (Trudeau’s) shoes … I’d be on that phone call every single day. I’d be up that guy’s yin-yang so far with a firecracker he wouldn’t know what hit him,” he said of Pfizer’s executives. “I would not stop until we get these vaccines.”

On Wednesday, Ford called Pfizer Canada President Cole Pinnow to discuss the situation.

“He reiterated the serious impact these cancelled shipments will have on Ontario and sought answers as to why Canada isn’t receiving vaccines as quickly as other countries,” Ford’s office said in a media statement after the call.

Ford also has suggested Biden should “help out its neighbour” by releasing some shots to Canada.

Ontario Premier Doug Ford watches a health care worker prepare a dose of the Pfizer-BioNTech COVID-19 vaccine at a UHN vaccine clinic in Toronto on Thursday, January 7, 2021. (Nathan Denette/Canadian Press)

Alberta Premier Jason Kenney said Tuesday the province is putting a temporary hold on the first dose of COVID-19 vaccinations to ensure it has enough vaccine to provide a second dose to people who have already received their first shot.

“By pausing first appointments, we can ensure enough vaccine is allocated for committed second-dose appointments,” Kenney said.

How is Canada doing compared to the rest of the world?

Canada has administered some 700,000 shots – roughly 1.7 per cent of the population has received at least one dose of either the Pfizer or Moderna products. In Ontario, about 40,000 people have been fully vaccinated against the virus.

The United States has vaccinated three times more people per capita than Canada.

The U.K., too, has been a world leader in getting shots into the arms of patients. Nearly 7.5 per cent of the British and Northern Irish population has so far received at least one dose.

Canada’s vaccination effort has also been outpaced to date by those in Bahrain, Denmark, Ireland, Israel, Italy, Lithuania, Malta, Slovenia, Spain and the United Arab Emirates, among others.

But according to the latest data collated by the University of Oxford-based Our World in Data, Canada has administered more shots per capita than G7 partners like Germany and France, and middle-income countries like Argentina and Costa Rica.

“I had a lovely conversation with Angela Merkel yesterday morning in which she sort of complained to me that every day she gets it from the German media that they’re not doing as well as Canada,” Trudeau told reporters Tuesday.

“I think a lot of people are comparing stories from country to country and trying to figure out how we can all move quicker.”

The EU authorized the Moderna product for use two weeks after Health Canada regulators gave that vaccine the necessary approvals, which could account for the slower start to vaccination campaigns in countries like Germany.

What about the other promising vaccine candidates?

Health Canada regulators are still reviewing clinical trial data for both the AstraZeneca and Johnson & Johnson products. Canada has placed orders for doses from these companies but a delivery schedule is far from certain, given that the regulatory review is still underway.

The U.K. approved the AstraZeneca vaccine on Dec. 30.

The product from Johnson & Johnson’s pharmaceutical division, Janssen, has not been approved for use anywhere in the world. Some countries are eager to secure doses of this vaccine because it only requires one shot.

The company has not yet presented publicly any final data on its effectiveness, although some early results, published in the prestigious New England Journal of Medicine, are promising.

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What you need to know about getting both doses of the COVID-19 vaccine

Getting vaccinated to protect yourself from the virus behind COVID-19 isn’t a one-and-done process in Canada right now.

The two approved options, from Pfizer-BioNTech and Moderna, both require a two-dose regimen, with each dose ideally spaced apart by a specific time interval that was used during clinical trials.

But that’s not how every region is handling the vaccine roll-out. While Ontario is striving to hold back enough doses so people get both shots in the recommended time-frames, B.C. is delaying second doses by up to a week or two past manufacturers’ guidelines, and Quebec is going even further, waiting up to three times longer.

The goal is to vaccinate as many people as quickly as possible, but there are still questions over just how effective these vaccines will be if policymakers stray too far from the guidelines.

What is the recommended dosing approach?

Official guidelines say the Pfizer-BioNTech vaccine is meant to be given as two doses, 21 days apart, while Moderna recommends spacing doses 28 days apart. 

Canada’s National Advisory Committee on Immunization, a federal body made up of scientists and vaccine experts, says every effort should be made to follow those dosing schedules.

But, since vaccine shipments are still trickling in, the panel offered some wiggle room — suggesting the second dose for either vaccine could be delayed up to six weeks at the most.

“The flexibility provided by a reasonable extension of the dose interval to 42 days where operationally necessary, combined with increasing predictability of vaccine supply, support our public health objective to protect high-risk groups as quickly as possible,” reads a statement released Thursday from Dr. Theresa Tam, chief public health officer of Canada, and the country’s provincial and territorial chief medical officers of health.

A nurse prepares a dose of the Pfizer-BioNTech COVID-19 vaccine at a clinic for care home workers at St. Michael’s Hospital, in Toronto, on Dec. 22. (Evan Mitsui/CBC)

Why are two doses, at a specific interval, even necessary?

The official guidelines for dosing intervals are based on each manufacturer’s clinical trial data, showing that the vaccines were most effective sometime after people got both rounds.

Vaccine efficacy for Pfizer-BioNTech’s option was around 95 per cent after both doses; for Moderna’s it was around 94 per cent following the second dose. (Certain high-risk groups weren’t part of those clinical trials, however, including anyone pregnant or immunocompromised.)

While research suggests there may be some level of protection from even just one shot, the consensus in Canada is that following guidelines based on the clinical trial data — as closely as possible — is the best bet to ensure people are protected.

“We also do not know how long lasting the protection will be,” said Dr. Howard Njoo, Canada’s deputy chief public health officer, during a briefing on Thursday. 

“We know it’s better with two doses, but with one single dose, we are not sure.”

WATCH | : Dr. Howard Njoo discusses spacing vaccine doses out 42 days:

Canada’s Deputy Chief Public health officer, Dr. Howard Njoo, addresses questions on whether the first and second dose of COVID-19 vaccine can be safely administered 42 days apart. 2:34

So can you get sick from COVID-19 if you only get one dose?

Potentially, yes. 

Clinical trials showed the level of protection from just one dose is lower for both vaccines, and it also takes time for your body to react — meaning you aren’t protected immediately after getting a shot.

The highest level of efficacy reported for Pfizer-BioNTech’s vaccine started a week after people got their second dose, and after at least two weeks following the second dose of the Moderna option.

In Quebec, health officials are currently examining how multiple residents of a long-term care home fell ill with COVID-19, despite being among the earliest in that province to receive a first round of the Pfizer-BioNTech vaccine.

That prompted questions over when the residents were infected, and Njoo noted the individuals may have already contracted the virus before getting vaccinated at all.

Long-term research will be helpful in confirming just how much protection people get from one dose of either of the approved two-dose vaccines, and how long it’s safe to delay the second shot.

The first care home in Quebec City to have been targeted for vaccination is seeing a steady increase in COVID-19 cases. (Evan Mitsui/CBC)

Why are different regions handling dosages differently?

Some provinces, such as Manitoba and Saskatchewan, are sticking with the dosing schedule set out by the vaccine manufacturers. 

But since federal recommendations suggest delaying a second dose up to 42 days at the most, other regions are considering a looser approach. 

Quebec — one of the country’s hardest-hit provinces for COVID-19 cases — is stretching the dosing time-frame to a maximum of 90 days.

The province’s Health Minister Christian Dubé stressed it’s about protecting as many people as possible with a first dose before April, when vaccine shipments from Ottawa are expected to ramp up. 

Njoo acknowledged some regions may be reacting to the realities on the ground. 

“The pandemic has intensified,” he said. “And there are more hospitalizations and deaths.”

Quebec Health Minister Christian Dubé says a second dose of a COVID-19 vaccine may be delayed from 42 to 90 days to allow more vulnerable people to receive their first shot. 1:05

Should you get doses of different vaccines?

It’s ideal for people to be given two doses of the same vaccine rather than mixing and matching, Njoo said.

That’s because without long-term research, federal officials are again stressing the need to stick as closely to the guidelines as possible, since clinical trials are the best-available data on how to ensure these vaccines are as effective as they can be at warding off COVID-19.

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Why Canada’s seniors need the coronavirus vaccine so urgently

The rising number of people testing positive for COVID-19 in Canada, coupled with the new threat from mutant variants, makes it more urgent to vaccinate our oldest and most vulnerable, experts say.

Vaccine supplies are now coming into Canada, and doctors say we need to get them into many more arms. Prime Minister Justin Trudeau said he plans to raise accelerating vaccine rollout with provincial and territorial leaders on Thursday.

More than 70 per cent of COVID-19 deaths in Canada have been among those aged 80 and older, according to an epidemiology update by the federal government. In Ontario, the province reported more than 2,700 pandemic-related deaths in long-term care homes as of Dec. 30.

Dr. Cara Tannenbaum, a professor in the faculty of medicine at the University of Montreal, usually treats outpatients as a geriatrician at Montreal’s geriatrics research institute. But during the spring wave of COVID-19, she joined the front lines at one of the city’s hardest-hit nursing homes.

“It was equally tragic and frustrating,” Tannenbaum recalled. “We had 150 deaths in our centre. Our seniors were isolated, depressed, dying.”

The “bodies in the hall,” she said, were grim proof that the oldest have borne the brunt of the coronavirus.

Crosses are displayed in November in memory of the elderly who died from COVID-19 at the Camilla Care Community facility in Mississauga, Ont. As of Dec. 30, Ontario has reported more than 2,700 pandemic-related deaths in long-term care homes. (Nathan Denette/The Canadian Press)

And now Tannenbaum faces a hospital at capacity, which means there won’t be staffed beds available for more patients sick with COVID-19 and other illnesses — a reality that makes vaccinations all the more pressing.

“I’d be happy to get in my car and start driving around vaccinating older adults if asked to do that by the government. That’s how seriously I think it’s needed,” Tannenbaum said. “But of course, I can’t do that because I don’t have a –80 degree freezer [needed for Pfizer-BioNtech’s vaccine], so it has to be more co-ordinated.”

To Tannenbaum, there’s a path forward to get more shots into arms more quickly.

Israel offers a role model. The country has vaccinated more than a quarter of its seniors, a feat credited in part to its small size, dense population and centralized medical services.

WATCH | Lessons from Israel’s vaccination success:

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

“We could do this with army-like efficiency if we got organized,” Tannenbaum said.

“We have the doses here to get our seniors vaccinated, and let’s do it. I think it’s a duty. I think it’s respectful. I think it’s a combination of science, and it reflects our societal values.”

Role of community connections

Tannebaum said she’s concerned not only about residents in long-term care facilities but also about some older adults who live independently in the community and are now isolated.

The first step, she said, is to make lists of those who receive home care or who needed help getting groceries delivered to them in the spring.

Residents at the St-André residence for seniors in Saint-André-Avellin, Que. Dr. Cara Tannenbaum, a geriatrician in Montreal, says she’s concerned not only about residents in long-term care homes but also about some older adults who live in the community. (CBC/Radio-Canada)

She suggests that pharmacies could compile such lists from their clientele, given that nine out of 10 seniors take prescription medications, and pharmacies may be physically closer than a doctor’s office.

The second part is facilitating delivery of vaccines into arms. If mobile vaccination isn’t available, working-age adults could volunteer to drive seniors to the locations where the shots are given by health-care workers, Tannenbaum said.

People 60 years of age and older are also a priority for receiving the vaccine in a computer model developed by Madhur Anand and Chris Bauch’s that still needs to be checked for errors before publication.

Anand, a professor in the School of Environmental Sciences at the University of Guelph, and Bauch, a professor of applied mathematics at the University of Waterloo, both in Ontario, helped to develop a computer model to determine the best vaccine deployment.

Public health measures ‘are essential’

Anand said what makes their model unique is the way it includes elements of game theory on how people interact in a group.

“Any interventions — whether it’s wearing a mask, keeping your contacts to an absolute minimum and getting the vaccine when it is offered to you — are all protecting not just you but everybody else in your community,” she said.

Madhur Anand, a professor in the School of Environmental Sciences at the University of Guelph, says it’s easy to forget how physical distancing, wearing masks and vaccines protect others, not just yourself, from COVID-19. (University of Guelph)

Anand acknowledged that lesson is easy to forget because everyone faces so many other competing problems during the pandemic.

But to eliminate COVID-19, the public health measures “are essential, and it’s something that absolutely can be done at the individual level,” she said.

Anand and Bauch adapted the susceptible-infected-recovered (SIR) modelling approach to vaccination to protect against COVID-19. (Susceptible refers to the group of people who haven’t gotten the disease before and can now get sick; infected includes those who are sick now; and recovered includes those who’ve recovered from the illness.)

“We talk about pandemic waves,” Bauch said. “These are like ocean waves that expand and move past you. These are kind of waves of our own creation that will continue to move through populations as long as there are susceptibilities and as long as our infection control doesn’t work as well as it could.”

More than 70 per cent of COVID-19 deaths in Canada have been among those aged 80 and older, according to the federal government, making vaccinations for older adults a priority, geriatricians say. (Jean-Claude Taliana/CBC/Radio-Canada)

The mathematical reality behind the model adds to what Bauch called the “ground truth” that the virus will continue its insidious spread as long as there are more people susceptible to infection — unless stopped in its tracks by vaccination.

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