Tag Archives: strategy

Canada urged to embrace an elimination-style strategy for COVID-19 but feasibility questions abound

As COVID-19 cases rise steeply across parts of Canada, some infectious disease experts are calling for a new strategy to curb the unruly spread of the virus.

The proposed goal is simple: whittle down case counts to zero, or at least close to it.

But doctors say it will be far more complicated to figure out how to reach that target, with some skeptics casting doubt as to whether it’s even realistic.

Advocates have taken to Twitter this week urging Canada to embrace an elimination-style strategy under the hashtag COVIDzero.

The aim of the approach is to wipe out the virus through stricter restrictions ranging from targeted closures to full-on lockdowns, bolstered testing and tracing capabilities and government relief for individuals and businesses.

While skeptics believe in the concept behind that idea, they worry it may fall short in execution.

“The goals are important — aiming for a low case number, an appropriate testing strategy, supporting people through contact tracing and isolation —that should be a part of our response,” said McMaster University’s Dr. Zain Chagla.

“But I don’t think we can plausibly achieve zero. And we have to be very, very careful and transparent about what this [strategy] would entail.”

Dr. Irfan Dhalla, an associate professor at University of Toronto who is among many doctors advocating for COVIDzero, has been arguing for an elimination strategy for months.

But he says the timing now is “urgent” as Canada’s average daily counts have climbed into the 5,000-range, and hospitals have begun facing “significant challenges” with overwhelmed intensive care units.

“We need more restrictions on activity than we have,” Dhalla said. “But we don’t necessarily need to prolong a lockdown.”

WATCH | Lockdowns and variations:

As COVID-19 cases continue to surge across Canada, provinces are implementing the short, sharp “circuit-breaker” lockdowns to fight the spread of the virus and prevent health-care systems from being overwhelmed. 1:58

Dhalla says places around the world have been successful in containing the virus by implementing elimination-type strategies, including Australia, New Zealand, Thailand and even Canada’s Atlantic bubble.

While a lengthy lockdown was needed in some of those areas — Melbourne had a strict shutdown lasting more than 100 days — Dhalla also pointed to places like South Korea, which relied on testing and tracing rather than a full lockdown, to show that it is possible.

Dr. Isaac Bogoch of the University Health Network “strongly doubts” a COVIDzero strategy can be achieved in Canada without a lengthy lockdown.

“And even if you do have lockdowns, like we did before, you still won’t get to zero unless you address the structural inequities that are driving COVID-19 in Canada,” he said.

Bogoch, like Chagla, sympathizes with the spirit of the COVIDzero movement, but questions if it’s feasible.

A health-care worker talks to a woman at a COVID-19 testing clinic in Montreal on Nov. 8. Testing and tracing would need to be boosted during a lockdown, some infectious disease physicians say. (Graham Hughes/The Canadian Press)

“If indeed you want to take an elimination strategy, it’s important to know what that involves,” Bogoch said. “At the end of the day, you can have all the hashtags and platitudes you want on social media. But there are very challenging hurdles to overcome to get to [a COVID zero] state.”

Businesses and low-income workers need support

He said one of the most significant obstacles will be convincing leaders at all levels of government to agree on a consistent message.

Officials would also have to provide “tremendous support” to businesses and low-income, marginalized workers to make up for lost revenues and employment cuts, said Bogoch.

There are also travel restrictions to consider, he said, pointing out that people in Melbourne were allowed only a five-kilometre radius for leaving their homes for essential purposes.

Canada had nearly 51,000 active cases as of Tuesday afternoon and more than 11,000 deaths since the pandemic began earlier this year.

Dhalla says that’s inexcusable at this stage in the pandemic.

“We’re losing several dozen Canadians every day to this virus, that at this point, we know how to prevent,” Dhalla said. “And we’re struggling in some hospitals, where we simply cannot provide the quality of care that we would like.”

Chagla agrees that pressure on hospitals needs to be lifted, noting that other plans of action have been brought forward recently to deal with the surge.

Some have argued for shorter “circuit breaker” lockdowns or targeted closures, while others have advocated for rapid testing to weed out new infections.

Chagla says a targeted closure approach appears to be working in Ottawa, where the spread has slowed down recently. But that may not translate to other hotspots like Brampton, Ont., where the positivity rate in some neighbourhoods is close to 20 per cent.

A period of lockdown could alleviate some of the strain on hospitals and contact tracing capacities, he said. But how close to zero cases would we need to get to before restrictions could lift?

As long as Toronto’s case counts of COVID-19 are increasing, restrictions would remain, said Dr. Irfan Dhalla. (Craig Chivers/CBC)

Dhalla said it’s “less about a number than it is about the trajectory,” using Toronto’s daily average of 500 new cases as an example. As long as the number is increasing, restrictions would remain.

While Chagla concedes that a full lockdown is “likely on the table at some point,” he says we need to work harder this time to fix the root of transmission.

He estimates it would take five or six months of a full lockdown, while also boosting testing and tracing, for Canada to get to a truly zero state.

“I wish there was a simple answer to this,” he said. “But the thing is when you just do a lockdown and you don’t address problems in those communities, you’re going to see the same issues after the lockdown is over.”

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CBC | Health News

Intel Details XPU Strategy, Launches New Server GPU, OneAPI Gold

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Intel made several announcements as part of its unveil of OneAPI Gold and a new GPU product intended for the video processing / Android cloud gaming market.

First up: the new Intel Server GPU. This new instantiation of the Xe-LP architecture has four separate graphics chips and work in tandem to process video streaming workloads, video transcoding workloads, and as a solution for Android game streaming. Xe-LP is the same architecture Intel is shipping in the Xe Max and inside of Tiger Lake. Performance reviews of Tiger Lake chips have put it somewhat ahead of AMD’s Ryzen 4000 integrated GPU, and the Xe Max is the same chip that’s inside TGL laptops, just running at a higher clock speed.

“We are on a journey from CPU to XPU,” Intel SVP and manager of pretty much everything (architecture, graphics, and software) Raja Koduri told ExtremeTech on a recent call. “Our CPU architecture has built Intel and it also played its part to enable the entire world of computing, but we know the workloads have evolved and we are striving for mastery over additional XPU architectures that are super-efficient for graphics, media, and AI, memory, security, and networking.”

Like Xe Max in laptops, the Xe-LP chip Intel is launching today is aimed at media workloads more than gaming, though in this case, the company is talking up the solution as an Android gaming platform. Apparently, Intel is working with several companies, including Tencent and GameStream, to bring Android streaming services to market. Intel’s argument is that the Xe-LP makes an attractive partner to Xeon, allowing customers to standardize on all-Intel solutions for these products.

Intel can support 120 streams in a two-GPU configuration and possibly up to 160 simultaneous players depending on the game in question. Since each card has 4 GPUs, Intel is supporting 15 Android gamers per GPU at 30fps. Android games are not nearly as hardware intensive as PC titles, but 15 streams per GPU at 30fps still works out to a cumulative total of 450 frames per second. It’d be interesting to know how the company distributes the disparate streaming workloads across the card and between the two GPUs. It’s also possible that the user claims here are a bit optimistic, of course.

OneAPI Goes Gold

Intel’s other major announcement concerns its OneAPI initiative. OneAPI is a cross-standard programming model intended to standardize code development between various system components, including GPUs, FPGAs, and CPUs. Intel has always offered its own libraries and code development tools, and the company is leveraging that expertise to create an overarching framework for product development. Support for features like AVX-512 and DLBoost is baked-in, as you’d expect.

Intel has been talking about OneAPI for several years now, but the project has only just gone gold, with toolkit availability expected in December. Free versions will be available both locally and in the cloud, and Intel will immediately transition its Parallel Studio XE and Intel System Studio tool suites to OneAPI products.

OneAPI has generated a fair bit of news for Intel over the past few years, but it isn’t very clear if it’s changed Intel’s overall fortunes in the AI market. Until its high-end Xe cards are available, Intel is working with one hand tied behind its back, as far as AI performance is concerned. Even with AVX-512 and DLBoost, a modern Xeon server cannot match the raw performance of a GPU.

With OneAPI, Intel is building an infrastructure backend it helps will attract programmers to its platforms as new GPUs — not to mention consumer CPUs with AVX-512 support — roll out in mobile and desktop through 2021 and beyond. For those of you concerned about CUDA support, there’s already a backend built into the Data Parallel C++ compiler that allows DPC++ code to run on top of CUDA GPUs. DPC++ is Intel’s unifying language implemented in OneAPI that can address FPGAs, CPUs, and GPUs and any other compatible accelerators anyone brings to market.

This announcement seems to conclude Intel’s plans for GPU launches in 2020, which means we’ll have to wait until 2021 to see what the company brings to the table in consumer cards. Tiger Lake has impressed in mobile, which hopefully implies good things about the larger cards Intel will ship in 2021.

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ExtremeTechExtreme – ExtremeTech

How an all-Canadian division might work as part of an NHL return-to-play strategy

Having an all-Canadian division as part of its return-to-play strategy is one option being considered by the NHL, but experts say the league will probably still need to use hub cities to host games.

Deputy NHL commissioner Bill Daly told ESPN that the continued closure of the border between Canada and the U.S. due to the COVID-19 pandemic is a major factor impacting how the league will operate in the upcoming season.

“One possibility is to create a competition within the league among the Canadian clubs,” Daly said.

Earl Brown, a professor emeritus in biochemistry, microbiology and immunology at the University of Ottawa, said health officials are still battling to control the rising number of cases on both sides of the border.

“Given that there’s a resurgence of COVID … I think you are going to have to have the bubble concept going again,” Brown said.

“It becomes a possibility [for teams] to move from city to city, but it does create a lot of demand on NHL owners and franchises.”

WATCH | NHL analyst Dave Poulin discusses NHL’s next steps:

The NHL had zero cases in the bubble during the 2020 Stanley Cup Playoffs, but what’s next for the league? Andi Petrillo speaks with NHL analyst Dave Poulin. 6:03

Moshe Lander, a senior lecturer in the economics of sports, gaming and gambling at Concordia University, said both the NHL and NBA held successful playoffs using bubble cities. Meanwhile both Major League Baseball and the NFL followed a traditional scheduling format and were forced to reschedule games due to COVID outbreaks on teams.

“The fact is the NHL and the NBA have shown that putting people in one location, no travel, is effective,” Lander said. “Allowing players to move about is not effective. Once you start allowing people to escape a bubble, you’re inviting disruption.”

The NHL used bubbles in Toronto and Edmonton for its Stanley Cup playoffs. Players and support staff from the 24 teams were only allowed access to their hotel and the arena.

Over the 65 days of the playoffs,1,452 league and club personnel stayed in the bubble secure zones. A total of 33,394 COVID-19 tests were administered with zero positive results.

NHL commissioner Gary Bettman has said the league hopes to begin a new season Jan. 1. The league and the NHL Players’ Association plan to meet soon to discuss a return to play, although there has already been some dialogue between the two sides.

NHLPA executive Don Fehr has already said players will not support the idea of being isolated from their families for an entire season.

Lander said the NHL has a couple of options.

Modified bubble format?

The seven Canadian teams could make up one of four NHL divisions. Each division would have a hub city.

“You come into the bubble for say four weeks, you [play] 14 games, then everybody gets a two-week break,” said Lander.

Two of the divisions could be playing games while players in the other two return home. That would allow for a continuity of games on television.

WATCH | NHL reports no COVID-19 cases after 65 days in bubbles:

The Tampa Bay Lightning took home the Stanley Cup, but the NHL is also celebrating. There wasn’t a single positive COVID-19 test within the league’s bubble, which is being heralded as a win and as a model for sports going forward in the pandemic. 1:59

Brown said the players returning home would probably face some sort of quarantine or testing.

“The bubbles open up, so obviously you’re going to have to have some extra precautions,” he said.

Lander said in Canada, instead of playing all the games in one city, the bubble could be moved, similar to how the NCAA’s March Madness tournament shifts to different cities.

“So, let’s bubble in Vancouver for three weeks, put the seven Canadian teams there,” he said. “They can play like a double round-robin, take two weeks off, then bubble in Edmonton.”

NHL officials have said they must be flexible in their planning. The format used to begin the season might change over time.

With fans not allowed in arenas, it makes no sense for owners to open all 31 buildings. That could change if a vaccine is developed and COVID cases begin to drop.

One scenario then could see a team like Vancouver fly east and play two or three games over a week in Montreal.

Lander said owners will look for a format that mitigates their losses this year.

“It’s lose less,” he said. “Do you want to lose $ 20 million [US], or do you want to lose $ 50 million? Take your pick.”

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CBC | Sports News

Canadian Premier League ‘unanimously’ agrees on proposed strategy for 2020 season

It looks like Prince Edward Island will lead the way in Canada’s return to soccer, with the Canadian Premier League looking to possibly kick off its pandemic-delayed season in Charlottetown.

Vancouver Island is also in the running to host the Canadian pro league.

“Both are very excited about the Canadian Premier League,” said CPL commissioner David Clanachan.

The Canadian Soccer Association announced Friday that the sport can resume in P.E.I. and B.C., providing clubs compete the final phase of its “Return to Soccer Guidelines” which includes completing a “self-assessment tool.”

A Canada Soccer spokesman said amateur teams could resume training in P.E.I. as soon as this weekend with clubs in B.C. perhaps following next week.

The CPL, meanwhile, said Friday that its owners, clubs and player leadership had unanimously agreed on “the structure and concept of a proposed strategy on the possibility of a 2020 CPL season.”

WATCH | Is it too early for a return to sports?:

CBC Sports’ Jamie Strashin details the various return to play scenarios unfolding across the professional sports landscape. 2:52

Now they just need to nail down a venue, with P.E.I. and Vancouver Island the two leading candidates. That involves getting the approval of local health authorities.

“We feel very confident that our health and safety protocols are very stringent,” Clanachan said in an interview. “And I can say our players are pleased with what they’ve seen. it’s answered all their questions and more.”

‘Charlottetown is open for business’

Charlottetown raised its hand via a statement Friday.

“Charlottetown is open for business,” Mayor Philip Brown said in a statement. “I’m excited to be able to extend an invitation to the Canadian Premier League and its eight member teams to play their modified single-city season in the birthplace of Confederation — it doesn’t get any more Canadian than right here in Charlottetown

The P.E.I. government confirmed last month it had been approached by HFX Wanderers FC about having the CPL resume its season in the province.

Vancouver Island and Langford, B.C., home to the league’s Pacific FC, have also expressed interest.

Lisa Beare, B.C.’s minister of tourism, arts and culture, said she has been in contact with the CPL about hosting a shortened season in Langford.

“We are currently reviewing their proposal,” Beare said in a statement. “It would be great to see Canadian soccer being played on Vancouver Island this summer in a way that is safe for everyone.”

Like Major League Soccer, the CPL is looking at staging a round-robin tournament in one location. The hope is both leagues may be able to resume play in their own host cities at a later date.

“The problem with the world we live in today is everything is changing so quickly every day,” said Clanachan. “That could be very good news for us a few months from now or it could be bad news.

“I’m holding out hope that that [playing in home cities] could be the case. I think everybody is kind of hoping for that.”

League targets July resumption

The league was slated to kick off its second season on April 11 but has been on hiatus due to the global pandemic.

As of Friday, P.E.I. had 27 confirmed cases of COVID-19 and no deaths. Vancouver Island had 130 cases including five deaths.

The league is looking at starting mid- or late July with play going into September. Clanachan says it will be up to the local health authorities if teams would have to self-quarantine upon arrival.

The league has some experience in transporting its teams en masse, having taken them to the Dominican Republic for pre-season training prior to the 2019 inaugural campaign.

Canada Soccer says another two to four provinces could follow P.E.I. and B.C. in returning to play.

“Starting with the suspension of sanctioned soccer in March, countless hours of thoughtful and measured discussion and planning have gotten us to a place where we are confident we can once again provide a safe sport environment in areas of the country where the provincial and local governments have permitted a return to physical activities,” Canada Soccer general secretary Peter Montopoli said in a statement.

Different regions may opt for different rules in resuming the sport. Ontario, for example, could choose to return to play depending on region.

Pro teams are governed by their league’s return to play protocols, as well as local health and government authorities.

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CBC | Soccer News

National strategy needed to address grieving process ‘distorted’ by pandemic, coalition says

Tasha Jory, 37, struggles with what she calls “suspended grief” over her father’s death. 

Dale Hunter, who lived on a southwestern Manitoba farm near Belmont, died suddenly at home from a heart attack on April 20.

He was 60 years old.

Jory, who has lived in British Columbia for the past 12 years, got the news over the phone from her dad’s sister, a nurse in Brandon, Man.

“I keep having this running track in my head of memories, or just constantly thinking about him. Replaying that phone call back in my head when my aunt told me he was gone. So many sleepless nights in the beginning,” said Jory.

She spoke with her sister in Grand Prairie, Alta., trying to figure out how they would hold a funeral during the COVID-19 pandemic, during which large gatherings have been restricted.

They also knew they couldn’t travel back home to Belmont, even though that is what they desperately wanted.

We are social beings who crave social contact, human contact. These are being blocked during the pandemic and there will be fallout.– Paul Adams, Canadian Grief Alliance

Jory’s grandmother is self-isolating in her condo, and her grandfather, who is in a Brandon personal care home, can’t have visitors.

“A family member was unable to tell my grandfather his son died until my aunt, the nurse, was able to see him before a medical procedure,” said Jory.

“My grandparents couldn’t even be together to grieve. We couldn’t be with either of them…. We just felt helpless.” 

They considered holding a very small service for five people, or even gathering on Zoom. In the end that didn’t feel right. Her grandparents don’t have computers.

“There is a reason why we have funerals. I find it hard to get any type of closure,” said Jory. 

No ritual of funeral

She knows other families across the country are having a similar experience. 

“This is new ground we really don’t know how to tread,” said Jory.

Dr. Harvey Chochinov says her story illustrates what he calls “distorted” dying and grief caused by the pandemic — and he’s part of a new organization that says Canada needs a national strategy to deal with that grief.

Chochinov is a distinguished professor of psychiatry at the University of Manitoba. He is also the co-founder of the Canadian Virtual Hospice — an online resource on issues related to death, dying and bereavement that connects with more than 2.5 million people every year.

Winnipeg psychiatrist Harvey Chochinov is the co-founder of the Canadian Virtual Hospice — an online resource on issues related to death, dying and bereavement. (CBC)

“As a result of the physical distancing and public health restrictions upon visiting and holding funerals, the process of dying is being distorted. As a psychiatrist, what we are seeing and what we anticipate is that the process of grieving is also distorted,” said Chochinov.

He says not only has COVID-19 affected patients who have been infected with the illness and died, but the pandemic has also affected the process of dying for tens of thousands of people who are facing death from other causes.

Alliance born out of COVID

In response, the Winnipeg-based Canadian Virtual Hospice formed the Canadian Grief Alliance, gathering 36 leaders in grieving and bereavement from across the country. The group includes psychiatrists, psychologists, social workers and researchers.

In a proposal released earlier this month, the coalition asks the federal government to invest $ 100 million over the next three years for a national pandemic-related grief strategy — including specialized supports for front-line health-care workers and first responders suffering grief-related trauma.

Paul Adams is the spokesperson for the alliance. He says having a support network of family and friends around you is critical in moving through grief leading up to a funeral and in the days after. 

But now, people finding out about the death of their loved one when they can’t be physically present, he notes. They may be alone in an empty home when they get the news.

“We are social beings who crave social contact, human contact. These are being blocked during the pandemic and there will be fallout,” said Adams.

Jory is experiencing that first-hand.

“I found it more difficult to grieve, and kind of be able to get the emotions out that I know need to come out. I am struggling to fully grieve without being able to see my sister,” she said.

“It’s bizarre.… It’s a weird feeling.”

Grief ‘hangover’ coming

Chochinov says there is a price to pay emotionally and psychologically for not being able to be at the bedside of a dying loved one.

That leaves mourners unable to follow what he calls “the path of least regret.” They don’t know if their loved one died in pain, for example, or if someone wearing a latex glove held their loved one’s hand when they took their last breath.

“Those are the things that we feel need to be done for the people we love. None of that is available,” because of COVID-19, said Chochinov.

There are other layers of grief too, says Adams, such as health-care workers leaving the bedside of a deceased person, having to isolate from their own families at home and being expected to “suck it up” on the job.

“There is a limit to how much those on the front lines can hold in terms of grief, and I think there is going to be a hangover,” he said.

Grief manifested 

In addition to a national grief strategy, the Canadian Grief Alliance is also calling for a public awareness campaign focusing on coping strategies such as the Canadian Virtual Hospice’s MyGrief — an online resource that aims to help people work through the grieving process — and KidsGrief, which offers resources for parents helping a child dealing with death.

The group is also calling for $ 10 million dollars for research. Chochinov says because we are in unprecedented times in terms of grief and mourning, research needs to be done to determine the best way to address it in the wake of COVID-19.

Both Adams and Chochinov say if grief support isn’t available, the consequences could be devastating.

“Grief may be more protracted,” Chochinov said.

“It may be grief that becomes complex, meaning that some people may become depressed.”

That might manifest as anxiety, post-traumatic stress disorder, substance abuse or even thoughts of suicide, Chochinov said.

“There is a kind of train that starts moving if grief isn’t dealt with. It can turn into a mental health issue and down the road affect someone’s physical health,” said Adams.

In a written statement, Health Canada has confirmed it has received the Canadian Grief Alliance’s proposal.

It says the government’s recently rolled out $ 25-million Wellness Together Canada Portal — which provides online access to a range of mental health and substance abuse supports — can be used to help people work through their grief of losing a loved one.

Adams, though, says the federal government’s latest funding for mental health does not include money for grief support services.

“Mental health services do not see grief as their mandate,” he said.

Channelling grief

Tasha Jory says she suspects there are many others who need support in dealing with their grief.

“I am constantly replaying what has happened in my head. Missing my dad, who was so well known and loved in the community,” as well as a lifelong baseball fan and player, who was inducted into the Manitoba Baseball Hall of Fame in 2008.

Tasha Jory says her dad, a lifelong baseball player and fan, ‘was so well known and loved in the community.’ (Submitted by Tasha Jory)

Dale Hunter was cremated a week after his death. Jory and her family are waiting for the go-ahead to hold a memorial when everyone can meet at his farm to celebrate his life.

In the meantime, she has found a way to channel her grief.

“I sat down and wrote a letter to my sister. She did the same. We both wrote letters, which was super therapeutic. And then we shared our letters together.

“We kind of found our own way of working around the pandemic.”

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CBC | Health News

New Zealand’s COVID-19 ‘eradication’ strategy looks to be paying off

After more than a month confined to dry land without being immersed in the salt and sea, New Zealander Zen Wallis says it feels like he’s living in someone else’s body.

“It’s really strange to not go into the water,” the professional surfer told CBC News in an interview by Skype. “My skin feels different; my hair feels different.”

Surfing has been one of the casualties of New Zealand’s extreme COVID-19 lockdown introduced in mid-March, one of the most stringent virus-fighting regimes anywhere in the world.

Wallis, 28, runs a surfing school in Piha on New Zealand’s North Island, about 40 kilometres southwest of Auckland.

Coming at the tail end of the Southern Hemisphere’s summer, his classes would normally have been full, he says, and he’d have been in water for as long as there was daylight. 

The deserted beach in Piha, New Zealand, which is normally filled with surfers. (Luke Darby)

“It was an interesting call to make — to actually make [surfing] criminal,” he said.

But with the end of the prohibition on surfing and many other activities now just days away, Wallis says he feels the gains in New Zealand probably made the ban worthwhile.

“We may be able to open New Zealand back up if we can ‘crush’ this,” he said of the government’s stated goal of eradicating the infection.

Eradicate COVID-19

On Monday, Prime Minister Jacinda Ardern announced that what New Zealand calls its Category 4 measures — the most intense level — would last until end of day April 27, after which the country will revert to Category 3, a level with greater freedoms.

“We have done what few countries have been able to do — we have stopped a wave of devastation,” said Ardern,  who has received widespread praise both at home and abroad for taking early, decisive action against COVID-19.

“The number of cases that each person with the virus passes it on to is now 0.48, less than half a person each. Overseas, the average is 2.5 people, so we have among the lowest number of confirmed cases per 100,000 people in the world.”

As of Tuesday, the country of five million people had registered 1,445 cases and just 13 deaths, most of them in nursing homes.

The majority of those infected have also now recovered.

New Zealand Prime Minister Jacinda Ardern speaks to media March 13. ‘We have done what few countries have been able to do — we have stopped a wave of devastation,’ she said April 20. (Martin Hunter/Reuters)

For much of March and April, under the Category 4 lockdown, only essential trips to the grocery store and pharmacies were permitted, along with brief trips outside for exercise. Swimming at the beach — and surfing — were not designated as essential activities, and related businesses closed.

Stringent measures

The measures, in place since March 25, go significantly beyond what most Canadian provinces have brought in.

In British Columbia, for example, restaurants have been serving takeout food, many public parks and beaches have remained open, organizations such as Amazon and Canada Post have been making deliveries and some retailers have been able to continue with in-store sales as long as they abide by physical distancing guidelines.

Whereas most countries have focused on “flattening the curve” of cases to ensure health-care systems aren’t overwhelmed at the peak of infections, New Zealand’s government decided early on it would go a big step further and try to wipe out COVID-19 completely.

Siouxsie Wiles is a microbiologist and associate professor at the University of Auckland. (Siouxsie Wiles/Skype)

“It’s only a viable strategy if you do it early enough. It becomes harder to do it the longer you leave it,” said Siouxsie Wiles, an infectious disease expert at the University of Auckland.

Wiles, with striking, bright pink hair and an easy way of communicating difficult concepts, has become something of a national celebrity since the beginning of the epidemic with near daily appearances on local media.

Measles outbreak

In an interview with CBC News, she said one of the key considerations for Ardern’s government in adopting the strictest measures possible, was the interconnectedness the country has with many small Pacific islands that were in an extremely poor position to fight COVID-19.

“We saw last year in Samoa, when we exported measles, how absolutely devastating it was to them. They just don’t have the health-care system we have.”

Andrew Chang asks an infectious disease doctor whether it’s safer to be indoors or outdoors during the coronavirus pandemic. 1:02

In 2019, the small nation in the South Pacific registered almost 6,000 cases of measles resulting in 84 deaths. Scientists believe the disease was carried there by an infected patient who arrived on an Air New Zealand flight.

After April 27, Wiles says the plan is to keep New Zealand’s borders closed to international travellers and to carefully track every new COVID-19 case that turns up, seeking out and isolating anyone who had contact with the infected person.

“If your contact tracing and testing is good enough, then you can minimize outbreaks — you can find cases and stop that spread.”

The surfing community of Piha, on New Zealand’s north island, is a ghost town after an intense, one-month lockdown. (Luke Darby)

While New Zealand health officials have not released the raw data on their capacity to contact trace, several independent experts brought in as consultants have agreed with the Ardern government’s approach and that New Zealand is in a position to make contact tracing work.

Incomplete data

Opposition politicians, however, insist the lockdown could have ended even sooner if the government had been more forthright about its ability to monitor the spread of the virus.

“This is a real shame, as businesses will suffer further damage, and that will lead to poor health outcomes as a result of the huge stress this will cause for a lot of people,” said opposition National Party Leader Simon Bridges.

Practically speaking, Category 3 will leave New Zealanders freer than Canadians in some ways but not in others.

People will be able to extend their “bubble,” as health officials refer to it, by having caregivers or cleaners return to their homes, for example, as long as those workers don’t also visit other homes.

Schools will open for elementary and middle school students, but the expectation is that any student who is in a position to continue with online learning from home will do so.

Wallis is ready to get back in the water, having been beached for the past month because of COVID-19. (Luke Darby)

Industries such as construction and forestry will be allowed to resume. Restaurants will not be able to open up for table service, but takeout will be permitted.

And people will be able to head to the beach again to surf.

Relapse possible

After two weeks, if there is no COVID-19 relapse, the prime minister said the nation could move down to Category 2 by the middle of May, which would permit even greater freedoms.

Taiwan and South Korea have had similar success to New Zealand’s in cornering the virus, though Singapore, which was also seen as a textbook case, is now experiencing a dramatic second-wave of infections after initially relaxing its prohibitions.

Wiles says it is still too soon to know when international flights will resume to New Zealand but she says she expects the first steps may be to resume flying to other nations, such as Taiwan, or those in the South Pacific, that have also virtually wiped out the infection.

“We may end up having countries around the world that are these little islands that you could travel between,” she said. 

“Going forward, it’s an interesting thing how you maintain [a virus free status].”

All of that is heartening news for Zen Wallis, who is planning to be back in the water first thing once the surf ban is lifted.

“I’m psyched up. I am getting ready now,” he said.

Still, after that instant rush, he says, he worries about how long it will take his business and so many others to recover.

“I am sure people are going to want to surf, but obviously, there’s no tourism.”

“There’s going to be a hit … for a long time.”

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Toronto approves strategy to combat anti-vaccination as parents accuse city of ‘genocide’

Tensions flared at Toronto city hall on Monday as a large group of anti-vaccination parents protested against the city’s decision to adopt a new vaccination strategy.

The recommendation by Dr. Eileen de Villa, Toronto’s medical officer of health, calls for a new public health strategy to address “vaccine hesitancy.” It includes a proposal that would prevent students from skipping vaccines for non-medical reasons.

The growing movement against vaccines includes the reluctance or refusal to vaccinate due to concerns about possible side effects, including serious injuries and death.

Most of the recommendations will need to be approved by the provincial and federal governments.

The City of Toronto estimates that around 20 per cent of parents in the city are vaccine hesitant.

On Monday morning, the plan to combat that trend was unanimously approved by the Board of Health. 

The decision came after several Toronto residents vociferously demanded that the board reject the plan due to concerns that vaccinations are dangerous.

‘My body, my choice’

People attending the meeting shouted “shame” and “genocide” after the vote was taken.

“I do not consent to having myself nor my children force-vaccinated, drugged and medically induced in order to attend public schools in Canada,” said Emanuela Caires during her deputation.

“I am not willing to subject this type of harm over benign childhood illnesses,” added the mother of three unvaccinated children.

Catherine Condinho, an unvaccinated student, said the plan would take away her freedom of conscience and religion.

“This is my body, my choice,” she said to the cheers of supporters, who filled the meeting room and city hall’s atrium.

Elizabeth Kennedy, Nicolas Kaszap and their son, Sam, travelled from Ottawa to attend a rally against the proposed changes. (Evan Mitsui/CBC)

De Villa’s report includes a range of recommendations to “improve vaccine acceptance,” including removing exemptions, improving digital immunization records and developing a vaccine injury compensation fund.

The case for vaccinations

“Vaccines work, full stop,” said Board of Health chair Joe Cressy. “There is an abundance of scientifically proven evidence demonstrating just that.”

Most medical experts consider vaccinations safe and effective at preventing the spread of many harmful illnesses.

“Vaccination is one of the world’s greatest public-health achievements, along with sanitation, antibiotics and clean drinking water,” according to Health Canada.

Cressy pointed to recent measles outbreaks in Canada, the United States and Europe as proof that vaccine hesitancy has potentially dangerous outcomes.

He said the plan will help Toronto prevent similar outbreaks, rather than reacting to them after they occur.

“People have the fundamental right to believe what they want, but they do not have the right to endanger others,” Cressy added.

‘I’m not prepared to wait for an outbreak,’ said Joe Cressy, chair of Toronto’s board of health. (Martin Trainor/CBC)

Last year, 1.72 per cent of Toronto students did not receive mumps and rubella vaccines due to philosophical and religious exemptions, up from 0.8 per cent in 2007.

While answering questions from board members, de Villa acknowledged that serious reactions can occur after vaccines are administered, though those instances are rare.

“That doesn’t take away from the fact that [vaccines] are one of the most significant life-saving interventions that has occurred in medical history,” she said.

While the recommendations were unanimously approved Monday, the provincial government previously indicated that it has no plans to update provincial regulations.

Under the Immunization of School Pupils Act, children are required to have proof of immunization for certain diseases to attend school in Ontario, unless there is a “valid medical exemption or affidavit of conscience or religious belief,” said health ministry spokesperson Travis Kann.

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Are food politics defeating Canada’s healthy eating strategy?

This is an excerpt from Second Opinion, a weekly roundup of eclectic and under-the-radar 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 a tough few months for the Trudeau government’s signature healthy eating strategy — a series of legislative initiatives aimed at improving public health through better food choices.

The first casualty was the law to limit advertising of unhealthy food to kids. It died on the Senate order paper last month after heavy last-minute lobbying from industry.

Now another key part of the strategy appears headed for a cliff. Time is running out for proposed new rules that would require symbols on the front of food packages to alert consumers when a food product is high in salt, sugar or saturated fat.

“It’s a big concern for us that the two key pillars from the healthy eating strategy haven’t been completed,” said Manuel Arango, director of policy advocacy and engagement with Heart and Stroke.

I think the issue is heavy industry lobbying and, as a result, political will.​– Manuel Arango, of Heart and Stroke

His organization is one of the groups in the Chronic Disease Prevention Alliance of Canada, which last month sent a letter urging the federal government to finalize the front-of-packaging labelling rules.

What is taking so long?

“I think the issue is heavy industry lobbying and, as a result, political will,” said Arango. “The only thing we can surmise is the breadth and extent of the lobbying from the food and beverage processors has caused this delay.”

Canada’s Food Guide still under fire

At this point, the Canada Food Guide is the only major part of the Trudeau government’s ambitious food policy promises to be implemented. The food guide lacks any legislative force, but it is an influential public policy document for schools, hospitals and other facilities.

Yet it’s clear that it’s still a political flash point. 

This week, Conservative Leader Andrew Scheer told the Dairy Farmers of Canada — which objected to the Canada Food Guide’s reduced emphasis on dairy products — that if he wins the upcoming election, he would revise the guide.

The prime minister quickly hit back.

Canada’s food policy got political this week as leaders trade barbs over the country’s new food guide. (Chris Young/Canadian Press)

It’s evidence that food policy is a deeply political issue in Canada. 

There’s more proof here, in a three-year public database listing more than 300 meetings and correspondence between Health Canada and the various stakeholders jostling for influence as bureaucrats drafted the new laws around the healthy eating strategy.

Mary L’Abbé, a nutrition expert at the University of Toronto, searched that database last month to see who was talking to the government about front-of-label packaging.

“Three-quarters of the comments and meetings that the government had were with food industry members,” L’Abbé said. “So that just says three-quarters of the people that they’re hearing from — who’ve been in and out of ministers’ offices and with senior officials — are with the food industry.”

As a food policy researcher, L’Abbé attended several stakeholder meetings with Health Canada and made a written submission in support of the legislation. 

“I’m still hopeful that it’s not dead,” said L’Abbé. “A huge amount of work went into it, a huge amount of consultation.”

‘It’s in the hands of the politicians’

There’s been no official word from Health Canada on the status of the rules. But one food industry lobbyist said Health Canada officials told her that it’s now up to the politicians.

“I’m in regular contact with them; I did meet with them last month,” said Michi Furuya Chang, senior vice-president of public policy and regulatory affairs for the Food and Consumer Products of Canada (FCPC). 

The FCPC, which represents food processors, is one of the industry groups that has been talking to Health Canada about the food-labelling legislation.

“What they said to me the last time is, ‘It’s out of our hands. The package is complete,'” said Furuya Chang. “They’re also in waiting mode. It’s really in the hands of the politicians and Treasury Board to sign off on publication.”

Nutrition policy expert Mary L’Abbé is concerned about the fate of new rules that would require symbols on the front of food packages to warn consumers about high levels of salt, sugar and saturated fat. (CBC)

There’s a risk that the whole process might have to start from scratch if the government doesn’t act soon.

Furuya Chang said that, according to government rules, the final regulations need to be published within 18 months of the first regulations. Those were published on Feb 10, 2018.

“Our understanding is that if Health Canada does not publish these final regulations by mid-August, so next month, Health Canada would be required to restart the entire consultation process,” said Furuya Chang.

A Health Canada spokesperson told CBC News in an email that the agency is still “considering all feedback and evidence” after “extensive consultations over the past several years.”

Front-of-package labels common around the world

For the last 30 years, many countries have passed front-of-package labelling rules using symbols, such as traffic lights or stop signs, to encourage consumers to purchase healthier food.

In Canada, processed food packages currently have a nutrition facts table on the back. But L’Abbé said some consumers are confused by that system. 

“It’s adding up that all of the symbols work better than the nutrition facts table for helping consumers understand the information and use it,” she said. “They actually purchase healthier foods.”

Health Canada released some prototypes of the labels in 2018, though the final design has not yet been released.

Health Canada previously released four proposed designs for a new front-of-package label for food and beverage packaging. The final designs have not yet been published. (Health Canada/CBC)

The label is one aspect that the FCPC lobbied to change, Furuya Chang said.

“The size of what they had proposed and the placement of it would have completely interrupted the branding of the product,” she said. “So some flexibility was the underlying message and theme throughout our feedback submissions.”

“We know that both of these measures — the front-of-pack labelling and the marketing to kids — are huge measures with a lot of teeth that would have a huge impact in terms of improving the health of kids over the long term and, in fact, helping all Canadians,” said Arango.

“Of course, it’s disappointing after all that effort that two of these big measures have not been done.”

Canada’s ban on trans fat, which took almost 15 years and three prime ministers to finally pass, was also included in the current government’s healthy eating strategy.

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Federal health minister releases $50M dementia strategy

The federal government released a national strategy on dementia on Monday that focuses on preventing the affliction, supporting caregivers and finding cures.

According to federal statistics, more than 419,000 Canadian seniors have been diagnosed with some form of dementia, and they rely on an average of 26 hours a week of help from relatives and friends.

Most people with dementia and most caregivers are women.

Mental decline can have many different causes but there are few treatments and those that exist don’t do much but slow dementia’s progression.

Prevention is a major emphasis in the $ 50-million strategy, with the government hoping that if Canadians get more exercise, eat better and don’t smoke, they’ll avoid dementia causes such as strokes.

The government also wants help to be more readily available to caregivers and make them more willing to ask for it.

“By working together with all orders of government and different sectors to implement this strategy, we can advance prevention and treatment efforts, and improve the quality of life for those living with dementia as well as their families and caregivers,” Health Minister Ginette Petitpas Taylor said in a statement. 

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WHO advisers recommend changes in Ebola vaccine strategy

The World Health Organization’s strategic advisory group (SAGE) of vaccine experts have recommended speeding up vaccinations to tackle the Ebola outbreak in Congo, the WHO said on Tuesday.

The changes include cutting the dose of the existing Merck vaccine, expanding the population eligible for vaccination, introducing targeted geographic vaccination where appropriate, and introducing a second experimental vaccine developed by Johnson & Johnson.

More than 111 000 people have been vaccinated in Congo since the outbreak was declared in August 2018.

The existing vaccine, originally developed in Canada is “highly efficacious,” WHO said, but the number of new cases continues to rise in part as violent incidents continue to hamper the ability of responders to identify those infected and vaccinate contacts at risk of contracting Ebola.

“We know that vaccination is saving lives in this outbreak,” WHO Director-General Dr. Tedros Adhanom Ghebreyesus said in a statement. “We also know that we still face challenges in making sure the contacts of every case receive the vaccine as soon as possible. These recommendations account for ongoing insecurity and incorporate feedback from experts and from the affected communities that will help us continue to adapt the response.”

Besides vaccinating contacts and contacts of contacts, the panel also now recommends giving the shot to people in villages and neighbourhoods where cases have been reported within the past 21 days. Doing so increases access to vaccination in the broader community and may improve community acceptance of the vaccine and other control measures, they said.

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