China’s ceremonial legislature on Thursday endorsed the Communist Party’s latest move to tighten control over Hong Kong by reducing the role of its public in picking the region’s leaders.
The measure adds to a crackdown against protests in Hong Kong since 2019 calling for greater democracy. That has prompted complaints Beijing is eroding the autonomy promised when Hong Kong return to China in 1997 and hurting its status as a global financial centre.
The National People’s Congress voted 2,895-0, with one abstention, to endorse changes that would give a pro-Beijing committee power to appoint more of Hong Kong’s lawmakers, reducing the number elected by the public. Delegates routinely endorse party plans by unanimous vote or overwhelming majorities.
President Xi Jinping and other party leaders sat on stage in front of delegates as they cast votes electronically. The NPC has no real powers but the party uses its brief annual meeting, the year’s highest-profile political event, to showcase major initiatives.
The changes in Hong Kong would give a pro-Beijing committee power to appoint more of its lawmakers, reducing the number elected by the public. Details have yet to be announced, but Hong Kong news reports say the committee might pick one-third of lawmakers.
The mainland government has rejected complaints it is eroding Hong Kong’s autonomy and says the changes are necessary to protect the region’s stability.
Also Thursday, the NPC endorsed the ruling party’s latest five-year development blueprint. It calls for stepping up efforts to transform China into a more self-reliant technology creator — a move that threatens to worsen strains with Washington and Europe over trade and market access.
Last year, the party used the NPC session to impose a national security law on Hong Kong in response to the protests that began in 2019. Under that law, 47 former legislators and other pro-democracy figures have been arrested on subversion charges that carry a possible maximum penalty of life in prison.
On Sunday, Foreign Minister Wang Yi defended the changes in Hong Kong as needed to protect its autonomy and defend its “transition from chaos to governance.”
Every asteroid that falls to Earth is a potential window into the origins of the solar system, but scientists have stumbled upon something quite strange when studying a fragment of the Almahata Sitta asteroid. It contains evidence of a huge, previously unknown object in our solar system — perhaps a long since destroyed dwarf planet.
The Almahata Sitta asteroid collection consists of about 600 fragments, all of which rained down on Sudan in 2008 when the space rock known as 2008 TC3 exploded. This was the first-ever asteroid impact correctly predicted by scientists, giving teams on the ground the chance to swoop in and collect a great deal of material from the 4-meter (13-foot) object.
Planetary geologist Vicky Hamilton led a new analysis of the Almahata Sitta material at the Southwest Research Institute. Hamilton’s team received a 50-milligram sample of the asteroid (AhS 202) for testing. They mounted and polished the tiny shard and used an infrared microscope to examine its composition. Inside AhS 202, the team found something unexpected — an extraordinary rare hydrated crystal known as an amphibole. This simply should not have been part of 2008 TC3.
These silicate crystals only form from prolonged exposure to high pressure and temperatures, which would never happen in a space rock like 2008 TC3 or other similarly sized carbonaceous chondrite meteorites. According to the study, the only conclusion that fits with what we know about amphiboles is that 2008 TC3 was once part of a much larger object. Researchers estimate the parent body was about as large as the dwarf planet Ceres, which measures 939 kilometers (583 miles) in diameter.
Micrograph showing amphibole crystals, in orange.
Obviously, we haven’t lost track of any planet-sized rocks drifting around the inner solar system. It’s theoretically possible there is still an undiscovered Ceres-sized asteroid in the outer solar system that spawned 2008 TC3, but that’s an outside chance. The researchers believe it more likely the parent body has long since crumbled into debris. And if that happened once, it might have happened numerous times.
The study concludes that the Almahata Sitta fragments could provide a glimpse of a previously unknown phase in the formation of our solar system. This mysterious dwarf planet existed long enough to leave its geological mark, and then it went to pieces for some reason. That’s something we probably want to understand better.
Manitoba reported 16 additional deaths on Tuesday, a new daily high in a province that has been struggling with growing COVID-19 case numbers.
“This is a tragedy for all Manitobans,” Dr. Brent Roussin said Tuesday after reading a list with the ages and communities of those who died.
“We know that these are much more than numbers. These are people who are missed right now.”
Manitoba, which has seen a total of 328 deaths, reported 283 new COVID-19 cases on Tuesday — the first time in more than a week that the new case number in the province dropped below 300.
Roussin said that while numbers aren’t “climbing rapidly,” they still aren’t where the province needs them to be.
“These numbers are still too high for us to sustain.”
The province’s health-care capacity is “being pushed” he said, noting that hospitals are reaching capacity and health-care workers are overwhelmed.
As of Tuesday, there were 338 people hospitalized, with 48 in intensive care.
What’s happening across Canada
As of 11:20 a.m. ET on Wednesday, Canada’s COVID-19 case count stood at 386,716, with 66,834 of those considered active cases. A CBC News tally of deaths based on provincial reports, regional health information and CBC’s reporting stood at 12,287.
British Columbia also reported 16 additional deaths on Tuesday, bringing the provincial death toll to 457. Health officials in the province reported 656 new cases of COVID-19 and said there were 336 people in hospital, including 76 in intensive care.
Faced with rising case numbers, Provincial Health Officer Dr. Bonnie Henry and Health Minister Adrian Dix reiterated their plea for people to follow rules put in place to try and slow the spread of the virus.
“Without exception, follow the provincial health officer’s orders in place,” the pair said in a statement. “Remember that events, which refer to anything that gathers people together — whether on a one-time, regular or irregular basis — are not allowed for now.”
WATCH |COVID-19 returns to B.C. nursing homes, death toll rises:
British Columbia has seen more COVID-19 deaths over the past two weeks than the preceding two months because the virus has found its way back into nursing homes. And with long-term care workers exhausted and families frustrated, it’s not clear what can be done. 1:54
In Alberta, health officials announced 10 additional deaths and 1,307 new cases of COVID-19 on Tuesday. Hospitalizations stood at 479, with 97 people in intensive care.
Dr. Deena Hinshaw, the province’s chief medical officer of health, said a decision around what sort of restrictions will be in place over the holidays is expected later in the month.
“However, in the past we have seen holiday gatherings lead to increases in cases and outbreaks as one case spreads to many,” Hinshaw said, pointing to the ongoing impact of Thanksgiving gatherings.
“This is not going to be the year for in-person office parties,” she said. “This is not going to be the year for open houses, or large dinners with friends and extended family.”
In Saskatchewan, health officials reported 181 new cases of COVID-19 and four additional deaths, bringing the provincial death toll to 51.
The province’s minister of corrections said she doesn’t know how COVID-19 arrived in the Saskatoon Correctional Centre, which is dealing with a growing outbreak that has led to well over 100 cases among inmates, as well as several infections among staff.
Ontario on Wednesday reported 1,723 new cases of COVID-19, with 500 cases in Peel Region and 410 in Toronto. Health Minister Christine Elliott said in a tweet that 44,200 tests had been completed.
Health officials also reported 35 additional deaths, bringing the provincial death toll to 3,698.
Hospitalizations increased to 656, with 183 people in intensive care units, according to a provincial dashboard.
Hospitalizations increased to 740, with 99 patients being treated in intensive care units.
Premier François Legault warned Tuesday that the province’s plan to allow gatherings for four days around Christmas is at risk as the number of hospitalizations in the province reached their highest level since June.
“We’re not going in the right direction,” Legault said at a press conference in Quebec City. “If hospitalizations continue to increase, it will be difficult to take that risk.”
WATCH | What doctors are learning about COVID-19 ‘long-haulers’:
Researchers are learning more about why some people who get a mild case COVID-19 end up experiencing other symptoms for months. Doctors say these so-called known as long-haulers often have symptoms that resemble a common blood circulation disorder known as POTS. 4:10
In Atlantic Canada, Nova Scotia reported 10 new cases of COVID-19 on Tuesday, New Brunswick reported seven cases and Newfoundland and Labrador reported one new case. There were no new cases in Prince Edward Island.
There were 11 new cases of COVID-19 reported on Wednesday in Nunavut, which is at the end of a two-week lockdown period that covered the entire territory. All of the new cases were reported in Arviat, where tight public health restrictions are still in effect.
Nunavut reports 11 new cases of COVID-19, all in Arviat.<br><br>Meanwhile, the total number of active cases continues to drop, now down to 80.<br><br>GN to hold a news conference at the top of the hour. <a href=”https://t.co/hcz7NmmAs7″>pic.twitter.com/hcz7NmmAs7</a>
The Northwest Territories and Yukon had no new cases on Tuesday.
What’s happening around the world
From The Associated Press and Reuters, last updated at 9:55 a.m. ET
WATCH | COVID-19 vaccine rollout — What the experts say:
As of early Wednesday morning, there were nearly 64 million reported cases of COVID-19 worldwide with more than 41.1 million of those listed as recovered or resolved, according to a tracking tool maintained by U.S.-based Johns Hopkins University. The global death toll stood at more than 1.4 million.
In Europe, British regulators insisted that “no corners have been cut” during the assessment of the COVID-19 vaccine developed by American drugmaker Pfizer and Germany’s BioNTech, which was cleared for emergency use on Wednesday.
In a briefing after the U.K.’s Medicines and Healthcare Products Regulatory Agency became the first regulator worldwide to approve the vaccine, its chair, Dr. June Raine, said the public can be “absolutely confident” that its standards are equivalent to those anywhere around the world.
Regulators also revealed the order by which the vaccine will be rolled out across the country over the coming weeks and months, beginning next week. The U.K. has ordered around 40 million doses of the vaccine, which can potentially immunize 20 million people as two doses are required.
Residents in nursing homes and their care givers will be offered the vaccine first, followed by those 80 and over and front-line health- and social- care workers. From there, the priority plan largely follows age groups.
According to Munir Pirmohamed, chair of a medicines panel, immunity begins seven days after the second dose.
British lawmakers approved new coronavirus restrictions in England that take effect Wednesday but many Conservative lawmakers are unhappy about the economic consequences.
Russia and Germany both reported record numbers of daily coronavirus deaths, with 580 deaths reported in Russia and 487 in Germany.
With more than 2.3 million infections, Russia has the fourth-largest number of COVID-19 cases in the world behind the United States, India and Brazil.
President Vladimir Putin ordered Russian authorities on Wednesday to begin mass voluntary vaccinations against COVID-19 next week as Russia recorded 589 new daily deaths from the coronavirus. Russia will have produced two million vaccine doses within the next few days, Putin said.
In the Asia-Pacific region, South Korean officials are urging people to remain at home if possible and cancel gatherings large and small as around half a million students prepared for a crucial national college exam.
Vice Education Minister Park Baeg-beom says the 490,000 applicants so far include 35 virus carriers who will take exams Thursday at hospitals or treatment shelters. Education authorities have also prepared separate venues for some 400 applicants currently under self-quarantine.
Applicants will be required to wear masks and maintain distance from each other. They will be screened for fever and take exams separately if they have symptoms.
Pakistan reported 75 new COVID-19 deaths Wednesday, one of the highest fatalities from coronavirus in recent months, prompting government to launch a week-long campaign beginning Saturday to urge people to wear masks.
The government, however, has ruled out re-imposing a nationwide lockdown to contain the spread of the virus, which has killed 8,166 people and infected 403,311 in Pakistan.
Pakistan flattened the curve in August but currently it is facing a lethal new surge of infections.
In the Americas, U.S. health officials are pleading with Americans to follow their recommendations.
In Colorado, Gov. Jared Polis joined the nation’s top infectious disease expert Tuesday and urged people to wear masks and physically distance to help prevent stay-at-home orders and overwhelmed hospitals as cases of the coronavirus surge during the holidays.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and a member of the White House’s coronavirus task force, warned during a virtual news conference that Colorado is not alone in seeing a spike in cases and pleaded with people not to travel or gather in large groups.
“If you look across the United States, we are really in a public health crisis right now because we are having a surge the likes of which is worse than the surges that we all saw in the late winter, early spring,” Fauci said.
He noted that “we are likely going to see a surge upon a surge” of cases, based on the number of people who travelled and gathered for Thanksgiving and on those who are expected to shop and attend holiday parties before celebrating Christmas and New Year’s in large groups.
Colorado has been hit with a substantial spike in COVID-19 cases, with one in 41 residents believed to be contagious.
Indigenous people, health workers and those aged 75 years and older will be at the front of the line to be vaccinated, Brazil’s Health Ministry said as it unveiled a four-stage preliminary plan for national immunization.
In Mexico, the government was expected to sign a contract on Wednesday with pharmaceutical company Pfizer for the delivery of its vaccine.
In Africa, South Africa’s reported COVID-19 case numbers stood at more than 792,000 on Wednesday. The country, which has seen more reported cases than any other nation in Africa, has seen more than 21,000 deaths.
Iran, the hardest-hit nation in the Middle East, was approaching 990,000 cases of COVID-19 and 49,000 deaths.
Racism, stereotyping and discrimination against Indigenous peoples in the B.C. health-care system are widespread and can be deadly, according to the findings of an independent investigative report.
The investigation was led by former judge Mary Ellen Turpel-Lafond, who released her report, titled In Plain Sight, on Monday.
“We have a major problem with Indigenous-specific racism and prejudice in B.C. health care,” she said.
The report weaves first-hand accounts from patients, witnesses and health-care workers through 11 key findings, followed by two dozen recommendations for change.
Nearly 9,000 people participated in the investigation.
Eighty-four per cent of Indigenous people who participated reported experiencing some form of discrimination in health care. More than half of the Indigenous health-care workers who participated said they had personally experienced racism at work.
“I am afraid to go to any hospital. When I do have to, I dress up like I’m going to church,” states a young Indigenous woman quoted in the report.
An Indigenous doctor is quoted as saying: “I have been asked to look after my ‘drunk relatives’ in the ER or have had Indigenous patients [who were considered difficult patients] reassigned to me on the wards when I was a resident.”
The report also sheds light on how current efforts in education and training are inadequate and why more Indigenous peoples are needed in health leadership and decision-making positions.
Turpel-Lafond was asked to lead the investigation after it was revealed that hospital emergency staff were allegedly playing a “game” where they would guess the blood-alcohol content of Indigenous patients.
She was asked to look into those allegations but also to report more broadly on the range and extent of Indigenous-specific racism in the provincial health-care system.
The investigative team was not able to substantiate allegations about the “game” being played in emergency rooms.
They did find, however, “extensive profiling of Indigenous patients based on stereotypes about addictions.”
Assumptions about substance use were among the many stereotypes the report found were commonly ascribed to Indigenous patients. The investigation then linked how stereotypes can lead to discriminatory care and how this can harm one’s health.
‘Stereotypes kill,’ nurse practitioner says
“Those stereotypes kill,” said Tania Dick, a nurse practitioner and member of the First Nations Health Council.
She recounted the death of her aunt as one such example.
She said her aunt was taken to an emergency room after falling and hitting her head. But when she arrived, Dick said health-care staff assumed she was intoxicated.
By the time they realized something serious was going on, Dick said it was too late. She said her aunt — who was experiencing a brain bleed — died while being transferred to a major regional hospital.
Dick said she knows her aunt’s experience isn’t an isolated incident.
“Almost every community I go to has that same sort of story,” she said. “It just breaks my heart.”
She said it’s emotional seeing Turpel-Lafond’s report and to see top government officials “shining a light on what we’re living on a day-to-day basis.”
Indigenous people participated in the investigation by sharing directly with investigators by phone, email and via an online survey. Nearly 2,800 people filled out the Indigenous Peoples’ survey.
Health-care workers were also encouraged to participate through an online survey and by making direct contact with the investigative team. More than 5,000 health care workers filled out the online survey.
Health minister apologizes
B.C. health minister Adrian Dix called the work of Turpel-Lafond’s team “extraordinary.”
“Racism has made B.C.’s health-care system an unsafe place for many Indigenous peoples to access services and the care they need,” he said Monday.
WATCH | Adrian Dix apologizes after report finds widespread racism in health-care system:
Health Minister Adrian Dix has apologized and promised action on the recommendations from an independent investigation into anti-Indigenous racism in the health-care system. 0:55
He promised action and apologized.
“I want to make an unequivocal apology as the minister of health to those who’ve experienced racism in accessing health-care services in British Columbia now and in the past,” he said.
Dix said he will appoint an associate deputy minister to lead a task force responsible for implementing the recommendations, which include legislative, policy and structural changes focused on changing systems, behaviours and beliefs.
Action needed, Indigenous leaders say
Indigenous leaders were quick to respond to the report on Monday — emphasizing the need for action on the recommendations.
“We have known for years that the healthcare system in this province treats First Nations people with disrespect and discrimination,” wrote Terry Teegee, B.C. regional chief of the Assembly of First Nations, in a news release.
“Now, thanks to Mary Ellen Turpel-Lafond and her team, we have the proof of this deep seated, systemic and horrific racism within the health-care system.”
The Association of Nurses and Nurse Practitioners of BC also responded to the report on Monday. In a news release the association thanked Turpel-Lafond for her investigation, acknowledged the findings and committed to responding directly to the recommendations.
“It is our responsibility to work to eradicate the conditions that perpetuate systemic racism,” the association wrote.
Health officials in British Columbia are warning of increasing strain on the health-care system as COVID-19 hospitalizations hit 209 — the highest they’ve been in the province since the global pandemic began.
The province reported 762 new cases of COVID-19 and 10 additional deaths on Wednesday, with the majority of the cases concentrated in the densely populated Lower Mainland.
“This second surge is putting a strain on our health-care system, our workplaces and us all,” said a statement from Provincial Health Officer Dr. Bonnie Henry and Health Minister Adrian Dix.
“We need a pan-Canadian approach to travel,” Horgan said. “That is, the people of Quebec and Ontario and Manitoba need to know that they should stay in Quebec, Ontario and Manitoba until we get to a place where we can start distributing a vaccine across the country.”
In neighbouring Alberta, the chief medical officer of health warned on Wednesday that if the province doesn’t change its current COVID-19 trajectory the “implications are grim.”
“This is deadly serious. I have asked for kindness but I also ask for firmness,” Dr. Deena Hinshaw said. “The need to control our spread and protect our health system is why I ask everyone, anywhere in the province, to abide by all public health measures.”
What’s happening across Canada
Canada’s COVID-19 case count — as of early Thursday morning — stood at 311,110, with 51,603 of those considered active cases. A CBC News tally of deaths based on provincial reports, regional health information and CBC’s reporting stood at 11,186.
In Saskatchewan, health officials reported one additional death and 132 more COVID-19 cases on Wednesday, bringing the number of active cases in the province to 2,099.
The province recently stepped up its public health regulations, making masks mandatory in indoor public spaces and limiting the number of people allowed at private indoor gatherings to five.
WATCH | Suffering through a COVID-19 lockdown in long-term care:
Months of isolation in her Saskatchewan long-term care facility brought Chelsea Dreher to the brink of suicide. As the province restricts care home visitors again, she shares her story with CBC News. 2:02
Manitoba’s top doctor said Wednesday it’s a “very daunting time” in the province as health officials announced 11 additional deaths and 400 more cases of COVID-19. Hospitalizations in the province hit 249, with 40 in intensive care.
Dr. Brent Roussin said in recent days contract tracers have dealt with hundreds of cases that don’t have a known source of exposure to the novel coronavirus.
In Nunavut, health officials reported 10 additional cases on Wednesday, bringing the number of confirmed cases to 70.
“This is it, folks — it’s time to take a stand and fight against COVID-19,” Premier Joe Savikataaq said as he provided an update on the first day of a two-week lockdown.
WATCH: Concerns about health-care access as Nunavut enters COVID-19 lockdown:
Nunavut has begun a two-week lockdown, after COVID-19 cases more than doubled this week. There are fears the virus will overwhelm the territory’s fragile health-care system. 2:03
Quebec on Wednesday reported 1,179 new cases of COVID-19 and 35 more deaths attributed to the novel coronavirus, including eight that occurred in the past 24 hours.
Health officials said hospitalizations increased by 14, to 652, and 100 people were in intensive care, the same number as the prior day.
In Atlantic Canada, there were nine new cases of COVID-19 reported in New Brunswick, with five of the new cases in the Moncton area.
There were three new cases reported in Nova Scotia and two new cases reported in Newfoundland and Labrador. In Prince Edward Island, which has just three active cases, there were no new cases reported.
What’s happening around the world
WATCH | Pfizer’s COVID-19 vaccine heads into approval phase:
Pfizer is preparing to formally ask for emergency use authorization for its vaccine in the U.S., after new data showed it’s safe and 95 per cent effective. The vaccine’s approval in Canada could come within the next couple of months. 4:04
From The Associated Press and Reuters, last updated at 10:10 a.m. ET
As of early Thursday morning, there were more than 56.3 million reported cases of COVID-19 worldwide, with more than 36.2 million of those cases listed as recovered, according to a COVID-19 tracking tool maintained by Johns Hopkins University. The global death toll stood at more than 1.3 million.
A day after an update from Pfizer about its potential COVID-19 vaccine, AstraZeneca and Oxford University’s potential COVID-19 vaccine produced a strong immune response in older adults, data published on Thursday showed, with researchers expecting to release late-stage trial results by Christmas.
In the Americas, long lines to get tested have reappeared across the U.S. ahead of the Thanksgiving holiday — a reminder that the nation’s strained testing system remains unable to keep pace with the virus.
The delays are happening as the country braces for winter weather, flu season and holiday travel, all of which are expected to amplify a U.S. outbreak that has already swelled past 11.5 million cases and 250,000 deaths.
Conditions inside the nation’s hospitals are deteriorating by the day as the coronavirus rages across the U.S. at an unrelenting pace.
“We are depressed, disheartened and tired to the bone,” said Alison Johnson, director of critical care at Johnson City Medical Center in Tennessee, noting that she drives to and from work some days in tears.
The number of people in the hospital with COVID-19 in the U.S. has doubled in the past month and set new records every day this week. As of Tuesday, nearly 77,000 were hospitalized with the virus.
The out-of-control surge is leading governors and mayors across the U.S. to grudgingly issue mask mandates, limit the size of private and public gatherings ahead of Thanksgiving, ban indoor restaurant dining, close gyms or restrict the hours and capacity of bars, stores and other businesses.
New York City’s school system — the nation’s largest, with more than one million students — suspended in-person classes Wednesday amid a mounting infection rate, a painful setback in a corner of the country that suffered mightily in the spring but had seemingly beaten back the virus months ago.
Texas is rushing thousands of additional medical staff to overworked hospitals as the number of hospitalized COVID-19 patients statewide accelerates toward 8,000 for the first time since a deadly summer outbreak.
Meanwhile, in Uruguay, a relatively coronavirus-free zone in hard-hit Latin America, health officials are starting to see a worrying rise in cases.
The African continent has surpassed two million confirmed cases as the top public health official warned Thursday that “we are inevitably edging toward a second wave” of infections.
The Africa Centers for Disease Control and Prevention said the 54-nation continent had crossed the milestone. Africa has seen more than 48,000 deaths from COVID-19. Its infections and deaths make up less than four per cent of the global total.
In Europe, Russia on Thursday surpassed two million cases after reporting an additional 23,610 infections and 463 deaths related to COVID-19, both record daily rises.
WATCH | Inside a Moscow COVID-19 ward:
A well-equipped, high-tech COVID-19 ward set up inside a Moscow convention centre is a stark contrast to the overwhelmed hospitals elsewhere in Russia. CBC News got a first-hand look at the facility and found out what’s creating the disparity in health care. 6:34
Ukraine registered a record of 13,357 new cases in the past 24 hours, while the number of deaths also hit a new high.
In the Asia-Pacific region, the leader of the small Pacific nation of Samoa appealed for calm Thursday after the country reported its first positive test for the coronavirus, although a second test on the same patient returned a negative result.
Prime Minister Tuilaepa Sailele Malielegaoi addressed the nation live on television and radio, urging people to remain vigilant with their virus precautions.
Samoa was among a dwindling handful of nations to have not reported a single case of the virus.
According to the Samoa Observer, the prime minister said the patient was a sailor who had been staying in a quarantine facility since flying in from New Zealand on Friday. He said the sailor returned a positive test four days after arriving, but then a second test on Thursday returned a negative result.
Tokyo raised its coronavirus alert to the highest level as the city’s daily tally of new infections rose to a record 534, while daily cases in Japan also hit a new record of 2,259.
Chinese President Xi Jinping is calling for closer international co-operation on making a vaccine for the coronavirus available.
“To beat the virus and promote the global recovery, the international community must close ranks and jointly respond to the crisis and meet the tests,” Xi said in an address delivered via video at an event at the Asia-Pacific Economic Co-operation forum.
Chinese companies Sinovac and Sinopharm are in the late stages of testing vaccines, putting them among nearly a dozen companies at or near that level of development. That has introduced both commercial and political competition among countries and companies to be the first to offer a solution to the pandemic.
In the Middle East, Iran on Wednesday said it registered 13,421 new infections in 24 hours, a new daily record. The country has reported more than 800,000 cases and more than 42,000 deaths.
Rose Foy was already worried that her son-in-law was having quadruple bypass surgery.
The 48-year-old husband of Foy’s daughter has long suffered from health problems, including a stroke five years ago and a heart attack earlier this fall.
After his five-hour, open-heart procedure on Nov. 10, Foy’s concerns grew: scans showed her son-in-law had a popped internal stitch. Then, on his fourth day recovering at Toronto General Hospital, he was discharged.
Staff told her daughter the hospital was getting ready for an influx of COVID-19 patients, Foy said.
“I can’t believe I had to drive him home so soon,” she recalled, adding that at every bump on the highway ride to her son-in-law’s Oakville, Ont., home, he would cry out in pain.
The family’s experience comes as Ontario hospitals are increasingly facing a juggling act.
That’s leaving patients and their families coping with a range of concerns, from fears over another shutdown of elective procedures, to ongoing booking delays, to what Foy sees as a hasty discharge for a loved one who did make it into a hospital.
The family was initially told her son-in-law would be in intensive care for two to three days, Foy explained, plus another four to five days in a cardiac unit.
“He had serious surgery. He needed to be in that hospital for at least a few days more,” she said. “You can’t just discharge people because of COVID.”
A visibly frustrated Premier Doug Ford said an announcement is coming Friday concerning Ontario COVID-19 hot spots. Health experts can only do so much and if people don’t listen to their advice, Ford said he won’t hesitate to issue lockdowns in order to protect the public. 3:08
‘Stress on the system’
According to a spokesperson for Toronto General, “discharge planning” at the hospital remains the same, timing can vary and no patient is sent home without a physician signing off.
But it’s clear that, more broadly, some Ontario hospitals and intensive care units are increasingly under strain.
“We’re trying to do more than normal and still make room for COVID,” said Dr. Niall Ferguson, head of critical care medicine for the University Health Network and Mount Sinai Hospital in Toronto.
His hospital is trying to ramp up surgery to a level even slightly more than average to make up for several months of cancelled surgeries this spring, he explained.
The ongoing demands, plus that backlog, means beds are full, and it’s all “putting stress on the system,” Ferguson said.
Across Ontario, at least 135 patients with COVID-19 are currently in intensive care, according to the latest-available census from Critical Care Services Ontario.
That snapshot, as of end of day Tuesday, is just 15 patients away from a provincial threshold of 150 COVID-19 patients in critical care beds that could require hospitals to start cancelling other procedures to manage the load.
“I think hospitals are doing everything possible to move patients forward and through the system fast,” said Dr. Brooks Fallis, a medical director and critical care physician at a hospital in Peel region.
But he warned the prospect of more cancellations is a real concern with COVID-19 cases spiking.
“Inevitably, resources have to be diverted to COVID,” he said. “And that will inevitably mean that other things can’t get done, such as elective surgeries.”
Surgery delays, reschedulings
Some patients and families say even now, months into the pandemic, delays and rescheduling continue.
On Wednesday, Toronto resident Rochelle Roberts finally had surgery to remove non-cancerous tumours in her uterus after waiting months for a procedure date.
She was diagnosed by ultrasound back on March 16 — the same day much of the country started shutting down — and recalls watching the news conferences from her hospital waiting room.
At her first consultation, Roberts learned no elective procedures were being done. When she followed up in August, the administrative assistant for her surgeon “gently explained” the hospital had no idea if she’d get a slot this year.
At last, near the end of October, she got a November surgery date, but even that moment felt uncertain for the 44-year-old.
“The [COVID-19] numbers started going up, which made me anxious,” she said.
In Bowmanville, the Le Fevre family is still waiting for a crucial procedure for their 11-month-old, Charlie.
After delivering her son last December, Jade Le Fevre learned one of his hands had some webbed skin, a condition known as syndactyly. Several of his fingers are fused together and won’t grow at a normal rate unless they’re surgically separated.
The family was booked for an initial consultation with Toronto’s Hospital for Sick Children in June, which got bumped until October.
“We were told COVID aside, if the world was well, we’d have been booked for December,” Le Fevre said.
But there’s still no word when Charlie will get in for the first of two procedures, even though the family was told not to wait much longer than a year after his birth.
“The longer these fingers stay attached, the longer the chance they won’t grow at all.… Just typing would be very difficult, or holding a pen,” Le Fevre said.
Dr. Simon Kelley, associate chief of surgery at the children’s hospital, said a ripple effect of the pandemic has been a rapid increase in the number of children waiting for surgeries.
Roughly 4,800 families are currently wait-listed for a spot even though the hospital is operating close to pre-pandemic levels, he told CBC News on Tuesday.
Hundreds of millions in provincial investment to support additional surgeries is a step in the right direction, but the ongoing delays threaten to increase the risks for children currently waiting, Kelley said.
Lockdown looms as hospitals ‘hitting capacity’
As the tension grows for both patients and health-care workers, Premier Doug Ford warned on Wednesday that a lockdown may be on the horizon for regions facing high COVID-19 case counts.
“The hospitals around, especially, Brampton and northern Etobicoke and other areas in Toronto are hitting capacity,” Ford said. “We need to be responsible.”
Foy hopes officials remember their responsibility to all patients, whether or not they have COVID.
But while she maintains her son-in-law was discharged too soon, she also appreciates that he had a crucial surgery this year while others are still waiting for elective procedures.
“He couldn’t have survived much longer,” Foy said.
Despite the ongoing hunt for Planet Nine and the general dissatisfaction with Pluto’s demotion more than a decade ago, there are still just eight planets in our solar system. You’ve probably seen diagrams of the solar system that place the planets in nice, orderly lines, but the truth is they’re often on the other side of the sun from Earth. We happen to be going through a period during which all the planets are visible, many without a telescope. You just have to know where and when to look.
Mercury: The closest planet to the sun appears like a bright, yellowish star in the sky. Currently, you can spot Mercury unaided by a telescope for the remainder of this year in the early morning right before dawn in the eastern sky. It will be at its brightest for the next week or so.
Venus: Earth’s sister planet has been visible for about half of the year so far, and will continue to twinkle in the sky through the end of the year. Its proximity and size usually make it the brightest planet when viewed from Earth. While there have been times in 2020 when you could see it more clearly, you can still spot Venus if you’re up in the early morning. Just look to the west before dawn, and it should be the brightest object up there.
Earth: Look down.
Mars: You might have spotted Mars in the sky recently and not realized what it was. The planet has been passing very close to Earth lately, which is why NASA launched the Perseverance mission over the summer. Mars appears as an orange-yellow point of light in the eastern sky (see above) starting in the early evening and continuing until near dawn. It’s getting dimmer now (and approaching the constellation Pisces), but should still be visible to the naked eye through the end of the year.
Jupiter and Saturn: The largest planet in the solar system, Jupiter, is too far away to outshine the inner planets, but it’s still glowing like a silver star in the sky right now. We’re actually coming up on an event known as a great conjunction when Jupiter and Saturn are very near each other, something that happens every 20 years or so. Saturn is harder to see (it’s a yellow-ish point), but both planets will appear high in the southwestern sky at dusk, but they’ll fall below the horizon just a few hours later. The conjunction reaches its peak next month, so keep an eye out for that.
Uranus: We’re getting pretty far out in the solar system now, and many people won’t be able to see Uranus without a telescope. It’s there, though. It will appear in the evening sky between Mars (see above) and the dipper-shaped Pleiades star cluster.
Neptune: This is another tough-to-see planet, but it will be up there in the evening sky for the rest of the year and into early 2021. To find Neptune, look toward the south for the constellation Aquarius an hour or two after sunset. With binoculars or a telescope, Neptune should be visible as a faint, bluish dot inside the group of stars.
And that completes our tour of the solar system. While many consider Pluto to be an honorary planet, it and all other Kuiper Belt objects are too tiny and far away to be visible without powerful telescopes.
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.
There’s a lot of confusion — and speculation — about immunity to COVID-19 at the moment.
You may have seen the headlines this week implying that antibodies the immune system creates to fight off the coronavirus decline rapidly after infection, jeopardizing the hope for long-term immunity from the virus.
But the issue is both more complicated than it may seem and more hopeful.
The preprint study, which has not undergone peer review, found the number of people with detectable antibodies in their blood in England fell from six per cent of the population at the end of June to just 4.4 per cent by mid-September.
The researchers concluded there was “decreasing population immunity” and “increasing risk of reinfection” and that the community study of 365,000 patients clearly showed detectable antibodies were in decline.
But while the study and its discouraging conclusion made headlines around the world, experts say there’s a lot more to consider before we can definitively say coronavirus antibodies don’t last long enough to protect us.
Drop in antibodies after infection is expected
One key factor to keep in mind is that it’s not uncommon for immunity to drop after an infection, said Alyson Kelvin, an assistant professor at Dalhousie University and virologist at the Canadian Center for Vaccinology evaluating Canadian vaccines with the VIDO-InterVac lab in Saskatoon.
“Simply showing that antibodies decline after an infection does not simply mean we are no longer protected,” she said. “Our immune system is more complicated than that — which is a good thing.”
A drop in detectable antibodies is actually expected after an infection and that high levels of antibodies remaining after an illness has passed could actually be a bad thing, Kelvin said.
“Typically, we would associate high levels of an activated immune response when there is no threat with more of an autoimmune disease,” she said.
“So we do want to see somewhat of a decline to know that our bodies are in check after we’ve cleared the virus.”
The other important factor is that the immune system can actually remember how to make new antibodies when needed to fight off future infections, by storing types of protective white blood cells in the body called B cells.
Kelvin said just because there aren’t detectable antibodies in the blood doesn’t mean we don’t have reservoirs of these immune memory cells stored in other parts of our body like in our bone marrow.
“That’s usually where your memory B cells would kind of hide out, waiting for another exposure,” Kelvin said. “Because you’re not going to have these circulating antibodies when you’re not being exposed, you kind of need to put them away for when you need them.”
It looked at antibody responses in the plasma samples of more than 30,000 COVID-19 patients in New York City’s Mount Sinai Health System between March and October.
It came to a much different conclusion than the preprint study: that more than 90 per cent of patients produced moderate to high levels of antibodies that were both powerful enough to neutralize the virus and lasted for many months after infection.
WATCH | COVID-19 antibodies may disappear quickly, study finds:
A new study out of the U.K. has found COVID-19 antibodies can disappear quickly from people who’ve had the virus, which experts say makes herd immunity unlikely without a vaccine. 3:33
One difference in the two studies is that the preprint looked at patients ranging from asymptomatic to severe, while the published study focused on hospitalized patients who were primarily symptomatic.
“There seems to be some type of split where milder cases after infection don’t have this notable increase in antibody responses for long periods of time,” Kelvin said. “That might be more evident in people who have more severe infection.”
Researchers in the New York study concluded that the antibodies they found were likely produced by “long-lived plasma cells in the bone marrow,” something that backs up the idea that dormant immune memory B cells could be hiding there.
“This study suggests that the majority of those people infected with SARS-CoV-2 [the coronavirus that causes COVID-19] will produce protective antibodies, which will likely protect from reinfection,” Kelvin said.
“This would support the notion that we will be able to produce a vaccine that is safe and leads to a protective immune response.”
How our immune system responds to the coronavirus
After an exposure to a virus from either an infection or a vaccination, the body goes through what’s called an “expansion phase” where these memory immune cells produce antibodies in response to it — something Kelvin likens to climbing a mountain.
Once the body believes it has cleared the infection and reached the top of the mountain, those antibodies then start to decline during what is known as the “contraction phase,” the start of the descent down the mountain.
As you get to the bottom of the mountain, the body moves into a “memory phase,” where the most effective antibodies get stored until the next exposure — like the experience you might have to better climb the mountain next time.
At that point, B cells are not thought to be detectable in the bloodstream, instead going into immune reservoirs in the body such as bone marrow, which means they could be missed by researchers only focusing on antibodies in the blood.
“We don’t yet know what level of these antibodies is actually needed to prevent infection,” said Dr. Lynora Saxinger, an infectious disease specialist and associate professor of microbiology and immunology at the University of Alberta.
“But there are lots of examples of low antibody levels getting boosted up quickly when you are re-exposed to an infectious agent due to B cell memory pumping out antibodies on re-exposure.”
Another tool our body uses to help fight infection are T cells, a different type of white blood cell stored in the body that can also attack the virus the next time they encounter it but are a separate arm of the immune system.
A recent paper published in the journal Cell found that a balance of both T cells and B cells produced in the body could lead to a better outcome after infection from the coronavirus, and Kelvin said understanding more about T cell immunity could be helpful for vaccine development.
One positive note is that memory B cells, which have the capacity to protect against future infections, have already been detected in both symptomatic and asymptomatic COVID-19 patients, as pointed out in another study published in the journal Nature this week.
Kelvin said COVID-19 patients who develop severe disease or die after being infected with the virus may have a lower ability to generate antibodies because it is possibly targeting and destroying those B cells.
“These results would support the idea that ‘herd immunity’ through natural infection will not lead to long-lasting immunity,” she said. “Which will instead keep our vulnerable populations at risk of death.”
Other coronaviruses, such as SARS and MERS, can also provide hints as to how long the dormant antibodies might stick around waiting to protect us from infection down the road.
“In both SARS and MERS, for years after antibodies were no longer detectable, immune memory cells geared for specific responses to both viruses could still be found in recovered patients,” said Dr. David Naylor, co-chair of the federal government’s Immunity Task Force.
“Bottom line: It seems really likely based on millions of people infected, the duration of the epidemic and the still very small percentage of reinfections that there is pretty durable immunity to SARS-CoV-2 after an initial infection.”
Vaccines safest way of achieving immunity
It’s important to keep in mind that research showing declining antibodies over time does not necessarily mean there is somehow less of a chance that we’ll be able to develop safe and effective vaccines in the coming months.
“There’s still lots to learn about durability of immunity,” Naylor said.
No one expects any of the vaccine candidates to grant “indefinite immunity,” and they may work more like an annual flu shot, he said.
“The immediate issue is whether vaccines will achieve and maintain enough overall immunity to keep spread under control so we can get on with our lives.”
Regardless, Kelvin says that immunity gained from vaccines is safer than achieving it through rampant infections, a concept also known as herd immunity.
“More work is needed to understand how long immunity lasts,” she said, adding that while a vaccine might not offer long-lasting protection either, it doesn’t come with the same risk of death faced by patients with COVID-19.
“So having a safe and effective vaccine would be the best way of controlling outbreaks.”
To read the entire Second Opinion newsletter every Saturday morning, subscribe by clicking here.
Prime Minister Justin Trudeau says he has no intention of trying to assert federal jurisdiction over long-term care facilities but still believes there is a role for Ottawa to play in fixing the country’s troubled nursing homes.
Trudeau is pushing the provinces to agree to harmonize minimum standards for long-term care so that vulnerable seniors are protected and cared-for well no matter where they live.
“This is a moment for us to step up and reassure Canadians that their loved ones, that they themselves as they advance in age, won’t be left aside, won’t be made vulnerable,” Trudeau said Friday.
Trudeau met with the premiers by phone about the issue Thursday.
The Canada Health Act does not govern long-term-care homes, and their existence and operation are entirely up to each province, a fact Trudeau said he fully recognizes.
“Obviously, I respect provincial jurisdiction in running those institutions,” he said. “But we’ve seen that those institutions haven’t done a good enough job in this pandemic particularly, but in a long-standing challenge.”
He said his proposal for “national norms” wouldn’t mean a top-down approach from Ottawa, dictating what provinces must do on long-term care.
Rather, he said provinces that have done better can share what worked with their counterparts, and all can commit to reaching minimum basic care standards on their own.
“We’ve seen varied outcomes in various provinces around our seniors and I think every Canadian can understand how important it is to make sure that all of our vulnerable senior citizens are properly protected, regardless of which province or territory they happen to live in,” he said.
Provincial governments are wary of federal intrusions, with Quebec Premier Francois Legault warning the prime minister before Thursday’s meeting that he was “playing with fire” and suggesting Ottawa intervening in long-term care would be akin to Quebec trying to make up rules about the Canadian border.
The second wave
The COVID-19 pandemic exposed serious problems in care homes across the country, with overcrowded conditions, underpaid staff with high turnover, staff levels too low to provide adequate care and very limited infection control.
In the spring, the federal government sent in the military to help replace staff at dozens of homes in Quebec and Ontario that could not cope with the pandemic.
Subsequent reports to the government from the military exposed horrific conditions in some of those homes, including COVID-19 patients not isolated from non-infected residents, cockroach infestations, rotting food and patients left in soiled clothing.
In the first wave of the pandemic, long-term-care residents accounted for about 20 per cent of all confirmed cases of COVID-19 — and 80 per cent of the deaths. Some homes saw more than one-third of their residents die.
In Ontario, nearly 2,000 long-term-care residents have died of COVID-19, and eight long-term care workers.
The infection rate slowed over the summer, but as the second wave began to explode this fall, long-term-care homes are starting to get hit again.
One care home in Ottawa saw 100 residents infected and 15 die of COVID-19 in September. The provinces have asked for a massive increase in federal health transfers, including to help improve long-term care, but with few if any federal strings attached.
The systemic racism endured by Indigenous people in Canada’s health care system exists because the system was designed that way, Health Minister Patty Hajdu said today after a meeting with representatives from the provinces, Indigenous groups and the health care sector.
“Sadly this is not shocking to me,” Hajdu said. “Racism is not an accident. The system is not broken. It was created this way. And the people in the system are incentivized to stay the same.”
Hajdu made the comments after attending a meeting with Indigenous Services Minister Marc Miller, Northern Affairs Minister Daniel Vandal and Crown-Indigenous Relations Minister Carolyn Bennett to discuss racism in Canada’s health care system.
The meeting with some 400 participants from across the country was called following the death of Indigenous mother of seven Joyce Echaquan, who died in a Quebec hospital last month.
Echaquan, 37, recorded some of the last moments of her life on a video later released on Facebook. The video captured Echaquan screaming in distress, along with the voices of staff members making degrading comments, calling her stupid and saying she would be better off dead.
“It’s always a very powerful experience to be trusted to hear these very personal experiences and there’s so much to reflect on. I have a deep gratitude for all speakers who shared fearlessly about their personal experiences of racism in the health care system and in the health care education process,” Hajdu said.
Those who attended today’s meeting will reconvene in January, when they are expected to bring “concrete plans for training, prevention, health care data, wraparound services and accountability,” Hajdu said.
Miller said that while the responsibility for delivering health care to Indigenous Canadians is shared between the federal and provincial governments, systemic reform should not happen without Indigenous leaders playing a key role in shaping the process.
While widespread reforms likely will have to wait until after the January meeting, Miller said that things can be done right away to improve the system for Indigenous patients, such as requiring greater accountability from health care providers and introducing better sensitivity training.
Federal and provincial responsibilities
“It is time for all of us, regardless of our jurisdiction, to step up and use the power that each of us has to insist that systemic violence of Indigenous peoples end,” Hajdu said.
Miller said that federal investments in health care have to respect provincial jurisdiction.
“The reality is that health is a jurisdiction that is jealously guarded by provinces,” he said. “We need their help to reform it. We cannot reform the licensing bodies. We do not have the power, the Supreme Court has said it clearly in black and white.”
Assembly of First Nations National Chief Perry Bellegarde said the meeting — which he described as a listening session — left those who took part with no doubts about the scope of the problem.
Watch: ‘Systemic change takes more than fear.’ – Minister of Health Patty Hajdu:
Health Minister says she wants to hear from provincial leaders, Indigenous partners and health professionals about how the government should address systemic racism in the healthcare system. 1:29
“There is systemic racism, there is systemic discrimination. let’s deal with it, let’s put an action plan in place so that it no longer persists in 2020 and beyond, because we’re all in this together,” he said.
“Nobody should be afraid to go into that system because of racism or discrimination or they’re gonna be treated differently, and we need to feel good about getting the proper healthcare, each and every one of us.”
“It was not an isolated incident,” Hajdu said. “It is not a few bad apples. It is a system that not just turns a blind eye but implicitly endorses and reinforces this behaviour many times over. And Joyce in the middle of her deep pain showed something that so many people would prefer to ignore. So she gave Canada a gift that has to be honoured no matter how difficult it is to receive it.
“We as leaders cannot let her gift of bravery go to waste.”
Watch: Miller says reforms to system, must be done with Indigenous representatives:
Indigenous Minister Marc Miller says reforms to Canada’s healthcare system, must be done with full consultations and participation from Indigenous representatives. 1:49
Prime Minister Justin Trudeau suggested today that the government could introduce specific Indigenous health care legislation.
“All premiers have condemned racism and there is still more work to do, obviously. But we are confident that we’ll be able to make significant improvements in the health care access by Indigenous peoples,” he told a news conference in Ottawa.
“As we did with the question of child and family services, we will be sitting down in partnership with Indigenous communities and Indigenous leaders to help design the principles that should underline better health outcomes and services for Indigenous peoples.”
The provinces are seeking billions more dollars in health transfers from the federal government, with Trudeau promising a first ministers conference on the subject soon.
On Thursday, Miller said the federal government is ready to use its financial leverage over the health system to fight anti-Indigenous racism in health care, but ruled out holding back federal transfers as a tactic to ensure that happens.
Miller said he doesn’t think it’s helpful to try to punish provinces for inadequate action on racism, especially in the middle of a pandemic, but the federal government has a moral duty to set and maintain standards.
Watch: Quebec launches inquiry into Joyce Echaquan’s death:
Protests were held in Montreal as Quebec announced a public inquiry in the racist verbal abuse of Joyce Echaquan at the Joliette Hospital during her final hours. Activists for Indigenous women say her experience was typical of the abuse Indigenous women encounter in health care. 2:03