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Delays, conflicts and confusion hampered Ontario's COVID-19 response: auditor general – CBC.ca

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Ontario’s response to the COVID-19 pandemic was hampered by poor emergency preparedness, inadequate lab capacity and a disorganized public health system, according to a report issued Wednesday by the province’s auditor general. 

In a special report on COVID-19, Auditor General Bonnie Lysyk raises concerns that flaws in Ontario’s communication, decision-making and management of positive cases contributed to a wider spread of the virus during the eight months since the pandemic was declared.

The audit found “delays and conflicts and confusion in decision-making,” said the 231-page report, tabled in the legislature on Wednesday morning. 

The report also lays bare for the first time the structure and membership of the so-called “tables” advising Premier Doug Ford and his cabinet on their response to COVID-19.

Among the auditor’s key findings: 

  • The Ford government paid a consultant $1.6 million to develop an organizational command structure for its COVID-19 crisis response, a structure that the auditor criticizes as “overly cumbersome,” with no top leadership roles given to public health officials. 
  • Laboratory testing, case management and contact tracing were not being performed quickly enough to contain the virus.
  • Weaknesses in the public health lab and information systems that were repeatedly flagged following the 2003 SARS crisis were never fixed before the arrival of COVID-19.
  • The province hadn’t updated its pandemic-related emergency plans for years, nor run them through testing scenarios. 

“Ontario’s response to COVID-19 in the winter and spring of 2020 was slower and more reactive relative to most other provinces and many other international jurisdictions,” Lysyk said in the report. 

Bonnie Lysyk, Ontario’s auditor general, has issued a report saying Ontario’s pandemic response was hampered by poor emergency preparedness, inadequate lab capacity and a disorganized public health system. (Frank Gunn/The Canadian Press)

“As we continue into this second wave, it is still not too late to make positive changes to help further control and reduce the spread of COVID-19.”

At a news conference Wednesday morning, Health Minister Christine Elliott said the report is “a disappointment, and in many respects a mischaracterization of the province’s pandemic response.

“The reality is that over the course of the pandemic, there have been differing views. Differing views among public health officials, amongst the medical community, amongst policy makers, and of course the public,” Elliott said.

“We have different views on various aspects of her report.”

 WATCH | Health Minister responds to auditor general’s report:

Minister of Health Christine Elliott says the report as “a disappointment, and in many respects a mischaracterization of the province’s pandemic response.” 1:36

One chapter of the report focuses on the public health systems for COVID-19 testing, for managing the cases of people who test positive and tracing their contacts who may have been exposed to the virus.    

Across the province, fewer than half of lab tests have been completed within 24 hours of the patient’s specimen being collected, the auditor found.

As recently as September and October, public health units contacted only 75 per cent of people who tested positive within 24 hours of receiving the result, short of the province’s target of 90 per cent. 

The auditor said the largest urban public health units were particularly slow at case management — the process of contacting people who test positive, advising them to self-isolate and investigating how they likely contracted the virus. In September and October, the auditor found the average time it took to begin managing a positive case after the person got tested was: 

  • Ottawa – 4.5 days.
  • Toronto – Four days. 
  • Peel – 3.25 days.
  • York – 2.25 days.

The delays “may have led to further exposure and spreading of the virus,” Lysyk said in the report. 

Ontario Premier Doug Ford declared a state of emergency in response to the COVID-19 pandemic during this March 17 news conference, alongside Health Minister Christine Elliott and Dr. David Williams, the province’s chief medical officer of health. (Frank Gunn/The Canadian Press)

The report delves into the command structure set up by the government to advise on the COVID-19 response.

At the top is the Central Co-ordination Table, co-chaired by the province’s top bureaucrat, cabinet secretary Steven Davidson; and the premier’s top political adviser, chief of staff James Wallace.

Its membership includes nine deputy ministers, as well as five political advisers from the offices of the premier and the health minister. However, the auditor notes, neither Chief Medical Officer of Health Dr. David Williams nor anyone from Public Health Ontario sits on this table.   

Below the Central Co-ordination Table are four others, including the Health Command Table, which the auditor found had as many as 90 participants. Its meetings were held by teleconference instead of videoconference until July, a format the auditor said was not effective for clear discussions.     

The auditor said Williams did not chair any of the Health Command Table’s meetings. She calls Ontario’s decision not to give its chief medical officer of health the lead role in its COVID-19 response “unusual.”  

Fewer than half of the COVID-19 lab tests conducted in Ontario have been completed within 24 hours of the patient’s specimen being collected, the auditor general found. (Craig Chivers/CBC)

At the same time, the auditor criticizes Williams for failing to use his full powers to issue directives quickly, notably for a provincewide masking order or for protecting temporary foreign workers on farms. Williams told the auditor he only issued directives after consulting with the Health Command Table.

The auditor’s report said Williams and the Ministry of Health were slow to react in the early weeks of the pandemic. The report questions why provincial officials: 

  • Waited until March 13, the Friday before the scheduled start of Ontario’s March Break, to warn against non-essential travel.
  • Refused to acknowledge community transmission of the virus until March 26.
  • Did not order all long-term care workers to wear masks throughout their shifts until April 8.    

The auditor finds instances where the government’s decisions did not follow the advice of public health experts, including allowing anyone who wanted to get tested to do so from late May until early October.

The auditor also details how the government ignored the advice of Public Health Ontario on setting infection thresholds for the restrictions in its colour-coded COVID-19 response framework. 

A report from Ontario’s auditor general lists the membership of the Ford government’s top advisory table on COVID-19, made up almost entirely of deputy ministers and political staff. (Ontario Auditor General)

She said Public Health Ontario has played a “diminished” role in responding to the pandemic and posed that this “may have been impacted by its funding.”  

The Health Ministry did not fully use the key lesson from SARS — the precautionary principle of acting as soon as there is reasonable evidence of a threat to public health — to guide its initial response to COVID-19, the auditor said.

The ministry categorized the risk to Ontarians as low even as the virus spread to more than 20 countries and the auditor said this meant Ontario developed its strategy for responding more slowly than other provinces. 

She points to repeated reports by her office since 2003 — a time period in which the Liberals were in power for nearly 15 years — warning of the need to strengthen the public health system and improve Ontario’s emergency preparedness.        

The auditor is working on a second special report on COVID-19, which will focus on health-related pandemic expenditures, personal protective equipment and long-term care, and said it will be issued soon. 

WATCH | How Ontario got to this point in the coronavirus pandemic:

With Premier Doug Ford poised to implement tighter restrictions in Toronto, Peel and possibly York, here’s a look back at how the novel coronavirus has surged this fall. 6:24

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What’s the greatest holiday gift: lips, hair, skin? Give the gift of great skin this holiday season

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Give the gift of great skin this holiday season

Skinstitut Holiday Gift Kits take the stress out of gifting

Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.

In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.

“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.

There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.

Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.

Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.

In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.

 

Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

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Here is how to prepare your online accounts for when you die

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LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?

It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.

Here’s how you can prepare your digital life for your survivors:

Apple

The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.

For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.

You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.

Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.

Google

Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.

When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.

You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.

There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.

Facebook and Instagram

Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.

When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.

The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.

You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.

TikTok

The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.

Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.

X

It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.

Passwords

Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?

Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.

But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.

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Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.

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Pediatric group says doctors should regularly screen kids for reading difficulties

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The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.

New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.

The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.

Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.

Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.

“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.

“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”

McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.

But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.

The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.

He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.

“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.

“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.

McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”

McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.

He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.

“Early identification of reading difficulty can truly change the trajectory of a child’s life.”

This report by The Canadian Press was first published Oct. 23, 2024.

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