Diana Grimaldos keeps getting the same questions from her kids.
“Is the virus gone? Has the virus gone away?”
Her seven-year-old daughter, Katalina, has always been an anxious child — but it got much worse during the pandemic.
“She worries,” said Grimaldos, who lives in Toronto.
Katalina’s anxiety was especially high during lockdown. Although seeing her parents get their COVID-19 vaccines helped, along with going back to school in person, “she’s still very fearful,” said her mother.
The meteoric rise in mental health issues among children throughout the pandemic is all too familiar for many parents — backed up by study after study and reflected in the practices of health-care providers across Canada.
The best medicine for many children, pediatric experts say, is to restore normalcy in their lives, while staying safe from COVID-19 infection.
Now that Health Canada has approved Canada’s first coronavirus vaccine for kids aged five to 11, many parents and children’s health-care providers see light at the end of the tunnel.
‘Vaccine is the way that we can get there’
The pandemic’s effect on kids extends beyond the threat of COVID-19 making them sick, said Dr. Eddsel Martinez, a pediatrician in Winnipeg and member of the Canadian Paediatric Society’s public advisory committee.
The public health measures that had to be taken to save lives have led to isolation, economic insecurity and parental stress, which are all “terrible for mental health,” he said.
“We’ve seen an increase in all sorts of mental health issues, including anxiety, depression, eating disorders, substance use and abuse.”
Children, in general, are resilient, Martinez said. For many, a return to regular activities, including school, birthday parties, sleepovers and visits with grandparents will do wonders.
“All those things are extremely important for mental health,” he said. “The vaccine is the way that we can get there.”
Many kids are also acutely aware of the fact that they can carry the COVID-19 infection and make someone they love ill, both parents and doctors say.
Grimaldos’s husband is immunocompromised and Katalina worries about making her dad sick, especially when there’s a COVID outbreak at her school.
Her mother tries to reassure her and “remove that guilt.”
But even at outdoor family gatherings where all the adults are vaccinated, “she feels more comfortable with the mask than without it,” Grimaldos said.
That’s a big emotional burden for a child to carry, said Dr. Anna Banerji, a pediatric infectious disease specialist with the Dalla Lana School of Public Health at the University of Toronto.
The children’s vaccine can not only reduce the risk of kids getting really sick, but also address “the worry about COVID and what’s going to happen next,” Banerji said.
“‘Am I going to get sick? Am I going to transmit this to my family members?’ That’s a huge stress,” she said.
When Health Canada and the National Advisory Committee on Immunization (NACI) decide whether or not to approve a vaccine, the key questions they must answer are whether the vaccine is safe and effective and whether the benefits outweigh any risks.
In the case of COVID-19, mental health has to be part of that discussion, said Dr. Caroline Quach-Thanh, a pediatric infectious diseases specialist and medical microbiologist at Chu Ste. Justine in Montreal.
“What you have to look at is the burden of illness. And the burden of illness includes not only the medical complications but also all the cross-collateral damages that occur,” said Quach-Thanh, who is also a former chair of NACI.
The recommendations released by NACI on Friday concluded that Pfizer-BioNTech’s vaccine was not only safe and effective in protecting children from illness, but also said that children are “at risk of collateral harms of the COVID-19 pandemic. Prolonged schooling disruptions, social isolation, and reduced access to academic and extra-curricular resources have had profound impact on the mental and physical well-being of children and their families.”
The U.S. Food and Drug Adminstration (FDA) and the Centers for Disease Control and Prevention (CDC) came to similar conclusions when they approved Pfizer’s vaccine for American children — a move that was applauded by the American Academy of Pediatrics (AAP).
“The numbers are trickling in now that [show] the COVID pandemic has really resulted in significant psychosocial stressors on children and families,” said Dr. Arwa Nasir, professor of pediatrics at University of Nebraska Medical Center and member of the AAP.
“We have numbers now to indicate an increase in the number of emergency room visits for mental health issues, suicide attempts,” she said.
That data backs up what pediatricians feared, Nasir said.
“We knew that the stressors associated with the pandemic, all the way from, you know, the illness itself, the death of family members, the quarantine, the interruption of school … we knew that this is not going to be good.”
Surge in ER visits
The alarming rise in mental health issues so severe that they require a trip to the hospital is also happening on this side of the border, said Dr. Michael Cheng, a child psychiatrist at CHEO in Ottawa (formerly the Children’s Hospital of Eastern Ontario).
“We are overloaded in terms of mental health issues,” Cheng said. “Kids have gotten more stressed, anxious, depressed, suicidal during the pandemic and now they’re just to the point they’re presenting to emerg,” Cheng said.
Part of that is due to the interruption of health-care services during the pandemic, so people delayed getting treatment for both physical and mental health problems and they got worse, he said. The other part is an increase in children experiencing psychological distress.
“Our wait lists have exploded,” Cheng said.
The good news, he said, is that if kids can get back to normal life, many will recover and be OK.
“Whenever you have a stress on a population … most people will recover from that stress,” he said. “Hopefully 80, 90 per cent of people will manage to move on.”
In the U.S., children have been getting COVID-19 vaccinations for a couple of weeks. While Nasir has been providing information to many families who are hesitant to get the vaccine, she’s also families with kids who are “just so happy” to get the shot.
“This is a happy, empowering, good adjustment feeling that … can be very helpful to their mental health,” Nasir said.
“[Kids feel like] ‘I’m not like a victim to this. I’m doing something about it … and I’m participating not only in my wellness but also in the community’s wellness.'”
That’s how Diana Grimaldos hopes her daughter will feel when she gets her vaccine soon.
“I think it will give her a sense of security, for sure.”
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Tiny wines find home in B.C.’s market, as Canadians consider reducing consumption
VANCOUVER — Wine lovers have growing options on the shelf to enjoy their favourite beverage as producers in B.C. offer smaller container sizes.
Multiple British Columbia wineries over the last several years have begun offering their product in smaller, single-serve cans and bottles.
Along with making wine more attractive to those looking to toss some in a backpack or sip on the golf course, the petite containers leave wineries with options for a potential shift in mindset as Canadians discuss the health benefits of reducing alcohol consumption.
Vancouver-based wine consultant Kurtis Kolt said he’s watched the segment of the wine industry offering smaller bottles and cans “explode” over the last several years, particularly during the COVID-19 pandemic when people were meeting outdoors in parks and beaches and looking for something more portable to take with them.
“You’re not taking a hit on quality, you know? In fact, if someone is only going to be having a glass or two, you’re cracking a can and it’s completely fresh, guaranteed,” he said.
It’s also an advantage for people who want to drink less, he said.
“It’s much less of a commitment to crack open a can or a small bottle or a smaller vessel than it is to open a bottle,” he said.
“Then you have to decide how quickly you’re going to go through it or end up dumping some out if you don’t finish it.”
Last month, the Canadian Centre on Substance Use and Addiction released a report funded by Health Canada saying no amount of alcohol is safe and those who consume up to two standard drinks per week face a low health risk.
That’s a significant change from the centre’s 2011 advice that said having 15 drinks per week for men and 10 drinks per week for women was low risk.
Health Canada has said it is reviewing the report.
Charlie Baessler, the managing partner at Corcelettes Estate Winery in the southern Interior, said his winery’s Santé en Cannette sparkling wine in a can was released in 2020 as a reduced alcohol, reduced sugar, low-calorie option.
“We’ve kind of gone above and beyond to attract a bit of a younger, millennial-type market segment with a fun design concept of the can and sparkling, low alcohol — all these things that have been recently a big item on the news,” he said.
Santé en Cannette is a nine per cent wine and reducing the alcohol was a way to reduce its calories, he said. The can also makes it attractive for events like a picnic or golf, is recyclable, and makes it easier for restaurants that might want to offer sparkling wine by the glass without opening an entire bottle.
At the same time, the lower alcohol content makes it an option for people who might want a glass of wine without feeling the same effect that comes from a higher alcohol content, he said.
“So the health is clearly one incentive, but I think more importantly, so was being able to enjoy a locally made product of B.C. from a boutique winery, dare I say, with a mimosa at 11 o’clock and not ruin your day,” he said.
Baessler said the winery has doubled production since the product was first released to about 30,000 cans a year, which they expect to match this year.
He said there’s naturally a market for the product but he doesn’t expect it to compete with the higher-alcohol wine.
“So this isn’t our Holy Grail. This is something that we do for fun and we’ll never compete, or never distract, from what is our core line of riper, higher-alcohol wine,” he said.
Jeff Guignard, executive director of B.C.’s Alliance of Beverage Licensees, which represents bars, pubs and private liquor stores, said the industry has seen a shift in consumers wanting options that are more convenient.
“It’s not a massive change in consumer behaviour but it is a definitely a noticeable one, which is why you see big companies responding to it,” he said.
Guignard said the latest CCSA report is creating an increased awareness and desire to become educated about responsible consumption choices, which is a good thing, but he adds it’s important for people to look at the relative risk of what they’re doing.
“If you’re eating fast food three meals a day, I don’t think having a beer or not is going to be the single most important determinant of your health,” he said.
“But from a consumer perspective, as consumer preferences change, of course beverage manufacturers respond with different packaging or different products, the same way you’ve seen in the last five years, a large number of low-alcohol or no-alcohol beverages being introduced to the market.”
While he won’t predict how much the market share could grow, Guignard said non-alcoholic beverages and low-alcoholic beverages will continue to be a significant piece of the market.
“I don’t know if it’s reached its peak or if it will grow. I just expect it to be part of the market for now on.”
This report by The Canadian Press was first published Feb. 5, 2023.
Ashley Joannou, The Canadian Press
Indian tycoon Adani hit by more losses, calls for probe
NEW DELHI (AP) – Trading in shares in troubled Adani Enterprises gyrated Friday as the flagship company of India’s second-largest conglomerate tumbled 30% and then rebounded after more than a week of heavy losses that have cost it tens of billions of dollars in market value.
The debacle, which led Adani to cancel a share offering meant to raise $2.5 billion, has drawn calls for regulators to investigate after a U.S. short-selling firm, Hindenburg Research, issued a report claiming the group engages in market manipulation and other fraudulent practices. Adani denies the allegations.
Opposition lawmakers blocked Parliament proceedings for a second day Friday, chanting slogans and demanding a probe into the business dealings of coal tycoon Gautam Adani, who is said to enjoy close ties with Prime Minister Narendra Modi.
“We have no connectionâ€³ with the Adani controversy, Parliamentary Affairs Minister Pralhad Joshi told reporters outside Parliament on Friday.
In an interview with CNN News 18, Finance Minister Nirmala Sitharaman brushed off concerns that the losses would spook global investors and said India’s financial market was “very well regulated.”
“As a result, the investors’ confidence which existed before shall continue even now,” she said, adding that the controversy wasn’t “indicative of how well Indian financial markets are governed.”
Amit Malviya, the governing Bharatiya Janata Party’s information and technology chief, said in a television interview that the opposition was using Adani’s crisis to target the Modi government over a private company’s shares and their market movements. “Regulators are looking into” what happened, he said.
The market watchdog, the Securities and Exchange Board of India, has not commented. The Economic Times newspaper reported, citing unnamed SEBI sources, that it had asked stock exchanges to check for any unusual activity in Adani stocks.
Shares in Adani Enterprises fell as much as 30%, to 1,017 rupees ($12), on Friday. At the end of trading, the price had recovered to 1,531 rupees ($18.70) but was still down by 2%. The company’s share price has plunged more than 50% since Hindenburg released its report last week, when it stood at 3,436 rupees ($41). Stock in six other Adani-listed companies were down 5% to 10% on Friday.
So far there has been no indication that the company’s woes might threaten the wider financial sector in India. Its equities market is large enough to sustain the fallout at this moment, said Brian Freitas, a New Zealand-based analyst with Periscope Analytics who has researched the Adani Group.
“Adani stock forms a small part of the equities market and investor concerns right now are restricted to the company, not the whole system or market itself,” Freitas said. India’s Nifty and Sensex indexes were both higher on Friday.
It could take time for problems to surface, Shilan Shah of Capital Economics said in a report. “From the macro perspective there are few signs of contagion,” he said. “But it is too early to sound the all clear.”
The S&P Dow Jones indices said Thursday it would remove Adani Enterprises from its sustainability indices beginning Tuesday, following a “media and stakeholder analysis triggered by allegations of stock manipulation and accounting fraud.”
That might dent the Adani Group’s sustainability credentials and could affect investor sentiment, Freitas said.
Adani, who made a vast fortune mining coal and trading before expanding into construction, power generation, manufacturing and media, was Asia’s richest man and the world’s third wealthiest before the troubles began with Hindenburg’s report.
By Friday, his net worth had halved to $61 billion, according to Bloomberg’s Billionaire Index, where he dropped to the 21st spot worldwide.
He has said little publicly since the troubles began, though in a video address after Adani Enterprises canceled its already fully subscribed share offering he promised to repay investors. The company has said it is reviewing its fundraising plans.
Hindenburg’s report said it was betting against seven publicly listed Adani companies, judging them to have an “85% downside, purely on a fundamental basis owing to sky-high valuations.” Other issues in the report included concerns over debt, alleged use of offshore shell companies to artificially raise share prices and past investigations into fraud.
Adani’s speedy, debt-led expansion in recent years caused his net worth to shoot up nearly 2,000%. Even before last week, critics said his ascent was aided by his apparent close ties to Modi and his government. Analysts say he has been successful at aligning his priorities with those of the government by investing in key sectors, but point out that he also has major infrastructure projects in states that are ruled by opposition parties.
“The question now turns to the future of the Adani Group and how they will grow,” said Aveek Mitra, founder of Avekset Financial Advisory.
As a company heavily involved in infrastructure — from airports and ports to highways — it needs financing to grow in order to service its debt, which stands at $30 billion, out of which $9 billion is from Indian banks.
Adani may be able to sell some assets and continue its expansion, but at a much slower pace than earlier, Mitra said.
“Banks, financial institutions and investors will think five times before investing now,” he added.
Associated Press writer Ashok Sharma contributed to this report.
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