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Flu surges on heels of RSV, COVID-19 to overwhelm children’s hospitals in Canada

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A flu season that started early, hospitalized far more children than usual and overwhelmed emergency departments has revealed that Canada’s healthcare system is chronically underfunded when it comes to the most vulnerable citizens, a pediatric infectious diseases specialist says.

Dr. Jesse Papenburg, who works at Montreal Children’s Hospital, said a system that was already struggling with a surge of respiratory syncytial virus, or RSV, on the heels of COVID-19 is now overwhelmed in much of the country.

“Certainly, Ontario and Alberta in particular have been hit very hard with an early and really quite explosive influenza season in pediatrics when it comes to more severe disease requiring complex hospitalization. And we’re also observing in Montreal as well that our influenza admissions are really starting to pick up,” he said.

The last week of November saw the highest number of pediatric hospitalizations for a single week in the past decade, said Papenburg, who is also an investigator for IMPACT, a program that monitors hospitalizations for vaccine-preventable diseases at 12 children’s hospitals across the country.

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A typical flu season sees about 1,000 kids admitted to hospital. Due to pandemic public health measures, he said last season saw only 400 and there were none the season before that.

Up to the end of November, over 700 children had been hospitalized with the H3N2 strain of the flu, which typically takes a toll on older adults. But the season could continue until March or April, Papenburg said of the unexpected epidemic.

“When you’re already stretched to the limit under normal circumstances and there’s something exceptional that takes place, it really has a greater impact on the type of care that we can deliver to Canadian children,” he said. “It’s unacceptable, in my view, that this is happening, that we are having to delay important surgeries for children because we need those resources for dealing with acute respiratory infections.”

While the number of RSV hospitalizations is stabilizing, there’s still a “significant burden of disease requiring complex hospitalization,” he said of the Montreal hospital.

Alex Munter, president of Ottawa pediatric hospital CHEO, said the Red Cross will be helping take some of the pressure off critical-care staff starting this week.

He said two teams of nine people will work rotating overnight shifts and that some will be porters while others get supplies or sit with patients.

“Having these Red Cross teams on-site will allow us to send back redeployed staff to their home base,” he said.

“The test positivity rate last week for flu was 30 per cent compared to 10 per cent at the end of October. That’s a big increase and it’s still climbing so flu hospitalizations are increasing and RSV is plateauing,” Munter said.

CHEO, including its emergency department and urgent care clinic, is also getting help from pediatricians, family doctors and nurses in the community while some patients are being transferred to adult hospitals, Munter said.

“We can’t run our hospital this way in perpetuity. I think the moral of the story here is that we have undersized child and youth health system in Canada.”

SickKids in Toronto continues to see high patient volumes in the pediatric intensive care unit and since November has reduced the number of surgeries so staff can be redeployed to provide care in that unit.

“We have been co-ordinating closely with other hospital partners that have the ability to care for some pediatric patients,” the hospital said in a statement, adding it is not currently seeking staffing support from external organizations.

Dr. Shazma Mithani, an emergency room doctor at both the Stollery Children’s Hospital and Royal Alexandra Hospital in Edmonton, said a temporary closure of a pediatric hospice in Calgary is “tragic” as staff are being diverted to a children’s hospital.

“It means that kids who are dying are not getting the palliative and comfort care that they deserve and need, and that acute care is taking priority over that,” Mithani said.

Federal Health Minister Jean-Yves Duclos has said Ottawa recently gave provinces an additional $2 billion as calls grow for both levels of government to do more to help hospitals facing unprecedented challenges.

Mithani said funding has to be targeted for children’s hospitals and could also go to staffing after-hours clinics, for example.

She said people planning large indoor gatherings over Christmas and for New Year’s Eve should consider scaling back, while schools should transition to temporary online learning if they have a large number of viral illnesses

Health officials also need to make a concerted effort to educate the public on the importance of vaccination amid misinformation on social media, Mithani said.

“The most vulnerable people in our society are suffering as a result of the decisions that adults made. That’s what’s happening here, that kids are suffering from the poor decisions of adult decision-makers who can’t seem to do the right thing in order to protect our kids.”

— With files from Jordon Omstead in Toronto

This report by The Canadian Press was first published Dec. 5, 2022.

This story is produced with the financial assistance of The Canadian Medical Association. It has no say in editorial choices.

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Hailed as green energy source, northern Quebec lithium project divides Cree

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NEMASKA, QUE. — Type the word “Nemaska” into a search engine and most results refer to Nemaska Lithium, the company that sought bankruptcy protection in 2019 before being partly bought out by the Quebec government’s investment agency. The episode resulted in tens of thousands of small investors losing significant savings.

However, Nemaska is above all a Cree community in the heart of the boreal forest, more than 1,500 kilometres from Montreal. They share their territory with a wide variety of species, and caribou herds have long visited the area, drawn by its abundance of lichen.

These fragile ecosystems are home to a multitude of threatened species that will soon have to deal with new visitors: starting in 2025, approximately 15 heavy trucks a day will roar through these ancestral hunting grounds carrying the thousands of tonnes of ore that Nemaska Lithium plans to mine.

According to the promoters, the region contains some of the world’s largest deposits of spodumene, a rock from which lithium — key to the energy transition and the electrification of transport networks — is extracted.

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Nemaska Lithium describes itself as a corporation that “intends to facilitate access to green energy, for the benefit of humanity.”

The Whabouchi open pit mine will be located about 30 kilometres from the village of Nemaska, in the watershed of the Rupert River, considered one of Quebec’s ecological gems.

“If the water becomes contaminated by the mine, I don’t see how we can limit the damage to the food chain,” says Thomas Jolly, who was chief of Nemaska from 2015 to 2019, stressing the importance of fishing to his community.

Nemaska means “Place of Plentiful Fish,” and that is what led the Cree to build their community here in 1979 after a proposed Hydro-Québec dam project threatened to flood their ancestral village. (In the end, the Crown corporation chose to build its reservoirs elsewhere, and the flooding of Old Nemaska never occurred.)

“At the time, the Department of Indian Affairs wanted to impose another site on us, but it was partly a swamp … so we chose to settle here instead, where it’s dry, in a place where there is everything we need to hunt and fish,” Jolly said in an interview in Nemaska.

Various other Hydro-Québec projects have led to an increase in mercury levels in lakes and rivers near Nemaska, to the point where for some bodies of water, public health authorities recommend eating no more than two fish of certain species per month.

According to public health data, one of the waterways with the highest mercury levels is the Nemiscau River, which is also set to receive mine effluent from Nemaska Lithium.

“How much more contamination can these streams handle?” Jolly wonders.

He explains that history has taught him to be wary of the studies carried out by the mining company on the environmental impacts of lithium extraction. “Hydro-Québec said they didn’t know (the mercury contamination) would happen,” he says. “Come on!”

The construction of the mine will cause the elimination of a lake and a stream in addition to modifying several other bodies of water. In total, the negative effects on fish and fish habitat are estimated at 54,600 square metres, according to the Impact Assessment Agency of Canada, and Nemaska Lithium is working to implement a compensation plan for this loss of habitat.

The federal government’s approval of the mine comes with dozens of conditions, including protecting water quality. In an interview with The Canadian Press, Vincent Perron, the director of environment and stakeholder relations at Nemaska Lithium, says the company has “a very comprehensive and rigorous water quality monitoring program.”

Perron explains that Nemaska Lithium, among other things, is committed to verifying every three years “the level of heavy metals in the flesh of fish, starting during the construction of the mine and until the end of a five-year period following its closure.”

He stresses that “a water treatment plant will be installed to treat the excess drainage water before it is released into the Nemiscau River.”

Company documents show that 10 species of mammals with a special status — either threatened, vulnerable or at risk — may frequent the mine area, including the wolverine and the woodland caribou as well as various species of birds, such as the golden eagle.

The Impact Assessment Agency of Canada cited potential “habitat loss and fragmentation” for those species but said the impact would not be significant because of the availability of similar habitat nearby and mitigation measures proposed by the proponent.

For Jolly, regardless of mitigation measures, “it’s obvious” that animals will be negatively affected by the blasting, the extraction and transportation of ore. He wants the mine administrators to consider traditional Indigenous knowledge and not just “book science” in managing the risks.

“You, people from the south, when you talk about animals and plants, you use the word species,” he says, “but we call them educators.”

Nemaska Lithium says it wants its mine project to set a benchmark for environmental responsibility. Powered by renewable electricity from Hydro-Québec, it will be one of “the greenest lithium producers in the world,” says Perron.

The project will have “one of the lowest intensities of production in the world in terms of CO2 equivalent emissions from processing and transportation combined,” he said. “It is nearly three times lower than the global average, and more than six times lower than China.”

However, Jolly stresses that hydro power is not as green as some people make it out to be. The environmental impacts of large dams are considerable, he says, citing examples of entire communities that have had to relocate because of flooding. Hunting grounds were submerged and mercury levels shot up in fish, among other upheavals in the James Bay Cree’s traditional way of life.

The Quebec government has invested hundreds of millions of dollars in Nemaska Lithium. Premier François Legault, who wants Quebec to export electric vehicle batteries worldwide and be a leader in 21st-century transportation, considers the company “an important component of the green economy.”

Jolly questions why lithium mined from Cree lands should be a central part of the government’s plan to combat climate change. “Who is responsible (for the climate crisis)?” he asked. “Is it up to us to pay and suffer for what they have done?”

He says the project was approved by the band council without properly consulting the population, a critique echoed by another former chief, George Wapachee. In his book “Going Home”, published last fall, Wapachee writes that the decision to accept the lithium mine “was made without the approval of community members.”

But while many in Nemaska are worried about the mine, it also gives hope to those who see it as an important tool for economic development. At a hearing in 2015, former Chief Matthew Wapachee presented a petition that included about 100 signatures in support of the project.

“Nemaska Lithium should be commended in recognizing and ensuring that this partnership is founded on mutual trust, protection of the environment and respect of Cree rights and traditional way of life,” Matthew Coon Come, who was then grand chief of the Grand Council of the Crees, said in a press release at the time.

Even though some in Nemaska say they were not sufficiently informed about the mine project, Nemaska band council spokesperson Laurence Gagnon maintains that the community was regularly consulted at annual general meetings. The council accepted the project “100 per cent for the economic benefits,” she said in an interview.

She said the village is expected to receive annual royalties. “We are talking about several million dollars over 30 years for the community,” she said. This money “returns to our citizens for better infrastructures, better services.”

Current Chief Clarence Jolly was among the elected officials who in 2014 voted to ratify the agreement with the mine.

Over a period of several months, The Canadian Press made numerous attempts to speak with him to discuss the impacts of the mine and its social acceptance, but he declined all requests. Gagnon explained the chief’s refusal by noting that the lithium mine was “a sensitive subject” that he preferred “not to discuss during an election period.”

The chief offered to provide an interview after the community elections later this month.

This report by The Canadian Press was first published Feb. 5, 2023.

Stéphane Blais received the support of the Michener Foundation, which awarded him a Michener–Deacon Investigative Journalism fellowship in 2022 to report on the impact of lithium extraction in northern Quebec.

 

Stéphane Blais, The Canadian Press

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Indigenous history class for lawyers justified and more common in Canada: experts

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EDMONTON — As Alberta’s Law Society seeks to defend rules that require members to take a course on Indigenous issues, experts say such measures are common elsewhere in Canada and are well-grounded in legal rationale.

“It is increasingly common that law societies across the country are requiring continuing education in certain particular areas” that include cultural awareness, said Trevor Farrow of York University’s Osgoode Hall Law School in Toronto.

“The law is continually changing,” said Jeremy Webber of the University of Victoria’s law school.

“The reason for the requirement is to ensure that a lawyer does not continue to practice their area of law as though it were the 1980s.”

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The Law Society of Alberta is to vote Monday on a motion that would suspend the group’s ability to require its members to undertake continuing education. The vote is a response to a petition from 51 lawyers concerned about The Path, a five-part course on Indigenous history and culture that follows one of the calls to action in the Truth and Reconciliation Commission report.

One signatory to the petition, Glenn Blackett, has called the course “political indoctrination” and compared it to a cancer infecting the roots of Canada’s legal system.

“The vitriol directed at Canadians in The Path seems less likely to promote reconciliation than to promote a distorted perception of history and of the causes of socioeconomic disparity, anger, shame, and enduring Indigenous alienation,” he wrote in the Dorchester Review.

Other signatories have said the course requirement reminds them of their childhood in authoritarian China.

“I understand the concerns around indoctrination and forced speech,” said Farrow.

“I don’t see this as indoctrination. This is continuing education in an area where Canadians have been woefully undereducated. It’s the law society playing part of its role in this larger social project.”

Webber said the complaint’s intent to disallow the society from requiring any continuing education suggests the motivation is elsewhere.

“We’re not talking about indoctrination. We’re talking about an unwillingness to learn.”

British Columbia is one province where the law society requires an Indigenous-themed course.

Other self-regulating professions also require their members to continually upgrade their qualifications.

The Association of Professional Engineers and Geoscientists of Alberta requires its members to take a certain number of classes every three years. It doesn’t mandate one class for all members, but gives them a range of choices they must pick from.

The College of Physicians and Surgeons of Alberta requires ongoing education as well as two mandatory courses related to sexual abuse and misconduct.

Requiring such educational updates is part of the bargain such professions make with society, Farrow said.

“The fundamental obligation is to regulate lawyers in the public interest. It’s in the idea of competence and what is required of a modern lawyer where these things rest.”

Nor is it convincing to claim that some types of legal practice don’t intersect with Indigenous issues, Webber said.

“Indigenous people are present in every area of the economy,” he said. “They exercise real control over lands that are important for resource development.”

Then there’s the outsized involvement of Indigenous people in the criminal justice system, of which lawyers are an integral part.

“It’s not a secret,” Farrow said. “What the law society and lawyers are going to do about it needs to be part of the solution and I think that’s where some of this comes in.”

About 400 Alberta lawyers have signed a counter-petition in support of the society’s right to require The Path. The law society’s 24 benchers — a type of board of directors — have also publicly opposed the original petition.

Alberta has about 11,000 lawyers.

This report by The Canadian Press was first published Feb. 5, 2023.

 

Bob Weber, The Canadian Press

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Canada sends military aircraft into Haiti’s skies as gang violence escalates

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OTTAWA — Canada has sent one of its military planes to Haiti to help the country cope with escalating violence.

A joint statement today from National Defence Minister Anita Anand and Foreign Affairs Minister Mélanie Joly says Canada has deployed a CP-140 Aurora aircraft to help “disrupt the activities of gangs” in Haiti.

Gang violence has become a reality for those living in the Haitian capital of Port-au-Prince since last summer, with hundreds having reportedly been kidnapped and killed.

The UN has also said gangs are restricting access to necessities like health care and water and are also allegedly sexually assaulting women and children.

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Haiti’s political and humanitarian crisis has led to calls for Western countries to intervene, with the Canadian government saying the aircraft deployment comes in direct response to Haiti’s request for help.

The government says the patrol aircraft is currently in Haiti and will remain there “for a number of days” to help with surveillance and intelligence efforts.

The aircraft deployment is the latest step the government has taken to assist Haiti, and not indicative of a military intervention.

Other support measures to date include levying sanctions against individuals it views as responsible for the violence in Haiti.

“The deployment of a Canadian patrol aircraft will strengthen efforts to fight criminal acts of violence and to establish the conditions necessary for a peaceful and prosperous future,” Anand said in Sunday’s statement.

This report by The Canadian Press was first published Feb. 5, 2023.

 

The Canadian Press

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