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'It wasn't called COVID at the time:' One year since Canada's first COVID-19 case – CTV News

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TORONTO —
The patient, when he came into the hospital ER with what seemed to be mild pneumonia, wasn’t that sick and might otherwise have been sent home.

Except the man had just returned from China, where a new viral disease was spreading like a brush fire. His chest X-rays were also unusual.

“We’d never seen a case like this before,” says Dr. Jerome Leis. “I’d never seen an X-ray quite like that one.”

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It was the evening of Jan. 23, 2020, when the team at Toronto’s Sunnybrook Health Sciences Centre decided to admit the 56-year-old patient. That same day, Canada’s chief public health officer, Dr. Theresa Tam, told the country:

“The risk of an outbreak in Canada remains low,” Tam said in a refrain she and other officials would repeat for weeks on end.

Less than two days after admission to Sunnybrook, the man would become “Patient Zero” — the first COVID-19 case in Canada.

For several weeks, Leis, the hospital’s medical director of infection prevention and control, had been anticipating just such a moment. He had known since the end of December about the outbreak in Wuhan, China, and he’d been following Chinese authorities as they published information about the new pathogen and its effects.

Drawing on lessons learned from the SARS epidemic years earlier, Sunnybrook’s screening staff were already asking new specific questions of incoming patients. Protocols were sharpened. Just that morning, in fact, internal-medicine residents and faculty had done a refresher around protective gear.

“We were extremely suspicious that this was the novel coronavirus that had been described,” Leis says. “It does feel like a lifetime ago and yet it does just seem like yesterday.”

Dr. Lynfa Stroud, on-call general internist and division head of general internal medicine at Sunnybrook, was notified the new patient needed to be admitted.

“We didn’t know what exactly we were dealing with,” Stroud says. “We had early reports of presentations and how people evolved. We were a bit nervous but we felt very well prepared.”

The following day, as China was locking down Hubei province, Dr. Peter Donnelly, then head of Public Health Ontario, was asked about lockdowns in Canada. “Absolutely not,” he declared: “If a case comes here, and it is probably likely that we will have a case here, it will still be business as normal.”

Confirmation of the clinicians’ suspicions at Sunnybrook would come from the agency’s laboratory, which had been working furiously to develop and validate a suitable test for the novel coronavirus based on information from China. The agency’s lab had been testing samples for two weeks when the Sunnybrook call came in.

“They sent a sample to us in a cab,” says Dr. Vanessa Allen, chief of microbiology and laboratory science at Public Health Ontario.

It would be the start of a round-the-clock effort to test and retest the new samples.

“The last thing you need is a false signal or some kind of misunderstanding,” says Allen, who had been a resident during the SARS outbreak.

By about midday of Saturday, Jan. 25, the lab was sure it had identified the new organism that would soon take over the world and become a household name.

“It wasn’t called COVID at the time,” Allen says of the disease.

Over at Sunnybrook, Leis received the confirmation without much surprise.

“It was consistent with what we were seeing and what we suspected,” he says. “I was actually happy that the lab was able to confirm it.”

Within hours, public health authorities would let the country know that Canada had its first case of the “Wuhan novel coronavirus,” although further confirmation from the National Microbiology Laboratory in Winnipeg was pending.

“I want Ontarians to know that the province is prepared to actively identify, prevent and control the spread of this serious infectious disease in Ontario,” Health Minister Christine Elliott declared as the province announced a new “dedicated web page” for latest information.

The wife of “Patient Zero” would also soon be confirmed as COVID-19 positive but was able to self-isolate at home.

“This (man) was one of the first cases to report on the more milder spectrum of disease, which was not something we were aware of,” Leis says. “It helped to teach us about the larger spectrum in disease severity that we see with COVID-19, which is very different from SARS.”

Looking back now at their roles in a small piece of Canadian pandemic history, those involved talk about how much we didn’t know about a virus that has since infected three-quarters of a million people in Canada, killing more than 18,800 of them.

“The initial detection, in some ways, was the easy part,” Allen says. “This virus and the implications are extremely humbling, and just the prolonged nature and impact of this was certainly not on my radar in January of last year.”

Yet treating “Patient Zero” and his wife afforded valuable lessons about what was then a poorly understood disease. For one thing, it became apparent that most of those afflicted don’t need hospital admission — hugely important given the massive number of infections and resulting stresses on critical-care systems.

“To be honest: We would have sent this patient home from the emergency room,” Stroud says. “We admitted him because, at that time, it wasn’t known very well what the course of illness was.”

Sunnybrook alone has now assessed more than 4,000 COVID-19 patients. To survive the onslaught, the hospital developed a program in which patients are screened and, if possible, sent to self-isolate under remote medical supervision.

Both “Patient Zero” and his wife recovered. Their cases would mark Canada’s first minor health-care skirmish of what was to become an all-out global defensive war against COVID-19. It also marked the beginning of relentless work hours for those on the front lines of health care.

For health-care workers, it’s been a long year since those first energized, if anxious, days one year ago. There’s a weariness in their voices, a recognition the war is still raging, even as vaccines developed with stunning alacrity offer some hope of a truce.

“We have been working essentially non-stop since last January and it’s not slowing down now,” Leis says. “Health-care teams are tired. There’s a lot of concern about burnout. It’s been challenging for sure.”

Despite COVID-19’s deadly toll, the vast majority of COVID-19 patients, like “Patient Zero,” recover. Still, even for some of those, their battle might never be over.

“These people just don’t get magically better,” Stroud says. “Some will have lifelong lung scarring and damage to their lungs.”

This report by The Canadian Press was first published Jan. 24, 2021.

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Johnson & Johnson COVID-19 vaccine becomes 4th to receive Health Canada approval – CBC.ca

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Health Canada has approved the use of Johnson & Johnson’s COVID-19 vaccine in Canada.

Health officials announced the approval at a media briefing today this morning in Ottawa.

The U.S. health-care giant’s vaccine is the fourth to be approved in Canada.

The approval is expected to provide a significant boost to Canada’s vaccine rollout. Johnson & Johnson’s vaccine is widely seen as one of the easiest to administer because it requires only one dose and can be stored for long periods of time at regular refrigerator temperatures.

Canada has ordered 10 million doses from Johnson & Johnson with options for up to 28 million more. Most of those shots are expected to arrive by the end of September.

Regulatory approval in this country follows similar approval by the U.S. Food and Drug Administration on Saturday. 

The FDA said Johnson & Johnson’s vaccine offers strong protection against serious illness, hospitalizations and death. One dose proved to be 85 per cent protective against the most severe COVID-19 illness in a global clinical trial spanning three continents.

More to come.

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Why Canadians should elect their Governor General – CBC.ca

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This column is an opinion by Charlotte Dalwood, a juris doctor student at the University of Calgary, Faculty of Law. For more information about CBC’s Opinion section, please see the FAQ.

A scandal involving workplace harassment and verbal abuse at Rideau Hall triggered former Governor General Julie Payette’s resignation in January. But the bigger scandal is that governors general are unaccountable to the Canadian people, and this one will not go away when Payette’s successor is sworn in – or until the position is reformed to make it an elected office.

It is essential there be such public accountability, because the Governor General wields substantial power, both at home and abroad.

Right now, oversight of Canada’s de facto head of state comes largely from the prime minister.

This starts with the selection of someone to fill the role. While the Queen approves her viceregal, she does so on the prime minister’s advice.

And the prime minister is under no obligation to consult the Canadian public before offering it. In Payette’s case, this allowed Justin Trudeau to choose a candidate whose history of mistreating staff his office had failed to identify.

Once the decision is made and a new governor general installed, it also falls on the prime minister to hold this figure accountable for their day-to-day activities. Canadians have few ways of providing this oversight themselves, since access to information laws do not apply to the Governor General’s office. This means the goings-on at Rideau Hall are largely hidden from the public.

Canadians must therefore take it on trust that the prime minister will not only monitor the Governor General to learn of any abuses of their powers as they occur, but also intervene to stop them.

WATCH | Gov. Gen. Julie Payette resigns after scathing workplace review:

Gov. Gen. Julie Payette resigned on Thursday after a scathing review about a toxic workplace at Rideau Hall. The review followed CBC reporting into allegations of workplace harassment and bullying in the Governor General’s office. 2:50

Giving Canadians a direct say in who occupies the country’s highest government position, along with the ability to monitor their conduct, won’t rule out the possibility of future scandals occurring. But it would bring heightened accountability to the Governor General’s office, and strengthen the demands on the person holding it to perform their role in a way that promotes the public’s interests.

This is necessary in a democratic nation, considering the Governor General’s powers and responsibilities.

Domestically, this figure summons and dissolves Parliament, grants Royal Assent to federal legislation, and ensures Canada is never without a prime minister able to command the House of Commons’ support.

They hold reserve powers, such as the ability to unilaterally dismiss a government and veto proposed laws, that allow the Governor General to safeguard democratic norms.

The Governor General is also one of Canada’s key diplomatic representatives on the international stage. Via state visits to other countries, events at home to welcome visiting dignitaries, and other official means, the viceregal supports and advances Canada’s foreign policy objectives.

The office is thus far from a merely ceremonial one. Indeed, an incompetent or ineffective governor general could do real damage to Canada’s constitutional order and global stature.

Which is why the whole country has a stake in who carries out the duties of governor general, as well as in how that person does so.

WATCH | Intergovernmental Affairs Minister Dominic LeBlanc says vetting process for Julie Payette’s replacement will be more robust:

Intergovernmental Affairs Minister Dominic LeBlanc says the Privy Council Office plans to advise Prime Minister Justin Trudeau in the coming week on replacing the governor general. 7:04

Transitioning to an elected governor general would afford the electorate an opportunity to weigh in on both counts via regular votes. In order to secure re-election, governors general would need to ensure they are exercising their powers to Canadians’ satisfaction.

Occupying an elected post would also empower an incumbent governor general to act as a much-needed counterbalance to the prime minister’s power.

As an appointee under the current system, Canada’s unelected representative head of state cannot override the recommendations of its democratically elected head of government, except in the most unusual of situations, without contradicting Canadian democratic values. Constitutional convention therefore dictates that the Governor General will almost always defer to the prime minister’s advice.

A skilled prime minister can take advantage of this fact to manipulate the Governor General’s powers to advance their own agenda and undermine parliamentary opposition. In 2002, for example, then-prime minister Jean Chrétien asked the Governor General to prorogue parliament, avoiding the tabling of a report into the sponsorship scandal. In 2008 and again in 2009, then-prime minister Stephen Harper used the Governor General’s authority to prorogue Parliament and keep his minority government in power. Most recently, Prime Minister Trudeau requested Parliament be prorogued in August 2020 during the WE Charity controversy.

An elected viceregal, by contrast, would have an independent mandate from the Canadian people. This mandate would provide the Queen’s representative with a democratic basis for rejecting prime ministerial advice that does not reflect popular sentiment, advice that is particularly likely during periods of minority rule in the House of Commons.

In other words, by exercising greater oversight over their de facto head of state, Canadians would also be exercising greater oversight over their head of government.

And they would be doing it at the ballot box, which in a democratic society is where all of Canada’s leaders — including the Governor General — should be held to account.


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Ontario expecting shorter timeline for COVID-19 vaccine rollout after good news on dosing and AstraZeneca – CP24 Toronto's Breaking News

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Health Minister Christine Elliott says that with the approval of a new COVID-19 vaccine in Canada and new guidelines for administering second doses, Ontario is “recalibrating” its timeline for rolling out vaccines and may be able to get more people their first dose sooner than initially thought.

“We were looking at the end of the summer, probably into perhaps September,” Elliott told reporters Thursday. “I think it’s fair to say that we will be able to shorten that timeline, given the new volumes of vaccines coming in with AstraZeneca, and the extension of the first and second doses for both Pfizer and Moderna, meaning we can get more first dose into more arms faster.”

Last week, Health Canada rubber-stamped the AstraZeneca vaccine, the third COVID-19 vaccine that has now been approved for use in the country. On Wednesday, a national panel of vaccine experts also recommended extending the interval between first and second vaccine doses to four months, based on data showing good protection after just a single dose.  

While it looks like the province’s vaccination program may proceed more quickly than first thought because of the two developments, Elliott said it is too soon to set a new target date.

“We expect that our timelines will be reduced overall, but I can’t give you a specific date right now,” she said.

The provincial government is expected to announce the next steps of its vaccination plan on Friday, CTV News has learned.

Speaking to CP24 on Thursday morning, infectious diseases specialist Dr. Isaac Bogoch, who is also a member of the province’s 10-person vaccine distribution task force, said recent developments indicate that Canada will be able to significantly speed up its timeline for vaccinating members of the general population.

“I think it is very, very, very likely that most Canadians will be able to have a vaccine by, just guessing here, but could be the early part of the summer,” he said Thursday.

The federal government previously said that all Canadians who want a vaccine should be able to receive one by late September.

Bogoch noted that after a sluggish start to vaccine shipments, more doses are finally starting to arrive in Canada.

“The real inflection point is as March turns into April. You are going to start to see the mass vaccine clinics expand, and then of course the massive expansion of the vaccines going into pharmacies,” he said.

“That giant shift really is at the tail end of March.”

To date, Ontario has administered 784,828 doses of a COVID-19 vaccine and about 268,118 of the province’s 14 million residents have received two doses for full immunization.

Ontario is expecting to receive approximately 700,000 more doses of the Pfizer-BioNTech vaccine over the next four weeks. While provincial allocations for the Moderna vaccine have not been updated on the federal government’s website, the company previously promised to deliver 1.3 million doses to Canada in the month of March.

At least 113,000 AstraZeneca doses manufactured in India are destined for Ontario after arriving in Canada this week.

Johnson and Johnson decision expected within a week

“We are actually starting to see a significant number of vaccines coming to the country, especially with AstraZeneca coming in. We are getting half a million doses now and much more of that in the coming weeks,” Bogoch said.

“If you look in the crystal ball, it is likely that we’ll have (the) Johnson & Johnson (COVID-19 vaccine) and even with some of the delays that Johnson & Johnson is having in manufacturing, we are seeing other indications that they will be able to ramp up manufacturing… At the end of the day, it just points to much shorter timelines for Canadians.”

Health Canada’s Chief Medical Adviser Dr. Supriya Sharma said Thursday that a decision on the Johnson & Johnson vaccine will likely be made within the next week.

“The review of the Johnson & Johnson submission is going very well. It is progressing and we are expecting to have that completed and a decision in the next few days. I would say within the next seven days or so,” she told reporters.

If approved, Canada is expecting to receive a million doses of the Johnson & Johnson vaccine by the end of September, however the delivery schedule is still unclear. On Thursday, federal officials said shipments could begin sometime in the second quarter of the year.

More encouraging news came earlier this when the panel of experts who provide advice to Ottawa on vaccinations said second doses of COVID-19 vaccines can now be administered up to four months after the first dose is given, allowing vaccines to flow to more members of the population sooner.

The panel cited emerging clinical evidence from the U.S., Israel and the UK that indicated the first dose of Pfizer or Moderna vaccines provides 90 per cent or better protection from coronavirus infection for much longer than initially thought.

The Ford government has signalled that it plans to accept that recommendation and delay second doses beyond the current 28-day timeframe.

“Most places in Canada will likely be spacing out the doses between dose one and dose two by anywhere from three to four months,” Bogoch said. “You can just vaccinate way more people in a shorter period of time.”

AstraZeneca to be used in pharmacy pilot starting next week

While some Ontario municipalities have begun to vaccinate people over the age of 80 who are living in the community, the province’s largest city has not yet been able to begin vaccinating members of the general population.

Toronto’s mayor has said that the city is still focused on trying to vaccinate other priority populations, including frontline health-care workers.

In the meantime, Elliott confirmed Thursday that the AstraZeneca vaccine will be used in a pilot project starting next week that will see vaccines distributed through pharmacies in three health units, including Toronto.

The storage requirements for the vaccine are simpler, making it easier to distribute through remote locations such as pharmacies.

“It can be moved more easily. It doesn’t have the same kind of temperature requirements that the Pfizer vaccine has and to a lesser extent Moderna,” Elliott told reporters. “I would say that in addition to pharmacies, you may also see it in primary care centres, and perhaps even in larger vaccination clinics.”

Ontario has said that keeping in line with advice from the  National Advisory Committee on Immunization (NACI), it will only distribute the Astra Zeneca vaccine to those under 65 years of age.

Infection-prevention measures still important in the meantime

Ontario’s Chief Medical Officer of Health Dr. David Williams called the possible shortening of the vaccination timeline “good news” Thursday.

“This means we can accelerate faster, and we have some advise on timelines that we might be able to move up on the previous predictions of early fall to complete, we may have it even sooner than we had anticipated, and this is good news for all,” he said.

However he cautioned that people still need to stick to public health advice while the vaccine rollout is underway, especially with the more contagious variants of the virus on the loose in the province.

“We still have to hold the other ones down while we undertake this task,” he said. “So our task of  maintaining our distancing, masking, staying home when sick, getting tests when we need to get tested, keep to your household, stay home if you do not need to (go out), limit your activities, even if you are in a zone within the framework that allows you to access those activities.”

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