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Justin Trudeau contends with the uncertainty of Canada’s vaccine supply

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In his last two appearances before reporters, Prime Minister Justin Trudeau asserted that the unpredictable messiness of vaccinating the globe against a novel coronavirus should have been expected.

“We knew that there would be some hurdles along the way with unpredictability and increased demand for production,” the prime minister said Tuesday.

On Friday, he explained that “the numbers on vaccine arrivals in this new process where industrial processes are being stood up around the world from scratch for these vaccines — we always expected them to fluctuate a little bit.”

If the Trudeau government’s move to purchase doses in advance from seven different suppliers was supposed to minimize the risk inherent to any one option, it apparently couldn’t eliminate all potential for trouble; including production interruptions for Moderna and Pfizer and the threat of export controls by the European Union.

But if that uncertainty was foreseeable — if a certain lack of control over events was inevitable — it likely should have been a greater point of emphasis from the beginning. For the government’s sake, it might have prepared Canadians for the interruptions that the Trudeau government has been scrambling to account for over the last week. For the country’s sake, it might have advanced the conversation about what, if anything, the government could have done differently to counter the increasingly obvious challenges of international vaccine procurement.

For now, Trudeau promises that his goal remains the same; that the two leading manufacturers will produce and deliver enough doses of a vaccine over the next eight months to vaccinate every Canadian that wants to be vaccinated against COVID-19. And, if he and the country are lucky, this will be the last of the major disruptions.

But his reassurances are challenged by both the demonstrated uncertainty of the global supply chain and competing assertions that Canada should somehow be doing better.

“Canadians deserve certainty and a plan,” Conservative Leader Erin O’Toole said in a statement issued on Tuesday. “Canadians should know when things are going to get better.”

Opposition parties unimpressed

On Tuesday, Trudeau came bearing the promise of domestic vaccine production, at least eventually. The news that Noravax will be able to produce vaccines at a Montreal facility by year’s end — and that the University of Saskatchewan’s Vaccine and Infectious Disease Organization will eventually be able to produce 40 million doses annually — is presumably a hedge against further disruptions. It also might help set Canada up to deal with future needs to either vaccinate against variants of the COVID-19 virus or deal with the next pandemic. But it doesn’t do anything to address the immediate need.

The opposition parties were, perhaps foreseeably, unimpressed — both the Conservatives and New Democrats quickly asserted on Tuesday that the Liberal government should have negotiated for domestic production much earlier.

“This should have been negotiated — Day 1,” NDP Leader Jagmeet Singh tweeted.

Negotiations necessarily involve more than one party, of course. That doesn’t absolve either party of responsibility for failing to find an agreement, but it does mean more investigation is needed to understand why a desired result wasn’t achieved. According to the Canadian Press, the federal government and the National Research Council have been trying to negotiate for domestic manufacturing with all the leading vaccine producers for months, but none had agreed until Noravax.

O’Toole vs Trudeau

Dr. Joel Lexchin, an emergency department physician and an associate professor at the University of Toronto whose research focuses on pharmaceutical policy, told the House of Commons health committee this week that, “Canada had warnings about the need for domestic vaccine manufacturing as a result of SARS in 2003 and H1N1 in 2009 but didn’t heed those warnings.”

That’s the long view. For the Trudeau government, the question is whether there was obviously something different that they should have done in the last 12 months to ensure faster, more-plentiful and better-guaranteed access to a vaccine — and whether the decisions they took were defensibly grounded in sound logic and expertise. If parliamentary committees were more generally adept at getting to definitive answers, one might expect the health committee’s hearings to help clarify such matters.

 

In this multiple-exposed image Conservative Leader Erin O’Toole, left, asks a question and Prime Minister Justin Trudeau answers during question period in the House of Commons last fall. O’Toole is continuing to press Trudeau over Canada’s pace of vaccine rollout. (Sean Kilpatrick / Canadian Press)

 

Opposite Trudeau’s concession to uncertainty, O’Toole continues to assert a desire to know more about what the future holds.

Whatever plan the Liberals could present to lay out exactly how many doses they expect to arrive in Canada each week between now and September, it’s now clear those numbers would be subject to change — if a factory in Belgium catches a cold, a whole supply chain can get sick. And maybe no one really knows when “normal” will return. But O’Toole is no doubt speaking to a widespread public desire for this to all be over as quickly as possible — and his critical view of the Trudeau government is aided by cold, hard math.

Whatever this moment lacks in certainty or control (or clear alternatives), it has an abundance of data about how well each and every country is doing to vaccinate its citizens.

Those global rankings might require context. Israel is reportedly leading the world because of the terms it was willing to negotiate and its own geographic and logistical advantages. The United States and the United Kingdom have access to domestic manufacturing of the current vaccines. The United Arab Emirates, Bahrain and Serbia are using vaccines from China and Russia that have not been approved for use in Canada. The Seychelles and Malta are tiny countries.

But even after the league leaders, there was still a gap on Tuesday between ninth-place Denmark (with 4.66 doses administered per 100 people) and 29th-place Canada (2.58 doses per 100 people). Canada is currently running behind most European countries — which purchased their vaccines as a bloc — though is still ahead of France. (Canada is actually on par with Belgium, where Canada’s doses of the Pfizer vaccine are being manufactured).

Maybe that gap will narrow. Maybe it won’t amount to a huge difference between when Denmark reaches herd immunity and when Canada does. But there is no doubt some segment of the Canadian public would like to imagine that this country should be much nearer to the top. And the bigger the gap, the harder it will be for the Trudeau government to explain away.

Uncertainty and a lack of control might be facts of Canadian life at the moment. But those facts will become only more unacceptable if Canadians seem to suffer disproportionately for them.

Source:- CBC.ca

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Champlain CBP Officers Recover Stolen Vehicle

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CHAMPLAIN, N.Y. – U.S. Customs and Border Protection (CBP) officers at the Champlain Port of Entry discovered a stolen vehicle, operated by a United States citizen.

Yesterday, CBP officers encountered a 2002 Chevrolet Astro van attempting entry into the United States, driven by a 36-year-old male U.S. citizen. The man indicated he had no intention to travel to Canada and performed a U-turn prior to crossing. During the inspection, CBP officers recognized some anomalies, the vehicle and man were then escorted to the secondary inspection area for further examination.

During the secondary examination, CBP officers discovered a loaded Ruger rifle along with 70 rounds of ammunition. After securing the rifle, working in conjunction with New York state troopers, it was determined that the vehicle was recently reported stolen.

“Our dedicated officers continue to intercept criminal activity to keep our communities and country safe,” said Area Port Director Steve Bronson. “Their skills, experience and knowledge, along with our strong relationships with local law enforcement, have led to continued success.”

After processing, the driver, rifle, ammunition and stolen vehicle were turned over to New York State Police to face felony charges of criminal possession of stolen property.

Follow us on X (formerly Twitter) @CBPBuffalo and @DFOBuffalo

For more on Customs and Border Protection’s mission at our nation’s ports of entry with CBP officers and along U.S. borders with Border Patrol agents, please visit the Border Security section of the CBP website.

Follow us on X (formerly Twitter) @CBPBuffalo and @DFOBuffalo

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After hurricane, with no running water, residents organize to meet a basic need

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ASHEVILLE, N.C. (AP) — It takes water to flush a toilet and tens of thousands of North Carolinians have been without it since Hurricane Helene ripped through the state three weeks ago. When Lark Frazier went around asking her Asheville neighbors how they were doing as far as water to flush, several burst into tears over the stress of where to go to the bathroom and what to do with the waste.

Some told her they were eating less to avoid going. Others said they were dumping poop in the yard and covering it with leaves. An elderly woman mentioned planning to scoop it out of the toilet with her hands.

“Not only is that horrifying and inhumane but it’s dangerous for her to be handling her waste like that,” Frazier said.

Since Helene swallowed mountain towns, damaged water infrastructure and killed nearly 250 people across the Southeast, local governments have been overwhelmed, and that’s spurred community organizing and innovation.

Frazier is one of the newly-minted leaders to have stepped up. She grew up in rural Colorado, using an outhouse for years before her family got a flush toilet. She drew on that experience, then came across the Emergency Toilet Guidebook online, published by the Regional Disaster Preparedness Organization in Oregon. She began fashioning rudimentary toilets and training others to do it, too.

The concept is simple: line a sturdy bucket with a thick plastic bag, cover the top with a toilet seat or a water-resistant foam noodle for comfort, then drop in a handful of wood chips or other dry material after every use to absorb liquid and reduce odor. Pee should stay separate.

“Not having waste treated appropriately can absolutely lead to a major public health crisis,” said Sue Mohnkern, who developed the guidebook. Mishandling fecal matter can lead to cholera, dysentery and other serious, even fatal diseases.

Mohnkern recommends everybody living in a disaster-prone area have an emergency toilet handy.

Neither the city nor the county have released official guidelines on how to manage human waste without water to flush.

Frazier called that lack of guidance “astounding.”

County spokesperson Lillian Govus said no county could give sufficient attention to every important issue in a disaster of this scale. City councilwoman Kim Roney has released a video explaining how to use an emergency toilet.

The city set up the first water refill sites about a week after Helene, when some 136,000 people across the Southeast had nonoperational water providers, according to the EPA. Around 100,000 were in the Asheville area, although the city says that number has been reduced significantly in the past week. Still, thousands lack water, and it’s unclear when it’ll be back on. Those who can’t get to these refill sites are getting missed, and here again, volunteers fil the gap.

Molly Black and Elle DeBruhl, strangers before the storm, now coordinate an army of neighbors from dawn to dusk to get flush water to people. From Florida to Ohio to Texas, people have donated cube-shaped, 250-gallon, white plastic containers known as IBC totes that are often used on farms, in the chemical industry and disasters. A single tote can nearly fill a 6-foot pickup bed. Black and DeBruhl have organized people to haul the totes to ponds, fill them using pumps, then take them to where they’re needed, like apartment buildings. Other neighbors and volunteers pick up the work from there, taking buckets of of water to residents in need.

“I don’t even feel like I’m living my real life,” said DeBruhl, whose employer EY, a global accounting firm, gave her paid leave to serve her community following the storm. “I went from a six-man tote operation to now I’m in charge of solving the nonpotable flushing water for the impacted area? Its crazy.”

With cell service returned now, residents can text Black and DeBruhl’s grassroots group, Flush AVL — AVL is the shorthand for Asheville — to request a refill when their tote is empty. The group replenishes some 400 sites every other day. The city is helping with some of those, but this stopgap effort to preserve dignity and public health is mainly individuals donating their time and money.

Govus applauded the volunteer efforts.

“It helps fill the gaps and meet peoples needs as we’re working on systems and major processes to get people food, shelter and water,” she said.

Yet another water solution is coming from people who still have water — because they have a well. Erik Iverson lives near a well owned by an urban farm that wanted to help after the hurricane. He laid two 200-foot lengths of plastic PEX pipe to route the well water to the road for public access.

Then he added ultraviolet light purification in order to offer drinkable water alongside the flush water (the city, howver, recommends boiling all water sources). Now people driving by can access multiple spouts, operated by a foot pedal connected to a chain, touch-free to minimize germs spreading.

“With climate change this is probably not going to the be last time this happens,” Iverson said. “No matter how resilient Asheville rebuilds their water system, it’s simply poor planning to not have this infrastructure in place to deal with something like this again.”

Wine to Water, a global nonprofit focused on clean water, paid for the purification for this and nine other wells whose owners have agreed to community access.

The private well owners “benefit from having purified water on their property, and when this happens again, they can jump right into offering this purified water again. That is resilience,” Iverson said.

Yet another grassroots group, Be Well AVL sprang up in the last two weeks and is pulling water from higher-capacity commercial wells offered up by local businesses, and distributing it at apartments for low-income, elderly and disabled residents. They can’t guarantee it’s potable, given the official warning to boil water, but purified well water is typically far cleaner than stagnant ponds. Both sources are essential, said Grace Barron, an organizer with Be Well AVL.

“We absolutely need toilets to be flushed,” Barron said. And “there’s this other area of need for sanitation … washing dishes, clothing and bathing,” she said. There are infants in the community, she said, and they shouldn’t be bathed in pond water.

Barron, an Asheville resident of 18 years, said Hurricane Helene has reminded residents of the caring culture that was a foundation of the city before it ballooned into one of the most expensive places to live in the state.

“Mutual aid has been a part of our community prior to this,” she said. “The community connections we had before have only grown.”

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Videojournalist Erik Verduzco contributed from Asheville.

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The Associated Press receives support from the Walton Family Foundation for coverage of water and environmental policy. The AP is solely responsible for all content. For all of AP’s environmental coverage, visit

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Adult day centers offer multicultural hubs for older people of colour

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BERGENFIELD, N.J. (AP) — At Sunshine Adult Day Center, every morning starts with a parade around the room.

Today, the theme is multicultural, and the flag bearers have no shortage of countries: Philippines, India, Haiti, Mexico, United States. Most of them older adults, attendees dance through the room, waving streamers and banging drums as Pitbull’s “I Know You Want Me” blasts.

Proudly representing her home country of Nigeria, Charity Wogwugwu, 87, is dressed to the nines in a pistachio green skirt embroidered with red and gold flowers, a lemon yellow floral top with puffed sleeves and a pleated gold headwrap.

“They pay attention to us. They recognize us,” said Wogwugwu, who lives in neighboring Teaneck with her daughter and six grandkids. “I love coming to Sunshine.”

Everyone at the center has a health need, be it mobility issues, dementia or difficulty completing daily tasks on their own. Sunshine staff say they have one goal: keep people mentally and physically sharp enough that they can stay out of places like nursing homes for as long as possible.

Adult day centers are the most racially diverse long-term care setting in the U.S., with many tailoring their offerings to the foods, traditions and cultures of their clientele and serving as key resource hubs to older people of color and immigrants. Day centers also serve the least amount of people of all long-term care settings, in part because of the cost and limited insurance coverage options; federal Medicare, the largest insurer of older adults, doesn’t cover them.

Sixty percent of people who use adult day centers identify as people of color, according to U.S. Centers for Disease Control and Prevention data. Centers like Sunshine are microcosms of their communities, attracting people from families who are especially reluctant to put their elders in residential long-term care due to cultural norms or their experiences with racism.

Overall, they’re “underrecognized” for the role they play in communities of color, said Tina Sadarangani, an adult and geriatric nurse practitioner who researches the aging of older immigrants at New York University.

“The biggest problem that adult day services contends with is public perception,” she said of the centers, which are sometimes seen as an equivalent to child “day cares.”

Battling isolation

On the other side of the country, He Fengling wakes up at 5:30 a.m. on days she goes to Hong Fook Adult Day Health Care Center near Oakland, California’s Chinatown district. It serves people of Chinese, Korean and Vietnamese backgrounds.

A day-center bus drops her off at about 8:30 a.m. She settles into her routine of a breakfast of toast and jam with a glass of milk, and reading the Sing Tao Daily, a Hong Kong newspaper. Then it’s time for physical therapy to relieve her arthritis and sciatica.

There are different pre-lunch activities each day. Today it’s table games: mahjong, tien gow, and Chinese chess, plus bingo. An automated voice says the bingo numbers in English, and a staff member follows with a translation.

“Everybody who sees me raises their thumb to tell me how great I’m doing, that I insist on coming,” said He, who is in her late 80s.

Corinne Jan, CEO of Family Bridges Inc., the nonprofit that runs Hong Fook, said they serve their clients in ways that other places can’t. She said the center’s focus is on the familiar — food, language and faces.

“I think all of our participants are monolingual, so they don’t speak English,” Jan said. “Imagine having to be in a nursing home or even just five days in a hospital or in the emergency room and not being able to communicate.”

Many older adults can feel isolated even among family as they age out of a caregiving role and into needing care themselves, experts said.

He came to the U.S. in the late 1990s to help her daughter with a new baby. Now, the same grandson that she helped raise checks on her and brings her to doctor’s appointments.

She has memory issues and reduced mobility, which has sometimes isolated her from simple interactions in her day-to-day life, like going to the store.

“After coming here … my thoughts are much more cheerful,” she said of the day center.

Older immigrants who might lack transportation, education, income and face language barriers can become “marginalized and sidelined in their own household,” Sadarangani said – even if they live with family. Adult day centers create a “kinship network” for them, she said.

And socialization can hold off depression, motivate people to stay active and even ease symptoms of dementia.

Sadarangani’s grandmother went to Sunshine in New Jersey before the pandemic. Her family’s experience inspired her to study the centers. She recalled the center giving her grandmother new experiences, including a tour of New York City in Hindi.

Serving families and communities

Advocates argue day centers are the most cost-effective long-term care. About 80% of people who attend day centers pay for it with Medicaid, which means the centers inherently serve a population that is not just more diverse but one that is almost entirely low-income.

The centers also are one-stop shops for communities of color to connect to resources that are otherwise hard to find and navigate.

Sunshine’s director of social work, Evan Heidt, spends each day talking with clients who are running out of food or have lost their housing. He wades through their Medicaid renewals and schedules surgeries and doctor’s appointments. Meanwhile, clients visit the in-house physical therapist to work on their mobility by pedaling a stationary bike, tossing balls and pulling exercise bands. Staff nurses check vitals, take blood sugar readings and administer medications daily.

Many adult day center clients report eating one meal per day – the one the center gives them, Sadarangani said. Heidt estimated some 20% of Sunshine’s clients have been homeless.

“We are the epicenter of the community, really,” Heidt said. “Not just the clients, but the families come to us, too.”

“Anybody have any problem, they solve it,” said Avtar Khullar, who attends Sunshine with his wife, Avinash. He came to the U.S. from New Delhi in 2007, and his aging parents attended Sunshine before they died.

But little is streamlined when serving such a diverse population. For breakfast alone, Sunshine’s small kitchen staff whips out 120 meals with 10 different options, including vegetarian, American, Filipino, Indian, kidney-friendly and fasting-friendly (fruits and nuts).

Grant funding is key for day centers, too, especially to bus clients there and home. Centers sent people care packages, activity books and meals during the pandemic even though they didn’t have enough money for it, said Lauren Parker, a gerontologist at Johns Hopkins University.

“A lot of programs actually ended up closing,” Parker said.

Sunshine has plenty of open spots, especially in its afternoon program. Many people didn’t come back after pandemic lockdowns were lifted.

Those who did say the center is a critical part of their routine and social life. That includes Theomene Valentine, 84, one of several Haitians who Sunshine buses in from Newark, an hour ride each way.

“I come here to talk in Creole with my friends,” she said.

Leticia Borromeo, 82, loved Sunshine so much she recruited her friends to attend with her. She is Filipino, and loves how the center exposes her to different cultures, foods and religions.

“We are like one family,” she said.

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Associated Press journalist Haven Daley in Oakland, California, contributed to this report.

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The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

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