This is an excerpt from Second Opinion, a weekly roundup of health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.
COVID-19 levels haven’t been this low in Canada in a long time — and that’s reason to breathe a collective sigh of relief — but the actions we take now to maintain control mean the difference between living with the virus or hiding from it in the weeks and months ahead.
In the past seven days, Canada averaged fewer than 500 new COVID-19 cases per day, under 750 patients in hospital and just 366 people in intensive care.
Ontario, Canada’s largest province with a population of close to 15 million people, recorded no new deaths from COVID-19 on Wednesday for the first time in nine months.
“That is remarkable,” said Dr. Zain Chagla, an infectious diseases physician at St. Joseph’s Healthcare Hamilton.
“That’s in the context of not having everyone vaccinated, so that’s even more remarkable. Vaccines are holding up, they’re doing exactly what they’re supposed to be doing.”
But without a clear strategy for containing the spread of COVID-19 as more of the country reopens, experts say Canada is destined to repeat the mistakes of the past by failing to protect our most vulnerable — which now includes the unvaccinated.
Yawen Han sits with her service dog Erya as she receives a dose of the COVID-19 vaccine at a mass vaccination clinic at Scotiabank Arena in Toronto. (Cole Burston/The Canadian Press)
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Delta variant has ‘moved the goalposts’ in Canada
Dr. David Fisman, an epidemiologist at the University of Toronto’s Dalla Lana School of Public Health, says the more contagious and potentially more deadly coronavirus variant known as delta has significantly “moved the goalposts” for eradicating COVID-19 in Canada.
“A few months ago my working assumption was that Canada would basically be done with this pandemic over the summer because we were going to be vaccinating so much,” he said, adding that individuals infected with delta are more likely to have severe outcomes from COVID-19.
“That’s moved herd immunity probably beyond reach.”
Canada has so far fended off another surge in COVID-19 largely thanks to vaccinations, but Fisman says delta has raised the reproductive rate of the virus from about 2.4 to between six and eight, meaning one person can typically pass it on to between six and eight others.
WATCH | What’s known about the delta variant and what makes it different:
A respirologist breaks down what is known about the coronavirus delta variant, including what makes it different, how dangerous it is and whether vaccines protect against it. 4:26
In addition to that increased transmissibility, Fisman and co-author Prof. Ashleigh Tuite, an infectious disease epidemiologist and assistant professor at the University of Toronto’s Dalla Lana School of Public Health, suggest in a new preprint study, which has not yet been peer-reviewed, that delta also has an increased risk of hospitalization and death.
Thankfully the vaccines are holding up well against the variants, with another recent Canadian preprint study on vaccine effectiveness, also awaiting peer review, signalling strong protection against severe illness from delta and echoing earlier global data from countries like Israel.
“There is that potential that the vaccinated people are going to be fine. At most, it might seem like they have a cold,” said study co-author Dr. Jeff Kwong, an epidemiologist and senior scientist at the Toronto-based Institute for Clinical Evaluative Sciences.
“But the people who are not vaccinated can still get very sick from delta and those are the people who are at risk of having serious outcomes like getting hospitalized or dying.”
“Unfortunately, for a 90 per cent efficacious vaccine, that’s not going to be enough,” Fisman said. “You have these pockets of vulnerability and you’re going to have tremendous pressure to not lock things down again.”
Canada’s Chief Public Health Officer Dr. Theresa Tam urged unvaccinated Canadians to get their shots now before colder months arrive to avoid anything like the devastating fall wave Canada experienced last year.
Canada’s Chief Public Health Officer Dr. Theresa Tam urged unvaccinated Canadians to get their shots now before colder months arrive to avoid anything like the devastating fall wave Canada experienced last year. (Adrian Wyld/The Canadian Press)
“We must keep the momentum up,” she said during a press conference Thursday. “The best target to reach for, to get ahead of highly transmissible variants as we head for an indoors fall, is getting the highest possible vaccine coverage as quickly as possible.”
But experts say simply encouraging unvaccinated Canadians to roll up their sleeves will only go so far, and keeping COVID levels low will require a targeted strategy.
Schools most ‘susceptible’ to spread of COVID-19
Children under the age of 12 now make up the single largest cohort of unvaccinated Canadians, due to their ineligibility to get vaccinated, and experts say they should be the first group to protect in the fall.
“Almost all the outbreaks are going to be among the school population, because that is the susceptible population,” said Raywat Deonandan, an epidemiologist and associate professor at the University of Ottawa.
“So we have to invest in ventilation, in small class sizes, in high-quality masks, and symptom checks and rapid tests for schools.”
In addition to schools, Fisman says the same precautions can be used in other places at heightened risk of airborne spread of the virus — including office buildings, restaurants and bars — where masking is intermittent and people come into close contact indoors.
“We really need to figure out how to make those places safe,” said Fisman. “Vaccines are a lot of it, but with the variants we’re not going to have this thing disappear as I think many of us had hoped in the spring.”
Children under the age of 12 now make up the single largest cohort of unvaccinated Canadians, due to their ineligibility to get vaccinated, and experts say they should be the first group to protect in the fall. (Martin Bureau/AFP/Getty Images)
Borders vulnerable to ‘import’ of variants
The importation of new and existing variants from countries around the world is another challenge for Canada’s ability to control COVID-19 in the future — especially with pressure to reopen the U.S. border mounting.
“We should look at border controls a bit more carefully,” said Deonandan. “Even if we get it under control in Canada, it’s raging around the world. We don’t want to import cases.”
Fisman says Canada’s borders are another key vulnerability for the future, because of the repeated pattern of variants from abroad arriving in the country in the past — more than almost any other country in the world.
“The U.S. is less vaccinated than we are — they’re probably going to be a variant factory come the fall,” he said, adding that Canada needs to address its “leaky quarantine system.”
“We need to be doing better on getting surveillance and coming up with smarter systems for actually doing proper quarantine and tracking people as they cross the border.”
Fortunately, Canada is armed with an incredibly effective weapon against the importation of variants — vaccines — we just need to build a big enough border wall of immunity.
“The issue is that with travel, with reopening the borders, there are going to be people coming in with infections potentially as well,” said Kwong.
“But as long as people here are vaccinated, then there’s nowhere for the virus to go.”
Passengers getting off international flights at Toronto’s Pearson airport get mandatory COVID-19 tests on Feb.1. The importation of new and existing variants from countries around the world is another challenge for Canada’s ability to control COVID-19 in the future. (Evan Mitsui/CBC)
COVID-19 now a ‘disease of the unvaccinated’
There’s been much discussion about the last group of unvaccinated Canadians that need to be reached due to hesitancy or accessibility, but what is less often talked about is that they are not a single homogenous group — making them much harder to target.
“The issue is that getting the last 25 per cent is going to take us double the work than it took us to get the first 75 per cent vaccinated,” said Sabina Vohra-Miller, a pharmacologist and science communicator with the South Asian Health Network.
“There’s a whole host of different reasons as to why they’re not vaccinated. So, we kind of have to peel through the layers and each layer is going to take a very targeted, very focused effort to get to them.”
Vohra-Miller says they could be homebound seniors or people with chronic medical conditions who are unable to access vaccination clinics, workers without paid sick leave, or those who are simply hesitant and would benefit from a conversation with their doctor.
Regardless, Chagla says COVID-19 is “now a disease of the unvaccinated” in Canada — one that previous protective measures won’t address.
“Unfortunately the solution out there isn’t going to be masking or physical distancing,” he said. “It’s going to be having antibodies in your blood.”
Thuy Vo gets her first dose of the Moderna COVID-19 vaccine during a door-to-door clinic for the residents of the San Romanoway apartments, in Toronto’s northwest Jane and Finch neighbourhood, on April 21. (Evan Mitsui/CBC)
Vaccine passports a potential ‘carrot’ in Canada
That’s why experts say Canada is at the most critical point of its vaccine rollout, the final stretch, and we need to pull out all the stops to get shots in arms now.
“We really need to use every single carrot and stick available to us in a society like ours to encourage people to get vaccinated,” said Fisman.
“That really means talking about selective access to things that people like to do, like concerts, like restaurants, and having possibly a different set of rules for vaccinated and unvaccinated people.”
Now Quebec may go a step further, by requiring digital vaccine passports that would bar the unvaccinated from some non-essential services — such as gyms, team sports and theatres, for example — as early as September.
WATCH | What digital vaccination passports will mean for Quebec:
Quebec may start using digital vaccination passports to bar people who are not fully vaccinated against COVID-19 from certain non-essential services as early as September, the province’s health minister announced on Thursday. 2:04
“If anyone knows anyone who hasn’t been vaccinated yet, if you could just please beg them, urge them, do whatever you can to try to convince them to get one dose at least,” Kwong said.
“It’s about finding those people who haven’t gotten their first dose yet whether it’s because they have been nervous, haven’t felt comfortable getting it or they just haven’t been able to access the vaccine yet — it’s time to really get on it.”
This is an excerpt from Second Opinion, a weekly roundup of health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.
Have questions about this story? We’re answering as many as we can in the comments.
VANCOUVER – The federal government is urging both sides in the British Columbia port dispute to return to the table after Saturday’s collapse of mediated talks to end the lockout at container terminals that has entered its second week.
A statement issued by the office of federal Labour Minister Steven MacKinnon on Monday said both the port employers and the union representing more than 700 longshore supervisors “must understand the urgency of the situation.”
The statement also urged both sides to “do the work necessary to reach an agreement.”
“Canadians are counting on them,” the statement from MacKinnon’s office said.
The lockout at B.C. container terminals including those in Vancouver — Canada’s largest port — began last week after the BC Maritime Employers Association said members of International Longshore and Warehouse Union Ship and Dock Foremen Local 514 began strike activity in response to a “final offer” from employers.
The union said the plan was only for an overtime ban and a refusal to implement automation technology, calling the provincewide lockout a reckless overreaction.
On Saturday, the two sides began what was scheduled to be up to three days of mediated talks, after MacKinnon spoke to both sides and said on social media that there was a “concerning lack of urgency” to resolve the dispute.
But the union said the talks lasted “less than one hour” Saturday without resolution, accusing the employers of cutting them off.
The employers denied ending the talks, saying the mediator concluded the discussions after “there was no progress made” in talks conducted separately with the association and the union.
“The BCMEA went into the meeting with open minds and seeking to achieve a negotiated settlement at the bargaining table,” a statement from the employers said.
“In a sincere effort to bring these drawn-out negotiations to a close, the BCMEA provided a competitive offer to ILWU Local 514 … the offer did not require any concessions from the union and, if accepted, would have ended this dispute.”
The employers said the offer includes a 19.2 per cent wage increase over a four-year term along with an average lump sum payment of $21,000 per qualified worker, but the union said it did not address staffing levels given the advent of port automation technology in terminals such as DP World’s Centerm in Vancouver.
After talks broke off, the union accused the employers of “showing flagrant disregard for the seriousness of their lockout.”
Local 514 president Frank Morena said in a statement on Saturday that the union is “calling on the actual individual employers who run the terminals to order their bargaining agent — the BCMEA — to get back to the table.”
“We believe the individual employers who actually run the terminals need to step up and order their bargaining agent to get back to the table and start negotiations and stop the confrontation,” Morena said.
No further talks are currently scheduled.
According to the Canada Labour Code, the labour minister or either party in a dispute can request a mediator to “make recommendations for settlement of the dispute or the difference.”
In addition, Section 107 of the Code gives the minister additional powers to take action that “seem likely to maintain or secure industrial peace and to promote conditions favourable to the settlement of industrial disputes,” and could direct the Canada Industrial Relations Board “to do such things as the Minister deems necessary.”
Liam McHugh-Russell, assistant professor at Schulich School of Law at Dalhousie University, said Section 107 “is very vague about what it allows a minister to do.”
“All it says is that the minister can refer a problem and a solution to the Labour Board. They can ask the Labour Board to try and solve the problem,” he said.
“Maybe the minister will try to do that. It remains to be seen.”
The other option if mediated talks fail — beyond the parties reaching a solution on their own — would be a legislated return to work, which would be an exception to the normal way labour negotiations operate under the Labour Code.
Parliament is not scheduled to sit this week and will return on Nov. 18.
The labour strife at B.C. ports is happening at the same time another dispute is disrupting Montreal, Canada’s second-largest port.
The employers there locked out almost 1,200 workers on Sunday night after a “final” offer was not accepted, greatly reducing operations.
This report by The Canadian Press was first published Nov. 11, 2024.
LONGUEUIL, Que. – A man charged with first-degree murder in the death of his partner in a Montreal suburb was out on bail for uttering threats against her when she was killed.
Shilei Du was charged today with the killing of 29-year-old Guangmei Ye in Candiac, Que., about 15 kilometres southwest of Montreal.
Sgt. Frédéric Deshaies of the Quebec provincial police says their investigators were called by local police to a home in Candiac at about noon on Sunday.
The charges filed at the Longueuil courthouse against 36-year-old Du allege the killing took place on or around Nov. 7.
According to court files, Du had previously appeared at the same courthouse for allegedly uttering threats to cause death or bodily harm against Ye on Sept. 7.
Du pleaded not guilty the following day and was released on bail one day later. He had been present in court on the uttering threats charges on Nov. 6.
Du, whose current address is listed in Montreal, was arrested on Sunday at the home where Ye was killed.
The case is scheduled to return to court on Nov. 19.
This report by The Canadian Press was first published Nov. 11, 2024.
MADISON, Wis. (AP) — The Wisconsin Supreme Court will hear oral arguments Monday on whether a law that legislators adopted more than a decade before the Civil War bans abortion and can still be enforced.
Abortion rights advocates stand an excellent chance of prevailing, given that liberal justices control the court and one of them remarked on the campaign trail that she supports abortion rights. Monday’s arguments are little more than a formality ahead of a ruling, which is expected to take weeks.
Wisconsin lawmakers passed the state’s first prohibition on abortion in 1849. That law stated that anyone who killed a fetus unless the act was to save the mother’s life was guilty of manslaughter. Legislators passed statutes about a decade later that prohibited a woman from attempting to obtain her own miscarriage. In the 1950s, lawmakers revised the law’s language to make killing an unborn child or killing the mother with the intent of destroying her unborn child a felony. The revisions allowed a doctor in consultation with two other physicians to perform an abortion to save the mother’s life.
The U.S. Supreme Court’s landmark 1973 Roe v. Wade ruling legalizing abortion nationwide nullified the Wisconsin ban, but legislators never repealed it. When the Supreme Court overturned Roe two years ago, conservatives argued that the Wisconsin ban was enforceable again.
Democratic Attorney General Josh Kaul filed a lawsuit challenging the law in 2022. He argued that a 1985 Wisconsin law that allows abortions before a fetus can survive outside the womb supersedes the ban. Some babies can survive with medical help after 21 weeks of gestation.
Sheboygan County District Attorney Joel Urmanski, a Republican, argues the 1849 ban should be enforceable. He contends that it was never repealed and that it can co-exist with the 1985 law because that law didn’t legalize abortion at any point. Other modern-day abortion restrictions also don’t legalize the practice, he argues.
Dane County Circuit Judge Diane Schlipper ruled last year that the old ban outlaws feticide — which she defined as the killing of a fetus without the mother’s consent — but not consensual abortions. The ruling emboldened Planned Parenthood to resume offering abortions in Wisconsin after halting procedures after Roe was overturned.
Urmanski asked the state Supreme Court in February to overturn Schlipper’s ruling without waiting for lower appellate courts to rule first. The court agreed to take the case in July.
Planned Parenthood of Wisconsin filed a separate lawsuit in February asking the state Supreme Court to rule directly on whether a constitutional right to abortion exists in the state. The court agreed in July to take that case as well. The justices have yet to schedule oral arguments.
Persuading the court’s liberal majority to uphold the ban appears next to impossible. Liberal Justice Janet Protasiewicz stated openly during her campaign that she supports abortion rights, a major departure for a judicial candidate. Usually, such candidates refrain from speaking about their personal views to avoid the appearance of bias.
The court’s three conservative justices have accused the liberals of playing politics with abortion.
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