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What Canada needs to do now to capitalize on low COVID-19 levels and keep them that way –



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)

Have a question or something to say? CBC News is live in the comments now.

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.”

The challenge now lies with the millions of unvaccinated Canadians who are now more at risk of COVID-19 than ever — despite hopes Canada can hit a goal of getting 80 per cent of our eligible population fully vaccinated.

“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.”

A new study published by the U.S. Centers for Disease Control and Prevention found the use of both masking and HEPA air filters reduced the risk of COVID-19 exposure in a classroom-like environment by up to 90 per cent.

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.”

Manitoba became the first province to unveil a type of vaccine passport last month, by allowing fully vaccinated travellers to skip quarantine if they showed proof of vaccination. The federal government followed suit earlier this month for all travellers to Canada.

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.

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Clean fuel standards allow companies to get both tax credits and sell carbon credits



OTTAWA — Canada’s new emissions standards for gasoline and diesel will allow oil companies that get a federal tax break for installing carbon capture and storage systems to also generate credits based on those systems, which they can then sell to refineries and fuel importers.

Cabinet approved the final regulations for the Clean Fuel Standard last week and The Canadian Press obtained them Monday ahead of their intended publication July 6.

The regulations require Canadian companies that produce or import gasoline or diesel to register as “primary suppliers” and then show how they are ratcheting down the life cycle emissions for the fuels by a fixed amount every year until 2030.

Life cycle emissions include every greenhouse gas produced from initial extraction, through refining, upgrading and transporting, to their final use such as to power a vehicle.

To comply with the new standards, companies need to show that they have reduced the life cycle emissions the required amount through a variety of activities, including buying credits from other companies along the life cycle chain that have reduced their own emissions.

Those credits can come from things such as building electric vehicle charging stations, replacing coal or natural gas power plants with renewable electricity sources, producing and distributing biofuels, or investments in clean technology including carbon capture and storage.

Carbon capture projects that benefit from the new federal tax credit — worth 50 to 60 per cent of the project’s cost — can also generate Clean Fuel Standard credits for sale.

“So they’re double counting,” said NDP environment critic Laurel Collins.

Collins said the Clean Fuel Standard is an “essential” tool to drive investments and conversions to renewable energy, but as it currently stands, it’s not appearing to be doing much of that.

Keith Stewart, the senior energy strategist at Greenpeace Canada, said double counting projects isn’t going to generate additional emissions cuts, and instead just takes the financial weight off companies that are now rolling in cash.

“There is no rational way anyone should get a credit for the Clean Fuel Standard, and a 50 per cent tax credit, along with being able to write it off on the royalties, at a time when oil companies are making more money than God,” he said.

The federal government watered down the Clean Fuel Standard plan in 2020 at a time when fossil fuel companies were struggling because of a pandemic-related oil price plunge. But in 2022, oil prices have surged, largely because of the Russian invasion in Ukraine, and most Canadian companies reported record profits or near-record profits in the first quarter.

Collins is also dismayed that the implementation timeline for the new standards is being pushed back another six months. The draft regulations published in December said they would take effect in December 2022, but the final regulations push that back to the second half of 2023.

An Environment and Climate Change Canada official speaking on background because he was not authorized to speak publicly about the regulations yet said the date was moved to allow a longer time to create the emissions reductions credits gasoline and diesel producers need to comply with the emissions standards.

The Canadian Fuels Association wouldn’t comment on the final version of the regulations until the government officially releases them but said it has long supported the plan.

“The CFA and its members are obligated parties and have consistently been on the public record in support of the Clean Fuel (Standard) because it promotes a ‘technology neutral’ approach to decarbonizing fuels and provides policy certainty that is necessary for companies to plan and invest in low carbon fuels projects,” a statement from the association said Tuesday.

“In preparation for this regulation our members have already committed to billions of dollars of investments in low-carbon fuel technologies.”

This report by The Canadian Press was first published June 28, 2022.


Mia Rabson, The Canadian Press

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Support dogs to comfort victims at Quebec’s specialized sexual violent courts



QUEBEC — Some Quebec domestic assault and sexual violence victims will be able to be accompanied by a support dog during court appearances.

Justice Minister Simon Jolin-Barrette says a pilot project is being launched in collaboration with a guide dog training foundation and the province’s crime victims assistance group.

Support dogs will be offered in the province’s specialized courts that were recently created to handle cases of sexual violence and domestic assault.

Jolin-Barrette says the animals’ presence will provide comfort to victims and help them feel more confident and safe as they navigate the legal process.

The courts are located in Quebec City, Beauharnois and Bedford, in the Montérégie region; Drummond, in the Centre-du-Québec region; and St-Maurice, in the Mauricie area.

The Quebec legislature adopted a bill last year to create the specialized tribunals, which are designed to offer a supportive environment to victims who come forward to denounce their alleged abusers.

This report by The Canadian Press was first published June 28, 2022.


The Canadian Press

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Trudeau expected to face tough questions on Canadian military spending at NATO summit



MADRID — Prime Minister Justin Trudeau is expected to face tough questions at a major NATO summit this week as a new report released by the alliance ahead of the meeting shows Canada heading in the wrong direction when it comes to military spending.

Members of the 30-member military alliance agreed in 2014 to increase their defence spending to two per cent of their national gross domestic product, and the target is expected to be front and centre when the summit begins on Wednesday.

Trudeau met with NATO leaders Tuesday evening at a dinner hosted at the royal palace in Madrid by King Felipe VI, and will begin formal talks in the morning.

The new report released by NATO Secretary-General Jens Stoltenberg estimates Canadian defence spending will instead decline as a share of GDP to 1.27 per cent this year, down from 1.32 per cent last year and 1.42 per cent in 2020.

The report did not specify the reason for the expected decline, or whether it includes $8 billion in new military spending that was promised in April’s federal budget and whose purpose has not been clearly defined.

Asked about the report during a news conference at the end of this year’s G7 meeting in Germany, as he prepared to head to Madrid for the NATO leaders’ summit, Trudeau said the government has announced several “significant” new investments.

Those include $4.9 billion to upgrade Norad, the shared U.S.-Canadian system used to detect incoming airborne and maritime threats to North America, as well as plans to buy new fighter jets to replace Canada’s aging CF-18s.

The prime minister also said Canada has repeatedly proven its commitment to the NATO alliance by deploying troops and equipment on a variety of missions, including by leading a multinational NATO force in Latvia.

“Canada is always part of NATO missions and continues to step up significantly,” Trudeau said.

“We know how important it is to step up and we will continue to do so to make sure that the world knows that it can count on Canada to be part of advancing the cause of democracy, the rule of law and opportunities for everyone,” he added.

Successive Canadian governments have shown little appetite for meeting the two per cent spending target, which the parliamentary budget officer has estimated would require an extra $75 billion over the next five years.

They have instead emphasized Canada’s numerous other commitments to the alliance, including the provision of 700 Canadian troops to Latvia along with several naval warships to assist with NATO patrols in the North Atlantic and Mediterranean.

That is despite Canada having agreed to the target, as well as repeated exhortations from Stoltenberg and criticism from American officials in Washington calling on Ottawa to invest more in its military and collective defence.

The continuing decline in Canadian defence spending as a share of GDP will almost certainly lead to even more pointed questions for Trudeau in Madrid than was already expected, said defence analyst David Perry of the Canadian Global Affairs Institute.

This is particularly true given confusion surrounding the government’s announcement last week that it plans to invest in Norad modernization, with uncertainty around where the money is actually coming from, when it will be spent and on what.

“I would assume that they were hoping to send a message with the continental defence piece that irrespective of what’s happening in Europe, Canada’s got other defence commitments and that contributes to overall alliance security,” Perry said.

“But the mechanics of how the continental defence piece rolled out would take away from some of that.”

That defence spending is on a downward track when Canada is facing pressure to contribute more overseas and struggling with significant military personnel and equipment shortfalls is also a concern, said Robert Baines of the NATO Association of Canada.

“I’ve always been amazed that Prime Minister Trudeau has facility for dancing over the very serious situation Canada is facing when it comes to defence,” Baines said. “Trying to do so much, and then having so many resource issues and challenges.”

To that end, Trudeau sidestepped a question over whether Canada is prepared to send more troops to Latvia, as NATO seeks to double the size of its forces throughout eastern Europe in response to Russia’s invasion of Ukraine.

Latvia’s ambassador to Canada told The Canadian Press earlier this week that Canada is talking with allies about reinforcing the Canadian-led battlegroup in his country.

The battlegroup in Latvia is one of four established by NATO in 2017, with Germany leading another such unit in Lithuania and Britain and the United States responsible for forces in Estonia and Poland, respectively.

Germany and Britain have both said in recent weeks that they are ready to lead larger combat units in Lithuania and Estonia, but Canada has so far remained silent about its plans in Latvia.

Trudeau also wouldn’t say whether Canada is prepared to put more of the military on high readiness, as Stoltenberg announced on Monday that the alliance plans to increase the number of troops on standby from 40,000 to 300,000.

“We have been working closely with NATO partners, with the secretary-general of NATO, and especially with the Latvians, where Canada leads the (battlegroup) and is committed to making sure we continue to stand up against Russian,” Trudeau said.

“We, like others, are developing plans to be able to scale up rapidly,” he added. “And those are conversations that I very much look forward to having over the next couple of days in NATO.”

Baines predicted whatever additional troops and equipment are added to the Canadian-led battlegroup in Latvia will predominantly come from other NATO members as Canada only recently deployed more troops to the region.

The government announced in February that it was sending an artillery unit and 100 additional soldiers to bolster the 600 Canadian troops already in the Baltic state. It also recently deployed two additional warships to the region.

Perry said it remains unclear how much more the Canadian military, which is short about 10,000 service members, has to spare.

“Maybe there’s an ability to find some more at the back of the cupboard,” he said.

“But if the alliance is going to collectively be stepping up with some additional … troop and equipment commitments, then I’m sure there’d be lots of pressure on us to be part of that as well.”

This report by The Canadian Press was first published June 28, 2022.

— With files from Lee Berthiaume in Ottawa


Laura Osman, The Canadian Press

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