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.
Six weeks ago, Prime Minister Justin Trudeau said the country was at a “crossroads” in the COVID-19 pandemic.
Now, with cases spiking in regions that were practically untouched by the virus in the first wave, it appears we’ve taken a wrong turn.
There have been more than 100,000 new cases of COVID-19 and over 1,000 more deaths in this country since Trudeau made those comments.
The percentage of COVID-19 tests across the country that have come back positive has also grown by more than 235 per cent — from 1.4 per cent in mid-September to 4.7 per cent in the past week.
So where did Canada go wrong?
Experts say a mix of insufficient public health measures and complacency brought us to where we are today and we need to act quickly to turn things around — or at the very least prevent them from getting worse.
Canada ‘failed’ to follow lessons
South Korea taught us that by building up a robust test, trace and isolate system, it’s possible to control the spread of the coronavirus without subjecting your population to a lockdowns at all.
New Zealand locked down quickly, then shifted to a South Korean model focused on building up testing, tracing and isolating cases.
But Australia learned the hard way in the second wave that, if you let the coronavirus spread unchecked for too long, tough action is needed to keep it under control through further lockdowns and strict public health measures.
“The lesson across all of the world is that the places that do the best are the ones that act hard and early,” said Raywat Deonandan, a global health epidemiologist and an associate professor at the University of Ottawa.
“That’s where we failed.”
Experts say Canada, comparatively, has seemingly not yet learned these lessons.
“In Canada, we never set clear goals and so we opened up without having built a solid test, trace isolate strategy,” said Dr. Irfan Dhalla, vice-president of physician quality at Unity Health in Toronto.
“We didn’t follow the indicators closely enough and now we’re paying the price. The good news is we’re not paying nearly as bad a price as people in some other countries are paying, but it would be a big mistake to compare ourselves to the worst countries in the world.”
“The situation we find ourselves in right now is highly unstable,” said Dhalla, who is also an associate professor at the University of Toronto who sits on provincial and federal committees related to the COVID-19 response.
“It wouldn’t take much to put us on a path towards the kinds of outcomes we’re seeing in Belgium, Switzerland, the United Kingdom, many American states.”
But with over half of Ontario’s cases with no known link to previous cases and community transmission running rampant, experts say the province doesn’t have a clear enough view of the situation.
“We don’t understand how many people are infected. We know that it’s a lot, but we really don’t know the magnitude,” said Dr. Andrew Morris, a professor of infectious diseases at the University of Toronto and the medical director of the Antimicrobial Stewardship Program at Sinai-University Health Network.
“If this were an iceberg, we don’t know how much is above or below water.”
“We know in Ontario that 1,000 cases per day is not a sustainable situation. We have too many outbreaks in hospitals, we have too many outbreaks in long-term care homes,” he said.
“We have to bring the number of cases down from 1,000 a day back down to something like 50 or 100 per day. And when we get back down there, we need to have a test, trace, isolate strategy that works.”
WATCH | Ontario’s restrictions system under fire:
Ontario has announced a new tiered system for triggering COVID-19 restriction, but critics say the sky-high thresholds won’t stop the virus from spreading across the province. 1:59
Manitoba suffered from ‘complacency’
Manitoba went from one of Canada’s shining examples of how to successfully manage the spread of the coronavirus, to facing its single worst outbreak.
“Some of us lost our way, and now COVID is beating us,” Premier Brian Pallister said Monday. “Perhaps we were cursed by our early success.”
It was that early success that caused the province to let its guard down, leaving it vulnerable to a surge in cases when the virus re-entered the community.
“We had a very good proactive response in early spring. We shut things down very quickly, everybody seemed to be quite on board and cases receded,” said Jason Kindrachuk, an assistant professor of viral pathogenesis at the University of Manitoba in Winnipeg and Canada Research Chair of emerging viruses.
“And that, probably, in some ways, fed a complacency across all levels.”
Kindrachuk said that because Manitoba didn’t bear the brunt of COVID-19 that other regions of the country had, it lost focus on the need to prepare for the future.
“Then everything hit at the perfect time — we had exponential growth, we had community transmission, we likely had superspreading events, we had outbreaks that occurred in long-term care facilities,” he said.
“The worst of the worst that could have happened, did happen.”
Alberta faces ‘tipping point’
Alberta shattered COVID-19 records on Thursday, recording what health officials described as “about 800” new cases after specific numbers were unavailable due to technical problems with the province’s reporting system.
It’s another province that saw low case numbers slowly rise after a lull in the summer, but waited to act on imposing stricter restrictions and now faces the prospect of a worsening second wave.
Dr. Lynora Saxinger, an infectious diseases specialist and an associate professor at the University of Alberta’s faculty of medicine, called the situation “profoundly disturbing.”
“You can have things simmering along, and then it just starts to boil over — there’s a tipping point, and it starts to change,” she said.
“And when that happens, what we’ve seen across the world, is the actions in that early phase make a really big difference.”
Alberta Premier Jason Kenney rejected the call for stricter public health restrictions this week, the same time a record 171 people were hospitalized with COVID-19, 33 of them in ICU, and nine more people died.
“We’ve seen other jurisdictions implement sweeping lockdowns, indiscriminately violating people’s rights and destroying livelihoods,” Kenney said Friday, rejecting the call for further measures to curb the spread of the virus.
“Nobody wants that to happen here in Alberta.”
Saxinger said Alberta should look at emulating a “circuit breaker” model of controlling the virus from the U.K., focused on brief lockdowns that can interrupt transmission and reverse rising case numbers quickly if rolled out successfully.
WATCH | Stop gatherings in homes, Kenney urges Albertans:
Premier Jason Kenney is calling on Albertans to not host parties or large family dinners and is expanding the 15-person limit on social gatherings to all communities on the province’s COVID-19 watch list. 2:42
“There’s a certain part of the population that’s just not really paying attention as much anymore,” she said. “So you might need to have that short, sharp, lockdown that’s visible to actually really get the whole population re-engaged.”
Saxinger said she’s worried Alberta is past the point of “targeted” restrictions due to rising community transmission and inadequate contact tracing and is being “surged under” by new cases and hospitalizations.
“I’m really afraid that it could take off in a really bad way,” she said. “A lot of us are very anxious right now and the hospitals are already stressed.”
Record numbers in B.C.
British Columbia was praised for its vigorous test, trace and isolate approach and became a global model for how to effectively control the spread of the virus, but could risk jeopardizing the progress it’s made if it doesn’t regain control of a surge in cases.
The province hit a record high COVID-19 case numbers two days in a row this week, with 425 on Thursday and 589 on Friday adding to the 3,741 active cases in the province currently.
Unlike Quebec, which saw its cases surge a month after school started and has been struggling to regain control, B.C. has largely seen outbreaks in community settings.
“Most of the transmissions are through gatherings … superspreader-type events that happen with lots of people in a room,” said Dr. Srinivas Murthy, an infectious disease specialist and clinical associate professor in pediatrics at the University of British Columbia.
“I think our lack of attention to that, and how we can target where we know those large-scale transmission events happen, was probably not as rigorous as it could have been.”
“So far we’ve been able to, with pretty rigorous data collection, follow up and trace and isolate most of the cases in the superspreading events that have happened,” he said.
“But if there is an increased, unlinked case number in the community that’s unable to be traced and isolated — then obviously large-scale social distancing would be probably the next step.”
Atlantic bubble needs vigilance
The Atlantic bubble, a success story for curbing COVID-19 spread, is another model that other parts of the country can learn from.
The four Atlantic provinces imposed tight restrictions on points of entry, moved quickly to clamp down on new outbreaks of COVID-19 and focused on aggressive contact tracing and isolating.
But epidemiologist Susan Kirkland said the recent surge in cases in parts of Canada that weren’t hit as hard in the first wave is a stark reminder of the need for the region to avoid letting its guard down.
“We have to be constantly vigilant,” said Kirkland, head of public health and epidemiology at Dalhousie University in Halifax. “As long as COVID isn’t introduced, we’re OK. But the minute it is, the environment is rife for it to spread very, very quickly.”
The Atlantic provinces have so far avoided rampant community spread of the virus with unknown origins, but Kirkland says rising numbers across the country show it could happen anywhere — even the North.
Nunavut confirmed its first case of COVID-19 on Friday and while health officials say contact tracing is currently underway in the community, the territory’s rapid response team is “on standby to help manage the situation should it become necessary.”
WATCH | No sign of bubble bursting:
Like an extended family, the four Atlantic provinces have walled themselves in, creating measures to restrict outsiders and COVID-19 cases. So far, it’s worked and there doesn’t seem to be much of a rush to burst the Atlantic bubble. 5:09
Kirkland said Atlantic Canada has much more in common with the North than it does with more populous provinces like Ontario and both regions face an uncertain future.
“Part of the reason that we’ve done so well is because we are isolated,” she said, adding that they have also benefited from strong public health messaging and a compliant public.
“But the minute we have community spread, we’re again in that situation where we’re putting ourselves at big risk. So it’s hard to be complacent.”
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BANGKOK (AP) — China has built a land-based prototype nuclear reactor for a large surface warship, in the clearest sign yet Beijing is advancing toward producing the country’s first nuclear-powered aircraft carrier, according to a new analysis of satellite imagery and Chinese government documents provided to The Associated Press.
There have long been rumors that China is planning to build a nuclear-powered aircraft carrier, but the research by the Middlebury Institute of International Studies in California is the first to confirm it is working on a nuclear-powered propulsion system for a carrier-sized surface warship.
Why is China’s pursuit of nuclear-powered carriers significant?
China’s navy is already the world’s largest numerically, and it has been rapidly modernizing. Adding nuclear-powered carriers to its fleet would be a major step in realizing its ambitions for a true “blue-water” force capable of operating around the globe in a growing challenge to the United States.
Nuclear carriers take longer to build than conventional carriers, but once in operation they are able to stay at sea for much longer because they do not need to refuel, and there is more room on board for fuel and weapons for aircraft, thus extending their capabilities. They are also able to produce more power to run advanced systems.
Right now, only the United States and France have nuclear-powered carriers. The U.S. has 11 in total, which allows it to keep multiple strike groups deployed around the world at all times, including in the Indo-Pacific.
But the Pentagon is growingly increasingly concerned about China’s rapid modernization of its fleet, including the design and construction of new carriers.
China currently has three carriers, including the new Type 003 Fujian, which was the first both designed and built by China. It has said work is already underway on a fourth, but it has not announced whether that will be nuclear or conventionally powered.
The modernization aligns with China’s “growing emphasis on the maritime domain and increasing demands” for its navy “to operate at greater distances from mainland China,” the Defense Department said in its most recent report to Congress on China’s military.
How did researchers conclude China has built a prototype reactor for a carrier?
Middlebury researchers were initially investigating a mountain site outside the city of Leshan in the southwest Chinese province of Sichuan over suspicions that China was building a reactor to produce plutonium or tritium for weapons. Instead they said they determined that China was building a prototype reactor for a large warship.
The conclusion was based upon a wide variety of sources, including satellite images, project tenders, personnel files, and environmental impact studies.
The reactor is housed in a new facility built at the site known as Base 909, which is under the control of the Nuclear Power Institute of China.
Documents indicating that China’s 701 Institute, which is responsible for aircraft carrier development, procured reactor equipment “intended for installation on a large surface warship.” as well as the project’s “national defense designation” helped lead to the conclusion the sizeable reactor is a prototype for a next-generation aircraft carrier.
What does China say?
Chinese President Xi Jinping has tasked defense officials with building a “first-class” navy and becoming a maritime power as part of his blueprint for the country’s great rejuvenation.
The country’s most recent white paper on national defense, dated 2019, said the Chinese navy was adjusting to strategic requirements by “speeding up the transition of its tasks from defense on the near seas to protection missions on the far seas.”
Sea trials hadn’t even started for the new Fujian aircraft carrier in March when Yuan Huazhi, political commissar for China’s People’s Liberation Army Navy, confirmed the construction of a fourth carrier. Asked if it would be nuclear-powered, he said at the time that would “soon be announced,” but so far it has not been.
Neither China’s Defense Ministry nor Foreign Affairs Ministry responded to requests for comment.
Even if the carrier that has been started will likely be another conventionally-powered Type 003 ship, experts say Chinese shipyards have the capability to work on more than one carrier at a time, and that they could produce a new nuclear-powered vessel concurrently.
LOS ANGELES (AP) — John Robinson, the veteran football coach who enjoyed many years of success at the University of Southern California and with the Los Angeles Rams, has died. He was 89.
The Rams confirmed Robinson’s death on Monday. He died in Baton Rouge, Louisiana, of complications from pneumonia, USC said in a release.
Robinson is high on the short list of football coaches who enjoyed significant success in both the college and pro ranks. He went 104-35-4 at USC and 75-68 with the Rams, winning postseason games and contending for championships regularly with both teams. Robinson was particularly successful in bowl games, going 8-1 in the postseason with USC and UNLV.
“Coach Robinson was one of the greatest college coaches ever, and his love for USC and his love for the game of football was second to none,” said Ronnie Lott, an All-American safety under Robinson at USC. “I’ve always felt that while playing for him, he gave us the ability to feel like we were larger than life. And his commitment to making sure that we had more than just football in our lives was so superior.”
Robinson was a member of the College Football Hall of Fame for his two successful tenures at USC. He also became the winningest coach in Rams history during his nine-year tenure with the NFL club. Sean McVay passed Robinson’s career victories total only last month.
Robinson coached at USC from 1976 to 1982 and again from 1993 to 1997. He never had a losing record at the school, and his Trojans won five conference titles and four Rose Bowls. Running backs Charles White (1979) and Marcus Allen (1981) won the Heisman Trophy while playing in Robinson’s relentless rushing offenses.
“Coach Robinson was very demanding, but in a human way,” said Paul McDonald, the quarterback of Robinson’s superbly talented 1979 team at USC. “He had great interpersonal skills, and he knew how to connect with people. He made you want to play hard for him and to run through walls. You cared for him because he cared so much for you.”
Robinson moved to the Rams in 1983 and reached the playoffs in six of his first seven seasons, winning four playoff games and advancing to two NFC championship games.
The Rams observed a moment of silence for Robinson at SoFi Stadium on Monday night before they faced the Miami Dolphins.
Robinson spent six seasons coaching UNLV after his second USC tenure, also serving a stint as the Rebels’ athletic director. He was most recently a senior consultant at LSU from 2019 to 2021 during the tenure of head coach Ed Orgeron.
Robinson was born July 25, 1935, in Chicago, and he grew up in the Bay Area, attending prep school with close friend John Madden and graduating from high school in 1954. He played tight end on Oregon’s 1958 Rose Bowl championship team before beginning his coaching career with the Ducks.
Robinson became John McKay’s offensive coordinator at USC in 1972, coaching the unbeaten 1972 consensus national championship team and the 1974 team that went 10-1-1. Robinson left the Trojans for one year to join Madden with the Oakland Raiders, but returned to USC in 1976 when McKay took over the Tampa Bay Buccaneers.
Robinson coached USC to seven outstanding seasons, winning the Pac-8 or Pac-10 titles and the Rose Bowl in three of his first four years in charge. His 1978 team was named national champions by the UPI coaches’ poll, while Bear Bryant’s Alabama won the AP title. He coached a long list of stars during his tenure, from White and Allen to Pro Football Hall of Famers Lott, Anthony Muñoz and Bruce Matthews.
Robinson kept winning in 1983 when he moved to the Rams, who played their home games in Anaheim, California. With an offense led by Eric Dickerson, Robinson’s teams racked up six playoff appearances and lost to the eventual Super Bowl champions in two conference title games.
Robinson’s second tenure at USC included a fourth Rose Bowl victory, but the school dismissed him following the 1997 season.
Robinson then coached UNLV from 1999-2004, taking over a program that had lost 16 games in a row. He got the Rebels to only the third bowl appearance in school history in just his second season, but Robinson stepped away after the 2004 season with a 28-42 record at the school. One of his more notable victories was a 23-5 win at No. 14 Wisconsin in 2003.
“Football lost a legend today,” UNLV director of athletics Erick Harper said. “Coach Robinson was revered by his players, peers, fans and co-workers. He led a wonderful life on and off the football field at so many places, including here at UNLV as both a coach and administrator. Our thoughts and prayers go out to John’s family as we remember all that he did for the sport nationally and right here in Las Vegas.”
Robinson spent many years between his coaching jobs in broadcasting on television and radio. He returned to football five years ago at LSU as a consultant to Orgeron, the former USC coach.
Robinson is survived by his wife, Beverly, his four children, two stepchildren and 10 grandchildren.
A celebration of Robinson’s life will be held following the college football season, in accordance with his wishes.
David Moore lays a wreath for his father every year at the Remembrance Day ceremony at the National War Memorial in St. John’s, N.L. His father served in the Second World War with the 166th Newfoundland Field Regiment and in the Korean War with the 2nd Regiment, Royal Canadian Horse Artillery. (Nov. 11, 2024)
