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.
Canada’s vaccine advisory committee has given advice that’s repeatedly been proven right throughout the pandemic — in the face of limited data and vocal criticism — and saved lives.
But multiple medical experts say the failure to do so quickly and transparently threatens to undermine public confidence on key vaccine issues and forces provinces to make crucial decisions on their own.
The National Advisory Committee on Immunization (NACI) released new guidelines on booster shots Friday — after weeks of deliberation — strongly recommending them for those over 80 and leaving the door open to others at risk of lowered vaccine protection.
But the NACI recommendations came after a handful of provinces and territories across Canada already announced their own plans for booster shots, calling into question the speed in which the committee can react to emerging evidence and issue national advice.
“It’s fair to say that NACI has come up with some excellent recommendations,” said Dr. Isaac Bogoch, an infectious diseases physician and member of Ontario’s COVID-19 vaccine task force.
“But it would be very helpful to have these recommendations faster.”
Provinces, territories ‘jump the gun’ on NACI
B.C. pre-empted NACI on Tuesday, rather than wait any longer for the committee’s highly anticipated guidance to be released, announcing its own plan to roll out boosters for everyone in the province by May 2022 that goes far beyond the committee’s approach.
Provincial Health Officer Dr. Bonnie Henry said in a phone interview the reason B.C.’s booster guidance came days earlier than NACI’s is because she wanted the province to have a “simple, longer term strategy that people will understand.”
“What we’re seeing now on the ground here is breakthrough [infections] in the older people who went first,” she said. “So that’s why we needed to be more proactive to try to get out booster doses to those people right away.”
WATCH | Breakthrough COVID-19 infections cause confusion, concern:
They only account for roughly 30 per cent of COVID-19 cases, but breakthrough infections are happening. The situation is confusing to the fully vaccinated who got the virus, and experts say the cases may be a worrisome signal. 4:13
The Northwest Territories offered boosters to everyone over the age of 18 on Thursday, and the Yukon will soon make them available to those over 50. Saskatchewan expanded boosters to Indigenous people over 50 and anyone over 65 and Alberta did the same for Indigenous people over 65 and anyone 75 or older earlier this month.
But this isn’t the first time NACI has been beaten to the punch.
NACI previously recommended third doses for severely immunocompromised people who don’t generate strong initial responses to the vaccine — a different matter than booster shots that top up declining antibody levels — but even that guidance was pre-empted by some provinces.
Ontario and Alberta began offering third shots for certain vulnerable groups including transplant recipients, cancer patients, immunocompromised individuals and long-term care residents weeks before NACI’s guidance finally came out in mid-September.
Bogoch says there’s “no reason” why NACI shouldn’t be able to release recommendations sooner, but they need more resources to stay on top of emerging data and to avoid “bureaucratic hurdles.” (It can take NACI a week to translate and upload its guidance online.)
“It would be very helpful if they had additional support, so that they can continue to do the excellent work that they do in a timely manner,” said Bogoch.
“That way, you could avoid having provinces jump the gun and we can avoid a situation where we have 10 provinces and three territories doing things differently.”
Lack of transparency ahead of ‘hot-button issues’
Another key area experts say NACI is falling behind on is transparent, open communication with Canadians and the media — especially as guidelines for sensitive topics like COVID-19 vaccines for children are expected to be released in the coming weeks.
Unlike the U.S., where vaccine advisory committee meetings on key issues like booster shots and vaccines for kids are live-streamed online with questions from the public addressed, NACI meetings are held behind closed doors without public input.
Helen Branswell, an infectious diseases journalist with STAT, said the U.S. approach of holding advisory committee meetings in public helps journalists and the public “understand what the concerns are” and “the thinking behind the decisions that are being made.”
“It’s absolutely possible to have a more open process, but I think that people were not ready to try that in the middle of a pandemic,” Quach said in a phone interview.
“After the pandemic it’s possible that something more open will come, but it’s just that changing everything in the middle of a crisis is never the best idea.”
NACI hasn’t held a press conference or taken questions directly from the media in months, since the departure of former NACI chair Dr. Caroline Quach, and now opts for federal government spokespeople to comment on their guidance. (Marc-André Lapierre)
But the independent advisory committee did ultimately opt to change its communication strategy in the middle of the pandemic — making it less accessible to the media, and less visible to the public as a result.
The Public Health Agency of Canada (PHAC) has since taken over all of NACI’s media duties, with interview requests and questions for NACI forwarded directly to PHAC media relations staff and press briefings held by Dr. Theresa Tam and Dr. Howard Njoo on NACI’s behalf.
“In principle, I have no problem with the decision to pass the communications mandate back to PHAC,” said Dr. David Naylor, who led the federal inquiry into Canada’s national response to the 2003 SARS epidemic and now co-chairs the federal government’s COVID-19 immunity task force.
“In practice, however, I don’t think this approach is working optimally. And that’s a worry because we have some hot-button issues coming up fast.”
Dr. David Naylor says there are ‘strong feelings’ on upcoming issues like vaccines for children and booster shots for the broader Canadian public, in addition to ‘gaps in the evidence’ that could lead to a ‘very polarized debate.’ (Jae C. Hong/Associated Press)
Naylor says there are “strong feelings” on upcoming issues like vaccines for children and booster shots for the broader Canadian public, in addition to “gaps in the evidence” that could lead to a “very polarized debate.”
“Whoever handles the communication on these fronts in the next few days and weeks needs to be fully committed and well prepared.”
WATCH | How communities work to get parents on board with COVID-19 vaccines for kids:
Communities work to get parents on board with COVID-19 vaccines for kids
3 days ago
Community groups are using some of the lessons they learned in overcoming COVID-19 vaccine hesitancy in adults to help parents on board with vaccinating their children. 2:05
Public spotlight ‘not sustainable’ for NACI
NACI is now far less open to discussing and explaining the reasoning behind its recommendations with the press and the public than it has been in the past — and that may be in part due to a change in leadership.
Unlike Quach, who is a professor of infectious diseases, immunology, microbiology and pediatrics at the University of Montreal with a somewhat flexible schedule, current chair Dr. Shelley Deeks is also Nova Scotia’s public health surveillance medical officer of health.
“Vaccines have been politicized at times,” said Naylor. “And it’s possible that one factor in the change is that having a very senior provincial official as chief spokesperson for a federal panel could be a bit awkward at times.”
A woman receives a booster dose of the Pfizer-BioNTech COVID-19 vaccine at Skippack Pharmacy in Schwenksville, Penn., on Aug. 14. (Hannah Beier/Reuters)
Quach says that once Deeks took over the role as NACI chair, the two of them agreed that keeping up the previous level of public press conferences and media interviews was “not sustainable.”
“That flexibility wasn’t there anymore and so that’s really when NACI asked the Public Health Agency of Canada to take back all the press, all the communications,” Quach said.
“I like giving media interviews — I don’t think Dr. Deeks likes it that much — and you can’t force her. She’s doing an amazing job as a chair of the committee but being a spokesperson was not part of her job description when she signed up for it.”
When asked by CBC News why questions from the press must now be forwarded to PHAC, instead of being answered directly by the NACI chair like the many times it had done so in the past, Deeks responded by forwarding the question to PHAC.
A spokesperson for PHAC said the interest from the general public and the media in the “rationale, data and evidence” of NACI’s recommendations has increased throughout the pandemic, which is why NACI began participating in press briefings in the first place.
“However, NACI is a committee that is comprised of volunteers whose time is very limited during a pandemic response,” the PHAC spokesperson said.
“In order to allow NACI to focus on its important deliberations and advice to public health decision-makers and healthcare providers, PHAC is responsible for conveying this advice to the Canadian public and media.”
Sabina Vohra-Miller, a pharmacologist and science communicator who co-founded Unambiguous Science and the South Asian Health Network, says NACI could benefit from a communications expert who could convey its recommendations to the public in a clear-cut way.
“The kind of support they need is not silencing them. I don’t think their voice should be silenced. They have a very strong, very needed voice here in Canada,” she said.
“We need to have that trustworthy, consistent voice speaking to the public. And frankly, I haven’t even seen that coming from the Public Health Agency of Canada either.”
WATCH | PHAC says booster shots not needed for general population yet:
Tam says COVID-19 booster shot not required for general population right now
Dr. Theresa Tam, Canada’s chief public health officer, says there is no evidence at this time of any widespread reduction in protection for those who have received their COVID-19 vaccines. 2:04
TORONTO – Will Taylor Swift bring chaos or do we all need to calm down?
It’s a question many Torontonians are asking this week as the city braces for the arrival of Swifties, the massive fan base of one of the world’s biggest pop stars.
Hundreds of thousands are expected to descend on the downtown core for the singer’s six concerts which kick off Thursday at the Rogers Centre and run until Nov. 23.
And while their arrival will be a boon to tourism dollars — the city estimates more than $282 million in economic impact — some worry it could worsen Toronto’s gridlock by clogging streets that already come to a standstill during rush hour.
Swift’s shows are set to collide with sports events at the nearby Scotiabank Arena, including a Raptors game on Friday and a Leafs game on Saturday.
Some residents and local businesses have already adjusted their plans to avoid the area and its planned road closures.
Aahil Dayani says he and some friends intended to throw a birthday bash for one of their pals until they realized it would overlap with the concerts.
“Something as simple as getting together and having dinner is now thrown out the window,” he said.
Dayani says the group rescheduled the gathering for after Swift leaves town. In the meantime, he plans to hunker down at his Toronto residence.
“Her coming into town has kind of changed up my social life,” he added.
“We’re pretty much just not doing anything.”
Max Sinclair, chief executive and founder of A.I. technology firm Ecomtent, suggested his employees avoid the company’s downtown offices on concert days, saying he doesn’t see the point in forcing people to endure potential traffic jams.
“It’s going to be less productive for us, and it’s going to be just a pain for everyone, so it’s easier to avoid it,” Sinclair said.
“We’re a hybrid company, so we can be flexible. It just makes sense.”
Swift’s concerts are the latest pop culture moment to draw attention to Toronto’s notoriously disastrous daily commute.
In June, One Direction singer Niall Horan uploaded a social media video of himself walking through traffic to reach the venue for his concert.
“Traffic’s too bad in Toronto, so we’re walking to the venue,” he wrote in the post.
Toronto Transit Commission spokesperson Stuart Green says the public agency has been working for more than a year on plans to ease the pressure of so many Swifties in one confined area.
“We are preparing for something that would be akin to maybe the Beatles coming in the ‘60s,” he said.
Dozens of buses and streetcars have been added to transit routes around the stadium, and the TTC has consulted the city on potential emergency scenarios.
Green will be part of a command centre operated by the City of Toronto and staffed by Toronto police leaders, emergency services and others who have handled massive gatherings including the Raptors’ NBA championship parade in 2019.
“There may be some who will say we’re over-preparing, and that’s fair,” Green said.
“But we know based on what’s happened in other places, better to be over-prepared than under-prepared.”
Metrolinx, the agency for Ontario’s GO Transit system, has also added extra trips and extended hours in some regions to accommodate fans looking to travel home.
A day before Swift’s first performance, the city began clearing out tents belonging to homeless people near the venue. The city said two people were offered space in a shelter.
“As the area around Rogers Centre is expected to receive a high volume of foot traffic in the coming days, this area has been prioritized for outreach work to ensure the safety of individuals in encampments, other residents, businesses and visitors — as is standard for large-scale events,” city spokesperson Russell Baker said in a statement.
Homeless advocate Diana Chan McNally questioned whether money and optics were behind the measure.
“People (in the area) are already in close proximity to concerts, sports games, and other events that generate massive amounts of traffic — that’s nothing new,” she said in a statement.
“If people were offered and willingly accepted a shelter space, free of coercion, I support that fully — that’s how it should happen.”
This report by The Canadian Press was first published Nov. 13, 2024.
TORONTO – Hundreds of Taylor Swift fans lined up outside the gates of Toronto’s Rogers Centre Wednesday, with hopes of snagging some of the pop star’s merchandise on the eve of the first of her six sold-out shows in the city.
Swift is slated to perform at the venue from Thursday to Saturday, and the following week from Nov. 21 to Nov. 23, with concert merchandise available for sale on some non-show days.
Swifties were all smiles as they left the merch shop, their arms full of sweaters and posters bearing pictures of the star and her Eras Tour logo.
Among them was Zoe Haronitis, 22, who said she waited in line for about two hours to get $300 worth of merchandise, including some apparel for her friends.
Haronitis endured the autumn cold and the hefty price tag even though she hasn’t secured a concert ticket. She said she’s hunting down a resale ticket and plans to spend up to $600.
“I haven’t really budgeted anything,” Haronitis said. “I don’t care how much money I spent. That was kind of my mindset.”
The megastar’s merchandise costs up to $115 for a sweater, and $30 for tote bags and other accessories.
Rachel Renwick, 28, also waited a couple of hours in line for merchandise, but only spent about $70 after learning that a coveted blue sweater and a crewneck had been snatched up by other eager fans before she got to the shop. She had been prepared to spend much more, she said.
“The two prized items sold out. I think a lot more damage would have been done,” Renwick said, adding she’s still determined to buy a sweater at a later date.
Renwick estimated she’s spent about $500 in total on “all-things Eras Tour,” including her concert outfit and merchandise.
The long queue for Swift merch is just a snapshot of what the city will see in the coming days. It’s estimated that up to 500,000 visitors from outside Toronto will be in town during the concert period.
Tens of thousands more are also expected to attend Taylgate’24, an unofficial Swiftie fan event scheduled to be held at the nearby Metro Toronto Convention Centre.
Meanwhile, Destination Toronto has said it anticipates the economic impact of the Eras Tour could grow to $282 million as the money continues to circulate.
But for fans like Haronitis, the experience in Toronto comes down to the Swiftie community. Knowing that Swift is going to be in the city for six shows and seeing hundreds gather just for merchandise is “awesome,” she said.
Even though Haronitis hasn’t officially bought her ticket yet, she said she’s excited to see the megastar.
“It’s literally incredible.”
This report by The Canadian Press was first published Nov. 13, 2024.
OTTAWA – Via Rail is asking for a judicial review on the reasons why Canadian National Railway Co. has imposed speed restrictions on its new passenger trains.
The Crown corporation says it is seeking the review from the Federal Court after many attempts at dialogue with the company did not yield valid reasoning for the change.
It says the restrictions imposed last month are causing daily delays on Via Rail’s Québec City-Windsor corridor, affecting thousands of passengers and damaging Via Rail’s reputation with travellers.
CN says in a statement that it imposed the restrictions at rail crossings given the industry’s experience and known risks associated with similar trains.
The company says Via has asked the courts to weigh in even though Via has agreed to buy the equipment needed to permanently fix the issues.
Via said in October that no incidents at level crossings have been reported in the two years since it put 16 Siemens Venture trains into operation.
This report by The Canadian Press was first published Nov. 13, 2024.
![](https://thumbnails.cbc.ca/maven_legacy/thumbnails/100/915/covid-breakthrough-cases-roumeliotis-111021.jpg?crop=1.777xh:h;*,*&downsize=510px:* 510w")
![](https://thumbnails.cbc.ca/maven_legacy/thumbnails/279/87/covid-vaccine-kids-reid-271021.jpg?crop=1.777xh:h;*,*&downsize=510px:* 510w")
![](https://thumbnails.cbc.ca/maven_legacy/thumbnails/848/931/ftrTAMboostersnotrequiredatthistimeOCT29_7000kbps_1280x720_1969065027741.jpg?crop=1.777xh:h;*,*&downsize=510px:* 510w")
