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Will 2023 be the year COVID-19 becomes endemic in Canada?

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As Canadians close the door to 2022 and look ahead to the new year, many may be hopeful they can also look forward to good news when it comes to COVID-19.

But will 2023 be the year the emergency phase of the pandemic is declared over and that Canada recognizes the virus as endemic?

It turns out, declaring or deciding that a virus is endemic is not a straightforward or clearly-defined practice.

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But if such a declaration is made in Canada in the coming year, some infectious diseases experts say they are concerned about how this could affect people’s attitudes and behaviours regarding the virus.

While the definition of COVID-19 endemicity may be unclear, SARS-CoV-2 has proven it is capable of presenting new surprises and challenges that can have significant impacts on the health of Canadians and the operation of health-care systems across the country, says Dr. Raywat Deonandan, epidemiologist and associate professor at the University of Ottawa.

“I think we’ve learned that there’s still a lot more to learn.”

 

How does a country determine if a virus is endemic?

An endemic virus refers to the “constant presence and/or usual prevalence of a disease or infectious agent in a population within a geographic area,” according to the U.S. Centers for Disease Control (CDC).

But making the official designation of a virus as endemic is not necessarily a scientific endeavour, but rather is more “political” and can vary, says, an epidemiologist at the University of Ottawa.

“There is not a set of criteria that we can use to define endemicity,” she said.

“It is very different from defining a pandemic.”

Infectious diseases specialist Dr. Isaac Bogoch agreed, saying the official designation of a virus as endemic in a country is “not all scientific.”

“A lot of it is based on politics, on perception, and different places might come up with different definitions,” he said.

“I don’t know how globally we’re going to define this, but I do know that it’s important that we not bury our head in the sand and ignore that it’s there.”

The last year has proven the most deadly for the disease in Canada, with over 19,000 deaths recorded to date, according to federal data.

2022 also saw a massive increase in the number of Canadians infected with the virus after the Omicron variant emerged in late 2021 and tore through communities and countries across the globe.

More than 70 per cent of Canadians have likely been infected with COVID-19 since Omicron arrived, compared to less than five per cent of the population who had contracted COVID-19 before Omicron, according to blood test studies funded by the federal government through the national COVID-19 Immunity Task Force.

In addition, Dr. Theresa Tam, Canada’s chief public health officer, told Global News in a year-end interview new federal data also shows about 15 per cent of people in Canada who self-report contracting the virus can experience prolonged symptoms.

While the risks of contracting long COVID are still unknown, the high numbers of Canadians who have been infected with the virus coupled with the fact 83 per cent of Canadians have received at least two doses of the vaccine means many people have acquired so-called hybrid immunity, which some studies have shown provides enhanced protection, Tam said.

And while this is good news for Canada, the fact that COVID-19 immunity wanes over time means it’s still too early to declare the emergency over, Bogoch said.

“The virus continues to mutate as viruses do, and we aren’t entirely sure if another variant will emerge that might undo some of the good that we’ve seen happen through vaccination… and hybrid immunity,” he said.

“Is there going to be another variant that emerges that causes more widespread harm? The answer is maybe. And I think it’s unwise to be overconfident that the worst is behind us.”

 

What role does data play in determining if a virus is endemic?

Data and surveillance that provides information about how a virus is behaving and changing in a population is key to determining responses, including on decisions about whether it remains an emergency situation, Deonandan said.

But Canada is among many countries that have seen a significant reduction in testing for COVID-19, due to provinces and territories adopting testing policies that rely mainly on rapid tests to detect the virus, which are not tracked.

That means there is less data available to track and understand the impact of the virus, he said.

“It hobbles our ability to explain to the public the status of the disease.”

While some surveillance of the virus does remain, including wastewater testing and some official PCR testing, the only significant signal that a new wave of the virus is present is hospital admissions, Deonandan said.

“That reduces all of the arguments down to what we see in the hospital, which is unfortunate because the argument should be about what we see in the community, but we don’t have a sense of what’s happening in the community.”

The World Health Organization (WHO) has been raising concern about a global drop in surveillance of COVID-19, and has warned this could open the door to a new variant of concern that could cause “significant mortality.”

For the last several months, WHO officials have been urging countries to beef up tracking, testing and sequencing of COVID-19, following a marked decline in surveillance measures as public health restrictions have been relaxed worldwide.

WHO has even added caveats to its weekly epidemiological reports on global COVID-19 circulation and case numbers, noting that any trends “should be interpreted with due consideration of the limitations of the COVID-19 surveillance systems.”

Bogoch says this drop in surveillance and data collection is “problematic” and a “major issue” in Canada and around the world.

“The less data we have, we’re wandering blindly into who knows what, and that can only harm us,” he said.

 

How declaring COVID endemic could affect responses to the virus

Given that virtually all former public health restrictions have been lifted across Canada, an official declaration of COVID-19 being endemic is unlikely to change much, Sulis said.

But she is concerned about the message such a declaration could send to the public.

“It is important to understand that saying that a disease is endemic doesn’t mean it is no longer a public health problem, because it is,” she said.

Diseases like tuberculosis and malaria are considered endemic in parts of the world where they continue to infect and kill millions of people.

When people talk about Canada moving into an endemic phase of COVID-19, it implies a level of success over the virus, Sulis said.

“But it is not, because endemic diseases still require policies, still require a structured response,” she said.

“It doesn’t mean we can stop bothering about those responses.”

If governments decide to change their messaging to say the virus is endemic, she believes the result could be “problematic.”

Deonandan echoed these concerns, saying he worries about the way the word endemic is used and the implications it can evoke.

“It seems to be an excuse by policymakers to do nothing just because something is endemic… hands up, we can’t do anything about this,” he said.

“High levels of endemicity are not good, and there are things we can still do to push those numbers down if we want to.”

 

How COVID-19 might impact Canada and the world in 2023

Health Canada says surveillance indicators, including clinical and wastewater testing, show that SARS-CoV-2 is still circulating across the country, and while Canada is past the peak of the last COVID-19 resurgence, “it is too soon to let our guard down.”

The federal agency also said variations in population-level of immunity and current global trends suggest that an uptick in COVID-19 could occur in the new year.

Genetic sequencing data that is available shows continuing increases in immune evasive variants, notably BQ.1 and BQ1.1, while the previously dominant BA.5 lineage variants are declining, said Anna Maddison, a spokesperson for Health Canada and the Public Health Agency of Canada, in a statement to Global News.

“With the increased prominence of these variants in Canada, at a minimum we could see a slower decline and higher plateaus in the number of infections as well as hospital admissions in Canada, as this respiratory virus season plays out.”

The situation in China could also play a major role in the evolution of the virus, as millions of people are now suddenly being exposed to the virus following the decision by the Chinese government to abandon its zero-COVID policy.

Dr. Monica Gandhi, an infectious disease doctor and professor of medicine at the University of California, San Francisco, says she is “very worried” about the situation in China, and how it could lead to new variants of concern that could pose a global threat.

“It’s true that variants do emerge when there’s rapid circulation among a lot of people, and as it is, it is very likely that there could be a new variant emerging from China,” she said.

Deonandan noted that the outbreak in China means about 10 per cent of the world’s population is about to become exposed to COVID-19 for the first time, due to low vaccination levels in that country.

This could have an impact on western countries like Canada that are now taking a “laissez-faire approach to COVID management,” he said.

“I think it’s likely that a new immune evasive variant will emerge, causing further waves,” he said.

“But the good news is that the vaccines continue to work against the worst outcomes. And if we continue to boost and we don’t see any bad effects from boosting, then the ability to curtail transmission should be maintained to some extent as well.”

Bogoch says the key message about the coming year when it comes to COVID-19 is that a lot of uncertainty remains, which means ongoing vigilance is necessary.

“Of course, we all hope that the worst is behind us, and we know that the vaccines have stood the test of time in terms of protecting us against hospitalization and death throughout the entire pandemic, regardless of what variant we’re dealing with,” he said.

“But I think we still have to communicate uncertainty as to what lies ahead, because the virus does continue to mutate as expected. And there may be other variants that emerge that are unfortunately more harmful than normal right now.”

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Child care in Canada: Trudeau unveils new help for providers – CTV News

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The federal government is launching a new loan program to help child-care providers in Canada expand their spaces, and will be extending further student loan forgiveness and training options for early childhood educators, Prime Minister Justin Trudeau announced Thursday.

The prime minister unveiled a trio of child-care-centric commitments that will be included in the upcoming federal budget, with the aim of opening up more $10-a-day child-care spaces across the country, as the Liberals continue to work towards creating 250,000 new spaces by March 2026.

Specifically, the Liberals are vowing to offer $1 billion in low-cost loans and $60 million in non-repayable grants to public and not-for-profit child-care providers, so they can build or renovate their care centres. 

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This funding will be administered through the Canada Mortgage and Housing Corp. (CMCH), which Trudeau called “a common sense approach that will help child care be developed alongside housing.”

An additional $48 million is being earmarked for the next four years to extend student loan forgiveness — similar to the program offered to rural doctors and nurses — to early childhood educators, in an effort to incentivize more teachers to work in smaller communities. 

The federal government is also promising $10 million over the next two years to train more early childhood educators.

The prime minister, speaking in Surrey, B.C., alongside the minister currently leading the file, Jenna Sudds, touted the bilateral child-care agreements in effect across the country for seeing thousands of children placed in affordable spaces.

However, in recent months Canadian parents and care providers have sounded alarms about increasingly long daycare waitlists. And, operators in some provinces have threatened to withdraw from the lower-cost program because they’re struggling to make ends meet. 

Trudeau said while the government has funded 100,000 spaces so far and is aware of the challenges in rolling out this new national program, not enough families have access and not all provinces are moving as fast as they should. 

“I want to take a moment to talk to young moms, many of you millennials. You’ve grown up with so many pressures in this economy, the 2008 recession, COVID, climate change … and we want to make sure that everyone — especially moms raising kids — has the best chance to succeed and thrive,” Trudeau said.

“As Canada grows, as families grow, we want to make sure more kids can access high-quality child care… That’s what fairness for every generation is all about.”

The prime minister also got political, accusing Conservative Leader Pierre Poilievre of opposing the program, despite the Official Opposition voting in support of a recently passed Liberal piece of legislation meant to enshrine in law a commitment to the Canada-wide early learning and child-care system, and the long-term funding needed to maintain it. 

Reacting to the news, NDP MP and critic for children, families, and social development Leah Gazan said the announcement was a “direct result of advocacy” by her party, care workers, unions, and women’s organizations.

She also pointed the finger at the Conservatives, accusing them of trying to stall the program and push for a “for-profit private system that parents can’t afford.” 

Liberal pre-budget strategy

Similar to how Wednesday’s rollout of renter-fairness-focused pre-budget news went, cabinet ministers are making echo announcements of the new child-care affordability measures across the country Thursday afternoon. 

This is all part of a new communications strategy the Liberals are employing in the lead up to the release of the April 16 federal budget.

Practically every day between now and when Deputy Prime Minister and Finance Minister Chrystia Freeland releases the massive economic document, the Liberals are expected to tease out bits and pieces of the budget.

In an effort to stretch out their ability to market the measures within it, Trudeau as well as members of his cabinet will unveil new initiatives over the next two weeks, to the point that the vast majority of the budget will be public prior to budget day.

Traditionally, governments have held budget news — save for some pre-tabling leaks — for the day the document is tabled in the House of Commons post-daylong reporter and stakeholder lockup.

Kicking off this strategy on Wednesday, Trudeau issued a video across social media platforms indicating the overall theme for the 2024 budget will be “generational fairness,” a message meant to speak to millennials and Generation Z.

“When I first decided to run for office, one of my biggest motivations was working to create a Canada that young people saw themselves… As prime minister, I’ve never lost sight of that,” Trudeau said in the clip.

“You as a young Canadian are the heartbeat of our economy. You power our growth and you deserve an economy that gives you a fair shot at success. But, this moment we’re all living in is throwing big challenges your way… So we’re going to roll up our sleeves and work like hell. And we’re going to tell you about what we’re doing to fix it, over the next two weeks.”

While Trudeau’s 2015 election victory was credited in part to a historic surge in young people turning up at the polls, Poilievre has been chipping away at that Liberal voting bloc of those aged 43 and under, seeking to appeal to their current struggles to get ahead with his “powerful paycheques” and housing affordability arguments.

In November 2023, Trudeau tapped Max Valiquette, a marketing guru with self-described expertise in understanding younger generations, as his new executive director of communications.

“We’re witnessing a different communication strategy from the government. They’re implementing something they’ve not tried before. We’re not going to have a budget day on April 16. We’re going to have budget days between now and April 16,” said political commentator Scott Reid in an interview on CTV News Channel.

“Frankly, this government knows that it needs to break through, it knows that it needs to connect with Canadians… Is it going to turn around the polls overnight? No. Might they get a little bit more of a hearing than they otherwise would have been? Probably.” 

With files from CTV News’ Vassy Kapelos and Annie Bergeron-Oliver

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Ontario releases 2023 Sunshine List, top earner made $1.9M – CBC.ca

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Five employees at Ontario Power Generation are in the top 10 earners on the province’s so-called sunshine list for 2023, with the province’s highest salary nearing $2 million.

The annual sunshine list documents public sector employees with salaries over $100,000. In this year’s edition, there are 300,570 names, more than 30,000 higher than last year.

Kenneth Hartwick, CEO of the electricity Crown corporation, is in the top spot again with a salary of $1.93 million.

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Two other executives at the organization — chief strategy officer Dominique Miniere and chief projects officer Michael Martelli — made nearly $1.2 million and nearly $1 million, respectively.

You can find a list of the top 100 earners below.

The presidents and CEOs of the Hospital for Sick Children and the University Health Network are also in the top 10, earning around $850,000 each. So is Phil Verster, who is president and CEO of the provincial transit agency, Metrolinx, with a $838,097 salary.

Caroline Mulroney, president of the Treasury Board, highlighted other high growth areas in a release.

“The largest year-over-year increases were in the hospitals, municipalities and services, and post-secondary sectors, which together represented approximately 80 per cent of the growth of the list,” she said.

The list shows 17 professors or associate professors at the University of Toronto had earnings of $500,000 or more.

A statement from a University of Toronto spokesperson said the school competes with top universities and private-sector employers around the world for faculty members.

“This occasionally results in salaries above the usual range for a small number of faculty members.”

An Ontario Power Generation building.
Five employees at Ontario Power Generation are among the top 10 spots of the annual sunshine list for 2023. (Cole Burston/The Canadian Press)

Premier Doug Ford earned $208,974 last year. His chief of staff, Patrick Sackville, earned $324,675.

Matthew Anderson, CEO of Ontario Health, a provincial agency the Ford government created in 2019, earned $821,000. Meanwhile the public servant leading the Ministry of Health, deputy minister Catherine Zahn, earned $477,360, and Health Minister Sylvia Jones, $165,851.

There are more than 25,000 registered nurses on the list, including seven who earned more than $300,000 last year.

Chief Justice Sharon Nicklas, who was appointed to the top post in the province’s judiciary last May, earned $388,960.

The police chiefs of Thunder Bay, Daniel Taddeo, ($376,428) and Hamilton, Francis Bergen, ($374,492) were paid more last year than OPP Commissioner Thomas Carrique ($373,472). Taddeo retired in April 2023. 

Toronto police Chief Myron Demkiw, who took over the post in late 2022, earned $353,411. 

Organizations that receive provincial government funding are also required to disclose salaries for the sunshine list, so it includes top earners at some registered charities.

The chief executive of the True Patriot Love Foundation, Nicholas Booth, earned $421,149. The foundation funds support programs for veterans and military families. 

The president and CEO of the Canadian Red Cross Society, Conrad Sauve, earned $412,970, while the YMCA of Greater Toronto’s chief executive, Medhat Mahdy, earned $394,057.

Salaries of other key Ontario public figures include:

  • $826,539 for Ontario Pension Board CEO Mark Fuller.
  • $709,581 for Ontario Lottery and Gaming Association president & CEO Alfred Hannay.
  • $601,376 for Registered Nurses Association of Ontario CEO Doris Grinspun.
  • $596,392 for Dean of Ivey Business School, Western University, Sharon Hodgson.
  • $563,291 for LCBO president & CEO George Soleas.
  • $546,053 for Dean of the Faculty of Health Science, Queen’s University, Jane Philpott.
  • $533,112 for Royal Ontario Museum president & CEO Joshua Basseches.
  • $486,192 for University of Toronto president Meric Gertler.
  • $464,148 for Chief Medical Officer of Health Dr. Kieran Moore.
  • $455,091 for Chief Coroner Dr. Dirk Huyer.
  • $404,003 Art Gallery of Ontario director and CEO Stephan Jost.
  • $395,974 for former auditor general Bonnie Lysyk.

Adjusting sunshine list threshold

The sunshine list has been around for almost 30 years, always set at six figures and up. 

At Queen’s Park on Thursday, some members of provincial Parliament faced questions on whether the $100,000 starting point should be adjusted.

Green Party of Ontario Leader Mike Schreiner said it should be pegged to the rate of inflation, but others disagreed.

“I think that people think that $100,000 is still a lot of money, especially in an affordability crisis,” said NDP MPP Catherine Fife, who’s also the finance critic.

Government House Leader Paul Calandra said the government has no plans at this time to change the threshold on the sunshine list.

“I think it’s an important document that serves the people well in highlighting the salaries of our public employees.”

The Public Sector Salary Disclosure Act, enacted by former Progressive Conservative premier Mike Harris in 1996, compels organizations that receive public funding from the province to report the names, positions and pay of people who make more than $100,000.

The interactive chart below shows the top 100 earners on the list, based on both salary and benefits.

Search the complete Sunshine List for yourself here.

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1 dead, 2 critically injured after car crash in Montreal

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Montreal

Three people are in hospital with critical injuries after their vehicle crashed into a tree. Police believe they might be connected to two drive-by shootings that took place early Thursday morning.

2 drive-by shootings also took place overnight

an SPVM car near a taped-off crime scene
Montreal police are investigating a car crash possibly linked to two drive-by shootings. (Mathieu Wagner/Radio-Canada)

Urgences-santé say one person died and two others were critically injured after their vehicle hit a tree in the Rosemont neighbourhood.

Montreal police believe the crash may be linked to two drive-by shootings early Thursday morning.

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The first happened around 5 a.m. on Pie-IX Boulevard. Police say a car was shot at repeatedly and the driver, a 41-year-old man, was injured in the upper body. He was transported to hospital, but his life is not in danger, say police.

Shortly afterward, shots were reported in the Plateau Mont-Royal borough, near the intersection of Saint-Joseph Boulevard and Henri-Julien Avenue. No one was injured.

Police say they are investigating to determine if there is a connection between the collision and the shootings. Montreal police spokesperson Jean-Pierre Brabant says it’s possible those in the vehicle were involved in the shootings.

The province’s independent police watchdog is now involved.

with files from Chloë Ranaldi

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