HALIFAX — Nova Scotia is now the first jurisdiction in North America to implement presumed consent around organ donation, a move health officials believe could see a significant rise in the number of donors over the next few years. Legislation passed in April 2019 finally took effect Monday following more than 18 months of work to ensure provincial systems were equipped to handle the change. Under the Human Organ and Tissue Donation Act, all people in Nova Scotia will be considered potential organ donors unless they opt out. "To my knowledge nobody else is close to considering this, but many places are thinking about it," said Dr. Stephen Beed, medical director of Nova Scotia's organ and tissue donation program. "We have an opportunity to transform a component of the health care system and that just does not happen very often." In an interview last week, Beed said the work to bolster the province's organ donation program has focused on planning, education and public awareness. He said the system has, in effect, been "rebooted" with the recruitment of several donation physicians and an increase to the number of system coordinators, who have also seen a change in their training. Overall, 27 new professionals have been brought into the system over the last three years. In addition, a donation data system has been developed to assess the program's performance. The province plans to spend $3.2 million this fiscal year to bolster the system. "Overall I honestly think that the system change is the most important part," Beed said of the shift to presumed consent. He said that was the message delivered to Premier Stephen McNeil when he first approached health officials with the idea for the legislation. "We said, 'If you change the law all you really have is words on a piece of paper, but if you change the law and then support the redesign of our system then you have reason to be optimistic'." Beed said organ donation rates increased by as much as 35 per cent in European countries such as Belgium and Spain after they adopted an opt-out system, though he noted other jurisdictions that made the switch have had the opposite experience. But one prospective organ recipient said the success stories abroad have left her more optimistic about matters closer to home. "I am very proud that Nova Scotia is the trailblazer for this," said Anita MacDonnell of Halifax, who is awaiting a kidney transplant. "I was very encouraged when they announced this back in 2019." MacDonnell, who turns 60 on Wednesday, was approved for a new kidney last May and started dialysis in October. She and her friend Brenda Mackenzie, also of Halifax, suffer from a genetic kidney disease that has seen several of their siblings and both of their mothers require transplants in the past. Both women undergo dialysis three nights a week for four hours at a time and liken the life-saving process to having a part-time job. Mackenzie, 60, describes her wait for a kidney as "pretty nerve-wracking." "So I guess my hope obviously would be that with this (change) that so many more people would be able to be transplanted," she said. "That's what the ultimate hope is." The new approach hasn't received universal support on its way to becoming provincial law. Some civil libertarians balked at the legislation when it was first proposed, raising concerns around governments having the power to tell people what to do with their bodies. Other opponents expressed potential cultural and religious concerns about the move. Beed said he believes those issues have been addressed through the development of an opt-out registry and safeguards such as double checking with families to ensure the last known wishes of a potential donor are honoured. Those who tell their families that they don't want to be donors will see those instructions respected, he said, even if they haven't formally opted out. In addition, certain groups will be exempt such as new immigrants, transient residents of Nova Scotia, and people who don't have capacity to make their own decisions. Beed said talks are also continuing with leaders of religious and faith communities to ensure they are "engaged" with the system. Peggy John, the acting director for the organ and tissue donation and transplantation program at Canadian Blood Services, agrees the opt out program will only be as good as the strength of the system put in place to support it. John, whose organization is the national collaborating body for provincial transplant systems, said the end goal should be to increase the opportunities for transplant for patients who are in need. According to the most recent figures compiled by Canadian Blood Services, 250 Canadians died while waiting for a transplant in 2019 — an increase from 223 in 2018. They also showed that Canada still has a shortage of organs, with 4,419 patients still waiting for transplants at the end of 2019. John said the new Nova Scotia law will be an opportunity to observe and to learn about what might work elsewhere to potentially boost donation rates. "We are keen to see what's going to happen," she said. "We know they (Nova Scotia) have been approaching this in the right way and we will continue to watch what the outcome will be." This report by The Canadian Press was first published Jan. 18, 2021. Keith Doucette, The Canadian Press
TOKYO — Japanese Prime Minister Yoshihide Suga vowed Monday to get the pandemic under control and hold the already postponed Olympics this summer with ample coronavirus protection. In a speech opening a new Parliament session, Suga said his government would revise laws to make anti-virus measures enforceable with penalties and compensation. Early in the pandemic, Japan was able to keep its virus caseload manageable with non-binding requests for businesses to close or operate with social distancing and for people to stay home. But recent weeks have seen several highs in new cases per day, in part blamed on eased attitudes toward the anti-virus measures, and doubts are growing as more contagious variants spread while people wait for vaccines and the Olympics draw closer. Suga said his government aims to start vaccinations as early as late February. “In order to restore sense of safety, I will get the coronavirus pandemic, which has raged worldwide and is now severely affecting Japan, under control as soon as possible,” Suga said. “I will stand at the frontline of the battle while I get the people's co-operation." Suga pledged to achieve the Olympics as “a proof of human victory against the coronavirus." “We will have full anti-infection measures in place and proceed with preparation with a determination to achieve the Games that can deliver hope and courage throughout the world," he said. Recent media polls show about 80% of the Japanese public think the Olympics will not or should not happen. Suga said the vaccine is the “clincher” of the pandemic and hopes to start vaccination when Japan's Health Ministry is expected to approve the vaccine developed by Pfizer, one of three foreign suppliers to Japan, as early as late February. But the pace of inoculation could be slow, as surveys have shown many people have safety concerns. Suga later told reporters that he created a new ministerial post to ensure smooth delivery of safe and effective vaccines, appointing Administrative Reform Minister Taro Kono to double as vaccine minister. Suga also said in his speech, just two days ahead of U.S. President-elect Joe Biden’s inauguration, that he hoped to meet the new American leader soon to further strengthen the Japan-U.S. alliance and to co-operate on the pandemic, climate change and other key issues. Japan has confirmed more than 330,000 infections and 4,500 deaths from COVID-19, numbers that have surged recently though they are still far smaller than many other countries of its size. Suga on Jan. 7 issued a state of emergency for the Tokyo area and expanded the step last Wednesday as the surge in infections strained medical systems. But he has been criticized for being slow to put preventative measures in place after the new surge began, apparently due to his government’s reluctance to further hurt the economy. He kept the state-subsidized “Go To” travel promotion campaign active until late December, which critics say misguided the public when people needed to practice more restraint. Suga in Monday’s speech made no mention of the “Go To” campaign, which was designed to support the tourism industry devastated by the pandemic. The state of emergency — covering more than half of Japan’s 127 million people — asks bars and restaurants to close by 8 p.m., employees to have 70% of their staff work from home and residents to avoid leaving home for nonessential purposes. It's set to end Feb. 7 but could be extended. One of the proposed changes to anti-virus measures would legalize compensation for business owners who co-operate with such measures and allow fines or imprisonment for those who defy them. Suga's government also plans to revise the infectious disease law to allow authorities to penalize patients who refuse to be hospitalized or co-operate with health officials, Economy Revitalization Minister Yasutoshi Nishimura, in charge of virus measures, said on a NHK public television talk show Sunday. Health officials believe a growing number of people are defying instructions from health officials to self-isolate or be hospitalized, spreading the virus and making contact tracing difficult. Opposition lawmakers and experts are cautious about punishment for the patients, citing human rights concerns. They also say such punishment is pointless when hospitals are running out of beds and forcing hundreds of people to wait at home. ___ Follow Mari Yamaguchi on Twitter at https://www.twitter.com/mariyamaguchi Mari Yamaguchi, The Associated Press
MAMUJU, Indonesia — Aid was reaching the thousands of people left homeless and struggling after an earthquake that killed at least 84 people on an Indonesian island where rescuers intensified their work Monday to find those buried in the rubble. More rescuers and volunteers were deployed in the hardest-hit city of Mamuju and the neighbouring district of Majene on Sulawesi island, where the magnitude 6.2 quake struck early Friday, said Raditya Jati, the National Disaster Mitigation Agency’s spokesperson. He said nearly 20,000 survivors were moved to shelters and more than 900 people were injured, with nearly 300 of them still receiving treatment for serious injuries. A total of 73 people died in Mamuju and 11 in Majene, said Didi Hamzar, the disaster agency's director of preparedness. He said rescuers also managed to pull 18 people alive from the rubble of a collapsed houses and buildings. Mahatir, a relief co-ordinator for volunteer rescuers, said his team was trying to reach many people in six isolated villages in Majene district after the quake damaged roads and bridges. Aid and other logistic supplies can be distributed only by foot over the severe terrain, said Mahatir who goes by one name. In a virtual news conference, Hamzar said that three helicopters were taking aid supplies Monday to four cut-off villages in Majene. In other hard hit areas. water, which has been in short supply, as well as food and medical supplies were being distributed from trucks. The military said it sent five planes carrying rescue personnel, food, medicine, blankets, field tents and water tankers. Volunteers and rescue personnel erected more temporary shelters for those left homeless in Mamuju and Majene. Most were barely protected by makeshift shelters that were lashed by heavy monsoon downpours. Only a few were lucky to be protected by tarpaulin-covered tents. They said they were running low on food, blankets and other aid, as emergency supplies were rushed to the hard-hit region. Police and soldiers were deployed to guard vehicles carrying relief goods and grocery stores from looting that occurred in some areas, said Muhammad Helmi, who heads the West Sulawesi police’s operation unit. Jati said at least 1,150 houses in Majene were damaged and the agency was still collecting data on damaged houses and buildings in Mamuju. Mamuju, the provincial capital of nearly 300,000 people, was strewn with debris from collapsed buildings. The governor’s office building was almost flattened and a shopping mall was reduced to a crumpled hulk. The disaster agency said the evacuees are in dire need of basic necessities — blankets, mats, tents, baby food and medical services. The disaster agency’s chief, Doni Monardo, said authorities were trying to separate high- and lower-risk groups and provided tens of thousands of anti-coronavirus masks for those needing shelters. He said authorities would also set up health posts at the camps to test people for the virus. People being housed in temporary shelters were seen standing close together, many of them without masks, saying that they difficult to observe health protocols in this emergency situation. West Sulawesi province has recorded more than 2,500 cases of the coronavirus, including 58 deaths. Indonesia has confirmed nearly 908,000 cases and almost 26,000 fatalities. Many on Sulawesi island are still haunted by a magnitude 7.5 earthquake that devastated Palu city in 2018, setting of a tsunami and a phenomenon called liquefaction in which soil collapses into itself. More than 4,000 people were killed, including many who were buried when whole neighbourhoods were swallowed in the falling ground. Indonesia, home to more than 260 million people, is lined with seismic faults and is frequently hit by earthquakes, volcanic eruptions and tsunamis. A magnitude 9.1 earthquake off Sumatra in 2004 triggered a tsunami that killed 230,000 people in a dozen countries. ____ Karmini reported from Jakarta, Indonesia. Niniek Karmini And Yusuf Wahil, The Associated Press
CAIRO — The death toll from tribal violence between Arabs and non-Arabs in Sudan’s West Darfur province climbed to at least 83, including women and children, a doctor’s union and aid worker said, as sporadic violence continued Sunday. The ruling sovereign council met Sunday and said security forces would be deployed to the area. The deadly clashes grew out of a fistfight Friday between two people in a camp for displaced people in Genena, the provincial capital. An Arab man was stabbed to death and his family, from the Arab Rizeigat tribe, attacked the people in the Krinding camp and other areas Saturday. Among the dead was a U.S. citizen. Saeed Baraka, 36, from Atlanta, had arrived in Sudan less than two months ago to visit his family in Darfur, his wife, Safiya Mohammed, told The Associated Press over the phone. The father of three children rushed to relieve a neighbour amid the clashes in the Jabal village in West Darfur, when he was shot in his head Saturday, his brother-in-law Juma Salih said. Baraka's wife said the U.S. Embassy in Khartoum phoned her to offer condolences. The embassy did not return phone calls and emails from AP seeking comment. The violence led to local authorities imposing a round-the-clock curfew on the entire province. Besides the 83 killed, at least 160 others were wounded, according to Sudan’s doctors’ committee in West Darfur. It said there were troops among the wounded. It said clashes subsided by midday on Sunday and the security situation started to improve. The committee is part of the Sudanese Professionals Association, which spearheaded a popular uprising that eventually led to the military's ouster of longtime autocratic president Omar al-Bashir in April 2019. The clashes pose a challenge to efforts by Sudan’s transitional government to end decades-long rebellions in areas like Darfur, where most people live in camps for the displaced and refugees. Sudan is on a fragile path to democracy and is being ruled by a joint military-civilian government. U.N. Secretary-General Antonio Guterres “is deeply concerned” about the violence and “calls on the Sudanese authorities to expend all efforts to de-escalate the situation and bring an end to the fighting,” his spokesman, Stephane Dujarric, said. The bout of violence came two weeks after the U.N. Security Council ended the joint U.N.-African Union peacekeeping force’s mandate in the region. The UNAMID force, established in 2007, is expected to complete its withdrawal by June 30. It also puts into question the transitional government’s ability to stabilize the conflict-ravaged Darfur region. Salah Saleh, a physician and former medical director at the main hospital in Genena, said clashes renewed Sunday morning at the Abu Zar camp for internally displaced people, south of the provincial capital. He said most of the victims were shot dead, or suffered gunshot wounds. Adam Regal, a spokesman for a local organization that helps run refugee camps in Darfur, said there were overnight attacks on Krinding. He shared footage showing properties burned to the ground, and wounded people on stretchers and in hospital beds. Authorities in West Darfur imposed a curfew beginning Saturday that includes the closing of all markets and a ban on public gatherings. The central government in Khartoum also said Saturday a high-ranking delegation, chaired by the country’s top prosecutor, was heading to the province to help re-establish order. A database by the U.N. Office for the Coordination of Humanitarian Affairs, OCHA, showed that inter-communal violence across Darfur region doubled in the second half of 2020, with at least 28 incidents compared to 15 between July and December 2019. West Darfur province experienced a “significant increase” of violence last year, with half of the 40 incidents reported in the entire Darfur region, OCHA said Sunday. Samy Magdy, The Associated Press
Kremlin critic Alexei Navalny on Monday urged Russians to take to the streets in protest after a judge remanded him in pre-trial detention for 30 days despite calls from Western countries to free the opposition politician. The United Nations and Western countries had told Moscow before the ruling to let Navalny go, and some countries have called for new sanctions on Moscow, which on Monday told them to mind their own business. The ruling to remand him in custody for violating the terms of a suspended jail sentence, a day after he flew back to Russia for the first time since he was poisoned with a nerve agent last summer, could be the prelude to him being jailed for years.
OTTAWA — As new cases of COVID-19 surge across Canada, the federal government and the provinces have been imposing stricter measures to try to limit the illness's spread. The Canadian Press interviewed three leading Canadian experts in disease control and epidemiology, asking their thoughts on Canada's handling of the pandemic, the new restrictions on activities — and what else can be done. Here's what they had to say. John Brownstein, Montreal-born Harvard University epidemiologist and chief innovation officer at Boston Children's Hospital Having a national testing strategy in Canada that uses rapid tests people could do at home would limit the spread of the virus, Brownstein says. "That would enable us to get insight on infection and actually have people isolate," he says. No such tests have been approved in Canada yet. "We've been saying this all along, so it's not just a purely Canadian issue, but having a strategy that implements that kind of information would go a long way to drive infections down in communities while we wait for the vaccine." Brownstein says curfews have unintended consequences because they force people to get together over a shorter period of time during the day. "We haven't seen a lot of evidence that curfews have driven down infection." He says a mix of testing and quarantine is the best way to make sure international travellers don't cause outbreaks when they return from the pandemic hot spots. Testing alone is not enough, he says, because tests can come back negative during the novel coronavirus's incubation period; people should be careful about relying on test results that could give a false sense of security. Brownstein says pandemic fatigue is real and the governments' support for people suffering in the crisis should continue. He says promoting low-risk activities, including walking and exercising outdoors, is also important. "Whatever we can do to allow for people to spend more time outside, probably the better." David Juncker, professor of medicine and chair of the department of biomedical engineering at McGill University Canada needs a national strategy for how to use rapid tests for the virus that causes COVID-19, says Juncker. Juncker is an adviser for Rapid Test and Trace, an organization advocating for a mass rapid-testing system across Canada. "Initially the Canadian government (spoke) against (rapid tests) and then they pivoted sometime in October or September," he says. The federal government then bought thousands of rapid tests and sent them to the provinces, where they've mostly sat unused. "Every province is trying to come up with their own way of trying them — running their own individual pilots. There's a lack of exchange of information and lack of guidelines in terms of how to best deploy them," he says. Juncker says the testing regime based on swabs collected in central testing sites was working in the summer but it collapsed in the fall. He says medical professionals prefer those tests because they are more accurate and can detect low levels of the virus, which is important for diagnoses, but rapid tests can be useful for public health through sheer volume, if they're used properly. A federal advisory panel's report released Friday, laying out the best uses for different kinds of tests, is a step in the right direction, he says. "I'm happy to see we're slowly shifting from the point of view of 'Should we use rapid tests?' to a point of view (of) 'How can we best use them?'" More recent research suggests that rapid tests are more accurate than was previously thought, he says. "We still don't have enough capacity to test everyone so we'd have to use them in a strategic way." Juncker says the lockdowns in Ontario and Quebec should have happened earlier in the fall, when cases started to rise. He says the late lockdowns in Canada won't be as effective as those in countries such as Australia, New Zealand and South Korea, where early lockdowns effectively stopped the disease from spreading. "Countries that were most aggressive early on, are the ones that have, I think, the best outcome." He says countries where health decisions are fragmented across the country, including Canada, have added challenges. "If you live in Ottawa-Gatineau, you have one province (that) allows one thing, the other province allows another thing, so this creates confusion among the citizens," he said. Donald Sheppard, chair of the department of microbiology and immunology in the faculty of medicine at McGill University and member of Canada's COVID-19 therapeutics task force: Canada's federal-provincial sharing of power over health care is highly inefficient and has led to major problems, says Sheppard. "There's a lot breakdown in communication, a lot of territorialism. It's greatly impacted the efficiency of the response," he says. The problems in long-term care homes are examples. "Quebec is screaming they want money but they're refusing to sign on to the minimum standards of long term care," he says. "I think it's heinous." He says highly centralized authority and decision-making has had a stifling effect on innovation. "It puts up roadblocks, and has led to the Canadian health-care system having lost any attempt to be innovative and nimble," he says. Sheppard says he doesn't think there will be mass vaccinations for Canadians this summer and the September timetable that the federal government is talking about for vaccinating everybody is optimistic. "Remember that we don't have vaccines that are approved in under-11-year-olds," he says. "There will still be opportunities for the virus to circulate in children, particularly children are in school settings." He suggested that the current immunization campaign's goal is not herd immunity, eliminating transmission of the virus and rendering is extinct. "The goal here is to create an iron wall of immunity around the 'susceptibles' in our population, such that this becomes a virus of the same public health importance as influenza." This report by The Canadian Press was first published Jan. 18, 2020 ——— This story was produced with the financial assistance of the Facebook and Canadian Press News Fellowship. Maan Alhmidi, The Canadian Press
David Pontone's voice still shakes as he recalls having to crawl out of Toronto's Humber River Hospital on his hands and knees. "The pain was unbearable," said Pontone. "To be able to walk properly was impossible." It happened on April 18, 2018, but involved a lengthy battle for his family to obtain video footage of the event. The 45-year-old had gone to emergency, complaining of excruciating pain in his legs. Pontone also told medical staff he took medication for bipolar affective disorder — a mental illness that causes severe depression and episodes of mania — but that he'd been stable for seven years. He says that disclosure affected his treatment. "They thought I was faking it because I was bipolar," Pontone told Go Public. "There are no words to describe what I went through that night." One of Canada's leading psychiatric experts says overlooking serious physical health issues in people who struggle with mental illness is a widespread problem — and that it can severely shorten their lifespans. "We are failing this population miserably," said Dr. Vicky Stergiopoulos, psychiatrist and physician-in-chief at the Centre for Addiction and Mental Health (CAMH) in Toronto, Canada's largest mental health teaching hospital. WATCH | Video shows man crawling from hospital after calls for help dismissed: "They go in for a broken leg and get sent to psychiatry to check their head." Pontone says he hopes sharing his story will prevent others from experiencing an ordeal like his. "I was mistreated. Misjudged. It should never be repeated, with any person," he said. When Pontone arrived at emergency he was seen by a doctor who ordered an MRI but also referred him to an on-call psychiatrist after learning about his mental illness. In medical records obtained by Go Public, the psychiatrist noted that "anxiety" seemed to be Pontone's most dominant symptom — despite Pontone having said he was in a great deal of pain and had been suffering from increasing leg pain for a month. Another note says the reason for Pontone's visit is "bipolar" — not his inability to walk. When the MRI didn't find anything unusual, the psychiatrist discharged Pontone. "As soon as they got the results … they took off the blankets and started saying, 'Come on, get up! You're fine, there's nothing wrong with you!'" said Pontone. 'Totally helpless' Video cameras at the exit captured Pontone as he was ordered to leave. The footage shows Pontone lying on the hallway floor, struggling to stand. As he gets to his hands and knees and crawls toward the exit, a nurse walks next to him, escorting him out. Passersby stop to look at the spectacle, but the nurse encourages Pontone to keep going. "The nurse kept saying, 'You're a big boy! You're strong! Come on, big boy, stand up!'" said Pontone. "I've always been a gentleman, but I was angry. I felt totally helpless." It took Pontone about 20 minutes to reach the exit. A security guard later helped him to a waiting taxi. He says the doctors had made him think his pain was "all in his head," so a few days later, he made his way to CAMH, where a psychiatrist immediately determined that his suffering had nothing to do with his mental health. An ambulance took him to Toronto Western Hospital in downtown Toronto, where a neurologist diagnosed Guillain-Barré Syndrome, a rare disorder in which the body's immune system attacks the nerves. Five weeks later, the family met with Humber management. They hadn't seen the video yet, but chief nursing executive Vanessa Burkoski had screened it and told them she was disturbed by what she saw. She apologized, and told the family they could have the video once people's faces had been blurred for privacy. In a follow-up meeting two months later, the family viewed the video for the first time. "They let him go, like a dog, outside," said Pontone's mother, Lucia. "Nobody should be treated like that." "It's hard to understand how the hospital thought this was OK," said Pontone's sister Laura. "It was humiliating. It was not OK." Pontone wanted a copy of the video, but in spite of Burkoski's earlier assurances, the hospital now said it couldn't hand the footage over, in case Pontone unblurred the faces of other people. The hospital took the matter to Ontario's Privacy Commissioner, stating it didn't feel comfortable giving Pontone the video and that a cybersecurity expert would have to be hired for about ten hours to use multi-layered obscuring technology, so Pontone couldn't unblur the faces later. It also said Pontone would have to pay the cost and sign an agreement, promising not to share the video. The Pontones met with Toronto personal injury lawyer Harrison Cooper, who offered to work pro bono after hearing about his ordeal. "In Canada we pride ourselves on evolving to understand mental illness," said Cooper. "And we don't want incidents like this — where someone who has a mental illness isn't treated the same way someone without mental illness is treated." The fight took two years to resolve. The privacy commissioner ruled Pontone could have the footage if basic blurring was done, stating that Pontone had shown no indication he wanted to reveal other people's faces. The hospital paid for the blurring and shared the footage. Hospital 'deeply troubled' Go Public requested an interview with a spokesperson for Humber River Hospital, which was declined. In a statement spokesperson Joe Gorman said the hospital was "deeply troubled" by Pontone's experience and that the staff involved "were dealt with accordingly." "Every patient at Humber River Hospital deserves compassionate, professional and respectful care from our staff," Gorman wrote. Go Public has learned that the nurse who escorted Pontone out of the hospital was fired. Gorman wouldn't say whether any of the doctors were disciplined. 'Diagnostic overshadowing' Stergiopoulos was not involved when Pontone visited CAMH. But she says it's so common for health-care professionals to blame mental illness for people's physical health concerns that there's a term for it — "diagnostic overshadowing." She recalls, several decades ago, "having to take a patient of mine with serious mental illness to the oncologist who had refused to treat her just because she had a mental illness." "It was through advocacy that I managed to get her into treatment and she was treated successfully," she said. "And to see that persist so many years later, it's really heartbreaking. I think we can do better and I think we should do better." A 2019 Lancet Psychiatry Commission reviewed the findings of almost 100 systemic reviews that examined the presence of medical conditions among people worldwide with mental illness. It found that people with serious mental illness have a life expectancy that's up to 25 years shorter than the general population. "The statistics are indeed shocking," said Stergiopoulos. "And what is most shocking is that they're persisting despite us knowing about these issues for many years now." She says several factors can be behind the shortened life expectancy for people with mental health issues — such as a sedentary lifestyle or a lack of disease prevention services — but a key reason is stigma and discrimination by health-care workers. At the root of the problem, says Stergiopoulos, health-care professionals see physical and mental health as separate. "This is flawed and we need to do a better job at seeing people as human beings." Pontone spent almost four months undergoing intensive rehabilitation, but considers himself lucky to be able to walk again — Guillain-Barré Syndrome can worsen rapidly and attack the organs. It can also lead to full-body paralysis and possibly death. His mother hopes that speaking out will benefit other people with mental illness who need help with a physical problem. "I want the hospital to change the way they look at mental health," she says. "So that this doesn't happen again."
Ambiguous language and the alleged killing of an inmate have led to a dispute between the Newfoundland and Labrador government and the province's largest public sector union. The province is refusing to pay the legal fees for 10 correctional officers accused of playing a role in the homicide of Indigenous inmate Jonathan Henoche, according to a source close to the situation. It's believed the total amount could range as high as $1 million to represent the officers in criminal proceedings, let alone any civil actions that are likely to follow. An arbitrator will be called in to settle the dispute between the government and the officers' union, NAPE. Both the union and provincial government declined comment for this story. According to the source, there is a fundamental disagreement between both sides around the wording of the collective agreement. "The employer shall undertake to assure a full and complete defence to any employee who is sued or charged in a criminal proceeding arising from the performance of his/her duties provided he/she was not deemed to have performed in a negligent manner as determined by the facts or the courts," the collective agreement states. According to several lawyers consulted by CBC News, the phrase "facts or the courts" leaves room for interpretation. It leaves space for someone other than a judge to interpret the facts of the case, and could allow the province to walk away from covering the guards if it deems them to have acted with negligence. "Management will abide by the terms of the collective agreement," reads a statement that theTreasury Board Secretariat issued last Tuesday. When pressed for more details, a government spokesperson said they could only provide that one line. How legal aid works Information on the Treasury Board Secretariat website states that in cases where the province provides lawyers for its employees, it will also pay for any settlements or damages that arise in civil court. It also states the province cannot claw back money from an employee in a case where a lawyer has been provided. That seems to indicate the province could not pay their legal fees in the beginning and then recoup money if the guards are found guilty. Seven officers are charged with negligence causing death, while three are charged with manslaughter. The officers, who are between the ages of 28 to 51, range in experience from newer guards to a senior lieutenant who has twice been commended by the province for exemplary service at Her Majesty's Penitentiary. Jonathan Henoche was involved in a physical altercation in his cell, before being taken to the segregation unit in the basement of the jail. It's not clear what happened next, or how much time elapsed before he was pronounced dead. Henoche was charged with first-degree murder in the 2016 death of Regula Schule, 88, a Swiss-born former missionary who had been living in Happy Valley-Goose Bay. He had been transferred to HMP while he awaited trial. Sources tell CBC News the incident in Henoche's cell was captured on video. Once an arbitrator has been appointed to the case, both sides will make arguments and the arbitrator will render a judgment. Both sides will then have a chance to appeal the decision in the Supreme Court of Newfoundland and Labrador. No timeline of proceedings has been provided to CBC News. The 10 guards are set to make a first court appearance on Feb. 11 in St. John's. Read more from CBC Newfoundland and Labrador
MONTREAL — A growing number of Canadian entrepreneurs say they plan to invest more in 2021 than they did last year as the vaccine rollout, improving cash flow and a quick rebound in some sectors buoys optimism for the year ahead. The findings of the Business Development Bank of Canada’s quarterly survey of 1,000 entrepreneurs released in a new report today are the most upbeat since the pandemic began. Pierre Cleroux, chief economist of the Montreal-based bank, says the more positive results bode well for the country’s economic recovery. He says investment intentions are improving, with technology emerging as the biggest focus of spending. The bank’s survey found that the key reasons for investing in technology included improving processes to reduce costs, boosting a company’s online presence and investing in remote working. Cleroux says while many entrepreneurs were wary about allowing employees to work from home before the pandemic, he says the last 10 months have shown it can benefit a business. “The pandemic has changed the game,” he said. “It changed the perception of working from home.” Cleroux said remote work can improve productivity, increase worker motivation and spur innovation. “It can also reduce costs,” he said, noting that 18 per cent of business owners surveyed by the bank said they plan to reduce their office space. Despite an increase in COVID-19 cases across much of the country, Cleroux said the optimism uncovered by the survey is unlikely to change. Businesses understand that once restrictions are lifted, the economy will rebound much faster than with other recessions, he said. “This optimism we’re seeing will likely survive the second wave of the virus because we all believe the vaccine is going to improve drastically the situation of the economy,” Cleroux said. Still, while business confidence has improved for the first time since the pandemic began, the study found that investment intentions compared to previous years are still relatively weak. Across Canada, business investment intentions for the next 12 months are down three per cent compared with last winter, for example, but have improved significantly from last spring’s rock bottom decrease of 32 per cent, according to the bank’s report. Investment intentions is the difference between negative and positive business sentiment. Of note are the investment intentions of small- and medium-sized enterprises in Atlantic Canada and Quebec, which at one per cent and four per cent, respectively, are the only positive results on investment intentions in the survey. Meanwhile, investment intentions in B.C. are down three per cent, Ontario came in at four per cent lower, while the Prairie provinces were the lowest at a 13 per cent decline. The online survey of business owners was completed between Dec. 3 and Dec. 18, 2020. The poll measures the confidence of entrepreneurs in the economy, business and hiring outlooks, as well as investment plans over the next 12 months. According to the polling industry’s generally accepted standards, online surveys cannot be assigned a margin of error because they do not randomly sample the population. This report by The Canadian Press was first published Jan. 18, 2021. The Canadian Press
JERUSALEM — Israeli military aircraft struck targets in the Gaza Strip early on Monday in response to two rockets fired from the Palestinian territory, the military said. In a statement, the military said fighter jets hit Hamas military targets, including sites for digging underground tunnels, some of which stretch into Israel. There were no immediate reports of injuries from the airstrikes. There were also no reports of damage or injury from the rockets launched. It was not immediately clear who fired the rockets. Hamas maintains an unofficial cease-fire with Israel, but Israel holds the group responsible for any fire emanating from Gaza. Hamas meanwhile accuses Israel of failing to honour its truce obligations, which include easing a crippling blockade on the Palestinian enclave, and allowing for large-scale infrastructure and job-creation projects. Israel and Hamas have fought three wars since the Islamic militant group seized power of the coastal enclave in 2007. While no major confrontation has occurred since 2014, there are often cross-border skirmishes and flare-ups between the sides. While militant rocket attacks and Israeli retaliatory artillery and aerial strikes are frequent, they have largely been subdued in recent months due to the coronavirus outbreaks in both territories. The Associated Press
It's been nearly a year since some P.E.I. gymnasts have had a chance to test their skills at a competitive level, but this weekend they got a taste of it. Provincial championships were cancelled and some athletes lost their opportunity to compete at the national level. It's all due to COVID-19 and the travel restrictions created by it. However, on Sunday, the Island Gymnastics Academy hosted a test competition. "It's just to … get their feet wet and get a feeling of all the jitters of trying to perform," said Shelley Ferguson, competitive program director at the academy. Usually the test happens right before Christmas, but circuit-breaker restrictions closed the academy for 10 days, Ferguson said. "The end of February, first of March, was our last actual competing time but they have been training since June," she said. "We feel very blessed because there are a lot of clubs across Canada that are completely closed." Island gymnast Isabelle MacKinnon, in Grade 8 at Queen Charlotte Intermediate School, said she was worried she may have forgotten a few things. But it all came back when she hit the floor. "The last time I competed was back last February, so it feels a little weird to get back, but it feels good," she said. "I like seeing my friends and like competing. Competing is really fun, especially at … floor because you have your own music." MacKinnon said she hopes she can get back to competing outside of P.E.I. soon. Parents, physically distanced and wearing masks, were able to watch as the gymnasts practised on floor, bars, vault and beam. "This is sort of the first competitive event that our gymnasts have had in which they are able to put on their gym suit and perform in front of judges," said Nick Murray, executive director of the academy. "I think everybody is delighted. I know the gymnasts have been really excited the last couple weeks. It gives the parents an opportunity as well. They haven't been in the gym in 10 months." Competition season usually runs from January until around May. 2021 competitions? Murray said he already knows the Eastern Canadian championships has been cancelled and there is a question mark around the nationals. "We just have to be grateful for what we got," he said. "The fact we are able to … run a program, it certainly is a good thing for us as a club." More from CBC P.E.I.
The emergency department at Kings County Memorial Hospital in eastern P.E.I. will open at 8 a.m. Monday as usual, after being forced to close on Sunday. Heavy rain and melting snow caused flooding in that area of the Montague hospital on Sunday, forcing its closure at midday. It was uncertain at the time when it would be able to open again. Health PEI confirmed Monday morning the department was ready to reopen. The emergency department at the hospital is open daily from 8 a.m. to 8 p.m. More from CBC P.E.I.
Cape Breton Regional Municipality is holding on to a large stash of plastic film after a major shift in recycling a few years ago. Several hundred bales of the material, enough to fill 300 pickup trucks, remains stored inside a facility in Sydport. CBRM solid waste manager Francis Campbell said they've been able to unload some of the thin plastic film, but more keeps coming in weekly garbage collections. Finding a home for the material is another challenge. "That's been the issue over the last few years, that the markets have really dried up," Campbell said. "We've been trying to search out places and find people that are willing to take the material. It's been a hit or miss over the last couple of years." Recycling conundrum Campbell said North America must begin developing its own market for recycling materials. Three years ago, Campbell said CBRM and other municipalities were left in a lurch. After decades of sending material to China to be recycled into new material, the government decided it would begin relying on its own market. "It's been a real struggle," he said. In some instances, plastics — such as shopping bags and food wrap — are made into lumber. But in CBRM's experience, demands for recycled plastic film have been few and far between. Bag ban changes In order to recycle the plastic into new materials, Campbell said municipalities must store collections inside to avoid contamination. "Luckily, we've been able to do that," he said. "At the end of the day, if we do run out of space to store the material we would have to dispose of it. We don't want to do that." Campbell said he hopes less waste will appear in CBRM recycling, as the province implemented a plastic bag ban in October. But so far, he said, that has not been the case. In order to bury the plastic, CBRM would need special permission from the province's Department of Environment. MORE TOP STORIES
As the first terminally ill cancer patient in Canada to legally use so-called magic mushrooms to treat anxiety, Thomas Hartle is hopeful that more temporary approvals from the federal government signal a permanent regulatory regime may be in the works. Hartle, 53, received a one-year exemption from the Controlled Drugs and Substances Act last August to use psilocybin, the active ingredient in magic mushrooms, during psychotherapy. Since then, Health Canada has approved 24 more applications from cancer patients for treatment of end-of-life distress. It has also granted exemptions to 19 health-care providers, giving them the right to possess and use mushrooms containing psilocybin for professional training purposes, a spokeswoman said in a statement. The department has yet to decide whether it will allow the public to use any psychedelics for therapeutic purposes beyond the exemptions it has granted so far. Hartle has had two psychedelic psychotherapy sessions at his home in Saskatoon, the last one in November, with psilocybin from mushrooms he grew and dried himself using a coffee grinder to turn them into powder and placed into capsules for precise dosages. The IT administrator, who is on leave from his job, said anxiety over dying from colon cancer and leaving his wife and two children, both on the autism spectrum, became unbearable after his inoperable condition was diagnosed in 2016. However, taking psilocybin during his two sessions with the help of his regular clinical psychologist helped him manage his anxiety to the point that he hasn't felt the need to have any more psychedelic-assisted therapy while he continues traditional therapy, Hartle said. "I think that's probably obvious to most people who have interacted with me before and after my sessions," he said of the marked improvement in his anxiety through a deeper understanding of the word "serenity." "I've been talking about subjects that I would previously have considered almost impossible to talk about and keep a clear voice and not break down into a very emotional state. Instead of focusing on the pain or discomfort, I'm focusing on making lunch for my family or something like that." Before each of the two sessions, Hartle said he met with his therapist and completed paperwork to gauge his anxiety level in order to establish a baseline that could be compared with how he would feel afterwards. The first session lasted about six hours, during which he took three capsules about an hour apart, containing a total seven grams of psilocybin, he said. His therapist and a friend remained by his side as he lay blindfolded and wearing a headset while listening to music from a playlist compiled by Johns Hopkins University as part of its research into psychedelics. Hartle said the range of music, from classical to chanting as well as South American and African beats, elicited different emotions and he saw multiple colours and geometric shapes as he entered "a state of other," which made it impossible for him to recall the names of his family members. "It was very serene and comforting to me to realize that I could have consciousness and awareness that had nothing whatsoever to do with this existence." Hartle said that prior to his cancer diagnosis, he had never used illegal substances and only started taking cannabis oil to deal with the nausea brought on by chemotherapy as part of his cancer treatments. Focused psychotherapy sessions before, during and after his two sessions were crucial to his use of psilocybin, Hartle said. "It's not like you take a pill and suddenly everything is fantastic. It doesn't work like that any more than regular therapy does. There is work to be done. There are challenges to face. There are issues that need to be worked through the same as any other session. The main difference is that with the psychedelic-assisted therapy, it can get your ego out of the way so you can get at some things." Spencer Hawkswell, CEO of TheraPsil, a Victoria-based advocacy group for patients, said it helped Hartle apply for exemptions to use psilocybin on compassionate grounds based on Canadians' right to medical assistance in dying. He said access to assistance in dying should also give terminally ill patients the right to try mushrooms to reduce their emotional suffering. "When we can't manage someone's symptoms, that's often when they choose MAiD. (Psilocybin) deserves to be put in between the treatment options that are failing those patients and MAiD." TheraPsil has helped people from six provinces apply for exemptions. Health-care providers who have received exemptions to use psilocybin themselves before leading psychedelic-assisted sessions include family doctors, nurses, psychologists, psychiatrists, clinical counsellors and social workers, Hawkswell said, adding the group is putting together a training program that will need partnerships with provincial governments. Psilocybin is just one of several psychedelics being considered to treat mental health conditions while a growing number of private companies promote their potential use for multiple issues including obesity, smoking, alcohol dependence and addiction to illicit substances. Mark Haden, chair of the board for the Canadian chapter of the Multidisciplinary Association for Psychedelic Studies, or MAPS Canada, said psychedelics appear to be seen as the new cannabis before it was legalized. "A lot of venture capitalists went into the cannabis world. Many of them made money. Some of them lost a huge amount of money, so the cannabis bubble exploded and then burst. So, all of that money is saying, 'Where do we go next? What's the next big thing?' And they've latched their view on psychedelics." MAPS Canada is currently conducting a Phase 3 clinical trial in Vancouver on the use of MDMA, commonly known as ecstasy, to treat post-traumatic stress disorder. Haden said the small trial involving about 12 people is expected to be completed next year as part of the research by over a dozen sites in the United States and Israel. Traditional PTSD therapy has a high dropout rate, may involve patients taking medication for years and has an effectiveness rate of 10 to 25 per cent, said Haden, who is also an adjunct professor at the University of British Columbia's School of Population and Public Health. "With MDMA, it takes a few months and the effectiveness is 60 to 80 per cent," he said of research findings elsewhere. This report by The Canadian Press was first published Jan. 18, 2021. Camille Bains, The Canadian Press
Police stopped a car of Black men and confiscated two of their guns at Virginia's annual "Lobby Day" on Monday while white gun rights activists defied local laws unimpeded in the state capital of Richmond. In a day with racial tensions on display, Black protesters denounced what they called a double standard in a state where people are free to openly carry firearms. Virginians converge on the capitol each Lobby Day to petition state legislators on issues of public interest, but the day has been dominated by gun rights activists in recent years.
France is expanding the eligibility for people to get their COVID-19 vaccines. Around 6 million people can now have the jab. Those over 75 can have their first dose along with anyone in a high-risk group, such as those with serious health conditions.View on euronews
A new study paints a troubling portrait of potential climate change impacts on Arctic char in Labrador, amid calls for more research to better understand what the future holds for the species that occupies a place of immense value in Canada's North. The study, published recently in the journal Nature Climate Change, is the result of years of field and laboratory work by a team of Canadian scientists. The researchers spent several summers sampling migratory Arctic char — the variant of the fish that moves from fresh to saltwater and back again — in rivers across the region, from its northern reaches in the Torngat Mountains all the way south to the tip of Newfoundland's Northern Peninsula. The study then analyzed the fish's genetic data and, combined with climate modelling from 2050, concluded the southernmost fish are the most vulnerable and "may be unable to adapt to pervasive warming in the Arctic." "What we think we're seeing with this data is that we can expect there to be declines in this region for decades to come, essentially. That we expect that we will be losing those migratory [southern] populations," said Kara Layton, a study co-author and an associate professor at Aberdeen University in Scotland. Predicting that the char will shift northward falls in line with already known science, said Layton. "We have seen this already in things, like plants and birds and that, so we know these sorts of trends, and this loss of the southern range contraction is happening elsewhere," she said. Scientific research on Labrador's Arctic char stocks is fairly thin, with study co-author Ian Bradbury saying the new work has helped map out the char's DNA and fill in some blanks about population, past and present. But overall, there's no solid understanding of just how many fish are out there. "We've started to scratch the surface in understanding which populations are going to be vulnerable, of Arctic char in Labrador. But I still think there's a lot of unknowns in terms of understanding how many individuals we have there and what the magnitude of these changes that are coming actually will be," said Bradbury, a research scientist with the Department of Fisheries and Oceans in St. John's. Labrador is predicted to warm much more than the island portion of the province, according to provincial climate data that shows Nain could be 7.3 C warmer in winter by 2050. With the new Arctic char knowledge assembled and published, Bradbury said it gives both scientists and communities information to help direct work around the species in a rapidly changing world. "It's something that I think really does further stress the need to mitigate climate change impacts, and it does give us something that we can start to monitor, so that we can start to prepare for these changes as they occur," he said. 'Crying' for more science: harvesters Arctic char is a highly prized traditional food in Inuit communities, such as the five within Nunatisavut territory on Labrador's north coast. The only commercial fishery for Arctic char in Newfoundland and Labrador is based in that region, where the Torngat Fish Producers Co-operative holds the distinction of operating the province's northernmost fish plant, in Nain. The head of the co-op said he doesn't get any comfort from the study's findings that his region's char could fare better than its southern counterparts. While Keith Watts welcomes the new research, he said far more of it needs to be done. "We've been crying and asking for more science from DFO, because it is their responsibility, for quite some time — decades," said Watts, the co-op's general manager. Watts said the co-op's annual harvest is well below the DFO-set quota, taking only up to 40 per cent of what's allowed. People in Nunatsiavut can also fish their own Arctic char through the Inuit domestic harvest program, but as Watts said that amount is also largely untracked, he's concerned about increasing commercial fishing in the face of so many unknowns. "We're not comfortable with the fact that there's not enough science on the abundance of the species. We don't want to put it into jeopardy," he said. From a business standpoint, the co-op's small catch doesn't make the Arctic char fishery viable, Watts said. The co-op offsets those losses from more lucrative species, as well as subsidies from the Nunatsiavut government, to ensure people can buy the fish either in Nain or the co-op's storefront in Happy Valley-Goose Bay. "Arctic char is very important to Nunatsiavut people and always has been, and always will be. Because of the decline of other things, such as caribou, and food insecurity in the north coast, Arctic char is very important," said Watts. Labrador: 'at the forefront of climate change' That cultural importance is not only cultural, but also ecological. Labrador's Arctic char live throughout the entire region's coast, which means they've adapted to very different temperature conditions, that Layton and Bradbury said can vary by as much as 10 C from its southern to northern edges, or what they call a "steep environmental gradient." That range in latitude, in a rapidly warming world, means an uncertain future for Labrador. "It's a region that I really think is going to be at the forefront of climate change impacts," said Bradbury. As such impacts happen, the char could act as a bellwether for Labrador's larger biodiversity, and better understanding how Arctic char have evolved to their current surroundings by looking at their DNA could help. "We know that its a really, really important species, and one that can tell us a lot, I think, about climate impacts more broadly," said Bradbury. As Watts and the co-op call for more science to be done, there is more research in the works. The Torngat Wildlife, Plants and Fisheries Secretariat is setting up a char-counting fence in the Fraser River, which empties into Nain Bay. Watts said the work was delayed for a year due to the pandemic. Bradbury said he'll continue the study's work, with more genetic sampling of char to come in summers ahead, in the hopes of refining their predictions and figuring out how many fish the future holds. "I think the only way we're actually going to start to get at that is through continued monitoring, and being in Labrador, and using some of these new approaches to start quantifying changes as we see them," he said. Read more from CBC Newfoundland and Labrador
Budgeting is a pain. But what’s more painful is a bill you can’t easily pay, debt that costs a fortune or not having enough money to retire. Fortunately, you can have a useful, working budget without watching every penny. Automation, technology and a few simple guidelines can keep you on track. The following approach works best if you have reasonably steady income that comfortably exceeds your basic expenses. If your income isn’t steady or doesn’t cover much more than the basics, you may need to track your spending more closely. Also, no budget in the world can fix a true income shortfall, where there’s not enough coming in to cover your basic bills. If that’s the case, you need more income, fewer expenses or outside help. One place to start your search for aid is 211.org, which provides links to charitable and government resources in many communities. Otherwise, though, you can craft a spending plan with the following steps. START WITH YOUR MUST-HAVES Must-have costs include housing, utilities, food, transportation, insurance, minimum debt payments and child care that allows you to work. Using the 50/30/20 budget, these costs ideally would consume no more than 50% of your after-tax income. That leaves 30% for wants (entertainment, clothes, vacations, eating out and so on) and 20% for savings and extra debt payments. A budgeting app or your last few credit card and bank statements can help you determine your must-have costs. The more these expenses exceed that 50% mark, the harder you may find it to make ends meet. For now, you can compensate by reducing what you spend on wants. Eventually, you can look for ways to reduce some of those basic expenses, boost your income or both. “After tax,” by the way, means your income minus the taxes you pay. If other expenses are deducted from your paycheque, such as health insurance premiums or 401(k) contributions, add those amounts to your take-home pay to determine your after-tax income. If you don’t have a steady job or are self-employed, forecasting your after-tax income can be tougher. You can use a previous year’s tax return or make an educated guess about the minimum income you expect to make this year. A withholding calculator can help you determine what you’re likely to have left after taxes. AUTOMATE WHAT YOU CAN Automatic transfers can put many financial tasks on autopilot, reducing the effort needed to achieve goals. If you don’t automate anything else, automate your retirement savings to ensure you’re saving consistently. Also consider saving money in separate accounts — often called “savings buckets” — to cover big, non-monthly expenses such as insurance premiums, vacations and car repairs. Online banks typically allow you to set up multiple savings accounts without requiring minimum balances or charging fees. You can name these accounts for different goals, and automate transfers into those accounts so the money is ready when you need it. My family typically has eight to 12 of these savings accounts at our online bank. I figure out how much I want to have saved by a certain date, divide by the number of months until that date and send the resulting amount, via automated monthly transfers, from our checking account. MANAGING WHAT’S LEFT Return to your after-tax monthly income figure. Subtract your must-have expenses, your contributions to retirement and savings accounts, and any extra debt payments you plan to make consistently. What’s left is your spending money for the month. (Nothing left? Try winnowing some of those must-haves or set less ambitious savings or debt pay-down goals.) In the olden days, you might have put cash in an envelope and used it for your spending money. Once the envelope was empty, you were supposed to stop spending. Some people still do that, but in today’s digital, contactless world, you might prefer other approaches. The easiest would be to put all your spending on a single credit card that’s dedicated to this purpose and paid in full every month. (And since you’re paying in full, consider using a cash back or other rewards card to get some extra benefit from your spending.) Check your balance every few days or set up alerts to let you know when you’re approaching your spending limit for the month. To protect your credit score, you can make payments periodically throughout the month so your balance stays low compared to your credit limit. Alternatively, you could use more than one card, a debit card or a spending app that’s tied to your checking account, such as Venmo, PayPal or Zelle. A budget app or spreadsheet can help keep you on track. You also could consider setting up a separate checking account just for this spending. Again, many online banks offer checking accounts without minimum balance requirements or monthly fees. Your budget won’t be perfect and you’ll have to make adjustments as you go. But at least you, and your money, will be headed in the right direction. ____________________________________ This column was provided to The Associated Press by the personal finance website NerdWallet. Liz Weston is a columnist at NerdWallet, a certified financial planner and author of “Your Credit Score.” Email: firstname.lastname@example.org. Twitter: @lizweston. RELATED LINK: NerdWallet: Budgeting 101: How to Budget Money http://bit.ly/nerdwallet-budgeting Liz Weston Of Nerdwallet, The Associated Press
The latest numbers of confirmed COVID-19 cases in Canada as of 4:00 a.m. ET on Monday Jan. 18, 2021. There are 708,619 confirmed cases in Canada. _ Canada: 708,619 confirmed cases (75,281 active, 615,324 resolved, 18,014 deaths).*The total case count includes 13 confirmed cases among repatriated travellers. There were 6,436 new cases Sunday from 70,499 completed tests, for a positivity rate of 9.1 per cent. The rate of active cases is 200.27 per 100,000 people. Over the past seven days, there have been a total of 47,285 new cases. The seven-day rolling average of new cases is 6,755. There were 149 new reported deaths Sunday. Over the past seven days there have been a total of 1,001 new reported deaths. The seven-day rolling average of new reported deaths is 143. The seven-day rolling average of the death rate is 0.38 per 100,000 people. The overall death rate is 47.92 per 100,000 people. There have been 16,557,083 tests completed. _ Newfoundland and Labrador: 396 confirmed cases (nine active, 383 resolved, four deaths). There was one new case Sunday from 204 completed tests, for a positivity rate of 0.49 per cent. The rate of active cases is 1.73 per 100,000 people. Over the past seven days, there has been three new case. The seven-day rolling average of new cases is zero. There have been no deaths reported over the past week. The overall death rate is 0.77 per 100,000 people. There have been 76,369 tests completed. _ Prince Edward Island: 104 confirmed cases (nine active, 95 resolved, zero deaths). There were zero new cases Sunday from 331 completed tests, for a positivity rate of 0.0 per cent. The rate of active cases is 5.73 per 100,000 people. Over the past seven days, there have been a total of two new cases. The seven-day rolling average of new cases is zero. There have been no deaths reported over the past week. The overall death rate is zero per 100,000 people. There have been 86,220 tests completed. _ Nova Scotia: 1,558 confirmed cases (29 active, 1,464 resolved, 65 deaths). There were four new cases Sunday from 743 completed tests, for a positivity rate of 0.54 per cent. The rate of active cases is 2.99 per 100,000 people. Over the past seven days, there have been a total of 30 new cases. The seven-day rolling average of new cases is four. There have been no deaths reported over the past week. The overall death rate is 6.69 per 100,000 people. There have been 195,810 tests completed. _ New Brunswick: 947 confirmed cases (293 active, 642 resolved, 12 deaths). There were 36 new cases Sunday from 874 completed tests, for a positivity rate of 4.1 per cent. The rate of active cases is 37.72 per 100,000 people. Over the past seven days, there have been a total of 168 new cases. The seven-day rolling average of new cases is 24. There were zero new reported deaths Sunday. Over the past seven days there have been a total of three new reported deaths. The seven-day rolling average of new reported deaths is zero. The seven-day rolling average of the death rate is 0.06 per 100,000 people. The overall death rate is 1.54 per 100,000 people. There have been 128,277 tests completed. _ Quebec: 242,714 confirmed cases (20,651 active, 213,008 resolved, 9,055 deaths). There were 1,744 new cases Sunday from 9,270 completed tests, for a positivity rate of 19 per cent. The rate of active cases is 243.38 per 100,000 people. Over the past seven days, there have been a total of 13,893 new cases. The seven-day rolling average of new cases is 1,985. There were 50 new reported deaths Sunday. Over the past seven days there have been a total of 369 new reported deaths. The seven-day rolling average of new reported deaths is 53. The seven-day rolling average of the death rate is 0.62 per 100,000 people. The overall death rate is 106.72 per 100,000 people. There have been 2,656,534 tests completed. _ Ontario: 237,786 confirmed cases (28,893 active, 203,484 resolved, 5,409 deaths). There were 3,422 new cases Sunday from 58,215 completed tests, for a positivity rate of 5.9 per cent. The rate of active cases is 198.35 per 100,000 people. Over the past seven days, there have been a total of 22,004 new cases. The seven-day rolling average of new cases is 3,143. There were 69 new reported deaths Sunday. Over the past seven days there have been a total of 380 new reported deaths. The seven-day rolling average of new reported deaths is 54. The seven-day rolling average of the death rate is 0.37 per 100,000 people. The overall death rate is 37.13 per 100,000 people. There have been 8,633,584 tests completed. _ Manitoba: 27,511 confirmed cases (3,081 active, 23,661 resolved, 769 deaths). There were 189 new cases Sunday. The rate of active cases is 224.98 per 100,000 people. Over the past seven days, there have been a total of 1,194 new cases. The seven-day rolling average of new cases is 171. There were eight new reported deaths Sunday. Over the past seven days there have been a total of 31 new reported deaths. The seven-day rolling average of new reported deaths is four. The seven-day rolling average of the death rate is 0.32 per 100,000 people. The overall death rate is 56.15 per 100,000 people. There have been 436,236 tests completed. _ Saskatchewan: 20,272 confirmed cases (4,121 active, 15,936 resolved, 215 deaths). There were 287 new cases Sunday from 862 completed tests, for a positivity rate of 33 per cent. The rate of active cases is 350.88 per 100,000 people. Over the past seven days, there have been a total of 2,158 new cases. The seven-day rolling average of new cases is 308. There were three new reported deaths Sunday. Over the past seven days there have been a total of 24 new reported deaths. The seven-day rolling average of new reported deaths is three. The seven-day rolling average of the death rate is 0.29 per 100,000 people. The overall death rate is 18.31 per 100,000 people. There have been 321,266 tests completed. _ Alberta: 116,837 confirmed cases (12,234 active, 103,167 resolved, 1,436 deaths). There were 750 new cases Sunday. The rate of active cases is 279.87 per 100,000 people. Over the past seven days, there have been a total of 5,385 new cases. The seven-day rolling average of new cases is 769. There were 19 new reported deaths Sunday. Over the past seven days there have been a total of 152 new reported deaths. The seven-day rolling average of new reported deaths is 22. The seven-day rolling average of the death rate is 0.5 per 100,000 people. The overall death rate is 32.85 per 100,000 people. There have been 2,979,663 tests completed. _ British Columbia: 60,117 confirmed cases (5,955 active, 53,115 resolved, 1,047 deaths). There were zero new cases Sunday. The rate of active cases is 117.42 per 100,000 people. Over the past seven days, there have been a total of 2,440 new cases. The seven-day rolling average of new cases is 349. There were zero new reported deaths Sunday. Over the past seven days there have been a total of 42 new reported deaths. The seven-day rolling average of new reported deaths is six. The seven-day rolling average of the death rate is 0.12 per 100,000 people. The overall death rate is 20.65 per 100,000 people. There have been 1,021,911 tests completed. _ Yukon: 70 confirmed cases (two active, 67 resolved, one deaths). There were zero new cases Sunday. The rate of active cases is 4.9 per 100,000 people. Over the past seven days, there have been a total of zero new cases. The seven-day rolling average of new cases is zero. There have been no deaths reported over the past week. The overall death rate is 2.45 per 100,000 people. There have been 6,256 tests completed. _ Northwest Territories: 28 confirmed cases (four active, 24 resolved, zero deaths). There were three new cases Sunday. The rate of active cases is 8.92 per 100,000 people. Over the past seven days, there have been a total of four new cases. The seven-day rolling average of new cases is one. There have been no deaths reported over the past week. The overall death rate is zero per 100,000 people. There have been 8,323 tests completed. _ Nunavut: 266 confirmed cases (zero active, 265 resolved, one deaths). There were zero new cases Sunday. Over the past seven days, there have been a total of zero new cases. The seven-day rolling average of new cases is zero. There have been no deaths reported over the past week. The overall death rate is 2.58 per 100,000 people. There have been 6,558 tests completed. This report was automatically generated by The Canadian Press Digital Data Desk and was first published Jan. 18, 2021. The Canadian Press
Studies have suggested previous COVID-19 infections may result in promising levels of immunity to the virus, leading to questions of whether those who've already recovered from the disease still need a vaccine. And is there urgency to inoculate them, or can they move to the back of the vaccination line? Experts say a vaccine will likely offer the safest bet for longer-term protection, meaning those with previous infections should still get them. And prior COVID illness shouldn't determine someone's place in the queue. The exact level of immunity acquired from a natural infection is yet to be fully determined, says Dr. Andre Veillette, a professor of medicine at McGill who's also on Canada's COVID-19 vaccine task force. It may be that protection begins to wane quicker in some people, or that those with previous mild infections aren't as protected as someone who had more severe symptoms, he says. Still others may think they've had a COVID-19 infection but can't be sure if they didn't get tested at the time. "I would say the simple rule would be that we vaccinate people who've had prior infections, just like everybody else," Veillette said. "If you had the infection, yes, you may have some protection, but it may not last a long time, and it may not be as good as the vaccine." Pfizer-BioNTech and Moderna vaccines were found to have a 95 per cent efficacy in clinical trials in protecting against severe disease. But there are still questions around whether the vaccines can actually prevent someone from catching the virus and spreading it to others. While Moderna has some data that their product may protect against acquiring the virus, it's still unclear. Antibodies from natural infections suggest the same — that they may protect us from getting really sick again, but not from getting the virus a second time. While there have been some cases of reinfection around the world, immunology expert Steven Kerfoot says the fact we're not seeing more of those suggests the immune response from initial COVID-19 infections is probably "pretty strong." Kerfoot, an associate professor at Western University, says vaccines are designed in a way that should produce an immune response "at least as good or better" than what we get after a natural infection. "So it may help fill in holes where people may not have developed an immune response effectively to the virus," Kerfoot said. "If anything, the vaccine could as act as its own booster that would improve your immunity." While some studies have suggested antibodies may disappear relatively quickly after COVID-19 infections, others have found a more lingering immune response. An American study published this month showed antibodies present for at least eight months, and possibly longer. Even studies suggesting an early drop-off of antibody levels aren't concerning, Kerfoot says. Infections trigger the body to produce other immune cells and memory cells that reduce slowly over years and help fight off future invasions from the same virus. If the immune response in those with past COVID infection is expected to be lengthy, could there be justification to defer their inoculations, especially if vaccine supply is low? It will be up to provinces to decide priority in each stage of their rollouts, but Jason Kindrachuk, a virologist with the University of Manitoba, says that will be a tricky decision. "I don't think we can use prior infection as an indicator of priority, because we just don't know what that person's immune response actually is," Kindrachuk said. "We don't know what long-term immunity looks like in those folks. "The recommendations are going to be that everybody gets vaccinated because that way we know — across vulnerable groups and all ages and different demographics — they'll all get a robust immune response." Veillette adds that many people with previous COVID cases were also in higher-risk settings — either because of their jobs or living environments — that would theoretically put them at risk for reinfection. And if they were to get the virus again but not show symptoms, they could still pass it on to other people. "There's probably a whole spectrum of situations there, and when there's so many variables it's better to have a simple rule," he said. "So I think that's another reason to vaccinate previously infected people." This report by The Canadian Press was first published Jan. 18, 2021. Melissa Couto Zuber, The Canadian Press