The Research Rush to Control SARS-CoV-2

"There's now enough data to support consideration of access under an emergency use authorization by FDA."
"The data from NIAID [National Institute of Allergy and Infectious Diseases] study should push this firmly over the line."
Scott Gottlieb, former commissioner, U.S.Food and Drug Administration

"The study demonstrates the potential for some patients to be treated with a five-day regimen, which could significantly expand the number of patients who could be treated."
Chief Medical Officer Merdad Parsey, Gilead Sciences Inc.

"As part of the FDA's commitment to expediting the development and availability of potential COVID-19 treatments, the agency has been engaged in ... discussions with Gilead Sciences regarding making remdesivir available to patients as quickly as possible, as appropriate." 
Michael Felberbaum, spokesman, U.S. Food and Drug Administration

"The data shows that remdesivir has a clear-cut, significant, positive effect in diminishing the time to recovery."
"Although a 31% improvement doesn't seem like a knockout 100%, it is very important proof of concept."
"What it has proven is that a drug can block this virus."
"[But] whenever you have clear-cut evidence that a drug works, you have an ethical obligation to immediately let the people in the placebo group know so that they can have access."
Dr. Anthony Fauci, immunologist, director, National Institute of Allergy and Infectious Diseases

"[The drug is] not the end of the story [when it comes to treatments for Covid-19]."

"We have work to do. We are looking for other therapies. This trial is going to continue."

"Four days [fewer] in a hospital is, for me as a clinician -- as a clinical practitioner -- it is not only significant but very meaningful. [This would matter] to all my patients and even to myself, if I would be in the same situation."

Dr.Andre Kalil, principal investigator behind the clinical trial

The experimental antiviral drug remdesivir, according to results out of Gilead Sciences' Inc.Bottles of remdesivir in a hospital for Covid-19 patients in Wuhan, China. FeatureChina via AP

The experimental antiviral drug remdesivir, according to conclusions reached through a clinical trial launched by Gilead Sciences Inc., helped to improve outcomes for patients diagnosed with COVID-19, the data indicating that the drug  worked more efficiently when used earlier in the course of the illness that has caused a global pandemic, infecting over a million people world-wide and leading to countless deaths.

Several studies had previously been released whose outcomes presented a contradictory picture of the drug's effectiveness. There were two clinical trials linked to Gilead; a study conducted by the NIAID met its major goal helping patients suffering a severity range of symptoms from the disease caused by the novel coronavirus. That trial compared how patients receiving remdesivir fared in comparison to others given a placebo, expected to definitively demonstrate any benefits provided by the drug.

Gilead announced that 62 percent of patients given early treatment with remdesivir were able to be discharged early from hospital, as opposed to 40 percent of patients who were given the drug treatment later in the course of the infection. The trial, with 397 patients taking part, evaluated safety and efficacy related to the five-day regimen. Still, there have been doubts expressed that it may not present a significant benefit.

The Lancet medical journal published results of a trial conducted in China which reached the conclusion that remdesivir had failed to improve the condition of patients. Gilead expressed its opinion that the Chinese trial was inconclusive merely as a result of the study being terminated too early. The result of the Chinese trial had been inadvertently released by the WHO's emergencies program. Dr.Mike Ryan who heads the WHO program declined comment.

A screenshot from the WHO website. Screen capture

Zeroing In On Counterfeit COVID-19 Products

"Counterfeit goods sold during the corona crisis do not meet the required quality standards and pose a real threat to public health and safety."
"People who buy these fake products have a false sense of security, while they are, in fact, left unprotected."
Catherine De Bolle, executive director, Europol

"Should goods be determined to be inadmissible, they may be ordered to be removed from Canada or seized by Health Canada."
"Health Canada is responsible for any additional enforcement activities under their legislation, such as laying charges."
Rebecca Purdy, spokeswoman, Canada Border Services Agency

"We are taking urgent measures to protect consumers from illegal, false or misleading advertising of products claiming to mitigate, prevent, treat, diagnose, or cure COVID-19."
Health Canada

"The threat from counterfeit products related to COVID-19, especially those aimed at the health-care sector, emerged quickly and created a notable impact."
"The estimated profits from the trade of these goods are assessed to be substantial."
"The counterfeiting of pharmaceutical products has been one of the most insidious forms of profiteering during a global pandemic. Counterfeiters have seized the opportunity to exploit the demand for drugs offering potential as treatment options in fighting COVID-19 infections."
"Particular attention should be paid to developments and criminal innovation if a genuine vaccine for COVID-19 is developed as this will likely prompt a wave of offers for counterfeit vaccines."
Europol (law enforcement agency of the European Union) report

Interpol said 121 arrests were made over the seizure of counterfeit COVID-19 medical supplies and medications. (Interpol)

European police have discovered, on a popular Canadian dark web market called CanadaHQ, that chloroquine is advertised for sale. This is the anti-malarial drug touted by many, including U.S. President Donald Trump as a "game-changer" protection against acquiring the novel coronavirus and for 'curing' it. It has also been found -- predictably enough, since both countries have long been a source on the global market of counterfeit pharmaceuticals -- that most of the counterfeit drugs emanate from China and India which frequently make use of Turkey and Ukraine as transit countries.

Fake COVID-19 test kits have been seized at a U.S. airport, just as suspected counterfeit medical masks were stopped at the Canadian border. Masks, face shields, safety glasses and disinfectants, along with promised 'treatments' for COVID are sold in Canada as they are elsewhere, from online retailers, even those that are housed on Amazon and Facebook. Criminals have found an opportunity opened to them with the arrival of the global pandemic.

eBay seller advertising a Covid-19 serological test

Through a website for an online dental equipment supply company whose address is in Edmonton, surgical masks, N95 masks and medical gloves were being offered. The contact information for the site happened to lead to Shanghai, China. Health Canada issued a warning recently about masks and respirators claimed to be N95-rated, the gold standard for protection from COVID, which were discovered to be substandard fakes.

Border agents with the Canada Border Services Agency recently stopped shipments entering Canada which contained suspected fake personal protective equipment; masks, gloves, gowns and face shields meant to be used solely by front-line medical workers as protection while treating COVID-19 patients. The CBSA referred the shipments to Health Canada for testing to determine whether they could meet Canadian standards.

The problem with counterfeit products and unapproved treatments is particularly profound in Europe, where COVID-19 has succeeded in forging a deep and wide trail of virus cases and subsequent deaths in large numbers. In Italy, police have focused on raiding black-market sanitizer factories. Huge shipments of faulty masks, falsely-labelled protective equipment and bogus treatments and tests have been seized there, in Europe's hardest-hit country, devastated by COVID.

Organized crime is in its element, having pivoted from producing and distributing counterfeit goods such as designer clothing and fake sports jerseys along with high-end running shoes, to take advantage of the profits to be realized by bilking frightened and gullible people out of funds they set aside for personal emergency equipment and hoped-for 'cures' to enable them to protect themselves from the dread virus.

A website claiming the World Health Organization was distributing free COVID-19 vaccine kits was raided in the United States by the FBI, which shut down and seized the advertised products at a time when there are no vaccines yet discovered to protect against SARS-CoV-2. Among the false purveyors of hope for terrorized people was a UV-light system for sale, claiming it to be "suitable" for COVID-19.

"The seizure of more than 34,000 counterfeit and substandard masks, 'corona spray,' 'coronavirus packages' or 'coronavirus medicine' reveals only the tip of the iceberg regarding this new trend in counterfeiting."
"Criminals will stop at nothing to make a profit."
"The illicit trade in such counterfeit medical items during a public health crisis shows their total disregard for people's well-being, or their lives."
Jürgen Stock, Interpol Secretary General

COVID Stress, Fear. Boredom and Alcohol

"At times of lockdown during the COVID-19 pandemic, alcohol consumption can exacerbate health vulnerability, risk-taking behaviours, mental health issues and violence."
"Alcohol consumption is associated with a range of communicable and noncommunicable diseases and mental health disorders, which can make a person more vulnerable to COVID-19."
"In particular, alcohol compromises the body’s immune system and increases the risk of adverse health outcomes."
"[Governments should consider] restricting access [during the COVID-19 pandemic, complemented by] communicating with the public about the risks [and] maintaining and strengthening alcohol and drug services."
World Health Organization, Europe 

"People turn to substances to cope with stress and trauma."
"These substances offer an immediate source of control. Having a drink or smoking can make you feel better right away."
"But long-term, as you get into addiction, then really the substance itself is driving that cycle of coping and stress rather than the outside environment itself."
Michael Chaiton, associate professor, Dalla Lana School of Public Health

A shopper wears a mask and gloves at the liquor store. Alcohol sales across Canada increased in March as people stocked up to stay home. (Evan Mitsui/CBC)

Alcohol-related COVID-19 misinformation is not hard to find on various social media platforms. The public was informed by health experts early in the first wave of infections from SARS-CoV-2 that alcohol consumption plays an inimical role in the novel coronavirus, enabling the virus to stake a larger claim on the human body. At first people were just having fun about Corona beer, and then things began taking an uglier turn with the word, as in the name of a young boy in Australia with that given name being bullied.

Alcohol is viewed as a social good, as a relaxant, tempering moods during  times of high tension. Self-congratulating videos began appearing on Instagram and other platforms as people were eager to demonstrate how they were handling the new rules around self-segregation, having virtual on-line cocktail hours with friends. And then there were the supposedly reliable heads-up claims that alcohol would kill the virus, leading people to load up their systems with alcohol in the hopes of forestalling infection.

Leading the World Health Organization to issue a six-page instruction on COVID-19 and alcohol consumption in the public interest: "Under no circumstances should you drink any type of alcoholic product as a means of preventing or treatment COVID-19 infection." Irrespective of which Canadians, in a reflection of what is occurring on a global scale, have taken to drinking more and more frequently since the implementation of social distancing.

One quarter of Canadians aged 35 to 54 and one-fifth aged 18 to 34 respond that they have increased their alcohol consumption, even as 10 percent over age 54 report drinking more frequently, according to a Nanos poll commissioned by the Canadian Centre on Substance Use and Addiction. Rita Notarandrea, CEO of the addiction centre, points out the obvious; that stress and anxiety can lead to an increase in substance use.

"Disrupted routine may be accompanied by loneliness and anxiety about the current situation. With the possibility that people are stocking up and there is more alcohol in the home than usual, some might drink more than they typically do", added senior research and policy analyst at CCSA, Catherine Paradis.

Increased alcohol use has been recognized in many areas of the world, leaving some experts concerned that misinformation plays a role in the situation. "Consuming alcohol will not destroy the virus", the WHO urges on the public. It also addresses misconceptions about drinking and stress relief, pointing out that alcohol is known to amplify symptoms of anxiety, depression and other mental disorders.

And underlying the twin concerns of contracting COVID, and seeking relief from the pressures of stress and worry, a new survey shows half of Canadians who participated reporting their mental health situation has been exacerbated as a result of the global pandemic. The Angus Reid Institute set out to illuminate how economic uncertainty and social distancing measures caused by the pandemic affect the psychological balance of Canadians.

When asked to describe their primary emotions in recent weeks, 44 percent of respondents stated they are worried, 41 percent that they're anxious, and 30 percent that they are quite simply bored.

A liquor store lineup is 50 people deep in downtown Toronto as shoppers await their turn, CBC

Defying Illness and Death for Life-as-Usual

"What we see is that in many states, you see an increase in influenza-like illnesses, and then a week or two later, you see an increase in deaths due to pneumonia and influenza."
"It provides some confirmation that what we are seeing is related to coronavirus."
"We decided to look at all deaths from pneumonia, or all deaths overall, and see how those numbers were changing,"
Dan Weinberger, epidemiology of infectious diseases, Yale University

Protesters demonstrate against safer-at-home orders at the Colorado Capital in Denver on Sunday. Some counties there have implemented stricter measures than the state, which had announced an easing for some businesses starting Monday. (Jason Connolly/AFP/Getty Images)

"In New York City, this discrepancy [between numbers forecasted and numbers realized] was even more stark, with three to four times as many excess all-cause deaths as pneumonia and influenza deaths."
"For instance, California had 101 reported deaths due to COVID-19 and 399 excess pneumonia and influenza deaths."
"Many states experienced a notable increase in the proportion of total deaths due to P&I (pneumonia and influenza) starting in mid-March through March 28 compared to what would be expected based on the time of year and influenza activity."
"In some states, such as Florida and Georgia, the increase in deaths due to pneumonia and influenza preceded the widespread adoption of testing for the novel coronavirus by several weeks."  

"Given the lack of adequate testing and geographical variability in testing intensity, this type of monitoring provides key information on the severity of the epidemic in different geographic regions."

"It also provides some indication of the degree to which viral testing is missing deaths associated with COVID-19 directly or indirectly."Research report, published in MedRxiv

The United States has been hit by one of the globe's worst epidemics of novel coronavirus. The death toll is approaching 58,000, increasing at a steadily rapid rate. Despite this, a growing number of state governors appear to be defying reality, in lock-step with the president anxious to see a return to normal life, in particular that business as usual would resume. The economy has been put to a standstill. From a situation of full employment and more jobs than people to fill them, suddenly mass unemployment has struck the country. On Saturday alone, there was an additional 2,404 coronavirus deaths reported.

Yet, a belief born of desperation appears to be informing decision makers, that the worst of the outbreak could have passed, matching pressure from the corporate community that the devastated U.S. economy must see some relief from the imposition of lockdown. Across the country anger and frustration have seen protests erupt, with citizens decrying the unneeded security steps, that their liberties have been abridged, that the American way of life has been upended for no good and reasonable purpose.

As evidence of that looming distrust in government action in response to the advice from their top expert medical advisers, Americans are demonstrating their penchant for ignoring stay-at-home orders in a demonstration of quarantine fatigue. A team led by the University of Maryland, with the use of mobile-phone data, discovered that Americans have been leaving the confines of self-isolation in increasing numbers.

Operating manager Barry Lennon cleans up the table of customer Duke Scott in the empty dining room of the J. Christopher's restaurant on Monday in Brookhaven, Ga. As of Monday, restaurants around Georgia are allowed to offer dine-in service. (Jessica McGowan/Getty Images)

In California, thousands of people have gone to the beaches amid soaring temperatures on the weekend, choosing to entirely ignore the state governor's orders. Demonstrations have been reported in Springfield, Ill and Baton Rouge, La. Demonstrations in Michigan, where one of the worst breakouts has occurred in Chicago, have been supported by conservative groups. In response the governor agreed to ease some of the imposed curbs allowing some businesses to reopen.

In Georgia, Governor Brian Kemp is allowing hairdressers, nail salons and tattoo parlours to re-open their premises; hardly the essence of 'essential' services for a population in lockdown against a dread disease. There have been guidelines issued that clients and staff wear masks and customers be asked questions of their health conditions; with no way to monitor compliance. A raft of businesses will be permitted to operate over the coming week in around 20 states.

According to the director of the Johns Hopkins Center for Health Security, Tom Inglesby, he believes the country is "at the end of the beginning" of the crisis. As for President Trump, he has stated that his daily White House briefings are to be scrapped, "not worth the time and effort".

Some health experts and local politicians are concerned that restrictions put in place to slow the spread of COVID-19 are being lifted too soon in some U.S. states such as Georgia.

Social Distancing in Mumbai's Slums

"Police flew a drone over our neighbourhood and saw some people sitting outside collecting water.
So they came and started hitting people with their sticks."
"I was standing in the doorway and they pushed me inside."
Unidentified resident, Dharavi, Mumbai

"I don't feel right about it, we're not animals."
"But this kind of thing is not new for us [experimental inoculations on groups of people living in Mumbai slums]."
"Shopkeepers are raising prices day by day [with staples like matchboxes, rice and nuts now more expensive]."
Sabina Khan, Dharavi resident

"Residents [of the Dharavi slum] feel they will be treated badly, as usual."
"And that comes from their long experience with public hospitals and authorities."
Vinod Shetty, founder, Acorn Foundation, NGO, India

An estimated 700,000 to 1 million people are crammed in the Dharavi slum [Prashant Waydande/Reuters]

Dharavi is a vast slum housing about a million poverty-stricken Indians, just outside the country's industrial city of Mumbai. And within Mumbai, that vast slum represents an economic powerhouse, its annual output of $1.4 billion substantially adding to India's GDP. The slum inhabitants work long hours for minimal pay, typically in factories or serving as labourers and domestic staff for more affluent Indians.

So far, eight patients fromDharavi have died

Javed Shaik, a tour guide, explained that in Dharavi food has become even scarcer during this time of lockdown in India and halted production. Police, he said, attack people with sticks any time they venture outside of their cramped homes. His own is an example, where he lives with five other members of his family in cramped quarters. "It's very, very tiny. It's liked a small cage", he said.

India's coronavirus epidemic has persuaded the government of Narendra Modi to institute lockdown orders. Shops have been closed, and when food becomes short, residents attempt to venture out of their homes to find food where they can. Food markets are open for several morning hours daily, and then there is the black market.

Photo India Today

Authorities have increased measures for the lockdown to be enforced. Hospitals across the country are overwhelmed with a reported 23,452 cases of COVID-19, among them 723 deaths. Dharavi's million population lives in poorly ventilated, dense housing, leading to expectations that residents will be badly affected by the highly contagious virus.

The local economy has reached standstill proportions as increased numbers of people become affected by the virus. Mumbai officials are giving consideration to inoculating people in Dharavi along with another slum nearby, with the antimalarial drug hydroxychloroquine, hoping it might be effective in providing a measure of immunity against the virus, despite that it has never been proven to be useful for that purpose.

When news of that prospect reached residents, some have complained they are being treated like laboratory animals, to trial a potential vaccine with no proven effectiveness for the purpose envisioned. This is a drug known to have serious side-effects, such as increased risk of heart attacks, nausea and blurred vision.

As for social distancing mandated by the central government, it is quite impossible in the packed, crowded living conditions of a slum, leaving containment in a position akin to impossible. Community lavatories service hundreds of people. Throngs of residents stand in line to purchase food at markets open only for several hours in the morning.

Coronavirus: Mumbai has the highest number of COVID-19 cases in India

The Elderly Health-Vulnerable : Deprived of a Decade of Life by COVID-19

"We need to be honest with people and tell them regardless of what decisions are made that there are going to be people dying who sadly might not have otherwise died."
"We looked at how long people with those 11 different [serious chronic health conditions] conditions, and in different combinations of those conditions would be expected to live. Then we basically subtracted one from the other."
"So, from Wales, we could find out that an 80-year-old person who had high blood pressure and diabetes, but who didn't have kidney disease, might be expected to live seven years. That means an 80-year-old with COVID-9 who had that same set of conditions had lost seven years of life."
"Nobody is suggesting they [people under age 50 with COVID] only had a short time to live."
"[Most people] lost considerably more than the 'one-to-two' years suggested by some commentators."
"But as countries move to re-open] this is one-half of a balancing judgement that needs to be made. It's not an easy decision. Undoubtedly there are people who are having worse outcomes following things like heart attacks and strokes as a consequence of the fact they're frightened to go to hospital [for fear of contracting COVID]."
"We need to do a similar exercise for these indirect effects of COVID-19 in order to make sensible decisions."
Dr.David McAllister, University of Glasgow, Scotland

(Photo : Reuters Connect) The Wider Image: Dealing with the dead: the female undertakers of Harlem

Most onlookers, those in the fields of science or medicine, or among the general population, assume that the disproportionate deaths attributed to the dire effects of the novel coronavirus on the elderly do not deprive them of many years of their lives. It is assumed that they would, under normal circumstances, perhaps live another year or two before succumbing to the effects of their advanced age coupled with chronic health conditions they are burdened with.

Which motivated Dr.David McAllister, a consultant in public health medicine at Public Health Scotland and some of his colleagues to measure the estimated number of years of life actually lost as a result of the health-destructive effects of COVID-19. Their research led them to conclude through analysis, that on average men lose 13 years of their lives, and for women that loss is 11 years. Bearing in mind that COVID appears to devastate more men than women.

Death from COVID-19 results in over ten years of life lost per person

While accounting for high blood pressure, diabetes and other common chronic conditions typical of elderly people dying of the pandemic virus, deprivation of more than a decade of life of those who died of the effects of COVID-19 resulted per person, analogous to the loss of years of life \ from heart disease. Globally there have been 192,125 confirmed deaths from the coronavirus, according to Johns Hopkins University, taking into account severe COVID-19 is the cause of acute respiratory failure.

The research paper was published in Wellcome Open Research. The researchers made use of published data from 6,801 deaths in Italy, studying what proportion of victims had one or more of 11 common chronic conditions; heart failure, stroke, hypertension, diabetes and chronic obstructive pulmonary disease among them. Use was also made of World Health Organization life tables and health-care data from Wales.

The focus was mostly on deaths in the 50-plus age demographic since so few deaths occurred in people younger, and additionally comments on scant years of life lost at advanced age and health condition fail to arise with the deaths of younger people. YLL (estimated years of life lost) turned out to be more than a decade of deaths in the elderly and health-impaired from COVID-19 deaths. Of confirmed cases worldwide, roughly one-third (38 percent) are identified in people aged 60 and older.

Medical staff applaud as a woman greets her mother (C), who was healed from the coronavirus (COVID-19) after having spend more than a month in a coma, upon her discharge from the hospital in the city of Ariana near the capital Tunis on April 24, 2020. FETHI BELAID/AFP via Getty Images

Coronavirus Lockdown Mental Equilibrium

"With more moderate assumptions about losses in work time and income, and with all non-sleep time listed as being with one's spouse, the simulations suggest that the happiness of married individuals could have been increased slightly by the lockdown."
"Even under fairly conservative assumptions, their [single people] happiness decreases and with more extreme assumptions the decrease is quite substantial." 
"Time alone remains highly significantly negative [for single people, as opposed to the happiness level of married people]."
Daniel Hamermesh, economist, Barnard College

There have been increasing reports in the news media from all different sources and countries experiencing lockdown during the novel coronavirus pandemic that domestic assaults have increased. That couples living together and experiencing the stresses of being together constantly see women being battered increasingly. The concern is that not only are women facing more physical violence at home with enforced lockdowns, the resources to which they might normally turn for aid are no longer available to them as all businesses and services have also gone into lockdown. Males simmering with resentment at losing employment, look for a scapegoat so they can release their tensions. Women become victims.

Life can be very complicated. Modelling undertaken by economists to try to determine how people are faring under lockdown conditions and social distancing emphasize, however, that it is single people who live alone and now really are alone, who are experiencing mental health adversity. Massive studies of how people use their time determining how happy they are formed the insightful base for the simulation.

The average person,, goes the assumption through the modelling insights, in spending time with their spouse receives a boost in the happiness quotient. Conversely, for every minute spent alone for the average single person, their unhappiness potential grows. This disparity in how people are managing to cope with the worldwide lockdown is emphasized in a working paper released at the National Bureau of Economic Research in the United States.

Economist Daniel Hamermesh's simulations clearly support the idea that the average married person is happier in lockdown, as opposed to the average single person who comes out of the experience miserable. Another, predicable boost in life satisfaction is supported by higher incomes. The more people work the more satisfied they appear to be with their lives. Those suffering a job loss, irrespective of marital status experience a low in life satisfaction.

Single people tend to spend more time with friends and relatives  under normal circumstances, to boost their happiness level, since we are after all, social creatures. Stay-at-home and social distancing regulations have put a crimp in that formula, making socializing of that kind difficult-to-impossible for a huge number of people.

COVID Intersection With Childhood Health Issues

"They're needing much more resuscitation and care than they should."

"I personally have seen some very sick diabetics."

"I hope parents aren't afraid to get their kids care or at least seek out help if they think their kids are sick."

Dr.Kevin Chan, chair, acute care committee, Canadian Paediatric Society / Hospital for Sick Children, Toronto

"Because they [children under novel coronavirus lock-down] are not coming into contact with as many people, typical viruses aren't spreading."

Dr.Bruce Wright, divisional director, Stollery Children's Hospital, Edmonton

During this time of national and international chaos over best-avoidance practices of contracting the voracious virus leading to COVID-19, hospital emergency departments have gone into overdrive in preparation for a massive surge of people struck down by COVID's most extreme symptoms. Respirators, breathing machines, personal protective equipment for health-care providers, ICU beds have had to be assembled, doctors alert to practising care for people presenting with acute respiratory syndrome, and hospital beds being cleared of patients, while elective surgeries have been cancelled.

People who would once have gone to hospital emergencies for injuries and sudden illness, no longer do, for fear of contracting the contagious virus, or mindful that the focus at hospitals has been overtaken with a panic over whether they can manage the expected number of cases of extremely sick people. With the impression that whatever has befallen them, they can make do on their own rather than attend a hospital, doubled by the concern that hospitals are now seeping with viral droppings, people have stayed away.

That includes people whose sudden appearance of symptoms of stroke, appendicitis or heart attack have decided to set aside any thoughts of entering a hospital emergency room at a time when family physicians no longer see their patients in person, or those who suffer serious accidents deciding to wait out their pain for home recovery. And it also includes children whose parents are loathe to take them to hospital, weighing whatever their symptoms are against the potential of a child contracting COVID-19 in a hospital setting.

Leaving doctors who man the emergency barricades at the nation's specialized children's hospitals scratching their heads in wonder and concern. That parents, fearing the virus could be keeping their children away from hospitals. A dramatic drop in emergency room visits has struck pediatricians across Canada, with some hospitals reporting that when parents do eventually bring their children around, whatever symptoms they had were by then well advanced.

Visits to the Hospital for Sick Children in Toronto for example have fallen by an estimated two-thirds since the global pandemic saw Canada infiltrated by the dread disease. In Ottawa, the Children's Hospital of Eastern Ontario has seen a 70 percent drop in new cases of diabetes in 30 days alone. And when children do appear at the emergency room they're sicker than doctors typically are accustomed to seeing.

Equally distressing is that child cancer patients are entering the hospitals' emergency departments to be seen, diagnosed and treated only after a prolonged period, when they've experienced symptoms for a longer period than should occur under other circumstances. Parents are struck with indecision whether the symptoms they're faced with in their children are merely transient and unimportant or signal something far more immediate and dangerous.

To the present, less than five percent of total cases of COVID-19 have been detected in children up to 19 years of age. Children are less likely to contract a serious case of the virus they're contracting in much smaller numbers than the general public, and researchers remain uncertain what role children have in the transmission of the virus. The general consensus, however, is that they may be carriers, passing the virus to older people at greater risk of complications.

For their part, hospitals take extreme precautions in an effort to prevent the occurrence of infections. Patients are carefully screened on entry, and those patients who might be harbouring infections are placed away from known non-infectious children. Dr.Wright, of Edmonton's Stollery Children's Hospital credits a relative absence of children at his hospital to the emergency public health measures to prevent COVID spread.

With schools cancelled, along with organized sports, the colds and flu typically that spread through schools and daycare centres winter-long have not appeared in the numbers usually anticipated, with less physical contact among children. With sports no longer high on children's agenda for the time being, injuries related to sports have diminished. Still, doctors are anxious to convey the message to uncertain parents that the emergency rooms are there for a distinct purpose, and no parent should hesitate to take their child there for quick attention when needed.

The emergency waiting room at Sainte-Justine Hospital is shown on Thursday, January 16, 2020 in Montreal. Paediatricians across the country say far fewer parents are seeking emergency care for their children, likely over concerns about putting their kids in contact with COVID-19.THE CANADIAN PRESS/Ryan Remiorz

COVID-Linked Food Security Concerns

"We don't anticipate having to deal with any sort of significant shortages at the meat counter in grocery stores across North America."

"We have a well-integrated system in which product moves both ways across the border. So if individual plants close, we will often see both inventories that we have help buffer some of those closures, and the reallocation of supply from some of the other plants."

"We might start seeing some more significant disruptions in the system where supplies may be compromised. Although we do expect a lot and have reasonably good inventories on hand, we might see prices go up."

"But we would see much more significant issues at the producer [farm gate] level."

Mike von Massow, food economist,  University of Guelph

BT_USDA_Beef_Meat_Packer_6

( U.S. Department of Agriculture )

Physical distancing between workers at meat processing plants is a difficult attainment; the plants were designed and work to their maximum when employees work in close communion. And that is a problem when social isolation is required to ensure that the highly contagious novel coronavirus is brought under control. Also, the fact that most workers at meat-processing facilities have been brought into the country as temporary workers, signed up for two-year stints, from Mexico, Asia and Africa. They are less likely to take recommendations from the health community and government agencies seriously about the need to distance themselves from others.

"Meat-packing’s low wages, combined with a dangerous and unpleasant work environment, make the job unattractive to most Canadians. In old-style plants, work varied between hog and cattle slaughter, and workers split their time between the kill floor and processing. But modern plants slaughter a single species. Most line workers stand shoulder to shoulder and make the same cuts over and over. Repetitive motion injuries are commonplace. Meat processing workers have the highest rate of disabling injury and disease among all manufacturing employees in the province. Injuries and low pay contribute to high employee turnover—6 to 8 per cent a month among line workers. This means about 1,800 workers leave Lakeside (Alberta) each year and must be replaced."

"About 3,500 mostly sub-Saharan refugees have moved to Brooks since 2000. They now account for about a quarter of the town’s population, the largest single source country being Sudan, followed by Ethiopia and Somalia. The African community is thriving; African grocery stores, hairdressers, a music shop and a nightclub enrich the community with their presence."

Michael Broadway, Alberta Views

Cargill meats has shut down due to COVID-19 near High River on Tuesday, April 21, 2020. Darren Makowichuk/Postmedia

Now, across North America, the meat-packing industry has become one of those vulnerable-to-infection hot-spots, while remaining one of the industries held to be indispensable to societal functioning. Over a dozen meat processing plants across the continent have been temporarily shut down as a result of workers being infected with COVID-19. Consumers aware of this have begun to take notice, just as they were concerned over other food availability leading to hoarding and shortage of eggs, flour and unaccountably, toilet paper. 

If, suddenly or gradually, consumers were met with the sight of empty refrigerated shelves as has already occurred temporarily, until the public plucked commonsense off the high, dark cupboard shelf they had tucked it into in a panic over disappearing food -- by the sight of brightly lit shelves absent ground beef, steaks roasts, pork and chicken, a nightmare scenario would impact the public and keep governments awake at night, leaving livestock farmers in a dilemma of how to manage their overstock of animals, with plant closures.

COVID-19 has affected meat packing plants across North America. Sean Gallup / Getty Images

The High River meat-packing plant, Cargill, whose output represents "roughly 40 percent of the beef processing capacity in Canada", temporarily closed operations when an employee died and over 360 workers tested positive for COVID-19. And following a two-week shutdown due to an outbreak in its meat processing facility in Yamachiche, Quebec, Olymel reopened. Smithfield Foods in Sioux Falls, South Dakota shuttered its pork factory after a coronavirus outbreak infected over 800 of its workers.

Meat company JBS USA shuttered its Minnesota pork processing facility following two dozen employees testing positive for COVID. "Nobody can quite figure out how meat processing workers can safely work alongside one another without running the risk of transmitting the virus", Rachel Maddow of MSNBC reported. So the very real fears of consumers do have a groundwork of reality they are based upon. 

But, as von Massow points out, that concern is centered on the scale and duration of plant closures. Should facilities close more frequently and remain closed for longer periods, there could very well be a change in the situation where shortages become acute and consumers have real-time reason to panic. Disruptions of any kind have their repercussions. New ways to hold or divert animals to alternate processors in the hope of avoiding bottlenecks consume the attention of meat processors and livestock farmers. 

For as senior director of the agri-food analytics lab at Dalhousie University, Sylvain Charlebois noted in a newsletter, farmers face increased costs related to the pandemic, having to house animals for longer periods, and having to ship them further distances. High inventory also means they must sell livestock at reduced prices. "We should be cognizant of [those pressures] and probably look at ways that we could support farmers through those difficult times."

Cargill set up tents to provide screening for its workers, similar to what Alberta Health Services has done for health-care workers. (Dan McGarvey/CBC)

Germany, Past and Present

"[Germany should approach the fight against the disease] more like a marathon than a sprint."

"Future measures must be designed and prepared in such a way that, on the one hand, they ensure good health care and, on the other hand, that they can be sustained over the necessary periods of time."

"Planning for this transition must begin immediately in politics, administration, companies and other organizations."

"The attempt to centrally control the resumption of production would ... not work in practice. This resumption must be controlled primarily by the institutions and companies themselves." 

Academic report, Ifo Institute for Economic Research

A man with a mask passes by an empty street during the coronavirus crisis in Berlin, Germany.

The first Western democracy that succeeded admirably in containing the COVID-19 spread is now prepared to begin the laborious process of re-opening its economy. Perhaps it is no coincidence that it is led by a woman. German Chancellor Angela Merkel is also by profession a trained scientist and as such is by definition a professional analyst with a degree in quantum chemistry. She is practical, plainspoken, firm and resolute as a leader, and Germans love their leader.

Coincidentally, Taiwan too has a trained scientist in its government in vice-President Chen Chien-jen, an epidemiologist and scientific researcher of some global renown. As an Asian democracy that prides itself on its sovereignty with a physical proximity to China, the source of the zoonotic SARS-CoV-2, Taiwan no doubt, like Germany, profited handsomely in gaining control of the novel coronavirus with the guidance and knowledge of its vice-president.

Having a background in science and economics is a great leg up in evaluating and analyzing complex data, aiding in decision-making beyond the capacity of lawyers and business leaders who typically become national leaders. Had matters moved forward for Germany as they did elsewhere, where the coronavirus established itself in large numbers it would not now be in a position to contemplate relaxing the measures it took early on in view of the emergence of that highly contagious virus.

Michael Kappeler / DPA / Alamy

Science-based policies succeeded in overcoming the deleterious effect of a densely populated country encircled by other nations that experienced high death rates. Germany's death rate of 54 deaths per million is immensely lower than that of other countries located nearby in Europe; Spain as example with 437 deaths per million; Italy with 384 deaths per million, France with 296 deaths per million, and that of the United Kingdom of 237 deaths per million population.

Much can also be attributed to the German temperament and culture of discipline and efficiency. During the worst days of the raging pandemic, Germany's Chancellor addressed the nation calmly and rationally with readily digestible explanations and statistics and a rationale for decisions taken. Most Germans trust and respect their Chancellor, her ethics and her values and her conscientious and conscious sense of humanity.

Her early imposition of stringent social-gathering limits, school closings, business closures, slowing of the economy and lockdowns in response to the early days of the novel coronavirus sweeping through the country along with the state of preparedness of its medical community to deal with the health crisis, the focus on testing and tracing of "every infection chain", all contributed to containing its spread.

It helped that, unlike other European and North American countries struggling to cope with the novel coronavirus in the absence of adequate, reliable personal protection equipment Germany was self-sufficient in medical devices, test kits and the production of equipment, with a surplus of ICU beds. It was able to initiate a robust testing program where now 120,000 tests are completed daily in a population of 83 million.

Leading to Germany's instituting a program of issuing "immunity cards" for people identified as having developed antibodies to the disease, enabling them to return to work, to travel and to socialize with a view to expanding the system to the degree that the country will gradually fully reopen its economy. The disciplined mind-set of the population, obedient to authority, resilient and given to national pride in this instance has been put to good use to benefit all of society.

Those same attributes seventy-five years ago led to a majority of the German population electing a political party calling itself the National Socialist German Workers' Party which most know in its abbreviated form: Nazi Party -- to which it was loyal and trusting. A party and a leader that led it to stretch beyond the bounds of human conscience, tolerance and compassion for those it accepted through a tremendous propaganda machine as sub-human, ripe for extermination.

This time, thankfully, it is a virus that German efficiency and bureaucracy is fixated on exterminating.

"Since the Second World War there has not been a challenge for our country in which action in a spirit of solidarity on our part was so important." -- Angela Merkel

Yad Vashem Security guard stands at the empty Hall of Names in the Yad Vashem Holocaust Memorial Museum in Jerusalem on April 19, 2020 (Yonatan Sindel/Flash90)

 

Not Much Left To Lose But Life

"It's one crisis too many for everybody. Homelessness is at its absolute worst. Then we have this vile opioid crisis. Then we have to get a pandemic?"

"You have to wonder what's next. You can't imagine it can get any worse. Then it does."

"When you talk about supplying opioids to people with an addiction, people can get all bent out of shape and say, ‘You should have an abstinent life.’ But the reality is in this kind of pandemic all of us are just trying to survive. I do feel that there’s an understanding that people have to do what they have to do to get through the day."
"All of us are struggling these days."

Wendy Muckle, executive director, Ottawa Inner City Health

Mark Barnes serves those with addiction. Jean Levac / Postmedia News

"They have more time on their hands. Time is dangerous to a person with opioid use disorder. Time leads to boredom and boredom leads to drug use. It gives them time to stew about their financial problems, their mental problems and why they use opioids in the first place. Addiction is not a character flaw. It's a true mental health disorder."

"There's an increased drug use risk and overdose potential because of the isolation, depression, anxiety due to COVID-19 and the lack of illicit-drug supply. Now they're going to try experimenting with anything they can get their hands on to turn off that brain. It's terrifying."

"Not only has the panhandling market dried up, many restaurants that have fed the homeless have now closed. Bathrooms are locked and parks are a no-go zone. On top of this, the street drug supply is drying up."

"It's harder to get drugs right now. Some advocates for abstinence think this is a positive thing. This is not a positive thing. This will lead to violence It will lead to crime. It will lead to other problems. Now there's even more of a need for a compassionate way to treat addiction disorder."

Pharmacist Mark Barnes, Respect RX, Vanier

At a time when the broader Canadian society has been stricken with a new reality of unemployment, lost wages, fragile finances, a government trying to convince then coerce people to remain indoors to practise social distancing, to leave home only when absolutely necessary, advocates for the homeless, the drug-addicted and those whose frail mental and physical condition makes them ideal candidates for the freakily communicable COVID-19 appeal for help to an audience focused on their own travail.

The homeless have been forced by the promulgation of orders to clear away from city parks as authorities frantically enact bylaws to compel people to create a physical distance between themselves and others. The homeless spend their days in such parks normally. But this new reality is as far from normal as is conceivable. Normal is where the homeless ask for 'spare change' from passing strangers and occasionally are rewarded for their persistence. They are able to accrue the cash to buy their illicit drugs.

These are not normal times; drugs that would ordinarily be available to feed the need of the addicted are now in short supply. Even while social distancing has also meant that the homeless addicted now also attempt to keep a distance from one another and the end result is loneliness to add to their despair. Being alone means that if someone inadvertently overdoses there is no one beside them to help. Among the multitude of homeless addicts a handful have been selected to take part in a pilot project.

Wendy Muckle of Ottawa Inner City Health. Jean Levac/Postmedia News

"Those most likely to die" are given access to prescription opioids through the provincial drug program. Just a few months into its inception, the safer-drug program focuses on those whom existing services haven't touched. "We're pushing hard on the safer-supply agenda. The illicit-drug supply, which has always been toxic and unstable is even more unstable in the midst of the pandemic", explained Wendy Muckle.

Homeless shelters have faced an immense burden in their efforts to accommodate the homeless, and now food scarcity is also looming as a problem for the unhoused and addicted. What in all likelihood strikes fear into the consciousness of the homeless addicted, however, is not the restrictions on their movement, the growing scarcity of places where they can gather, the growing lack of places offering them food and the disappearance of the source of their begging-cup, but the supply drying up of the street drugs their lifestyle depends upon.

Currently in Ottawa there are approximately 860 individuals living in the community shelter system along with about 90 people living on the streets, according to the city's community and social services department. (Jean Delisle/CBC)