COVID's Life Disruptions

People's daily routines have been severely disrupted by the pandemic, which over time can lead to new ideas of what is normal

"When the only stories you hear [are] about the people that aren't doing what they're supposed to do, and are constantly messing up and making things worse and so on, it makes people forget that that's a very small proportion of the actual populace, and that actually they are the exceptional cases rather than the norm."

"People don't get enough recognition for that [their adherence to distancing, mask-wearing, etc.], and I think that's a bit of a problem."

Simon Bacon, professor, Concordia University, co-director Montreal Behavioural Medicine Centre 

"This [trust in state institutions associated with fewer COVID-19 deaths; social trust and group belonging linked to more fatalities] is likely because trust and affiliation with others are incongruent with physical distancing measures. So you can't see COVID-19."

"And trusting that your neighbour, trusting that your best friend, trusting that your family members are engaging in behaviours that reduce the risk of transmission may increase virus transmission."

Michael Wohl, psychology professor, Carleton University

"I explain what happens to me through circumstances and I explain what happens to you through character. That could lead you to chalk up someone else's failure to wear a mask to their being lazy, for example, while excusing your own decision not to wear one as a one-off, resulting from pandemic-related exhaustion."

"We have to be so careful of this kind of storytelling where the non-compliance gets told as a personal deficiency."

"It's not just disseminating knowledge or instructions, but asking the tough questions about how realistic it is for people to follow advice."

"In our planning, we have to anticipate that this is going to happen with a pandemic this long. The instructions that make sense early in the pandemic when people see this as a big threat and a scary thing, and people are energized to fight it, we're going to need different resources and different supports as it drags on."

"We need to acknowledge that everyone's going to get tired, and figure out how our interventions can account for and accommodate for that fatigue." 

Eric Kennedy, associate professor of disaster and emergency management, York University

 

The percentage of Canadians reporting wearing face masks outside their homes between March and July most of the time, rose from two percent to 54 percent. Simon Bacon is at work on an international study of COVID-19-related attitudes and behaviours based on data from close to 14,000 Canadians who participated in a study between March and mid-September -- over 80 percent have been consistently handwashing and physical distancing since the beginning of the pandemic.

A fairly high ratio of compliance. And Dr. Bacon feels that 80 percent should be recognized for their steady reliability as a functional base of people who engage not only in safeguarding their own health but that of their community. As opposed to the quite small number of people comparatively speaking, who appear to believe that rules are made for others to follow and they have no obligation, social or ethical to be a part of that compliant majority. Many among them believe that the pandemic represents a scare-tactic on the part of government to bring people to heel.

Messaging focused on most people dedicating their efforts to sound virus-aversion practices is seen by Dr.Bacon as a reinforcing tool that validates the morality of continued behaviour that becomes normalized. Rather than risk people beginning to question why they should continue making an effort when others fail to. He speaks of consistent policy as a byword for public acceptance. In Quebec, he says as an example, people are not permitted visitors in their home from another address in the province's COVID red zones. On the other hand, up to 25 people are able to gather at places of worship.

 

Social distancing has meant that people have had to get along without the usual daily face-to-face contact with friends, family and colleagues

 

"What people then invariably do is they start defaulting to their personal perspective, their personal values. Do they think this is important? Do they think they should be doing this?" 

 

Researchers at McGill and Carleton universities examined data from dozens of countries, to discover that while trust in state institutions was associated with fewer COVID deaths, social trust and group belonging were linked with greater numbers of fatalities.

And according to Dr.Wohl, one of the study's authors, with COVID-19 case and death numbers -- the anonymity behind the numbers, the de-personalization of the sheer numbers of victims -- growing steadily in numbers results in insensitivity within the population formerly personally empathizing; they become too distanced from the reality that simply overwhelms them. 

 

Dr. Kennedy speaks of the necessity of clarity and consistency in messaging along with the importance of transparent explanations why messaging may change, when it does, along with modelling oneself the very behaviour being asked for the public. The message is more advantageously received when a service is more readily accessed. As for example asking people to get themselves out to testing facilities when symptoms arise, but testing centres have limited operating hours or fail to be conveniently located for easy access, taking a prolonged time to complete. 

 

Another critical issue is the tendency of people to begin to succumb to COVID-inspired fatigue. Acclimatizing to threats that become incorporated as part of routine environment.Those new routines can become difficult after time has passed, to continue along with, given their inconvenience and become life-stressors. 

 

Changed work conditions, childcare disturbances, all take a psychological toll to match the physical toll. In current conditions what people once thought of as routine and predictable has undergone a complete transition, a crisis-forced change, one that disturbs their sense of resilient accommodation because it is unrelenting and intrusive in their lives. People despair over that elusive 'light at the end of the tunnel'.

Dine Out on WHAT?!!!

"The cellular agriculture industry is a very important industry -- it's a very important area of biological design. But a lot of people don't pay attention to the real costs of lab-grown meat."

"There's constantly a hype cycle. We should be critical about this hype and be realistic about what's possible at any given time. And also ask people the very basic question: Why don't you just consume less meat instead of trying to replace our meat consumption with all kinds of more expensive and [less desirable] solutions?"

"When people are choosing between killing animals, or lab-grown meat versus plant-based alternatives, this human steak needs to be considered because it also asks us the question: How far can we go to meet our protein needs when we are running out of options?"

"It is a little bit combined storytelling with real, hard science [prototypes of the Ouroboros Steak installation]. But ultimately, it's about asking these questions."

"We all like to think about sustainability as 'how do we survive on the planet in a longer period'? But we don't really want to take the risks or question our own assumptions. So we push by saying that, 'Well, maybe you need to eat yourself to be able to survive on the planet'."

"People feel very offended. And that offence is an important place to really ask these questions."

"Ultimately this project is doing its job in terms of creating this self-reflexive environment."

Orkan Telham, interdisciplinary artist, designer, researcher

(Photo : Stuart C. Wilson/Getty Images)
LONDON, ENGLAND - OCTOBER 20: 'Ouroboros Steak by Andrew Pelling, Orkan Talhan and Grace Knight on display during the "Beazley Designs Of The Year 2020" photocall at Design Museum on October 20, 2020 in London, England.

"The fuzziness is actually part of the whole myth of the cannibal -- what is cannibalism and what is not."

"Who is a cannibal? 'It's them, but it might be us' is part of what makes it powerful."

"People have different taboos but food is just so symbolic that it's a statement about who you are, and what you believe in. It's a statement of values. And that's clearly part of the whole design [of the Ouroboros steak]."

Maggie Kilgour, Olson professor of English Language and Literature, McGill University

"If you wanted to grow meat in a laboratory setting, you could do it with chicken or you could do it with beef, or you could do it with fill-in-the-blank."

"But the whole idea of doing it with humans is just completely absurd."

"It's been ingrained in us since the time of Homer. The worst thing you can do to another person is to cannibalize them. Now tie that into Christian ideas about what you do with the dead and how at a certain point you'll be resurrected -- your body and soul will be together up in heaven. And then tie that into food, which people are all worked up about anyway."

Bill Schutt, zoologist author, Cannibalism: A Perfectly Natural History

The grow-it-yourself kit would include mycelium scaffolds (centre) and human serum (right)

 

Well, then ... eat yourself? Think of culturing human cells in human serum for the purpose of growing, yes, human meat. A team of scientists and designers gave birth to this concept, naming it Ouroboros Steak. But what is quite different about the concept itself is that the cells used to produce the human meat are to be grown by those intending to consume the meat, using their own body cells. They are, in effect, planning in so doing, to consume themselves in a sense; biologically that is.

The 'steak called Ouroboros Steak's conception visualizes the grower/eater using their own cheek-swabbed cells along with a blood bank by-product. The word Ouroboros refers to the ancient Egyptian symbol of a snake swallowing its own tail representing an infinite loop; the concept merges the consumer with the consumed. The conception is comprised of an art installation on display at London's Design Museum which displays four bite-sized, red morsels of flesh preserved in resin. Titled "Breakfast Before Extinction".

 

Aleph Farms unveiled its thin-cut steak prototype at the Asia-Pacific Agri-Food Innovation Summit in Singapore on Nov. 20. Photo by Aleph Farms

It was featured in Dezeen, an architecture and design magazine, in mid-November where an article: "Ouroboros Steak grow-your-own human meat kit is 'technically' not cannibalism" was published, likely as an avant-garde piece. It was meant to represent a thought experiment explained Mr.Telhan; a critique of lab-grown meat whose purpose was to initiate a discussion, not necessarily to present as a possible solution for proteins to reach a market niche. Lab-cultured meat is often thought of as 'clean meat', slaughter-free meat production, more environmentally friendly than conventional livestock agriculture.

On the other hand, a startup, Aleph Farms based in Israel whose concept was released in 2018, appears to be approaching commercial product realization after launching its program to grow steaks in space earlier this month. It revealed its thin-cut prototype at the Asia-Pacific Agri-Food Innovation Summit held in Singapore on November 20. SuperMeat, yet another Israeli company, is in the process of trialling cultured chicken burgers at a new restaurant in Tel Aviv.

For display, the bite-sized steaks are preserved in resin

 

The Ouroboros Steak creators highlight the  use of fetal bovine serum (FBS) used by the cultured meat industry. This is a frequently used ingredient in a wide range of fields, including lab-grown meat, biotechnology research and vaccine production where FBS is harvested from living fetal calves, through a puncture to the heart without the use of anesthesia -- during the slaughter of pregnant cows. Incentives for a replacement ingredient are led not by ethical concerns but by the cost; 400mL of FBS sells for $1,084.

"While many commercially available growth media are free of the decidedly non-vegan fetal bovine serum, they have all been judged to be too expensive for use at industrial scale" writes Genjamin Aldes Wuirgaft in Meat Planet: Artificial Flesh and the Future of Food. Some lab-grown meat companies including Aleph Farms, Moss Meat in the Netherlands and Tiftek out of Turkey report they no longer use FBS for production. Mr. Telhan, on the other hand, doesn't visualize the FBS issue being resolved yet.

It took three months for the prototypes for the Ouroboros Steak installation to mature, and there are no plans to commercialize the project. Its creators felt no compulsion to taste what they had created. Critics of the concept have equated the Ouroboros Steak with autocannibalism. A word that has been loosely used, cannibalism has been replaced by some anthropologists with the word anthropophage; 'people eater'. What is clear is that civilized societies view cannibalism with revulsion.

The word ouroboros was a symbol of renewal in antiquity. Greek and Roman magical practices adopted from ancient Egypt exemplify the concept with the name combining the Greek oura (tail) and boros (devouring or gluttonous). 

 

Ouroboros Steak was previously exhibited at the Designs for Different Futures exhibition at the Philadelphia Museum of Art

"[In Greek and Roman mythology, cannibalism marks a] final, ultimate transgression."

"It's resisting these ideas of autocannibalism as a taboo by labelling it as something that is a symbol of rebirth and regeneration."

"It really raises questions about the morality of meat-eating and what lengths we should go to to avoid eating other animals -- and so eating yourself."

"It's not really cannibalism when you think about it as this ouroboros ... it's using yourself to regenerate. And in that sense it's like an infinite cycle of life and rebirth and regeneration, instead of this horrific killing and end of life that we get when we eat other animals."

Rebecca Moorman, course lecturer on Horror and the Grotesque in Ancient Rome, University of Toronto, Mississauga

Perplexing, Overwhelming : Who Gets The Bed

"It was like a forest fire, and all I had was a garden hose. [She died] and we watched this. What were her fears? Her hopes? None of that."

"I don't think the community knows that these conversations [with hospital ethicists on how to ration care] are going on. We're talking about them -- we're not talking about something esoteric about ourselves. We're talking about how ICUs, if we reach the limitation of our capacity to treat COVID patients, then we're going to have to make decisions about who gets the bed." 

"We're going to be following some of the sequelae of this acute, news-grabbing issue [people who don't appear to fully recover from COVID-19] for the next several years."

"Only it won't be so news-grabbing, because it will just be people with chronic disease that happened a long time ago with something we called COVID."

Dr.Peter Goldberg, head, critical care program, McGill University Health Centre

Doctors are looking for markers to predict the likelihood of “critical events” and death from COVID-19 — signs, like fast breathing, high blood pressure or elevated proteins in the blood, that someone might go from sitting on the edge of his or her hospital bed eating lunch, to sudden intense distress, to being sedated, and being lost. Saltwire

"The way his abdomen was contorting and the way his muscles in his chest wall and thoracic cage were contracting -- when I contrast that to the same guy who poked fun at me in my broken Italian, that was truly heartbreaking for me."

"He didn't use a cane. He was full of personality. He was gregarious, he had his wits about him, he was a father. He was life."

"These are the stories, this is the burden of trauma that I'm seeing inside those walls. I feel like so much of this pandemic has been reduced to this narrative of what form of life is more valuable or expendable than other forms of life."

Dr.Abda Sharkawy, infectious disease specialist, Toronto General Hospital

"If these are young people or middle-aged people we can offer some extraordinary support measures, like putting you on cardiopulmonary bypass basically [where a machine pumps and oxygenates blood]."

"The one unusual way that people with COVID-19 die is with bleeding and clotting problems."

"If there is anything more distressing than seeing someone die, it is seeing them die alone, or a nurse holding up a phone on Zoom or Skype so that family members can watch this."

Dr.Anand Kumar, intensive care doctor, Winnipeg Regional Health Authority

The number of patients in Ontario hospitals typically peaks in January. Data obtained by CBC News shows acute care hospitals with high occupancy rates even in early fall. (Frank Gunn/The Canadian Press)

 

The cardiopulmonary bypass mentioned by Dr.Kumar is a procedure that in extremis can temporarily take over heart-lung function to allow the organs to begin healing after a traumatic assault by COVID.  The process can work for a limited time, perhaps weeks in the hope that lungs may heal although the result can lead to two-thirds of patients developing multiple organ failure. The heart begins to fail, the kidneys fail, the liver begins to fail. It's similar to what happens to people on dialysis or those with diabetes-related organ injury.

Mystery of the COVID 'long-haulers'  PBS.org

Medical experts continue to be perplexed over the complexity of the SARS-CoV-2 virus's effect on the human body as they attempt to understand the nature of COVID-19; unpredictable, barely affecting some people and dreadfully harming and even killing others. 

 

Age is known to be one of the variables, along with underlying medical conditions, but there are no guarantees; many victims don't fit those neat categories; young, fit people collapse, suffer organ failure and die, while some in fully advanced age and burdened with medical conditions somehow manage to survive.

Still, some progress has been made. Doctors recognize emerging patterns and developing models, studying them, searching out predictive markers for the likelihood of 'critical events' and death occurring. Symptoms such as fast breathing, high blood pressure, elevated proteins in the blood that might cause someone to transit from being seated on the edge of a hospital bed having lunch, to suddenly exhibiting intense distress, having to be sedated, doctors watching helplessly as they expire from life. 

In Canada, cases are rising so steadily in this second wave that it's expected to begin seeing 20,000 to 60,000 daily cases by December's end, according to federal modelling. The official death toll is 11,856 and counting. Deaths are on the rise in all regions of the country, according to University of Toronto infectious disease researcher, Dr.Tara Moriarty. Canada has attained the third-highest case fatality rate of 3.5 to date among its peer countries: "higher even than Spain, France, the U.S.A. and Germany". And yet the case fatality ratio estimates only the number of deaths among identified, confirmed cases "meaning that we're likely significantly underestimating the full size of the epidemic".

Oakville, Ont. resident Rose Foy was already worried about her son-in-law having quadruple bypass surgery. The 48-year-old husband of Foy's daughter has long suffered from health problems, including a stroke five years ago and a heart attack earlier this fall.After his five-hour open-heart procedure on Nov. 10, Foy's concerns grew — scans showed her son-in-law had a popped internal stitch. Then, on his fourth day recovering at Toronto General Hospital, he was discharged. Staff told her daughter the hospital was getting ready for an influx of COVID-19 patients, Foy said."I can't believe I had to drive him home so soon," she recalled, adding that at every bump on the highway ride to her son-in-law's Oakville home, he would cry out in pain.The family's experience comes as Ontario hospitals are increasingly facing a juggling act. Many of the thousands of surgeries put off by the first wave of the pandemic are now being scheduled, all while COVID-19 admissions keep rising. The family was initially told her son-in-law would be in intensive care for two to three days, Foy explained, plus another four to five days in a cardiac unit. "He had serious surgery. He needed to be in that hospital for at least a few days more," she said. "You can't just discharge people because of COVID." CBC

Of the more than 9,500 people in Canada who died of COVID in the first wave -- March to July -- 90 percent had one other cause, condition or complication at least, reported on the death certificate (comorbidity), according to Statistics Canada. Dementia or Alzheimer's being the most common condition associated with deaths involving COVID, listed on death certificates of 42 percent of women, 33 percent of men. Over half of those seniors age 80 and older who live in long-term care have dementia.

Cancer, nervous system disorders such as Parkinson's, or ALS, respiratory disease, diabetes, kidney failure, heart disease, high blood pressure and pneumonia all increase the risk of a lethal case of COVID occurrence, and all are more common within age groups 65 and up, accounting for 94 percent of all COVID-related deaths in the first wave. On the other hand, those chronic conditions and diseases affect millions of other Canadians, three million of whom regardless of age live with diabetes, over seven million with hypertension.

COVID Long-Hauler "Suppose you suddenly are stricken with COVID-19. You become very ill for several weeks. On awakening every morning, you wonder if this day might be your last."

"And then you begin to turn the corner. Every day your worst symptoms — the fever, the terrible cough, the breathlessness — get a little better. You are winning, beating a life-threatening disease, and you no longer wonder if each day might be your last. In another week or two, you’ll be your old self."

"But weeks pass, and while the worst symptoms are gone, you’re not your old self — not even close. You can’t meet your responsibilities at home or at work: no energy. Even routine physical exertion, like vacuuming, leaves you feeling exhausted. You ache all over. You’re having trouble concentrating on anything, even watching TV; you’re unusually forgetful; you stumble over simple calculations. Your brain feels like it’s in a fog."

Your doctor congratulates you: the virus can no longer be detected in your body. That means you should be feeling fine. But you’re not feeling fine."

Anthony Komaroff, MD Editor in Chief, Harvard Health Letter

Rachelle Aubichon, left, and Jodi Fellner share what it's like to experience lingering COVID-19 symptoms months after they contracted the disease.  CTV News

 

Research, Innovation, Discovery, Production, Distribution

"Enhanced Big Pharma reputations may well be the result. In its search for COVID profits, Pfizer last March issued $1.25 billion in 'sustainability bonds' under the United Nations' Sustainable Development Goals. The money raised, said Pfizer, will be used to fund capital investments in the manufacturing and development of medicines and vaccines, including the COVID vaccines."

"By issuing the bonds and taking a lead role on the vaccine search, Pfizer may in fact be seizing an opportunity to improve its image. Sustainalytics, which ranks corporations according to their perceived ability to live up to dubious environmental, social and governance objectives, currently ranks Pfizer as a 'high-risk' operation."

"At the end of the day, however, the arrival of effective vaccines will in fact mark another triumph in the role of profit-maximizing corporations in bringing good to society. The story will be how Big Pharma rescued global governments from the COVID-19 pandemic -- and at a fraction of the cost of what governments have expended on the project."

Terence Corcoran, journalist, Financial Post 

The laboratory at the University of Toronto where insulin was discovered.  University of Toronto

When insulin was discovered in a University of Toronto laboratory headed by J.J.R. Mcleod in 1921, its discoverers, Frederick Banting and Charles Best with the help of lab assistant James Collip, aspired to save lives lost to a dread disease, where children diagnosed with [juvenile-onset insulin-dependent] diabetes -- now known as Type 1 -- were as good as given an imminent death sentence, when their pancreas was no longer able to produce insulin to convey glucose to cells to be converted into energy. 

It was Frederick Banting whose idea formulated the production of insulin to save millions of lives around the world. And he had no interest whatever in profiting from his invention. He 'sold' the patent to the University of Toronto for the princely sum of one dollar. He felt the discovery should have no price tag connected with it, that it was the property of science and the world community, not his own. Thereafter insulin was mass-produced and widely available for the treatment of diabetes everywhere in the world. That was then, this is now.

 

Pfizer identifies lead coronavirus candidate ... WSJ

 

Laboratories of today bear no physical resemblance in their state-of-the-art equipment and scientific upgrades in fast-evolving techniques. And though there will always be laboratories and discoveries in university settings, the manufacture of pharmaceuticals is the work of large production facilities, the private property of big business popularly named as Big Pharma, and not with affection. They are driven, like any other business, to expand their profit margin.

And claim that much of their profit is plowed right back into new discoveries -- apart from what shareholders are guaranteed. That without charging hefty prices for their biological/chemical formulations -- developed in their laboratories by their own scientists and subsequently patented to ensure their research would profit their own business until patents ran out -- the wherewithal to continue important research into the many chronic illnesses and diseases that bedevil humanity. Research is costly, trials are time-consuming and also costly.

Government safety and efficacy regulations are a concern and products must be approved and only then will the production line proceed and distribution begin, to service the needs of the public requiring medication for a wide range of conditions. But because pharmaceutical companies make huge profits and their earnings burden health systems, the public, led by health services and government agencies view the producers as scalpers, unjustified in the prices they set in a capitalist free enterprise system.

Photograph: Dado Ruvić/Reuters

So we mentally sneer and refer to them contemptuously as conscienceless "Big Pharma" out to get the biggest bang for their research prowess. They're sinister in the sense that they're driven by Filthy Lucre, but their research, development and production are critical to our general well-being, battling the scourge of human illness and disease, goes the grudging admission. We don't regard manufacturers of far less vital products charging hefty fees in the same way, however.

There are governments, such as Canada's that castigate Big Pharma for their operations and pricing, placing pressure on the pharmaceutical companies for pricing concessions tied to bulk purchasing in the case of national health care schemes. Which leaves the pharmaceutical companies that sell to Canada no incentive to also produce in Canada. Canada's forced low prices present a conundrum whereby Americans try to purchase their drugs from Canada though the drugs are produced in the U.S. where they sell at competitive prices.

So Canada has no production capacity. And at a time of critical access to developing vaccines to combat a sometimes-deadly and frequently-devastating coronavirus Canada has left itself in the lurch. Those countries which enable the production of drugs without pressing the producers for lower pricing will have expedited access to vital vaccines. Canada will have to wait before its population is able to be inoculated, a considerable length of time after other nations' populations have been serviced. 

Since those in the health and pharmaceutical fields have been sounding the alarm to Canadian governments over its pricing and regulatory regimes undermining pharmaceutical capacity in the country for years, and government has taken little heed, this is one of the dire consequences. "Innovative new medicines" entry to Canada will lag and sometimes not be available at all should producers fail to launch their products in a country that haggles firmly over pricing.

 

Banting and Best were satisfied with a Nobel prize.

F. G. Banting and C. H. Best with a Marjorie on the roof of the U.of T. Medical Building

The Anguish and the Agony

The spread of COVID-19 ramps up. (Ben Nelms/CBC)

"In the next two weeks, that's when we're really going to start feeling that [burnt-out] in our hospitals. We are very worried. We're terrified."

"It 's inevitable it's going to happen and we just need to brace ourselves for it [a COVID 'third wave']."

"Let's say the ICU is full. That's a real risk right now. How do you make the choice about which person deserves a ventilator or an ICU bed more [than another patient]?"

Dr.Shazma Mithani, emergency room doctor, Edmonton, Alberta 

"We're all really, really scared about what the next -- not even just the next couple weeks, it's the next few days -- we know that ICU numbers can increase by leaps and bounds in a matter of hours."

"We don't know if we're going to be able to keep up tomorrow or the next day, forget the next couple of weeks."

"Everyone is just extra tense, extra nervous."

"[With workers off sick or caring for family, or resulting from virus exposure, the] pool of nurses is getting smaller and smaller."

Edmonton emergency room nurse, name withheld

"It's so busy. this is the forgotten part of the pandemic."

"When we talk about burnout, it's because we are really being called to go above and beyond what we would naturally do in our general family practice."

"I'm really tired, I'm really, really tired ... we're just at the early stages of this wave."

Dr.Christine Gibson, Calgary family doctor

Quebec Orderlies train on the job   CTV News

Canada has seen the number of COVID-19 cases sweep past 344,000 with deaths linked to the coronavirus over 11,600 in number leaving medical workers fearful of the health system breaking down. They also worry that while treating patients with COVID they are exposed to the virus; will they become ill, will they bring the virus back home with them? Who will look after their family if they're ill? For that matter, who will be left to look after patients' needs, if health workers continue to succumb to the virus? 

Even now, staff shortages bedevil the system resulting in part from nurses and orderlies becoming ill. Burnout and illness continue to sideline medical workers right across Canada. This second wave that has inundated the country has taken its toll, and even while it has not yet reached an anticipated crescendo, fears of a third wave haunt the health community. Health care workers are doing double duty given the growing shortage of workers and they're exhausted.

Doctors like Shazma Mithani feel Alberta's government has failed to bring in sufficiently stern legislation, leaving people free to gather indoors at places of worship, in bars, casinos and restaurants. Contact tracing has broken down while up to 80 percent of cases are without data to show where they were contracted. COVID-related hospital occupancy and ICUs across the country both on the rise in an already difficult situation where most hospitals have reached their capacity.

 

‘This is the most scared I’ve seen people in my 27 years as a nurse.’ BC’s health care workers are doing their best to find relief. Photo by Joshua Berson

 

Two days ago Ontario had 523 people in hospital, 159 of those in ICU, while in British Columbia 284 people were in hospital, 61 in ICU. "It becomes a daily struggle to find the right place to care for people and the right tools to apply your knowledge well", remarked Dr.Kevin Smith, president and CEO, University Health Network, Toronto. Hospital staff fear longer wait times in crowded hospitals will result in worsening health outcomes for their patients.

The first wave in the spring presented a problem of shortage of protective gear and medical supplies, along with hospital beds, whereas this second wave threatens outcomes through a shortage of trained medical personnel. Demands of the pandemic has led to 'moral distress' for health workers. "When you can't provide the quality of care that you have in the past, it becomes that much harder to tell yourself you're doing a good job", explained Lonee Rousseau, a registered nurse, and vice-president of the union local at Royal Alexandra Hospital in Edmonton.

In Steinbach, Manitoba, nurses point out that patients are now forced to wait in their cars as a result of insufficient hospital space, calling out for more staff in a province that has recently seen its case load explode. Over 3,200 health-care workers in Alberta alone have been infected by COVID-19. According to data published by the Ontario government, over 8,400 health-care workers ranging from dentistry to first-responders, to respiratory therapists, to personal care workers, have contracted COVID-19 since spring.

 

Care workers are ‘constantly on edge waiting for the next step and reflecting on the last step,’ says Dr. Ed Marquis of Prince George. Photo by Joshua Berson

"The fear right now is that this is only getting worse and so there's an anticipation, a dread anticipation, going on within our system."

"We really need to see people when they're sick. There was this mortality bump [in May and June] ... basically due to people putting off hospital visits for illnesses when they should've [come in]."

"And that [seeing two COVID-19 deaths recently] may seem like, whatever, you're an emerg.doc, you see death."

"But this is different. And so fast. And we just know that it's going to get worse."

Dr.Joe Vipond, emergency room doctor, Calgary

A World Treasure Pilfered, Lifted, Absconded With : The Origin of Carelessness

 Darwin wrote On the Origin of Species. (AP)

"We know they were photographed in November. But we do not know what happened between then and the time in January 2001, when it was determined they were not in their proper place on the shelves."

"There isn't anything on the remaining record which tells us anything more [about the missing Darwin notebooks]."

" [Theft] should be ruled in as a possibility from the start and that wasn't."

"Now, if anything of this scale and significance was not found, we would be going to the police."

"We won't stop looking. There are good examples where things have been found, thanks to the help of the public."

"So I would really appeal to members of the public, former staff, researchers, anyone who might have information which would shed light."

"[If anything, now is the time to] safely, even anonymously [get in touch]."

"It's possible they are under a bed, that's the best case scenario, someone has found they can't sell them or they're just holding on to them."

"It's those new leads we're looking for, with the help of the police, in order to help recover these for the nation."

Dr.Jessica Gardner, director of library services, Cambridge University Library

Priceless notebooks that were once studies written down by Charles Darwin leading to his world-famed observations and conclusions on the origins of life and of the ascent of humanity -- as life forms mutated and matured and adjusted themselves to their environments gradually over the aeons becoming more capable of sustaining their existence taking on new forms and adjustments in evolving to the forms known to this day -- purloined. They were held in stewardship by one of the world's most famous institutes of learning.

To infer by what is being made public that the Cambridge University Library was devoid of sufficient cautionary sense as to permit these treasured notebooks to be carried off for the purpose of being photographed as though this would be a casual event barely worth bothering about is mind-boggling. Microfiche is a technology that has been in use for decades. That the notebooks wouldn't have been copied in some form, digitized with meticulous care so that the originals would be permanently maintained in absolute secure conditions is not to be believed.

Given the inestimable historical, cultural, scientific value of the notebooks it is difficult to wrap one's mind around the fact that they could be taken from a secure storage unit ostensibly for a stated purpose -- copying -- by just anyone without exacting records being kept as to their whereabouts at any given moment, and that no one in authority appeared to have been involved and knowledgeable as to their entrusted handling and return leaves one incredulous.

The current head of library services is determined to find them and restore them to the possession of the library. On the basis of the library's utter failure in securing the notebooks for posterity, one would have to question the wisdom of permitting the notebooks, if and when found, to be returned to their care. It would appear that world-esteemed naturalist Charles Darwin's notebooks were removed from a storage room shelf, taken to some place on campus or a studio to be photographed. How perplexingly casual.

 

The Transmutation Notebooks  (Cambridge University Library)

They were never seen again, according to the university librarian, appointed to the position 17 years after their disappearance. She had a "routine checkup" conducted several months earlier only to discover at that time that the books had never been returned to the shelves. Whereupon library curators undertook an "extensive search" in an effort to locate the missing notebooks, just incidentally valued in the millions. Finally the conclusion was reached that the books may have been misappropriated, stolen.

Library staff originally apparently assumed the notebooks to have been misfiled -- again stunning casualness. any time a search was undertaken to discover where the books might be in the library, the search failed. Essentially staff shrugged metaphorically assuming the books would some day turn up. The library at the venerable university measures over 200 kilometres of shelving and has in its care over ten million maps, manuscripts, and bound books, along with other objects.

Charles Darwin's 1837 "Tree of Life" sketch.  

Cambridge University Library

The missing notebooks are no larger than the size of a postcard, stored in a blue box itself the size of a paperback. The current head librarian, Ms.Gardner, has launched a new probe to meticulously comb through storage areas, conducting "fingertip" checks within the collection of Darwin's books, drawings and letters, all 189 boxes of them. Nothing has been revealed. But Dr.Gardner insists she is "not willing to accept" the notebooks would eventually be found and had her team discuss the issue.

The earlier assumption that the books had merely been misshelved was rejected and current staff "completely reviewed what happened at the time.  Reluctantly, I have decided that was not the right conclusion [misshelving]." The notebooks, Dr.Gardner now believes, had "probably been stolen". As the years progressed, security procedures were revised, reviewed and tightened, she said. As one might have hoped would be the case.

The Cambridgeshire Police have now been advised. They recorded the disappearance on the National Art Loss Register for missing cultural artifacts, and had the notebooks' disppearance placed on Interpol's database of stolen artworks. Even so, albeit unlikely, hope still exists that the notebooks might eventually be discovered having been inadvertently placed somewhere in the library on the wrong bookshelves....

"These notebooks really are Darwin's attempt to pose to himself the question about where do species come from, what is the origin of species?" 

"It's almost like being inside Darwin's head when you're looking at these notebooks. They're jottings of all sorts of information that he's writing down."

"You have the sense of him working through these ideas at great speed and that kind of intellectual energy which I think the notebooks really convey."

"I'm a fan of James Joyce and it's always struck me that it's a bit like Leopold Bloom on steroids. You just get the sense of scientific imagination running really deep."

"To have such an iconic object go missing is really a tragedy."

Jim Secord, emeritus professor of history and philosophy of science, Cambridge University

Cambridge University Library have appealed for the notebooks to be returned  Cambridge University Library

First The Vaccines, Then The Logistics Surrounding Delivery

"We typically haven't had mass vaccinations campaigns for adults that required multiple doses."

"This is something that could be easily overlooked, but could be an Achilles heel in our program."

Dr.Kumanan Wilson, epidemiology professor, vaccine policy expert, University of Ottawa

"Additional staff may be required to accommodate the added workload to administer the vaccines, manage wait lists and appointments and monitor inventory."

"I have heard some health professionals state that giving the COVID-19 vaccine is going to be like experiencing flu season two times over in terms of their anticipated workload."

Dr.Sherilyn Houle, pharmacy professor, University of Waterloo

Moderna scientists used an innovative technique for developing the vaccine so quickly   Moderna

 

The world of public health is beginning to focus on the work involved in administering newly-approved COVID-19 vaccines to billions of people worldwide -- in two-shot injections, about a month apart. Logistics for immunization is vastly complicated by the fact that people will receive an initial shot, and then weeks later be expected to turn up for the second and final shot of the vaccine. That, apart from the decisions to be arrived at determining who will be receiving the first shots. Oh, and concerns over the level of uptake, given public resistance to the very idea of the COVID vaccine..

The one issue that appears quite perturbing to the experts, however, is that for the majority of the pharmaceutical companies the vaccine they're promoting is a two-stage inoculation, vastly complicating the entire problem of delivering the vaccine expeditiously, efficiently and reliably. Concerns that people will accept the idea of an initial shot, then resist the urging of medical professionals to return to complete the process with the second shot.

There are ample reasons for concern, given research that consistently concludes that up to 70 percent of adults prescribed a multi-dose vaccine fail to return once the first injection has been done. Should a similar pattern evolve of non-compliance with COVID, it would obviously impair the goal of reaching herd immunity. A good proportion of  the public has always been resistant to taking the annual flu shot, irrespective of health authorities' call on the public to do just that.

 

Pediatric infectious disease specialist Dr.Caroline Quach at the University of Montreal, a member of the national advisory committee on immunization, acknowledges that having to administer two doses will represent "a challenge", but "it has to be done". Dr.Wilson and his colleagues developed a mobile app to send text messages reminding people they're due their second dose of the vaccine.

On Monday, a report was issued by AstraZeneca collaborating with Oxford University, that their vaccine was between 70 and 90 percent effective at preventing COVID-19, depending on the dose administered. These front-runners all need two doses for effectiveness; a gap of 21 days is required for Pfizer's vaccine and 28 days for Moderna's and AstraZeneca's. Of seven vaccines completing late-stage trials, one only, developed by Johnson & Johnson requires a single injection, but it is still awaiting Phase 3 results.

Adult vaccination research confirms findings with a consistent theme; "suboptimal". Only 40 to 50 percent of people went on to complete their two-dose hepatitis A and varicells (chickenpox) vaccinations, and numbers fall even lower for teens and young adults. Published last year, a study out of the U.K. found a mere 11 percent of adults received two doses of Hepatitis A vaccine in the space of a year, rising to 23 percent by 36 months.

In 2018, a similar American study suggested a mere 32 percent of adults obtained their second Hepetatitis A injection with 42 months. Reasons/excuses vary from people admitting to researchers they had no idea an additional shot would be required; they couldn't fit an appointment into their schedule; or they needed a reminder, according to Dr.Houle at University of Waterloo, citing results gleaned with a similar study using Alberta data.

 

 

 

December COVID Vaccine U.S. Rollout

Pfizer and its partner BioNTech announced this week that the vaccine was 95 percent effective and that it worked well in older people and in preventing severe Covid-19.   Credit...Bebeto Matthews/Associated Press

"Filing in the U.S. represents a critical milestone in our journey to deliver a COVID-19 vaccine to the world and we now have a more complete picture of both the efficacy and safety profile of our vaccine."

"[Throughout the vaccine development process I wasn't certain Pfizer could produce a safe and effective vaccine ready for FDA review in less than a year.] Conviction is a part of it, so I was always telling [our teams] that we will make it, and we will make it by October, and if not us, then who?:

"But I knew that it was an extremely risky suggestion, I knew it was going to be difficult, and the stars needed to be aligned all the way to the end."

"[The partnership with BioNTech is built on a mutual focus on advancing science; the two companies began work, including sharing confidential information, before signing a formal contract, since those agreements can take months]. In fact, we are still finalizing the contractual obligations we have that we need to sign with them. It’s the perfect relationship for me."

"Ugur [Sahin, BioNTech’s co-founder and chief executive] is a wonderful human being, and a great scientist. He shares the same passion [as I do] about saving lives and I’m very optimistic that not only will we do very well together bringing a COVID-19 vaccine to the world, but later hopefully a flu vaccine."

Albert Bouria, chief executive officer, Pfizer Inc.

"[If the data is solid], we literally could be weeks away from the authorization of a 95 percent effective vaccine."

U.S.Health Secretary Alex Azar

 

"Within 24 hours from the approval, the vaccine will be moving and located in the areas where each state will have told us where they want the vaccine doses."

Dr. Moncef Slaoui, chief scientific adviser, US "Operation Warp Speed" vaccine program

Dado Ruvic/Reuters 

Some Americans could "hopefully" receive the vaccine for COVID-19 as soon as December 11 or 12

A date has been set for an FDA advisory committee to meet and discuss plans surrounding the COVID vaccine developed by Pfizer and BioNTech. That date is between the 8th and tenth of December. Leading to speculation that as early as December 11 the vaccines could be rolled out and distribution initiated. Pfizer has been busy long before the final Phase Three test results were arrived out, producing the vaccine. It is now prepared to apply to U.S. health regulators for emergency use authorization.

 

This will be the first of several and perhaps many such applications. Moderna will be certain to follow closely, since the announcement was made public that its COVID-19 vaccine had passed the Third Stage tests with similar results to Pfizer's. AstraZeneca is another contender whose vaccine appears ready for approval, production, distribution and inoculation. These vaccines tested in the amazing 95 percent effective rate with no major safety concerns emerging. 

 

The market responded as affirmatively as the public and government leaders around the globe at the news of the test results, seeing Pfizer's shares rise 1.6 percent and BioNTech's 6 percent. Hopes have been raised for the end of the pandemic responsible for claiming over a quarter of a million lives of people in the United States, and 1-1/3 million lives lost to COVID's complications around the world. Moreover, case numbers are now again steadily rising alarmingly. 

 

Pfizer's COVID-19 vaccine clinical trial  The Associated Press

Safety data on around 100 children ages between 12 and 15 were included with the application, the company attesting that 45 percent of U.S. trial participants fell between the ages of 56 and 85, both groups representing the demographics hit hardest by the virus. Agreement for the EUA by the FDA is anticipated by mid-December, Pfizer claiming it is prepared to begin shipping doses as soon as agreement is received, expecting to have 50 million doses ready for use this year, which would protect 25 million people in a two-dose protocol.

 

The Pfizer vaccine provided a level of protection evenly across different ages and ethnic backgrounds, vital news since the virus disproportionately harms the elderly and minority groups. In Pfizer's trial with over 43,000 people participating, there were 170 volunteers who contracted COVID-19, 162 of whom had received a placebo only; the vaccine was adjudged to be 95 percent effective based on those results, eclipsing expectations for a success rate.The FDA had considered a minimum bar for efficacy of 50 percent.

 

Close to 42 percent of global participants and 30 percent of U.S. participants in the Phase 3 study were of racial and ethnically diverse backgrounds, Pfizer had announced. Next in line at this juncture to seek a U.S. emergency use approval for a COVID-19 vaccine is contender Moderna, and from there the sky's the limit as one health expert after another speaks with a tremor of relief, of "a light at the end of the tunnel". 

 

FDA vaccine advisors reportedly will meet Dec. 10 to discuss approving vaccines. (AFP)