nationalobserver--2020-04-29--'COVID-19 kills in many ways': The suicide crisis facing health-care workers

Dr. Lorna Breen dedicated her life to saving others .
As the medical director of New York-Presbyterian Allen Hospital ’ s emergency department in northern Manhattan , Breen worked on the front lines of the fight against coronavirus in the city that has become the epicentre of the deadly pandemic , with more than 162,000 confirmed cases and at least 12,509 deaths as of Wednesday morning .
Even after coming down with the virus herself , Breen remained determined to get back to work at the 200-bed hospital where she and her colleagues provided care to as many as 170 @ @ @ @ @ @ @ she did recover and return to work , the 49-year-old ER doctor found herself struggling to make it through her regular 12-hour shifts .
After the hospital gave her a leave , Breen decided to go to her family ’ s home in Charlottesville , Va. , to recuperate .
Instead , that ’ s where she died .
• Long-term care homes were in crisis well before politicians woke up to the problem • Ontario has a COVID-19 reopening plan , but it comes with big caveats Following a call for medical @ @ @ @ @ @ @ taken to UVA Hospital for treatment , but later succumbed to self-inflicted injuries , ” Charlottesville Police Department spokesperson Tyler Hawn said in a statement Monday .
Her father , Dr. Phillip Breen , told The New York Times that his daughter had no history of mental illness , but said when he last spoke to her , she seemed “ detached ” as she described how distressing it was to have to watch so many patients die , including some who never even made it out of the ambulance .
“ She @ @ @ @ @ @ @ front line , ’ ’ he told the Times .
“ She tried to do her job , and it killed her.
” Her father described her as a “ hero ” and said her death was yet another tragic “ casualty ” of the pandemic , a sentiment that was echoed by Charlottesville Police Chief RaShall Brackney .
`` Front-line health-care professionals and first responders are not immune to the mental or physical effects of the current pandemic , '' Brackney said in a statement Monday .
`` Personal protective equipment ( @ @ @ @ @ @ @ being infected , but what they can not protect heroes like Dr. Lorna Breen , or our first responders , against is the emotional and mental devastation caused by this disease , '' she added .
Front-line health care workers bear constant witness to the human toll of the # coronavirus pandemic .
And all too often , they become part of it .
In New York City , as in other hard-hit locations , health-care providers have been forced to work exhausting hours , often in overcrowded and under-resourced settings , with @ @ @ @ @ @ @ while dealing with the fear of exposing themselves or their families to the virus .
Without adequate protective gear , some New York City doctors describe going to work every day as a “ suicide mission.
” At the same time , as hospitals have filled up with sick and dying patients , doctors have been left with the burden of making excruciating decisions about rationing life-saving medical equipment and watching as their colleagues fall ill and even die from the virus .
These front-line health-care workers bear constant witness to the human @ @ @ @ @ @ @ all too often , they become part of it .
Two days before Breen ’ s death , 23-year-old Bronx EMT John Mondello fatally shot himself following weeks of high-pressure work as a first responder .
Mondello was based at EMS Station 18 , which handles some of the highest 911 call volumes in the city .
“ He told me he was experiencing a lot of anxiety witnessing a lot of death , he ’ d feel it was a heavy experience when he ’ d fail to save a life , @ @ @ @ @ @ @ told the New York Post .
These back-to-back deaths by suicide are a tragic reminder of the secondary crisis mental health professionals have been warning about — a crisis that is likely to hit front-line health-care workers especially hard .
“ The worldwide COVID-19 pandemic , and efforts to contain it , represent a unique threat , and we must recognize the pandemic that will quickly follow it — that of mental and behavioural illness — and implement the steps needed to mitigate it , ” Dr. Sandro Galea , of the Boston @ @ @ @ @ @ @ colleagues wrote in an April article in JAMA Internal Medicine .
A separate article , published this month in JAMA Psychiatry , warned that the stress , trauma , and isolation associated with the coronavirus pandemic may create a “ perfect storm ” among medical professionals , many of whom are already at an increased risk of death by suicide .
With an average of one physician dying by suicide every day , doctors have the highest suicide rate of any profession .
Compared to the rest of the population , physicians are @ @ @ @ @ @ @ by suicide , and those working on the front lines of the battle against COVID-19 face unique stressors that may further increase their risk .
In China , front-line health-care workers who treated COVID-19 patients were found to have a significantly increased risk of developing “ unfavourable mental health outcomes , ” with about half reporting elevated symptoms of depression and anxiety , and more than 70 per cent experiencing significant distress .
Italy , which has struggled to protect its health-care workers amid shortages of basic supplies and PPE , has reported @ @ @ @ @ @ @ Earlier this month , Carlo Palermo , head of Italy ’ s hospital doctors ’ union , tearfully told reporters about the severe psychological trauma caused by the pandemic , saying : “ It ’ s an indescribable condition of stress .
Unbearable.
” The Italian news agency ASNA reported on one of the deaths , noting the nurse “ had been living with heavy stress out of the fear of having infected others.
” Deaths by suicide among health-care providers have also been reported in Iran and Indonesia .
The causes of @ @ @ @ @ @ @ with patient deaths and the associated feelings of failure , helplessness , and hopelessness appear to play a role in many cases , according to Dr. Pamela Wible , an Oregon-based family medicine doctor who runs a suicide prevention hotline for physicians and medical students .
“ Patient deaths hurt doctors .
A lot .
Even when there 's no medical error , doctors may never forgive themselves for losing a patient , ” Wible wrote in a 2018 Washington Post article describing more than 750 physician suicides she documented between 2013 and @ @ @ @ @ @ @ an “ occupational hazard in medicine , ” noting certain specialities , such as emergency medicine , carry a particularly high risk of “ on-the-job PTSD ” and , in some cases , death by suicide .
Although dealing with patient deaths is always difficult , the circumstances of the coronavirus pandemic are uniquely challenging and have left many health-care providers feeling powerless and guilty about not being able to do more , said Dr. Seth Norrholm , associate professor of psychiatry and behavioural neurosciences at Wayne State University School of Medicine in @ @ @ @ @ @ @ suicidality is a sense of loss of control and guilt , ” Norrholm told the National Observer .
Doctors often cope with the death of patients by “ falling back on their confidence and competence , which provides a buffering effect , ” he said .
“ If they know they did everything they could , everything they needed to , it helps mitigate guilt and helps them process the situation properly , ” he said .
“ But if you ’ re robbing them of that confidence and competence by not providing @ @ @ @ @ @ @ it opens the door for guilt and it opens the door for doubt and second-guessing.
” Furthermore , Norrholm said , the sheer volume of critically ill patients combined with a lack of necessary resources and treatments mean that many doctors are left to deal with a mounting death toll and very few positive patient outcomes to rectify it in their minds .
“ It ’ s one thing to say , ‘ I lost this number of patients this week , but look how many I helped , ’ ” he explained @ @ @ @ @ @ @ have those success stories to keep them going , it creates a psychological imbalance that “ sets the table for some really bad outcomes , including suicidality , ” he warned .
Based on the experiences of health-care providers who treated patients during the SARS epidemic , some mental health professionals are predicting that suicide rates could increase by as much as 30 per cent in some states , with doctors , nurses , and first responders bearing the brunt of the “ aftershock.
” For most medical professionals , life-or-death situations are @ @ @ @ @ @ @ to deal with these situations by providing treatment , performing surgery , or taking other actions to save lives .
But they ’ re not trained to deal with death , especially at the scale they ’ re seeing it right now , nor are they trained to go to work every day while fearing for their own lives .
“ The ER felt like a battlefield .
A living nightmare , ” said Dr. Anna Podolanczuk , a pulmonologist at New York-Presbyterian Hospital who worked with Dr. Breen during the peak of @ @ @ @ @ @ @ For the tens of thousands of health-care providers like her who ’ ve spent weeks working in conditions that have been likened to a “ war zone , ” the psychological consequences are likely to be enduring — and in some cases , they could end up being as deadly as the disease itself .
“ Let ’ s remember that many front-line workers will keep reliving this nightmare long after this is over , ” Podolanczuk wrote on Twitter .
“ COVID-19 kills in many ways.
” The National Suicide Prevention Lifeline @ @ @ @ @ @ @ , suicide prevention and support is available from Crisis Services Canada at 1-833-456-4566 .

After the hospital gave her a leave, Breen decided to go to her family’s home in Charlottesville, Va., to recuperate.
Even after coming down with the virus herself, Breen remained determined to get back to work at the 200-bed hospital where she and her colleagues provided care to as many as 170 COVID-19 patients a day. But when she did recover and return to work, the 49-year-old ER doctor found herself struggling to make it through her regular 12-hour shifts.
As the medical director of New York-Presbyterian Allen Hospital’s emergency department in northern Manhattan, Breen worked on the front lines of the fight against coronavirus in the city that has become the epicentre of the deadly pandemic, with more than 162,000 confirmed cases and at least 12,509 deaths as of Wednesday morning.
“She was truly in the trenches on the front line,’’ he told the Times. “She tried to do her job, and it killed her.”
Her father, Dr. Phillip Breen, told The New York Times that his daughter had no history of mental illness, but said when he last spoke to her, she seemed “detached” as she described how distressing it was to have to watch so many patients die, including some who never even made it out of the ambulance.
Following a call for medical assistance on Sunday, Breen “was taken to UVA Hospital for treatment, but later succumbed to self-inflicted injuries,” Charlottesville Police Department spokesperson Tyler Hawn said in a statement Monday.
At the same time, as hospitals have filled up with sick and dying patients, doctors have been left with the burden of making excruciating decisions about rationing life-saving medical equipment and watching as their colleagues fall ill and even die from the virus.
In New York City, as in other hard-hit locations, health-care providers have been forced to work exhausting hours, often in overcrowded and under-resourced settings, with no clear end in sight, all while dealing with the fear of exposing themselves or their families to the virus. Without adequate protective gear, some New York City doctors describe going to work every day as a “ suicide mission .”
"Personal protective equipment (PPE) can reduce the likelihood of being infected, but what they cannot protect heroes like Dr. Lorna Breen, or our first responders, against is the emotional and mental devastation caused by this disease," she added.
"Front-line health-care professionals and first responders are not immune to the mental or physical effects of the current pandemic," Brackney said in a statement Monday.
Her father described her as a “hero” and said her death was yet another tragic “casualty” of the pandemic, a sentiment that was echoed by Charlottesville Police Chief RaShall Brackney.
Two days before Breen’s death, 23-year-old Bronx EMT John Mondello fatally shot himself following weeks of high-pressure work as a first responder. Mondello was based at EMS Station 18, which handles some of the highest 911 call volumes in the city.
These front-line health-care workers bear constant witness to the human toll of the pandemic. And, all too often, they become part of it.
“He told me he was experiencing a lot of anxiety witnessing a lot of death, he’d feel it was a heavy experience when he’d fail to save a life,” one of Mondello’s friends told the New York Post.
These back-to-back deaths by suicide are a tragic reminder of the secondary crisis mental health professionals have been warning about — a crisis that is likely to hit front-line health-care workers especially hard.
“The worldwide COVID-19 pandemic, and efforts to contain it, represent a unique threat, and we must recognize the pandemic that will quickly follow it — that of mental and behavioural illness — and implement the steps needed to mitigate it,” Dr. Sandro Galea, of the Boston University School of Public Health, and colleagues wrote in an April article in JAMA Internal Medicine.
A separate article, published this month in JAMA Psychiatry, warned that the stress, trauma, and isolation associated with the coronavirus pandemic may create a “perfect storm” among medical professionals, many of whom are already at an increased risk of death by suicide.
With an average of one physician dying by suicide every day, doctors have the highest suicide rate of any profession. Compared to the rest of the population, physicians are more than twice as likely to die by suicide, and those working on the front lines of the battle against COVID-19 face unique stressors that may further increase their risk.
In China, front-line health-care workers who treated COVID-19 patients were found to have a significantly increased risk of developing “unfavourable mental health outcomes,” with about half reporting elevated symptoms of depression and anxiety, and more than 70 per cent experiencing significant distress.
Italy, which has struggled to protect its health-care workers amid shortages of basic supplies and PPE, has reported multiple deaths by suicide among nurses. Earlier this month, Carlo Palermo, head of Italy’s hospital doctors’ union, tearfully told reporters about the severe psychological trauma caused by the pandemic, saying: “It’s an indescribable condition of stress. Unbearable.” The Italian news agency ASNA reported on one of the deaths, noting the nurse “had been living with heavy stress out of the fear of having infected others.”
Deaths by suicide among health-care providers have also been reported in Iran and Indonesia.
The causes of physician suicide are complex, but dealing with patient deaths and the associated feelings of failure, helplessness, and hopelessness appear to play a role in many cases, according to Dr. Pamela Wible, an Oregon-based family medicine doctor who runs a suicide prevention hotline for physicians and medical students.
“Patient deaths hurt doctors. A lot. Even when there's no medical error, doctors may never forgive themselves for losing a patient,” Wible wrote in a 2018 Washington Post article describing more than 750 physician suicides she documented between 2013 and 2018.
Wible calls death by suicide an “occupational hazard in medicine,” noting certain specialities, such as emergency medicine, carry a particularly high risk of “on-the-job PTSD” and, in some cases, death by suicide.
'COVID-19 kills in many ways'
Although dealing with patient deaths is always difficult, the circumstances of the coronavirus pandemic are uniquely challenging and have left many health-care providers feeling powerless and guilty about not being able to do more, said Dr. Seth Norrholm, associate professor of psychiatry and behavioural neurosciences at Wayne State University School of Medicine in Michigan.
“What often leads to suicidality is a sense of loss of control and guilt,” Norrholm told the National Observer.
Doctors often cope with the death of patients by “falling back on their confidence and competence, which provides a buffering effect,” he said.
“If they know they did everything they could, everything they needed to, it helps mitigate guilt and helps them process the situation properly,” he said. “But if you’re robbing them of that confidence and competence by not providing adequate (PPE) and support, it opens the door for guilt and it opens the door for doubt and second-guessing.”
Furthermore, Norrholm said, the sheer volume of critically ill patients combined with a lack of necessary resources and treatments mean that many doctors are left to deal with a mounting death toll and very few positive patient outcomes to rectify it in their minds.
“It’s one thing to say, ‘I lost this number of patients this week, but look how many I helped,’” he explained. But when doctors don’t have those success stories to keep them going, it creates a psychological imbalance that “sets the table for some really bad outcomes, including suicidality,” he warned.
Based on the experiences of health-care providers who treated patients during the SARS epidemic, some mental health professionals are predicting that suicide rates could increase by as much as 30 per cent in some states, with doctors, nurses, and first responders bearing the brunt of the “aftershock.”
For most medical professionals, life-or-death situations are not unfamiliar territory. Doctors are trained to deal with these situations by providing treatment, performing surgery, or taking other actions to save lives. But they’re not trained to deal with death, especially at the scale they’re seeing it right now, nor are they trained to go to work every day while fearing for their own lives.
“The ER felt like a battlefield. A living nightmare,” said Dr. Anna Podolanczuk, a pulmonologist at New York-Presbyterian Hospital who worked with Dr. Breen during the peak of the pandemic in New York City.
For the tens of thousands of health-care providers like her who’ve spent weeks working in conditions that have been likened to a “war zone,” the psychological consequences are likely to be enduring — and in some cases, they could end up being as deadly as the disease itself.
“Let’s remember that many front-line workers will keep reliving this nightmare long after this is over,” Podolanczuk wrote on Twitter. “COVID-19 kills in many ways.”
The National Suicide Prevention Lifeline phone number is 1-800-273-8255. In Canada, suicide prevention and support is available from Crisis Services Canada at 1-833-456-4566.


nationalobserver--2020-04-29--From hassle free to major hassle: Toronto health services for LGBT shrink amid pandemic

The waiting room at the Hassle Free Clinic — nestled between the downtown campus of Ryerson University and the gay village of Church Street in Toronto — used to often fill to overflowing with patients checking on their sexual health .
These days , hours have been cut and no one can just drop in .
Those that want to book an appointment are triaged by phone or video call ; only those with symptoms of a sexually transmitted infection ( STI ) or who have been intimate with someone who has tested positive are given a time to come @ @ @ @ @ @ @ strictures of social isolation mean sexual activity between people who do not live together has likely fallen dramatically , it would be a mistake to assume it has gone to zero , the co-director of the clinic says .
“ Certainly people are still having sex because we ’ re still getting positive test results , ” Jane Greer said in a phone interview .
“ I think there are vast amounts of unmet needs.
” “ Overall STI risks have gone down because people aren ’ t out and about as much @ @ @ @ @ @ @ the numbers will go up , ” Greer said .
• Long-term care homes were in crisis well before politicians woke up to the problem • Ontario has a COVID-19 reopening plan , but it comes with big caveats She said the clinic is still providing contraception , squeezing in repeat pap tests when abnormal results are shown , and dealing with a sharp jump in referrals for treatment from family doctors .
But it has had to cut HIV testing and halt or sharply curtail counselling services , including around domestic violence @ @ @ @ @ @ @ risky sexual behavior .
The usually bustling waiting room of the Hassle Free Clinic in downtown Toronto is often empty since COVID-19 struck .
Photo supplied by Hassle Free Clinic It ’ s a tough balance , Greer said , between restricting the number of tests the clinic sends to Public Health Ontario laboratories that are struggling to work though a COVID-19 test backlog , and ensuring they meet the needs of the clinic 's patients — the majority of whom identify as lesbian , gay , bisexual , trans or queer ( @ @ @ @ @ @ @ between 150 and 200 specimens a day to the public labs , but that has been cut sharply with the reduced access .
“ It doesn ’ t feel good , ” she said .
“ We recognize these restrictions have implications.
” A sign inside the Hassle Free Clinic in downtown Toronto .
Photo by Hassle Free Clinic LGBTQ people face a range of related barriers to adequate health care , with queer youth much more likely to be homeless and queer people of all ages more likely to have unmet mental @ @ @ @ @ @ @ by isolation from family and societal prejudice .
“ Certainly people are still having sex because we ’ re still getting positive [ STI ] test results , ” Jane Greer said in a phone interview .
“ I think there are vast amounts of unmet needs.
” Researchers at University of Toronto say people who identify as LGBTQ are also more likely to have compromised immune systems , rate their health as poor and are less likely to seek urgent care — all of which put them in greater danger from COVID-19 @ @ @ @ @ @ @ the heightened stress of COVID-19 and the cancellation of community health and social resources .
“ If you have poor mental health and rely on community resources , as a lot of queer people do , or rely on chosen family , then you ’ ll be more likely to have quarantine affect you negatively , ” said Miranda Schreiber , one of the U of T researchers .
Miranda Schreiber , one of the University of Toronto researchers looking at the health inequities of LGBTQ people .
Photo supplied by Miranda Schreiber @ @ @ @ @ @ @ have also been cut sharply in the wake of the pandemic .
“ Due to COVID-19 , Crossways Clinic is currently the only Toronto Public Health sexual health clinic continuing to operate and provide client services , ” said Toronto Public Health ’ s Associate Medical Officer of Health , Dr. Rita Shahin .
“ Clients with urgent concerns are being seen by appointment only and are required to call ahead for assessment and screening by our nurses.
” She said that Talk Shop , The Jane Street Clinic and Scarborough Sexual Health @ @ @ @ @ @ @ .
The four clinics operated by Toronto Public Health served around 1,500 clients per month in 2019 .
Crossways Clinic is now seeing about 50 clients per week for urgent STI and contraceptive issues and providing phone counselling to another 25 clients a week .

The waiting room at the Hassle Free Clinic — nestled between the downtown campus of Ryerson University and the gay village of Church Street in Toronto — used to often fill to overflowing with patients checking on their sexual health. These days, hours have been cut and no one can just drop in. Those that want to book an appointment are triaged by phone or video call; only those with symptoms of a sexually transmitted infection (STI) or who have been intimate with someone who has tested positive are given a time to come in for tests. But while the strictures of social isolation mean sexual activity between people who do not live together has likely fallen dramatically, it would be a mistake to assume it has gone to zero, the co-director of the clinic says. “Certainly people are still having sex because we’re still getting positive test results,” Jane Greer said in a phone interview. “I think there are vast amounts of unmet needs.” “Overall STI risks have gone down because people aren’t out and about as much, but when more testing is available the numbers will go up,” Greer said.
She said the clinic is still providing contraception, squeezing in repeat pap tests when abnormal results are shown, and dealing with a sharp jump in referrals for treatment from family doctors. But it has had to cut HIV testing and halt or sharply curtail counselling services, including around domestic violence and sexual assault, as well as risky sexual behavior. The usually bustling waiting room of the Hassle Free Clinic in downtown Toronto is often empty since COVID-19 struck. Photo supplied by Hassle Free Clinic Billion-dollar land deals in Ontario raise corruption suspicions It’s a tough balance, Greer said, between restricting the number of tests the clinic sends to Public Health Ontario laboratories that are struggling to work though a COVID-19 test backlog, and ensuring they meet the needs of the clinic's patients — the majority of whom identify as lesbian, gay, bisexual, trans or queer (LGBTQ).
The clinic typically sends between 150 and 200 specimens a day to the public labs, but that has been cut sharply with the reduced access. “Certainly people are still having sex because we’re still getting positive [STI] test results,” Jane Greer said in a phone interview. “I think there are vast amounts of unmet needs.” “It doesn’t feel good,” she said. “We recognize these restrictions have implications.” A sign inside the Hassle Free Clinic in downtown Toronto. Photo by Hassle Free Clinic LGBTQ people face a range of related barriers to adequate health care, with queer youth much more likely to be homeless and queer people of all ages more likely to have unmet mental health needs, which can be caused by isolation from family and societal prejudice. Researchers at University of Toronto say people who identify as LGBTQ are also more likely to have compromised immune systems, rate their health as poor and are less likely to seek urgent care — all of which put them in greater danger from COVID-19.
Those challenges are only exacerbated with the heightened stress of COVID-19 and the cancellation of community health and social resources. “If you have poor mental health and rely on community resources, as a lot of queer people do, or rely on chosen family, then you’ll be more likely to have quarantine affect you negatively,” said Miranda Schreiber, one of the U of T researchers. Miranda Schreiber, one of the University of Toronto researchers looking at the health inequities of LGBTQ people. Photo supplied by Miranda Schreiber


nationalobserver--2020-04-30--The journey of a single COVID-19 patient and the people who cared for him

It was his first potential case of COVID-19 and he felt both trepidation and a sense of duty .
Paramedic Jeff Booton watched the details flash across the screen as he and his partner made their way to the clinic .
The call came in on an afternoon in March : a patient at a medical clinic in Vancouver complained of chest pains .
Booton was one of at least 125 health workers , ranging from dispatchers and nurses to hospital housekeepers , who cared for the patient .
`` I can only imagine what he was feeling in that @ @ @ @ @ @ @ like a true sense of vulnerability to what uncertainty lay ahead , '' Booton said .
After a physical exam , they got back in the ambulance and Booton did what he always tries to do : comfort the patient as they travelled together towards St. Paul 's Hospital .
When Booton arrived , he put on protective gloves , a fluid-repellent gown , N-95 mask and face shield .
`` I see this job as working in the service of people .
And getting to do so in the context of a @ @ @ @ @ @ @ apprehension some days , but it 's work that still resonates with me , '' he said .
`` My husband likened it to both of us running into a burning building at the same time . ''
Together , they decided that if there were a major outbreak , one would work at the hospital and self-isolate from the family , while the other would care for the kids .
COVID-19 has transformed not only the hospital but O'Donnell 's home life , too .
She and her husband , also an @ @ @ @ @ @ @ of their three children at home since schools closed .
Like everyone the patient would interact with , O'Donnell examined him through a heavy armour of personal protective equipment .
The paramedics brought the patient directly into a negative pressure room set up for high-risk cases .
It reduces the risk of the virus spreading by air .
`` I was a little anxious , '' she said .
`` We do n't know what we 're getting , how much distress a patient is going to be in or how sick they @ @ @ @ @ @ @ you 're worried also about being exposed to infection . ''
Dr. Shannon O'Donnell knew she had only a few minutes to prepare after paramedics phoned the hospital to warn that a suspected COVID-19 case was on the way .
This is the story of those who cared for a single case at St. Paul 's .
Under normal circumstances , the emergency doctor would work with several nurses but only one is allowed in the isolation room at a time to protect against contagion .
`` You know they 're in the @ @ @ @ @ @ @ dire outcome from COVID .
That is really hard to see , '' she said .
For registered nurse Rachel Mrdeza , some of the hardest cases to handle have been the older patients who arrive short of breath , with a fever and chest tightness .
By the time registered nurse QianQian Wu began her night shift , she was only the third nurse to see the patient .
Wu began her shift by putting on the uncomfortable protective gear that she would wear all night .
`` It 's a little @ @ @ @ @ @ @ said .
`` And sometimes you get sleepy with it on for a long time , it 's very warm . ''
While the patient waited in the emergency department , blood samples and swabs were sent to the hospital 's laboratory .
Dr. Marc Romney , medical director of medical microbiology and virology , said manual molecular testing for COVID-19 typically requires five to 10 lab staff .
`` It 's not like a pregnancy test you get from London Drugs , it 's much more complicated , '' Romney said .
@ @ @ @ @ @ @ the arrival of a machine in March that can automate part of the testing process .
The Roche cobas 6800 system was adapted from HIV testing to increase the number of COVID-19 tests the lab could do that month .
Romney excitedly talks about the changes and ideas they 've come up with to deal with the pandemic .
`` We 're under tremendous pressure to deliver , it 's been a challenging time .
But we 're pleased . ''
It has also come at personal cost .
One technologist was basically @ @ @ @ @ @ @ five hours a night .
Romney went weeks without a day off .
`` The front-line workers are amazing and we are here to support them but I think it 's good for people to know there are also a lot of people behind the scenes working on this too , '' he said .
`` It 's not just machines that are being plugged into walls , it 's very human what we do here . ''
Suspected COVID-19 cases that appear more serious are accelerated to the intensive care unit for @ @ @ @ @ @ @ , Dr. O'Donnell called Dr. Mathieu Surprenant for an assessment while they awaited test results .
The 29-year-old clinical associate put plans to move back to Montreal on hold when the pandemic struck .
When he got the call from emergency , Surprenant headed downstairs with resident Dr. Charles Yang .
`` In my mind I was wondering , OK what are the precautions I need to take in order to protect myself and other patients while maintaining the level of care I would typically provide for a patient , '' Yang said @ @ @ @ @ @ @ develop his care plan before the patient was transferred to the ICU for monitoring overnight .
Best practices have changed rapidly on the new coronavirus , Surprenant said .
Initially , for example , the idea was to intubate as soon as possible because if a patient gets too ill , his chance of dying on a ventilator increases .
But intubation is also more invasive than other procedures and risky for health workers because it pushes droplets of the virus into the air .
Since the pandemic began , recommendations have relaxed @ @ @ @ @ @ @ it 's constantly changing , Surprenant said .
He believed intubation was needed , which meant calling in a group dubbed the COVID airway team .
Anesthesiologist Dr. Shannon Lockhart was part of the planning group that conceived of the COVID airway team .
Their idea was to form teams with respiratory therapists to perform intubations so that emergency and ICU doctors would n't expose themselves .
Anesthesiologists self-selected into one of three groups : The first wave was ready to start serving on the COVID airway team immediately .
The second would @ @ @ @ @ @ @ sick .
And the third would not participate because they or their loved ones were at risk of serious illness if exposed to the virus .
For Lockhart , the decision to be part of the first group was easy .
`` I 'm 35 years old , I 'm young and healthy .
I have a family who is young and healthy , so the personal risk was pretty low for me , '' she said .
When Lockhart heard the patient needed intubation , she had already examined him and was @ @ @ @ @ @ @ a patient 's throat under normal circumstances takes between five and six minutes .
But she said that has ballooned to between 60 and 90 minutes because of the extra protective gear and the cleaning or disposal of everything in the room .
After intubating the patient , the riskiest part of Lockhart 's new job is doffing her gear .
Lockhart and the respiratory therapist watch one another carefully as they remove the equipment piece by piece , monitoring for any possible slip that would allow contamination .
`` It 's kind @ @ @ @ @ @ @ when you 're trusting this person with this very important task but you may never have met them before . ''
When Dr. Gavin Tansley met the patient , he was sedated and breathing through a ventilator .
Tansley had given the OK for intubation when Surprenant woke him up with a phone call .
In the ICU , the focus shifts to the more holistic care of all the patient 's major organ systems .
`` Critical illness is a bit of a funny thing where you really do recognize how intertwined @ @ @ @ @ @ @ '' Tansley said .
`` With COVID in particular we see very familiar patterns where often times the kidneys wo n't be working 100 per cent , sometimes the heart wo n't be working 100 per cent . ''
When Tansley decided to become a doctor he wanted to help people heal .
He did n't realize at the time that in the ICU , he would n't get to know his patients very well .
`` Very often by the time I meet patients , they 're already sedated or on a @ @ @ @ @ @ @ n't talk to you .
So your relationship becomes with the family , and you develop amazing relationships with families , '' he said .
By the time the patient reached the ICU , about 25 health workers had played a role in his case .
Some interacted with him directly , while others played important but indirect roles in his care , ranging from hospital housekeepers to X-ray technologists .
About 90 intensive care staff saw him , and from there , he would be turned over to a general medicine team @ @ @ @ @ @ @ a wide network of specialists from dieticians to physiotherapists and social workers .
Kevin Novakowski is a respiratory therapist and in his 28 years of work , he 's never felt an illness create such a constant psychological burden as COVID-19 .
`` It 's kind of always on my mind , '' he said .
In recovery , a patient begins physiotherapy to build his strength .
Novakowski is there monitoring how it affects his breathing .
But the first major step towards independence is weaning a patient off the ventilator .
@ @ @ @ @ @ @ began reducing the ventilator 's power and gave him short trials without it .
Weaning is a gradual process .
Off the ventilator , a patient 's breath rattles .
`` They cough and they sputter , '' he said .
The rattle may disappear then return when they stand for the first time , or when they start walking .
It 's a stressful process for patients .
If they do n't keep coughing to clear their airway , infections can return .
During those first trials , Novakowski waits and listens @ @ @ @ @ @ @ , '' he said .
`` And then all of a sudden , it 's just kind of really quiet and their breathing just sounds like our breathing , normal .
And you think , OK. That 's good . ''
This report by The Canadian Press was first published April 30 , 2020 .

When Booton arrived, he put on protective gloves, a fluid-repellent gown, N-95 mask and face shield.
"I see this job as working in the service of people. And getting to do so in the context of a pandemic is obviously wrought with fear and apprehension some days, but it's work that still resonates with me," he said.
It was his first potential case of COVID-19 and he felt both trepidation and a sense of duty.
Paramedic Jeff Booton watched the details flash across the screen as he and his partner made their way to the clinic.
The call came in on an afternoon in March: a patient at a medical clinic in Vancouver complained of chest pains.
Booton was one of at least 125 health workers, ranging from dispatchers and nurses to hospital housekeepers, who cared for the patient.
"I can only imagine what he was feeling in that moment, but it must have felt like a true sense of vulnerability to what uncertainty lay ahead," Booton said.
After a physical exam, they got back in the ambulance and Booton did what he always tries to do: comfort the patient as they travelled together towards St. Paul's Hospital.
The paramedics brought the patient directly into a negative pressure room set up for high-risk cases. It reduces the risk of the virus spreading by air.
"I was a little anxious," she said. "We don't know what we're getting, how much distress a patient is going to be in or how sick they'll be. And you know, you're worried also about being exposed to infection."
Dr. Shannon O'Donnell knew she had only a few minutes to prepare after paramedics phoned the hospital to warn that a suspected COVID-19 case was on the way.
This is the story of those who cared for a single case at St. Paul's.
Together, they decided that if there were a major outbreak, one would work at the hospital and self-isolate from the family, while the other would care for the kids.
COVID-19 has transformed not only the hospital but O'Donnell's home life, too. She and her husband, also an emergency doctor, juggle the full-time care of their three children at home since schools closed.
Like everyone the patient would interact with, O'Donnell examined him through a heavy armour of personal protective equipment.
"My husband likened it to both of us running into a burning building at the same time."
For registered nurse Rachel Mrdeza, some of the hardest cases to handle have been the older patients who arrive short of breath, with a fever and chest tightness.
"You know they're in the window of vulnerability for having quite a dire outcome from COVID. That is really hard to see," she said.
Under normal circumstances, the emergency doctor would work with several nurses but only one is allowed in the isolation room at a time to protect against contagion.
By the time registered nurse QianQian Wu began her night shift, she was only the third nurse to see the patient.
Wu began her shift by putting on the uncomfortable protective gear that she would wear all night.
"It's a little hard to breath sometimes," she said. "And sometimes you get sleepy with it on for a long time, it's very warm."
TESTING
While the patient waited in the emergency department, blood samples and swabs were sent to the hospital's laboratory.
Dr. Marc Romney, medical director of medical microbiology and virology, said manual molecular testing for COVID-19 typically requires five to 10 lab staff.
"It's not like a pregnancy test you get from London Drugs, it's much more complicated," Romney said.
The virology lab has been transformed since the arrival of a machine in March that can automate part of the testing process.
The Roche cobas 6800 system was adapted from HIV testing to increase the number of COVID-19 tests the lab could do that month.
Romney excitedly talks about the changes and ideas they've come up with to deal with the pandemic.
"We're under tremendous pressure to deliver, it's been a challenging time. But we're pleased."
It has also come at personal cost.
One technologist was basically living in the lab and sleeping only five hours a night. Romney went weeks without a day off.
"The front-line workers are amazing and we are here to support them but I think it's good for people to know there are also a lot of people behind the scenes working on this too," he said.
"It's not just machines that are being plugged into walls, it's very human what we do here."
THE TRANSITION TEAM
Suspected COVID-19 cases that appear more serious are accelerated to the intensive care unit for isolation. Back in the emergency department, Dr. O'Donnell called Dr. Mathieu Surprenant for an assessment while they awaited test results.
The 29-year-old clinical associate put plans to move back to Montreal on hold when the pandemic struck.
When he got the call from emergency, Surprenant headed downstairs with resident Dr. Charles Yang.
"In my mind I was wondering, OK what are the precautions I need to take in order to protect myself and other patients while maintaining the level of care I would typically provide for a patient," Yang said.
The team examined the patient to develop his care plan before the patient was transferred to the ICU for monitoring overnight.
Best practices have changed rapidly on the new coronavirus, Surprenant said.
Initially, for example, the idea was to intubate as soon as possible because if a patient gets too ill, his chance of dying on a ventilator increases. But intubation is also more invasive than other procedures and risky for health workers because it pushes droplets of the virus into the air.
Since the pandemic began, recommendations have relaxed to allow for other treatments first but it's constantly changing, Surprenant said.
He believed intubation was needed, which meant calling in a group dubbed the COVID airway team.
THE COVID AIRWAY TEAM
Anesthesiologist Dr. Shannon Lockhart was part of the planning group that conceived of the COVID airway team.
Their idea was to form teams with respiratory therapists to perform intubations so that emergency and ICU doctors wouldn't expose themselves.
Anesthesiologists self-selected into one of three groups: The first wave was ready to start serving on the COVID airway team immediately. The second would step in if the first wave got sick. And the third would not participate because they or their loved ones were at risk of serious illness if exposed to the virus.
For Lockhart, the decision to be part of the first group was easy.
"I'm 35 years old, I'm young and healthy. I have a family who is young and healthy, so the personal risk was pretty low for me," she said.
When Lockhart heard the patient needed intubation, she had already examined him and was prepared.
Putting a breathing tube into a patient's throat under normal circumstances takes between five and six minutes. But she said that has ballooned to between 60 and 90 minutes because of the extra protective gear and the cleaning or disposal of everything in the room.
After intubating the patient, the riskiest part of Lockhart's new job is doffing her gear.
Lockhart and the respiratory therapist watch one another carefully as they remove the equipment piece by piece, monitoring for any possible slip that would allow contamination.
"It's kind of an interesting position to be in when you're trusting this person with this very important task but you may never have met them before."
THE ICU
When Dr. Gavin Tansley met the patient, he was sedated and breathing through a ventilator.
Tansley had given the OK for intubation when Surprenant woke him up with a phone call.
In the ICU, the focus shifts to the more holistic care of all the patient's major organ systems.
"Critical illness is a bit of a funny thing where you really do recognize how intertwined all of these organ systems are," Tansley said.
"With COVID in particular we see very familiar patterns where often times the kidneys won't be working 100 per cent, sometimes the heart won't be working 100 per cent."
When Tansley decided to become a doctor he wanted to help people heal. He didn't realize at the time that in the ICU, he wouldn't get to know his patients very well.
"Very often by the time I meet patients, they're already sedated or on a ventilator or so sick that they can't talk to you. So your relationship becomes with the family, and you develop amazing relationships with families," he said.
RECOVERY
By the time the patient reached the ICU, about 25 health workers had played a role in his case. Some interacted with him directly, while others played important but indirect roles in his care, ranging from hospital housekeepers to X-ray technologists.
About 90 intensive care staff saw him, and from there, he would be turned over to a general medicine team.
Recovery is a long road involving a wide network of specialists from dieticians to physiotherapists and social workers.
Kevin Novakowski is a respiratory therapist and in his 28 years of work, he's never felt an illness create such a constant psychological burden as COVID-19.
"It's kind of always on my mind," he said.
In recovery, a patient begins physiotherapy to build his strength. Novakowski is there monitoring how it affects his breathing.
But the first major step towards independence is weaning a patient off the ventilator.
As Novakowski monitored the patient, he began reducing the ventilator's power and gave him short trials without it.
Weaning is a gradual process. Off the ventilator, a patient's breath rattles.
"They cough and they sputter," he said.
The rattle may disappear then return when they stand for the first time, or when they start walking.
It's a stressful process for patients. If they don't keep coughing to clear their airway, infections can return.
During those first trials, Novakowski waits and listens.
"You listen to them breathing," he said. "And then all of a sudden, it's just kind of really quiet and their breathing just sounds like our breathing, normal.
And you think, OK. That's good."
This report by The Canadian Press was first published April 30, 2020.


nationalobserver--2020-04-30--Manitoba to lift some COVID-19 restrictions starting in May

Many non-essential Manitoba businesses that have been shut down by the COVID-19 pandemic are to reopen as of Monday .
The Progressive Conservative government released a phased-in plan Wednesday to ease restrictions that were imposed in March to slow the spread of the novel coronavirus .
`` We 've had mom-and-pop shops forced to close their doors and lay off their people because of this pandemic , '' Premier Brian Pallister said .
`` We need to keep working hard to protect our most vulnerable people by reopening our economy in a safe and a measured way . ''
Non-urgent @ @ @ @ @ @ @ are to resume their services Monday .
Retail stores , hair salons and restaurant patios are to reopen , but at no more than half their capacity .
• Long-term care homes were in crisis well before politicians woke up to the problem • Ontario has a COVID-19 reopening plan , but it comes with big caveats Campgrounds , museums , libraries and art galleries will also be allowed to open their doors as long as they maintain physical distancing among customers .
Day camps will be allowed for up to 16 kids @ @ @ @ @ @ @ remain closed .
A second phase , no earlier than June 1 , would see nail salons , dine-in restaurants and non-contact children 's sports allowed .
Remaining in place are travel restrictions , including a 14-day self-isolation period for people returning from out of province , and a 10-person limit on public gatherings .
Pallister said the limit may be raised to 25 in mid-May if the province 's COVID-19 numbers remain low .
Large gatherings such as concerts and big-league sporting events will not be considered until September at the earliest @ @ @ @ @ @ @ the move to allow more businesses to open .
Manitoba to ease some COVID-19 restrictions starting in May `` What 's going to be critical for those businesses that are allowed to open is making sure that they 're doing so in a manner that their employees feel safe coming in and ... consumers feel safe coming in , '' said the group 's president Chuck Davidson .
The Manitoba Nurses Union said it is concerned about how quickly the province is moving .
`` The decision to reopen the economy with less @ @ @ @ @ @ @ raise our concern about whether the ( COVID-19 ) curve can remain flat for the foreseeable future , '' union president Darlene Jackson wrote in a statement .
`` By significantly loosening restrictions that contradict social- distancing recommendations we risk undoing the progress we have made in limiting the spread of the virus . ''
The Opposition New Democrats said with schools still closed , the government must address parents ' concerns about child care .
`` Will they have access to child care if they have to return to work , or @ @ @ @ @ @ @ still must work from home ?
Will parents ' jobs be protected if they must stay home to care for their children ? ''
asked New Democrat legislature member Lisa Naylor in a written statement .
The province also released some numbers Wednesday based on modelling that health officials have done on the outbreak .
Under current restrictions on business and personal activity — not the looser rules to take effect Monday — Manitoba could expect a total of 6,250 cases by next April , chief public health officer Brent Roussin said .
@ @ @ @ @ @ @ of which are active .
Six people have died since the outbreak began .
Roussin cautioned the projected numbers are general and subject to change .
He was unable to say how many cases at any one time would tax the health-care system .

Many non-essential Manitoba businesses that have been shut down by the COVID-19 pandemic are to reopen as of Monday. The Progressive Conservative government released a phased-in plan Wednesday to ease restrictions that were imposed in March to slow the spread of the novel coronavirus. "We've had mom-and-pop shops forced to close their doors and lay off their people because of this pandemic," Premier Brian Pallister said. "We need to keep working hard to protect our most vulnerable people by reopening our economy in a safe and a measured way." Non-urgent health providers such as dentists and physiotherapists are to resume their services Monday. Retail stores, hair salons and restaurant patios are to reopen, but at no more than half their capacity.
Campgrounds, museums, libraries and art galleries will also be allowed to open their doors as long as they maintain physical distancing among customers. Day camps will be allowed for up to 16 kids at each site. Schools are to remain closed. Billion-dollar land deals in Ontario raise corruption suspicions A second phase, no earlier than June 1, would see nail salons, dine-in restaurants and non-contact children's sports allowed.
Remaining in place are travel restrictions, including a 14-day self-isolation period for people returning from out of province, and a 10-person limit on public gatherings. Pallister said the limit may be raised to 25 in mid-May if the province's COVID-19 numbers remain low. Manitoba to ease some COVID-19 restrictions starting in May Large gatherings such as concerts and big-league sporting events will not be considered until September at the earliest. The Manitoba Chambers of Commerce welcomed the move to allow more businesses to open. "What's going to be critical for those businesses that are allowed to open is making sure that they're doing so in a manner that their employees feel safe coming in and ... consumers feel safe coming in," said the group's president Chuck Davidson. The Manitoba Nurses Union said it is concerned about how quickly the province is moving.
"The decision to reopen the economy with less than a week’s notice does raise our concern about whether the (COVID-19) curve can remain flat for the foreseeable future," union president Darlene Jackson wrote in a statement. "By significantly loosening restrictions that contradict social- distancing recommendations we risk undoing the progress we have made in limiting the spread of the virus." The Opposition New Democrats said with schools still closed, the government must address parents' concerns about child care.


nationalobserver--2020-04-30--Local news media being 'kneecapped' by COVID-19

Local reporting is being kneecapped by pandemic-driven cuts to media outlets across B.C .
at a time when community-specific , trustworthy reporting is vital to public health .
A project to map the impacts of COVID-19 on Canadian media paints a bleak picture of communities in Canada hurtling towards news poverty in the midst of a pandemic .
The project , which involves J-Source , the Local News Research Project at Ryerson University and the Canadian Association of Journalists , found 2,053 editorial and non-editorial staff have been laid off by media across Canada in the last six weeks .
@ @ @ @ @ @ @ , with 48 community newspapers closing .
And experts say it is difficult to see how the already struggling industry could fully recover from such a blow .
In B.C.
, at least four media outlets have closed temporarily or permanently , and nine have cancelled some or all print editions or cut back on broadcasts .
• Long-term care homes were in crisis well before politicians woke up to the problem • Ontario has a COVID-19 reopening plan , but it comes with big caveats Journalists at 16 publications in the province @ @ @ @ @ @ @ have cut or reduced hours for their reporters .
These include Glacier Media-owned community newspapers in the northern hubs of Dawson Creek , Prince George and Fort St. John , and Black Press Media-owned community papers across the Lower Mainland and Fraser Valley .
The pandemic-related cuts are only the latest blow , April Lindgren of the Local News Research Project told J-Source .
“ To put the damage to the community newspaper sector in perspective , we know from the Local News Map that 215 community papers have been shut down in @ @ @ @ @ @ @ said .
“ For almost 50 papers to close in just the last six weeks is unprecedented .
It shows just how seriously residents ’ access to local news is being undermined.
” Community reporting in Vancouver has also been lost as legacy media staff see pay cuts and lay-offs .
The Glacier Media-owned Vancouver Courier , where The Tyee ’ s Chris Cheung and many others got their starts in journalism , temporarily halted publication earlier this month and laid off most of its staff .
Traditional News Media Were Already Ill. @ @ @ @ @ @ @ Georgia Straight temporarily laid off most of its staff in March .
The media industry has been struggling to find a sustainable business model in the digital age for years .
But since public health measures were put in place revenue for advertising-dependent outlets has sharply declined as businesses shutter and events are cancelled .
Publisher Jeanette Ageson said The Tyee is bucking the trend .
“ When businesses started to close , right off the bat we lost most of our advertising revenue , ” she said .
“ However , The @ @ @ @ @ @ @ advertising makes up a small percentage of our budget so it was luckily not devastating.
” The Tyee ’ s model of independent journalism relies on support from readers while continuing to keep the site paywall-free , she said .
And reader contributions have increased since the pandemic began , allowing The Tyee to expand its coverage while others are forced to cut back , Ageson said .
“ I ’ m happy to report The Tyee is in stable condition.
” But as more than half of Canadians rely on traditional media @ @ @ @ @ @ @ internet access continues to be a problem for many rural , remote and Indigenous communities , local news is more important than ever to the daily lives of Canadians .
Many corporate media outlets have begun asking readers to subscribe , buy ads or donate to support their work .
Ageson suggests people take the time to get to know their local outlets ’ situations .
“ If you value their coverage and you are confident that your support will indeed go towards maintaining good coverage , consider giving , ” she said @ @ @ @ @ @ @ a new local news startup in your community , check them out and see how you can help.
” The state of the industry is troubling for journalists and communities alike , said Ageson .
Recognizing the journalists who are working in a pandemic and an industry crisis can go a long way , too .
“ If you appreciate the coverage being done by your local reporters , a nice note of appreciation really goes a long way to boost spirits and let reporters know their work matters , ” she said @

Local reporting is being kneecapped by pandemic-driven cuts to media outlets across B.C. at a time when community-specific, trustworthy reporting is vital to public health. A project to map the impacts of COVID-19 on Canadian media paints a bleak picture of communities in Canada hurtling towards news poverty in the midst of a pandemic. The project, which involves J-Source, the Local News Research Project at Ryerson University and the Canadian Association of Journalists, found 2,053 editorial and non-editorial staff have been laid off by media across Canada in the last six weeks. More than 100 outlets have been affected, with 48 community newspapers closing. And experts say it is difficult to see how the already struggling industry could fully recover from such a blow. In B.C., at least four media outlets have closed temporarily or permanently, and nine have cancelled some or all print editions or cut back on broadcasts.
Journalists at 16 publications in the province have been laid off and 14 outlets have cut or reduced hours for their reporters. These include Glacier Media-owned community newspapers in the northern hubs of Dawson Creek, Prince George and Fort St. John, and Black Press Media-owned community papers across the Lower Mainland and Fraser Valley. Billion-dollar land deals in Ontario raise corruption suspicions The pandemic-related cuts are only the latest blow, April Lindgren of the Local News Research Project told J-Source.
“To put the damage to the community newspaper sector in perspective, we know from the Local News Map that 215 community papers have been shut down in the last 12 years,” she said. Traditional News Media Were Already Ill. COVID-19 Is Killing Some “For almost 50 papers to close in just the last six weeks is unprecedented. It shows just how seriously residents’ access to local news is being undermined.” Community reporting in Vancouver has also been lost as legacy media staff see pay cuts and lay-offs. The Glacier Media-owned Vancouver Courier, where The Tyee’s Chris Cheung and many others got their starts in journalism, temporarily halted publication earlier this month and laid off most of its staff. Local weekly the Georgia Straight temporarily laid off most of its staff in March. The media industry has been struggling to find a sustainable business model in the digital age for years. But since public health measures were put in place revenue for advertising-dependent outlets has sharply declined as businesses shutter and events are cancelled.
Publisher Jeanette Ageson said The Tyee is bucking the trend. “When businesses started to close, right off the bat we lost most of our advertising revenue,” she said. “However, The Tyee has multiple revenue streams, and advertising makes up a small percentage of our budget so it was luckily not devastating.” The Tyee’s model of independent journalism relies on support from readers while continuing to keep the site paywall-free, she said.


nationalobserver--2020-04-30--Trudeau not discounting digital tracking to limit spread of COVID-19

Prime Minister Justin Trudeau is leaving the door open to using digital technology to try to limit the spread of the novel coronavirus through tracking down contacts of people who have it , but says it needs to be done in a way that protects the privacy of Canadians .
`` Getting that balance right will be extremely important , '' Trudeau said Wednesday in Ottawa .
Countries such as South Korea and Singapore have used cellphones and other digital technology to track people 's movements and warn about potential contacts with individuals who have COVID-19 to slow the spread @ @ @ @ @ @ @ provinces have since suggested they are looking at voluntary programs to conduct contact tracing , which is usually performed by public health officials who carefully question patients about where they have been and with whom they 've interacted .
`` We have a number of proposals and companies working on different models that might be applicable to Canada but as we move forward on taking decisions , we 're going to keep in mind that Canadians put a very high value on their privacy , on their data security , '' Trudeau said @ @ @ @ @ @ @ crisis well before politicians woke up to the problem • Ontario has a COVID-19 reopening plan , but it comes with big caveats `` We need to make sure we respect that , even in a time of emergency measures and significant difficulty and crisis , '' adding that voluntary measures could be one way to resolve that issue .
One possibility is a system that would send alerts to smartphones that have recently been close to devices carried by people who test positive for the novel coronavirus .
Canada 's chief public @ @ @ @ @ @ @ in addition to privacy concerns , the technology itself remains unproven and will need to be refined to ensure false positives and other issues do not emerge .
`` Those kinds of characteristics are not what you want to have , because that would alarm a whole bunch of people .
They may then show up to be tested when in fact they were not at risk , '' Tam said Wednesday during a media briefing in Ottawa .
Tam says such technology could make it easier to manage the spread of COVID-19 @ @ @ @ @ @ @ public health officials who are on the front lines of contact tracing .
`` Whatever we have has to complement the work .
It ca n't sort of replace the work , '' she said .
Contact tracing needs to balance public health benefits with privacy : Trudeau This report by The Canadian Press was first published April 29 , 2020 .

Prime Minister Justin Trudeau is leaving the door open to using digital technology to try to limit the spread of the novel coronavirus through tracking down contacts of people who have it, but says it needs to be done in a way that protects the privacy of Canadians.
"Getting that balance right will be extremely important," Trudeau said Wednesday in Ottawa.
Countries such as South Korea and Singapore have used cellphones and other digital technology to track people's movements and warn about potential contacts with individuals who have COVID-19 to slow the spread of the virus.
A number of provinces have since suggested they are looking at voluntary programs to conduct contact tracing, which is usually performed by public health officials who carefully question patients about where they have been and with whom they've interacted.
"We have a number of proposals and companies working on different models that might be applicable to Canada but as we move forward on taking decisions, we're going to keep in mind that Canadians put a very high value on their privacy, on their data security," Trudeau said.


nationalobserver--2020-04-30--Tory MP Sloan ducks call to apologize for challenging Tam's loyalty

Ontario Conservative MP Derek Sloan held to his leadership campaign slogan of being `` Conservative without apology '' and refused Wednesday to heed the demands of his fellow MPs to apologize for remarks questioning the loyalty of the country 's chief public health officer .
Sloan dug in at the same time as the group organizing the party 's leadership race was deciding to resume the contest , but with revisions that will likely see a successor to Andrew Scheer named in late August .
Sloan , the MP for Hastings-Lennox and Addington , is one of four candidates in @ @ @ @ @ @ @ the Conservative caucus was challenged this week .
A motion had been put forward by other Conservative MPs from Ontario during a meeting Tuesday afternoon demanding he apologize or retract his comments , two sources told The Canadian Press .
Otherwise , some of the very MPs he wants to lead were prepared to try to get him kicked out of caucus , said the sources , who were granted anonymity in order to discuss confidential caucus matters .
But just after the 6 p.m. Eastern time deadline they 'd set for him @ @ @ @ @ @ @ suggesting his remarks about Dr. Theresa Tam had been `` deliberately '' mischaracterized by the Liberals .
• Long-term care homes were in crisis well before politicians woke up to the problem • Ontario has a COVID-19 reopening plan , but it comes with big caveats `` I did not — and am not — questioning Dr. Tam 's loyalty to Canada , '' he said .
Sloan drew national attention late last week when , in an email to supporters , he criticized Tam 's handling of the COVID-19 pandemic in Canada @ @ @ @ @ @ @ upon data from the World Health Organization .
The WHO has come under scrutiny after it emerged that China , where the outbreak of the novel coronavirus began , potentially underreported the extent of illness in that country , in turn tainting the guidance the UN 's health agency was providing to other countries .
Sloan asked whether Tam was working for `` China or Canada . ''
She was born in Hong Kong , and that question prompted accusations that Sloan was being racist in his approach , as challenging someone 's @ @ @ @ @ @ @ In his statement Wednesday , Sloan said he never once mentioned Tam 's race or sex in his remarks .
He said it is obvious she is employed by Canada , not China , and while she is affiliated with the WHO , does n't work for that agency .
`` I am sure that she wants what she thinks is best for Canada , '' Sloan said .
But Sloan said she is relying on flawed data from the WHO and China , and while ultimately the prime minister is responsible for @ @ @ @ @ @ @ step down for making decisions that have cost Canadian lives .
Sloan was condemned across the political spectrum for his initial remarks , including by some of his fellow MPs who used social media last week to highlight their opposition .
Among them , Conservative Michael Chong .
His father immigrated to Canada from Hong Kong .
`` While I might not agree with every decision she 's made , I 've no doubt about her loyalty to Canada , '' he wrote of Tam on social media .
`` We 're in @ @ @ @ @ @ @ is doing their best . ''
Chong did not bring forward the motion to kick Sloan out .
But it is a piece of legislation that he brought forward several years ago that gives MPs the power to oust one of their own .
The Reform Act , which became law in 2015 , gives MPs , and not a party leader , the ability to decide whether a fellow parliamentarian stays or goes .
To remove Sloan , written notice is required from 20 per cent of MPs requesting his membership be @ @ @ @ @ @ @ vote to expel him — a vote that must be held by secret ballot .
MPs have been meeting via video or teleconference since the COVID-19 pandemic shut down most in-person gatherings across the country .
How a secret ballot could be conducted to oust Sloan is unclear , nor is whether it would pass .
Sloan is one of only two MPs in the running for the leadership .
The other is Ontario MP Erin O'Toole .
Two sources told The Canadian Press that O'Toole was not in favour of the motion @ @ @ @ @ @ @ request for comment .
Before the COVID-19 pandemic , the party had planned a convention to declare a new leader on June 27 .
In March , with the viral outbreak worsening , organizers suspended the official race .
Wednesday night , the group announced the competitors can return to raising funds , and the May 15 deadline to sign up new members remains unchanged .
The balloting is to be conducted by mail , as the Conservative constitution requires , with votes now due by Aug. 21 .
`` The result will @ @ @ @ @ @ @ can be properly processed and examined by scrutineers while respecting any health guidelines in place at that time , '' the organizing group said .
It hopes to be more specific `` in the coming weeks . ''
Besides Sloan and O'Toole , the other candidates are former MP and cabinet minister Peter MacKay , and Toronto lawyer Leslyn Lewis .
MacKay leads in endorsements from current MPs , and O'Toole and Lewis also have some declared supporters among elected Conservatives .
Sloan and Lewis , however , do both have the backing @ @ @ @ @ @ @ Life Coalition .
The organization circulated an email to its membership Wednesday asking for help to `` save '' Sloan .
It said a refusal by Scheer , the current leader , to publicly back him , and the fact that other potential leadership candidates were disqualified for controversial comments , does not bode well .
`` We can not allow the party establishment swamp to eliminate a third socially conservative leadership candidate , '' the group wrote .
This report by The Canadian Press was first published April 29 , 2020 .

Ontario Conservative MP Derek Sloan held to his leadership campaign slogan of being "Conservative without apology" and refused Wednesday to heed the demands of his fellow MPs to apologize for remarks questioning the loyalty of the country's chief public health officer. Sloan dug in at the same time as the group organizing the party's leadership race was deciding to resume the contest, but with revisions that will likely see a successor to Andrew Scheer named in late August. Sloan, the MP for Hastings-Lennox and Addington, is one of four candidates in the race, but his place within the Conservative caucus was challenged this week. A motion had been put forward by other Conservative MPs from Ontario during a meeting Tuesday afternoon demanding he apologize or retract his comments, two sources told The Canadian Press. Otherwise, some of the very MPs he wants to lead were prepared to try to get him kicked out of caucus, said the sources, who were granted anonymity in order to discuss confidential caucus matters. But just after the 6 p.m. Eastern time deadline they'd set for him to apologize, Sloan issued a statement suggesting his remarks about Dr. Theresa Tam had been "deliberately" mischaracterized by the Liberals.
"I did not — and am not — questioning Dr. Tam's loyalty to Canada," he said. Sloan drew national attention late last week when, in an email to supporters, he criticized Tam's handling of the COVID-19 pandemic in Canada, citing her association with and reliance upon data from the World Health Organization. Billion-dollar land deals in Ontario raise corruption suspicions The WHO has come under scrutiny after it emerged that China, where the outbreak of the novel coronavirus began, potentially underreported the extent of illness in that country, in turn tainting the guidance the UN's health agency was providing to other countries.
Sloan asked whether Tam was working for "China or Canada." Tory MP Sloan ducks call to apologize for challenging Tam's loyalty She was born in Hong Kong, and that question prompted accusations that Sloan was being racist in his approach, as challenging someone's loyalty is a historical racist trope. In his statement Wednesday, Sloan said he never once mentioned Tam's race or sex in his remarks. He said it is obvious she is employed by Canada, not China, and while she is affiliated with the WHO, doesn't work for that agency. "I am sure that she wants what she thinks is best for Canada," Sloan said. But Sloan said she is relying on flawed data from the WHO and China, and while ultimately the prime minister is responsible for following her advice, she should still step down for making decisions that have cost Canadian lives.
Sloan was condemned across the political spectrum for his initial remarks, including by some of his fellow MPs who used social media last week to highlight their opposition. Among them, Conservative Michael Chong. His father immigrated to Canada from Hong Kong. "While I might not agree with every decision she's made, I've no doubt about her loyalty to Canada," he wrote of Tam on social media.


nationalobserver--2020-04-30--Supreme Court to hear provincial appeals of carbon tax to September

Canada 's national fight over the carbon tax wo n't get sorted out at the Supreme Court of Canada until the fall .
The Supreme Court says appeals from both Saskatchewan and Ontario over cases that upheld Ottawa 's right to impose a carbon price on provinces will be heard in September .
The cases were to go forward last month but were postponed along with all others scheduled for March , April and May when the court shut down due to the COVID-19 pandemic .
Four hearings , including three involving criminal trials , will be heard by videoconference @ @ @ @ @ @ @ to hear the two carbon tax cases and two unrelated matters in September .
• Long-term care homes were in crisis well before politicians woke up to the problem • Ontario has a COVID-19 reopening plan , but it comes with big caveats All other cases will be rescheduled for the court 's fall sitting , which is set to begin Oct. 5 .
Chief Justice Richard Wagner thanked everyone for being flexible .
`` Your creativity and resourcefulness have helped ensure that we continue to deliver the justice our duty to parties @ @ @ @ @ @ @ said in a statement .
The carbon tax battle has been raging in Canada for several years .
On one side is the federal Liberal government , which implemented the national price on pollution last year .
On the other , provincial conservative governments who argue Ottawa is overstepping its bounds .
Ottawa argues taxing fuels that produce greenhouse gases when burned creates an incentive to improve energy efficiency and reduce fuel use , thereby cutting overall emissions .
It is a critical part of the Liberal government 's plan to cut Canada @ @ @ @ @ @ @ what they were in 2005 over the next 10 years .
To offset the financial impact to consumers , Ottawa issues carbon rebates on tax returns that for most Canadians exceed how much more they pay because of the carbon tax .
Several provinces say carbon taxes do n't cut emissions , they just raise prices for consumers .
The federal carbon tax applies only to provinces that do not have an equivalent price on pollution of their own .
Saskatchewan and Ontario both challenged the tax in court , and in both @ @ @ @ @ @ @ rights to enact the policy .
Both provinces appealed to the Supreme Court of Canada .
Alberta won a court challenge in that province this past winter , but last month appealed that decision to the Supreme Court hoping to have the case heard at the same time as the other two provinces .
The court has not yet determined if that will happen .
This report by The Canadian Press was first published April 29 , 2020 .

Canada's national fight over the carbon tax won't get sorted out at the Supreme Court of Canada until the fall. The Supreme Court says appeals from both Saskatchewan and Ontario over cases that upheld Ottawa's right to impose a carbon price on provinces will be heard in September. The cases were to go forward last month but were postponed along with all others scheduled for March, April and May when the court shut down due to the COVID-19 pandemic. Four hearings, including three involving criminal trials, will be heard by videoconference in June. The court has agreed to hear the two carbon tax cases and two unrelated matters in September.
All other cases will be rescheduled for the court's fall sitting, which is set to begin Oct. 5. Chief Justice Richard Wagner thanked everyone for being flexible. Billion-dollar land deals in Ontario raise corruption suspicions "Your creativity and resourcefulness have helped ensure that we continue to deliver the justice our duty to parties and all Canadians requires," he said in a statement.
The carbon tax battle has been raging in Canada for several years. On one side is the federal Liberal government, which implemented the national price on pollution last year. On the other, provincial conservative governments who argue Ottawa is overstepping its bounds. Supreme Court moves provincial appeals of carbon tax to September Ottawa argues taxing fuels that produce greenhouse gases when burned creates an incentive to improve energy efficiency and reduce fuel use, thereby cutting overall emissions. It is a critical part of the Liberal government's plan to cut Canada's emissions to 70 per cent of what they were in 2005 over the next 10 years. To offset the financial impact to consumers, Ottawa issues carbon rebates on tax returns that for most Canadians exceed how much more they pay because of the carbon tax. Several provinces say carbon taxes don't cut emissions, they just raise prices for consumers. The federal carbon tax applies only to provinces that do not have an equivalent price on pollution of their own. Saskatchewan and Ontario both challenged the tax in court, and in both cases courts ruled Ottawa was within its rights to enact the policy. Both provinces appealed to the Supreme Court of Canada.


nationalobserver--2020-04-30--Métis treasurer wants a seat at the table amid COVID-19 crisis

The elected treasurer for the Métis Nation-Saskatchewan is demanding a seat at the table of the Provincial Métis Council following its court appeal of her role as treasurer .
“ Regardless of whether there ’ s an appeal or not , I am still to sit at the table and be considered a part of the Provincial Métis Council , ” Mary Ann Morin told National Observer in an interview Wednesday .
On March 27 , the Métis Nation of Saskatchewan appealed a March 9 declaratory judgment by the Queen ’ s Bench for Saskatchewan in Prince Albert ruling that @ @ @ @ @ @ @ , but she said she ’ s not being allowed to participate .
“ I ’ ve always said … right from the start , that I did not resign .
I am still the director .
I am still responsible for the duties that are given to me under the constitution and legislation of our Métis people , ” Morin said .
Mary Ann Morin at the Metis Nation Legislative Assembly ( MNLA ) in Saskatoon , April 2018 .
Photograph courtesy of Charlene Lavalee .
She also retains her role as @ @ @ @ @ @ @ Secretariat Inc. , and is a member of the Métis Nation Legislative Assembly .
• Long-term care homes were in crisis well before politicians woke up to the problem • Ontario has a COVID-19 reopening plan , but it comes with big caveats Morin said she is still responsible for the actions taken by the executive while the appeal is ongoing .
On April 22 , she wrote to Carolyn Bennett , minister of Crown-Indigenous Relations , requesting that Métis Nation of Saskatchewan ’ s federal funding be put on hold and for @ @ @ @ @ @ @ management until it has demonstrated financial responsibility to the people it represents , and until internal governance issues are resolved .
She also asked for copies of all financial correspondence between the federal government and the Métis Nation of Saskatchewan .
Mary Ann Morin wants a seat at the table of the Provincial Métis Council so that she can fulfill her duties as elected treasurer for the Métis Nation-Saskatchewan .
She 's running in next year 's election , too .
Photograph courtesy of Charlene Lavalee .
“ As a duly elected leader @ @ @ @ @ @ @ relief ) funding reaches the areas in most need as the nearest hospital is 500 kilometres away and 16 cases in this area have been reported.
” “ These people voted for us and they wanted change .
They showed that in the votes .
There ’ s only one more year to the elections , ” Mary Ann Morin .
She also requested the minister ’ s support in closing negotiations of the Île-à-la-Crosse residential school on behalf of the survivors .
The boarding school was founded in the 1860s and housed @ @ @ @ @ @ @ in the 1970s .
“ There are very few people left and it has left our nation with unfinished business , which continues to hurt the people and their descendants.
” Morin told National Observer that her job is more important than ever right now with communities at risk due to the coronavirus pandemic .
She said that COVID-19 relief funding needs to get to the right people quickly .
Four months after Morin was elected treasurer in 2017 , she wrote a letter to the executive addressing what she saw to be @ @ @ @ @ @ @ letter , she said she would resign if her concerns were not addressed , but the executive took the letter as a resignation .
Morin thinks the reason they tried to remove her from her position was because there has always been conflict between the treasurer and other executives .
“ Why would ( the Métis Nation of Saskatchewan ) instigate getting rid of a person who has the ability to meet the obligations of the federal government … ?
It ’ s really because of internal controls , ” Morin said .
@ @ @ @ @ @ @ appeal takes , and since she did nothing wrong , she needs to be allowed into the workspace to do her job .
“ A declaratory judgment is a binding judgment from a court defining the legal relationship between parties and their rights in a matter before the court .
Declaratory judgments are conclusive and legally binding , ” Morin said in a statement Wednesday .
Morin said she ran for the position so she could maintain high standards of accountability and transparency within the Métis government .
“ I ’ ve been @ @ @ @ @ @ @ nobody seems to know what ’ s going on .
We didn ’ t know what money was coming in , what money was going out and what was being settled on behalf of the Métis people.
” In 2015 , Métis Nation of Saskatchewan ’ s federal funding was put on hold and it had to agree to a third-party funding proposal to continue to operate .
When Morin was elected , she said she set out to ensure that wouldn ’ t happen again .
“ These people voted for us @ @ @ @ @ @ @ that in the votes .
There ’ s only one more year to the elections.
” Morin said she will be running again in the next election and suggested Métis citizens should call for a vote of non-confidence on the current leadership ’ s financial practices if they want the change they voted for to happen .
“ It ’ s up to them to make leadership accountable .
It is up to them .
Each and every one of them .
If leadership ( is ) not meeting your needs , they @ @ @ @ @ @ @ them .
”

The elected treasurer for the Métis Nation-Saskatchewan is demanding a seat at the table of the Provincial Métis Council following its court appeal of her role as treasurer. “Regardless of whether there’s an appeal or not, I am still to sit at the table and be considered a part of the Provincial Métis Council,” Mary Ann Morin told National Observer in an interview Wednesday. On March 27, the Métis Nation of Saskatchewan appealed a March 9 declaratory judgment by the Queen’s Bench for Saskatchewan in Prince Albert ruling that Morin remain in her role as treasurer, but she said she’s not being allowed to participate. “I’ve always said … right from the start, that I did not resign. I am still the director. I am still responsible for the duties that are given to me under the constitution and legislation of our Métis people,” Morin said. Mary Ann Morin at the Metis Nation Legislative Assembly (MNLA) in Saskatoon, April 2018. Photograph courtesy of Charlene Lavalee.
She also retains her role as director of the Métis Nation Saskatchewan-Saskatchewan Provincial Secretariat Inc., and is a member of the Métis Nation Legislative Assembly. Morin said she is still responsible for the actions taken by the executive while the appeal is ongoing. Billion-dollar land deals in Ontario raise corruption suspicions On April 22, she wrote to Carolyn Bennett, minister of Crown-Indigenous Relations, requesting that Métis Nation of Saskatchewan’s federal funding be put on hold and for the group to be placed under third-party management until it has demonstrated financial responsibility to the people it represents, and until internal governance issues are resolved.
She also asked for copies of all financial correspondence between the federal government and the Métis Nation of Saskatchewan. “These people voted for us and they wanted change. They showed that in the votes. There’s only one more year to the elections,” Mary Ann Morin. Mary Ann Morin wants a seat at the table of the Provincial Métis Council so that she can fulfill her duties as elected treasurer for the Métis Nation-Saskatchewan. She's running in next year's election, too. Photograph courtesy of Charlene Lavalee. “As a duly elected leader … I want to ensure (COVID-19 relief) funding reaches the areas in most need as the nearest hospital is 500 kilometres away and 16 cases in this area have been reported.” She also requested the minister’s support in closing negotiations of the Île-à-la-Crosse residential school on behalf of the survivors. The boarding school was founded in the 1860s and housed children from northern Saskatchewan until it closed in the 1970s. “There are very few people left and it has left our nation with unfinished business, which continues to hurt the people and their descendants.”
Morin told National Observer that her job is more important than ever right now with communities at risk due to the coronavirus pandemic. She said that COVID-19 relief funding needs to get to the right people quickly. Four months after Morin was elected treasurer in 2017, she wrote a letter to the executive addressing what she saw to be a lack of transparency. In that letter, she said she would resign if her concerns were not addressed, but the executive took the letter as a resignation.