Canada recommends suspension of use of AZ Vaccine for people under 55

Why Canada is suspending use of AstraZeneca vaccine in people under 55

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No reported cases of rare blood clots after vaccinations in Canada, but Health Canada still assessing risk

Adam Miller · CBC News · Posted: Mar 29, 2021 4:17 PM ET | Last Updated: March 29

Change in advice renews apprehension around AstraZeneca vaccine

2 days ago3:14A change in advice has renewed apprehension around the AstraZeneca vaccine, which has been compounded by contradictory messages in Ontario. There’s also concern the confusion will add to vaccine hesitancy. 3:142586 comments

Canada’s vaccine advisory committee is recommending immediately suspending the use of the AstraZeneca-Oxford COVID-19 vaccine in Canadians under 55 following reports of rare but potentially fatal blood clots in Europe that appear to be connected to the shot.

The National Advisory Committee on Immunization (NACI) updated its guidelines to provinces and territories against the use of the vaccine for younger Canadians on Monday over safety concerns. 

Health Canada said Monday that 300,000 doses of AstraZeneca vaccine have been administered and no cases of the rare blood clotting adverse events have been reported in Canada, but that it was aware of additional cases that have recently been reported in Europe. 

Quebec, Ontario, Alberta, Saskatchewan, Manitoba, Newfoundland and Labrador and Prince Edward Island have all suspended the use of the vaccine for anyone below the age of 55. Other provinces and territories are expected to follow. 

Dr. Isaac Bogoch, an infectious diseases physician and member of Ontario’s COVID-19 vaccine task force said that the discovery of a potential connection with the vaccine to blood clots raised a “red flag” that “warrants further exploration.” 

“People should appreciate that not all blood clots are created the same,” he said. “This is a very specific and particular method of blood clotting that likely has an association with the vaccine.” 

Risk of blood clots seems not to affect older age groups: NACI

NACI previously recommended earlier this month that Canadians over 65 not receive the shot, despite emerging evidence from around the world demonstrating its ability to prevent severe COVID-19 in older adults.

But that guidance changed on March 16 after more real-world data on the vaccine’s effectiveness was reviewed by NACI, and CBC News broke the story revealing documents on the federal government’s plans to allow those 65 and older to receive it.

“This vaccine has had all the ups and downs — it looks like a roller coaster,” said Dr. Caroline Quach, chair of NACI and a pediatric infectious diseases expert. “The problem is because data are evolving, we are also evolving our recommendations.” 

Quach said the risk of rare blood clots appears to only occur in younger populations, which is why NACI recommended suspending the vaccine in those under 55.

“What we’re doing is trying to contrast the risks and benefits,” she said. “So if you have that vaccine versus having to wait for two months while COVID is ramping and you’re at risk of catching it and having complications from it, I think that taking the vaccine is the best option at this point.”

Quach added that the vaccine works well in preventing severe outcomes and death in older populations over 55, particularly in those over 70, and the risk of blood clots does not appear to be present in those age groups. 

WATCH | Vaccine committee recommends pause on use of AstraZeneca vaccine on those under 55:

Vaccine committee recommends a pause on use of AstraZeneca COVID-19 vaccine on those under the age of 55

2 days ago1:34Dr. Supriya Sharma, Health Canada’s chief medical adviser, discusses NACI’s recommendation to pause the use of AstraZeneca’s COVID-19 vaccine on those under the age of 55. 1:34

“What we need to have is continued confidence in our expert review panel that it’s looking at these vaccines and deciding what is going to be best, safest and most effective for Canadians,” said Alyson Kelvin, an assistant professor at Dalhousie University and virologist at the Canadian Center for Vaccinology in Halifax. 

“This is a new vaccine to a new virus, it’s really important that we’re following all the data as closely as possible and as the vaccines are rolling out, we’re understanding them more and reviewing what the guidance should be.”

Dr. Zain Chagla, an infectious diseases physician at St. Joseph’s Healthcare Hamilton and an associate professor at McMaster University, said NACI is taking a calculated risk by recommending older Canadians still get the vaccine because they are at higher risk of severe outcomes from COVID-19.

“Scientifically, it makes sense,” he said. “This isn’t saying that everyone under 55 is going to get this complication. It’s the slight risk of this complication seems to be more predisposed in this age group. But again, the raw numbers seem to be very, very low.”

What led to Canada’s decision to suspend AstraZeneca

The decision to halt the use of the vaccine in Canadians under 55 comes after the European Medicines Agency (EMA) investigated 25 cases of the rare blood clots out of about 20 million AstraZeneca shots given. It concluded on March 18 that the benefits from the vaccine far outweigh its possible risks, although a definitive link could not be ruled out.

But 18 of the cases in Europe were of an extremely rare type of blood clot called cerebral venous sinus thrombosis (CVST) — where veins that drain blood from the brain are obstructed and can potentially cause fatal bleeding.

The EMA said on March 18 at least nine deaths have been associated with the adverse events in Europe and the agency is continuing to investigate the situation.

Germany’s medical regulator told The Associated Press on Monday it had received reports of 21 cases of rare blood clots in people who had recently received AstraZeneca’s coronavirus vaccine. 

The Paul Ehrlich Institute also said that seven people affected by the blood clots have died. It added that of the 21 cases reported in Germany until March 25, 12 also involved an abnormally low level of platelets in the patients’ blood.

WATCH | Canada pauses use of AstraZeneca vaccine in people under 55

Canada pauses use of AstraZeneca vaccine in people under 55

2 days ago4:34″We are being fully transparent. Maybe it’s too transparent, I don’t know,” says Dr. Caroline Quach-Thahn, Chair of the National Advisory Committee on Immunization. NACI issued guidance for the AstraZeneca vaccine for the third time, now recommending a pause for those under 55. 4:34

Nineteen of the 21 cases were in women ages 20 to 63, while two were in men ages 36 and 57. During the period covered by the reports, some 2.27 million first doses of the AstraZeneca vaccine were administered in Germany.

“You cannot ignore the blood clots that have been associated with AstraZeneca globally,” said Bogoch. “It’s not entirely clear what the true incidence of this is, but it does appear to be a rare event.” 

What Canadians need to know about the AstraZeneca vaccine

The federal health ministry said it would be requiring both manufacturers, AstraZeneca and India’s Serum Institute, to conduct risk assessments by age and gender — but is requesting more data before deciding whether or not to change authorization of it in Canada. 

Health Canada had previously updated the vaccine’s label with information on the rare blood clotting events.

Canadian health officials said during a press conference Monday the specific syndrome is being called Vaccine-Induced Prothrombotic Immune Thrombocytopenia (VIPIT) and that they are in contact with European officials about it. 

The National Advisory Committee on Immunization (NACI) updated its guidelines against the use of the vaccine for younger Canadians on Monday. (Dado Ruvic/Reuters)

“I do understand why Canadians might feel worried,” said Canada’s Deputy Chief Public Health Officer Dr. Howard Njoo.

“What I can say is that the chief medical officers of health of the provinces and territories take vaccine safety very seriously and we want Canadians to have confidence in these vaccines.”

Officials added that Germany’s Paul Ehrlich Institute reported VIPIT has an incidence rate of about one in 100,000, with a mortality rate of about 40 per cent, although more research is needed and that risk is reduced if treated early enough. 

“Where the true rate is, we just don’t know at this point in time,” said NACI Co-Chair Dr. Shelley Deeks. “But we are continuing to follow the data, as it emerges.” 

WATCH | AstraZeneca guidance change ‘precautionary,’ says federal government adviser

AstraZeneca guidance change ‘precautionary,’ says federal government adviser

1 day ago12:00Pausing the use of the AstraZeneca vaccine in people under the age of 55 was a precautionary measure, says Dr. Shelley Deeks of the National Advisory Committee on Immunization. Deeks also said that the NACI continues to revise guidance based on evidence. 12:00

Symptoms to watch for

The Public Health Agency of Canada released a statement on Monday saying that “there is no cause for concern” for Canadians who have already been vaccinated with AstraZeneca for more than 20 days, but that you should seek immediate medical attention in the rare event you develop the following symptoms four or more days after vaccination:

  • Shortness of breath.
  • Chest pain.
  • Leg swelling.
  • Persistent abdominal pain.
  • Sudden onset of severe or persistent worsening headaches or blurred vision.
  • Skin bruising (other than at the site of vaccination).

PHAC said decisions on the type of second dose that will be offered to those who have been vaccinated with AstraZeneca will be determined based on the “latest evidence and research.” 

Most of the complications in Europe occurred within 14 days of receiving the AstraZeneca shot, and the majority were in women under the age of 55. It’s worth noting that CVST is typically more common in women, particularly during and after pregnancy, while on birth control and hormone replacement therapy.

Germany and Italy resumed vaccinations with the shot on March 19, but France opted to vaccinate only those over 55 with it after discovering several cases of CVST. Denmark and Norway have suspended the use of the vaccine altogether for at least three weeks, while Sweden has resumed the use of the vaccine in those over 65. 

“The real question here is, how common is it, and are there identifiable risk factors for this? That way, we could probably continue to use this vaccine in people with very, very low risks of having a blood clot and selectively vaccinate people who would benefit,” Bogoch said.

“If there is that risk, we would hopefully have better data to support who we could safely and selectively vaccinate with this product.”

Benefits still outweigh risks, says vaccine maker

A spokesperson for AstraZeneca Canada said in a statement the company respects the decision by NACI but stressed that Health Canada’s guidance to health care providers around the use of the vaccine remains unchanged.

“Regulatory authorities in the U.K., European Union, the World Health Organization and Health Canada have concluded that the benefits of using our vaccine to protect people from this deadly virus significantly outweigh the risks across all adult age groups,” the statement read. 
 
“Tens of millions of people have now received our vaccine across the globe. The extensive body of data from two large clinical data sets and real-world evidence demonstrate its effectiveness, reaffirming the role the vaccine can play during this public health crisis.” 

Chagla said NACI’s decision will likely hurt confidence in the vaccine in the eyes of Canadians, especially among those over 55 who may be left “scratching their heads” as to why the vaccine is being recommended for their age group but not younger people. 

“I, unfortunately, envision this vaccine is going to have a limited rollout in Canada moving forward,” he said.

“Even if the dust starts settling, and it’s a completely separate issue or it’s much lower risk than expected, I don’t think you’re going to get many under 55-year-olds to get this vaccine anymore and that’s the reality.”

Ontario to invest $500 Million in Sanofi Vaccine Plant

NEWS RELEASE

Ontario Expands Domestic Vaccine Manufacturing Capacity and Improves Pandemic Preparedness

By Investing in Sanofi Province Will Create Hundreds Of Jobs and Increase R&D

March 31, 2021

Office of the Premier

Table of Contents

  1. Content
  2. Quick Facts
  3. Quotes
  4. Additional Resources
  5. Related Topics

TORONTO — The Ontario government is partnering with the federal government, the City of Toronto and Sanofi, a leading global biopharmaceutical and vaccines company, to expand its Ontario facility to meet growing demand for flu vaccines, boost Canada’s preparedness for future pandemics and create 300 high-quality jobs.

Ontario is investing $55 million through a performance-based loan, toward construction of Sanofi’s $925 million state-of-art vaccine facility to meet growing demand for flu vaccines, specifically for populations at greater risk of influenza. The company is also committing to an average of $79 million a year in research and development in Ontario or more than a half a billion dollars over the life of the agreement. Sanofi will also be leveraging leading scientists in the province giving them the industrial R&D experience that is valuable to companies.

“This is a critical investment as it will create 300 high quality jobs and push Ontario toward becoming less reliant on others for the production of flu and potentially other vaccines,” said Premier Ford. “By supporting companies like Sanofi we will continue to strengthen our excellent pharmaceutical sector and ensure we are prepared for future public health events with Made in Ontario products.”

The investment will enable Sanofi to bulk manufacture Fluzone® High-Dose Quadrivalent Influenza Vaccine, a flu vaccine approved for people 65 years and older, at its historic Connaught site in Toronto. The facility will include industrial scale Formulation, Filling and Packaging, a key requirement for pandemic preparedness.

The project will result in the production of more flu shots in Canada, while strengthening Ontario’s biopharmaceutical industry, making the province a strong candidate for future vaccine production. Through this investment, research and development activities will continue at Sanofi’s Toronto location and there will be expanded opportunities for the agricultural industry value chain.

“It is critical, now more than ever, that we build the capacity to supply Ontario and all of Canada with flu vaccines,” said Vic Fedeli, Minister of Economic Development, Job Creation and Trade. “The support we provide Sanofi will build on this province’s bio-manufacturing capacity, save lives and help prepare us for any future pandemic emergency.”

This new facility is a second large manufacturing mandate for Sanofi at this site. In 2018, Ontario and Sanofi announced another large bulk vaccine manufacturing facility focused on doubling the site’s capacity to produce childhood vaccines.

Sanofi Pasteur, a subsidiary of French headquartered Sanofi, is Ontario’s largest brand name biopharmaceutical company with a full spectrum of R&D, manufacturing, clinical trials, regulatory and quality affairs and distribution operations.

Quick Facts

  • In addition to creating high-quality jobs, the project will result in hundreds of supporting jobs, including scientists, service providers, construction workers, egg farmers and transportation.
  • The project is expected to support $6 million in staff training and developing tomorrow’s workforce, including collaborations with Ontario post-secondary and industry institutions.
  • Ontario’s 44 public universities and colleges produce 49,300 STEM graduates (science, technology, engineering and math) each year, accounting for more than 42 percent of Canadian STEM graduates.
  • As Ontario’s new investment attraction agency, Invest Ontario will play a pivotal role in the province’s economic recovery and growth. It will initially focus on three important sectors for COVID-19 recovery where Ontario has a globally competitive advantage: advanced manufacturing, life sciences, and technology.
  • Ontario’s Action Plan: Protecting People’s Health and Our Economy, brings total investments to $16.3 billion to protect people’s health and $23.3 billion to protect our economy. Ontario’s COVID-19 action plan support now totals $51 billion.

Toronto Hot Docs 2021: “Fanny: The Right to Rock”

Being honest with you as I must I watch several past prime female rockers in their late sixties recording what you might want to call a “comeback album”. I think in many cases The Beatles had it right and that is bow out in your prime. Those of you who have recently see the Rolling Stones or The Who you note they are parodies of their past. No creativity or new music. They are in it to embarrass themselves and rake in the cash.

This is the impression I had with a bunch of granny rockers in the band Fanny that start the film recording a “comeback album”. Perhaps I am right on it my observations as I am a rocker in their 1970-75 niche. Perhaps I am still right. They should have packed it in when they folded in 1975.However in the comeback album “Fanny Walked the Earth” there is original material.

But forget the present and enjoy the rich delve into their history as the first recorded girl rock band. Filipina and one member a gay in that 70’s period. They were ahead of their time long before the Go-Go’s or the Bangles.

Heavily praised in the media but seen as a “female” band in a macho male rock world they made it ito # 29 in Billboard with “Butter Boy” in 1975. They partied with the elite of rock n roll at the time smoking hash with Jagger then heroin with him.

They never crashed into stardom and was it because they were “women of colour”? On the cusp of “Butter Boy” they disbanded. Exhausting road schedules and money that disappeared with their management.

A history of discrimination on sexism and racism. Yet praised by rock n rollers and rock journalists and particularly loved in the UK. Admired by many prominent musicians including David Bowie their comeback album is speared by a stroke of one of their members but they regroup for a performance hoping that their stroke bound member recovers so they can go on the road again.

A great trip back into mid seventies rock studded by tributes of American and British rockers and journalists.

Is rock n roll a young person’s realm or is their room for seniors? Your choice.

Whatever your opinion a nostalgic romp in the hay for 70’s American rock.

Directed by Bobbi Jo Hart and will be a world premiere at Toronto Hot Docs 2021 film festival.

Available to stream April 29th-May 9th in Canada only. See https://boxoffice.hotdocs.ca/websales/pages/info.aspx?evtinfo=141666~367cbc04-eb03-453a-90f8-88ca48c4cf79&epguid=9759e3f1-085c-4e15-88c2-e02a8ee1f1d1&

“Mutantism on the March”: Chapter 31 “Revolt of the Slug People”

Montenez read Mudrage’s editorial and this caused some introspection on his part concerning “clean consciousness”. Perhaps he was not seasoned enough with conflict to understand what the cures for violence might be. He was somewhat confused and wondered if he was spouting gibberish. Perhaps it was time to step down from the clouds and experience firsthand situations of repression and violence. But he was certain if brute force reigned only the most technologically advanced would rule. He had been attempting to convey to the Zortixians the ultimate but the world was not always logical and peaceful! The world as he knew most of it was rude and barbaric. His meditations were broken by the buzz of the com announcing the spacecade was ready to transport him to the waiting rocket which was going to transport him back to Earth. As he walked to his transport vehicle he was greeted by the glare of the telecameras and deafened by the cheers of the crowd shouting, “Montenez back soon! Montenez back soon!” The lime green flag of Zortixia was waving in every Zortixian’s hand. The last time Montenez’s namesake had left the planet the situation was much different!

At the rocket field he read a brief statement of gratitude and promised that he would visit regularly. The premayor of Zortixia, Algno trying to hold his emotions in check said, “ We Zortixians are proud of you William. You share many of the attitudes of your late father except your actions will be carried on in this planet called Earth. We wish you nothing but astounding and glorious victories in that galaxy for I am sure what happens there will have effects here. As a gesture of Zortixian solidarity we adopt Earth as our sister planet. We offer our help only if you ask for it. We hope they can solve their own problems. Good-bye William and safe voyage!” As the doors of the rocket were closing he heard his name being chanted. Little did the adoring crowd realize the slug people had revolted!

Who in Jakka are the slug people? They are a race of half slug and half humanoid creatures inhabiting the Irony Mountains of Zortixia. They never played a role in the development of Zortixia and quite frankly that is the way that they wanted it. In the ancient Zortixian-Zorollian War they were persecuted without mercy by the Zorollians millions slaughtered or placed in “re-education camps”. As the Zorollians were defeated they were forced to pay huge war crime settlements to the slug people. After years of trepidation they once again settled down to a peaceful existence being protected by Zortixian law as an endangered species.

The slug people had no great achievements in the annals of Zortixian history but they had a valuable role to play and that was consuming all organic garbage created by Zortixians. The entire activity of the slug people consisted of mating and consuming garbage. The had no desire for political activity so why on earth did they revolt?

Although initial reports were confused and disjointed it appeared as if thousands of heavily armed slug people broke into suburban fruit and vegetable warehouses outside the capital city consuming tons of fruit and vegetables. They had also burnt the municipal bath complex to the ground. It would seem as the slug people were incapable of planning such an attack there was some agitation involved by an outsider. Witnesses reported seeing some of the slug people waving the flag of the Opposite Party once headed by the Jiber!

Keeping Advertising Executives Busy in Saskatchewan! Sell, Sell, Sell

Stick It To COVID: Saskatchewan Launches Vaccination Ad Campaign

Released on March 29, 2021

The Government of Saskatchewan has launched a province-wide, multi-media campaign encouraging Saskatchewan residents to stick it to COVID by getting vaccinated.

“Today, we are asking people to help us get back to normal by rolling up their sleeves to stick it to COVID,” Premier Scott Moe said.  “Saskatchewan’s vaccination efforts have been the most effective in the nation because Saskatchewan people know that the best thing we can do to protect ourselves, others, and to get back to doing the things we love is by getting vaccinated.”

The Stick It To COVID campaign features real Saskatchewan people sharing their stories of why they are getting vaccinated and will roll out as part of a multi-faceted media plan to encourage Saskatchewan residents to get vaccinated.

The main 60-second advertisement is narrated by Regina ER Nurse Leah Sawatsky, who has worked on the front-lines throughout the pandemic and was one of the first people in the province to receive the COVID-19 vaccine.  Launching on Monday, March 29, the ad thanks the people of the province for all of their efforts during the pandemic and calls on Saskatchewan people to roll up their sleeves for the COVID-19 vaccine when it is their turn.

“I think it’s a powerful ad with a powerful message,” Moe said.  “It reminds us of all the things we have missed doing this past year but more importantly, all the things we can look forward to doing again once enough Saskatchewan people are vaccinated.”

Part two of the campaign will feature seven 30-second advertisements featuring 11 real Saskatchewan people.  The seven supporting advertisements will launch in the days and weeks following the initial launch, and will provide a personal insight into what the COVID-19 vaccine represents to each of them.

“These messages from Saskatchewan people are a reminder that when we get vaccinated, we aren’t just doing it for ourselves,” Moe said.  “We are doing it to protect those around us, which is what we do in this province. We look after one another.”

The multi-media campaign will feature TV ads, radio, social media (YouTube, Facebook, Instagram, Spotify), billboards, washroom posters, newspaper ads and cinema ads.  The campaign will run province-wide and include content broadcast by radio in Cree and Dene in northern Saskatchewan.

“We all have a reason to get immunized, and I encourage everyone to watch the videos and reflect on who they will be keeping safe by getting the vaccine,” Health Minister Paul Merriman said.  “Thank you to all those that participated in the campaign by sharing their inspiring stories.”

The advertisements feature the following Saskatchewan people. 

  • George Reed – Rider Legend – Regina
  • Moni – Neonatal Nurse Practitioner – Regina
  • Leah Sawatsky – Emergency Room Nurse – Regina 
  • Emily – Elder – Lac La Ronge Indian Band
  • Dr. Hassan Masri – ICU Physician – Saskatoon 
  • Richard – Retired – Saskatoon
  • Jenni – Teacher – Moose Jaw
  • Brad – Rec hockey player – Yorkton
  • Arlene – Home Care Aide – Weyburn
  • Darcy – Small Business Owner – Regina
  • Kyla – mother of immunocompromised child – Swift Current

Learn more about how to book your COVID-19 vaccine by visiting www.stickittoCOVID.ca.

To watch the first Stick It To COVID ad, visit https://www.youtube.com/watch?v=t99gWB-Txng.

Jon Kabat-Zinn’s “Full Catastrophe Living”: Commitment to Mindfulness

“The spirit of engaged commitment we ask of our patients during their eight weeks MBSR (mindfulness based stress reduction) is similar to that required in athletic training. The athlete who is training for a particular event doesn’t practice only when he or she feels like it-for instance only when the weather is nice, or there are other people to keep him or her company, or there is enough time to fit in a workout. The athlete trains every day, rain or shine, whether she feels good or not, whether the goal seems worth it or not on any particular day.”

Susan Cain’s “Quiet”: Open plan offices

“Open plan offices have been found to reduce productivity and impair memory. They’re associated with high staff turnover. They make people sick, hostile, unmotivated and insecure. Open plan workers are more likely to suffer from high blood pressure and elevated stress levels and to get the flu; they argue more with their colleagues; they worry about co-workers eavesdropping on their phone calls and spying on their computer screens. They have fewer personal conversations with colleagues. They’re often subject to loud and uncontrollable noise, which raises heart rate: releases cortisol, the body’s fight or flight “stress” hormone; and makes people socially distant, quick to anger: aggressive, and slow to help others.”

From Susan Cain’s “Quiet: The Power of Introverts that Can’t Stop Talking”, Broadway Books 2013

“His Name is Ray”: Desperation an Understatement

Michael Del Monte followed Toronto based panhandler Ray originally from PEI but now a panhandler on Lakeshore Boulevard in Toronto. He goes from car to car hoping for handouts to fund his heroin addiction.

Del Monte noticed him on his drive home and he was invited by Ray to follow him for 8 months single-handedly. Apparently, Ray worked for the Coast Guard but what ill fate brought him to his beggarly drug addicted status in Toronto is unexplained.

Mostly incoherent he professes many times he will be back on the water and it will just take him some concentration to do that. Dream on fantasy.

Sadly it seems but an impossible dream as he suffers overdoses, robbery and intimidation by a drug dealer he owed money to.

We are introduced to his social circle of alcoholics and drug addicts but to say there are “friends” in this world may be a stretch. “Friends” rob each other. It is always for the next hit. Day after day of drudgery to numb the pain.

Drug overdose deaths are common and one reaches a sense of alarm when Ray starts on fentanyl where we watch him shooting up it is like waiting for his demise.

What a dark and oppressive world Del Monte exposes in my hometown which makes it all the more real for me.

Del Monte says, “It’s a hard story to watch, but it’s a much harder story to live. It’s a film that begs the audience to have the courage to look Ray in the eye and have empathy.” I agree with Del Monte here on the understanding that empathy means doing something to make Ray’s life better as opposed to sympathy which is pity.

At one point in this film I think Ray is beyond help and deluded about his return to the sea. I doubt he will return to the sea but will perish with a fentanyl overdose. By the way the leading cause of death for Canadians 55 and under is a drug overdose and drug rehabs have an initial success rate of 10%. The obsession with COVID in the health care system seems to leave few resources or empathy to deal with people like Ray.

I am ready to give up on Ray until near the end of the doc he is invited for a sail on a sailboat on Lake Ontario and for a brief moment the viewer might feel there is hope. Ray becomes an involved and  becomes an engaged human but returns to a mundane and dangerous career of panhandling to feed his deadly drug habit.

But for an instant I think if there was a custom rehab programme for Ray that involved some sailing there might be some hope. But given the resource hog of COVID in the health system and the lack of a meaningful rehab system Ray and many others will be doomed.

A hard watch indeed for those with empathy and even an angry watch as the opioid epidemic takes a backseat to the COVID pandemic. A bit of a paradox if the opioid death rate exceeds COVID deaths. Well let the politico-medico elite deal with this problem. Postpone cancer surgeries and ignore the opioid death rate for the glossy headlines of the crusaders against the evil COVID. Who is getting screwed?

Digital access will be available for Canadians from 22April until 27 May at Hot Docs Ted Rogers Cinema. This is one film I would have loved to interview theatre goers about their reaction to the film. My thoughts on this that there might be a sense of hopelessness, disgust or “he got what he deserved”. However being imprisoned by a COVID holy commandment of social distancing this will not be possible.

This doc will be available for Canadians from April 22 until May 27. For others depending on international distribution rights you may the opportunity to see this film. But wherever you live Ray will be on a street corner near you.

10 Steps We Can Take to Never Have a Year Like 2020: # 9 Restructure our cities

Again the Quebec magazine L’actualitê has an interesting feature article in its April edition dealing with COVID-19 and translated it means what are the steps we can take to ensure we don’t have a year like 2020?

Christian Savard the director general of “Vivre en Ville” said that it was not only Montreal green spots that have experienced a boom but suburban parks as well. The increased use of these parks show us just how important it is to our lives and collective resilience.

Experts on urban planning agree that the greening of cities should be accelerated to make us more resilient to future crisis whether health or climate change related. One must not underestimate the value of trees. Not only do they purify the air but create areas of natural cooling and help combat stress and anxiety.

Cyril Frazao executive director of Nature Quebec says that the access to nature must be a right for all not simply for those that can leave the city easily in their cars.

Urban planning laws are over 40 years old and were based on the automobile and real estate construction. The post pandemic world must be greener and more inclusive.

10 Steps We Can Take to Never Have a Year Like 2020: # 8 Facilitate Access to Nature

Again the Quebec magazine L’actualitê has an interesting feature article in its April edition dealing with COVID-19 and translated it means what are the steps we can take to ensure we don’t have a year like 2020?

The eighth step is to have better access to nature.

The article mentions how Quebeckers were elbowing for room in the fresh air in the summer of 2020. National parks, beaches and trails were crowded. Although there is some paradox in Quebec as some of the most beautiful spots are inaccessible to so many as they are far removed from centres of population. Privatization of rivers, forests and real estate construction are destroying the “green belts” of Quebec.

It is difficult to create protected geographic areas of Quebec as so many different governmental ministries have conflicting interests. One ministry wants to give logging rights while another wants to crate public access on trails through the forest. Some critics of the grant of logging rights and the profits gained from it are less than what economic benefits from tourism could be. The doctrine of L’allemansträtt is a constiututional right in Sweden to walk and camp on all private property. There is no obligation to reserve camping spots but Quebeckers lack the civility of the Swedes not knowing how to properly treat nature and leave garbage everywhere.

The expropriation laws in Quebec that are some 40 years old set back any tendency to create publicly accessible land as owners are entitled not only to the market value of the land but grant them the theoretical right to profits that would have been made from the land had it not been expropriated.