9 babies born to Malian mother ‘all doing well’

A Malian woman gave birth to nine babies on Tuesday — two more than doctors had detected inside her crowded womb. She joins a small pantheon of mothers of nonuplets.

Mali’s healthy ministry released this photo of some of the nine babies born in Morocco to 25-year-old Halima Cisse on May 4. (Mali Ministry of Health and Development)

A Malian woman gave birth to nine babies on Tuesday — two more than doctors had detected inside her crowded womb — thereby joining a small pantheon of mothers of nonuplets.

The pregnancy of Halima Cisse, 25, has fascinated the West African nation and attracted the attention of its leaders. When doctors in March said Cisse needed specialist care, authorities flew her to Morocco, where she gave birth.

“The newborns (five girls and four boys) and the mother are all doing well,” Mali’s health minister, Fanta Siby, said in a statement.

Cisse was expected to give birth to seven babies, according to ultrasounds conducted in Morocco and Mali that missed two of the siblings. All were delivered by caesarean section.

Nonuplets are extremely rare. Medical complications in multiple births of this kind often mean that some of the babies do not reach full term.


India accounted for 46% of global COVID-19 cases last week, WHO says

India accounted for nearly half the coronavirus cases reported worldwide last week, the World Health Organization said on Wednesday, as the country’s deaths rose by a new high of 3,780 during the last 24 hours.

A man carries an oxygen cylinder as he arrives to refill it for a COVID-19 patient at a refilling centre in New Delhi. India is dealing with a major uptick in cases that is overwhelming health systems. (Tauseef Mustafa/AFP/Getty Images)

India accounted for nearly half the coronavirus cases reported worldwide last week, the World Health Organization said on Wednesday, as the country’s deaths rose by a new high of 3,780 during the last 24 hours.

In a weekly report, the WHO said India accounted for 46 per cent of global cases and 25 per cent of global deaths reported in the past week.

Daily infections rose by 382,315 on Wednesday for a 14th straight day of infections in excess of 300,000, health ministry data showed.

Hospitals are scrabbling for beds and oxygen as they desperately battle a second deadly surge of infections, while morgues and crematoriums struggle to deal with a seemingly unstoppable flow of bodies.

Many people have died in ambulances and car parks waiting for a bed or oxygen.

Workers monitor as a tanker gets refilled with medical oxygen for hospitals and medical facilities treating COVID-19 patients. Oxygen, critical for treatment of people with COVID-19, has been in short supply in India. (Manjunath Kiran/AFP/Getty Images)

Prime Minister Narendra Modi’s government has been widely criticized for not acting sooner to suppress the second wave, as religious festivals and political rallies drew tens of thousands of people in super-spreader events.

“We need a government. Desperately. And we don’t have one. We are running out of air. We are dying,” the Booker Prize-winning author Arundhati Roy wrote in an opinion piece that called for Modi to step down.

“This is a crisis of your making,” she said in the article published on Tuesday. “You cannot solve it. You can only make it worse…. So please go. It is the most responsible thing for you to do. You have forfeited the moral right to be our prime minister.”

India’s delegation to the Group of Seven foreign ministers’ meeting in London is self-isolating after two of its members tested positive for COVID-19, Britain said on Wednesday.

Foreign Minister Subrahmanyam Jaishankar, who is in London, said in a Twitter message that he would attend virtually. Broadcaster Sky News said Jaishankar did not test positive for the virus, however.

Nepal sees surge in cases

Neighbouring Nepal is being overwhelmed by a surge of infections as India’s outbreak spreads across South Asia, the International Federation of Red Cross and Red Crescent Societies said.

As international aid trickles into India, journalist Aditya Raj Kaul says medical supplies can help immensely, but will not change the situation in the country overnight. 7:29

With 57 times as many cases as a month ago, Nepal is seeing 44 per cent of tests come back positive, it said. Towns near the border with India are unable to cope with the growing numbers seeking treatment, while just one per cent of its population is fully vaccinated.

Medical experts say India’s actual figures could be five to 10 times the official tallies, however. The country has added 10 million cases in just over four months, after taking more than 10 months to reach its first 10 million.

Two “oxygen express” trains carrying the life-saving gas in liquid form arrived in the capital, New Delhi, on Wednesday, Railways Minister Piyush Goyal said on Twitter. More than 25 trains have distributed oxygen supplies nationwide.

The government says supplies of the gas are sufficient but transport woes have hindered distribution.

Drop in vaccination, testing

India’s surge in infections has coincided with a dramatic drop in vaccinations because of supply and delivery problems.

At least three states, including Maharashtra, home to the commercial capital of Mumbai, have reported a scarcity of vaccines, shutting down some inoculation centres.

Daily testing has fallen sharply to 1.5 million, the state-run Indian Council of Medical Research said on Wednesday, off a peak of 1.95 million on Saturday.

The opposition has urged a nationwide lockdown, but the government is reluctant to impose one for fear of the economic fallout, although several states have adopted social curbs.

A health worker inoculates a man with a dose of the Covaxin COVID-19 vaccine in a school-turned-vaccination centre in New Delhi on Wednesday. Vaccine supply has become an issue as the country tries to ramp up its rollout. (Tauseef Mustafa/AFP/Getty Images)

The central bank asked banks on Wednesday to allow more time for some borrowers to repay, as the infection surge threatens a nascent economic revival.

In the remote state of Mizoram bordering Myanmar, beds in its biggest coronavirus hospital are in such short supply that all victims of other diseases have been asked to leave, said government official Dr. Z R Thiamsanga.

Just three of a total 14 ventilators are still available.

“In my opinion, a complete lockdown is required to control the situation,” he told Reuters from the state capital, Aizawl.

Public health experts believe India will not reach herd immunity any time soon, though hospitalizations and deaths will fall off within six to nine months, the Economic Times newspaper said.

Herd immunity is reached when a sufficiently large share of the population has been vaccinated or infected, generating antibodies, so that an infected person can theoretically infect fewer than one other person, putting a halt to the virus’s spread.


More Canadians hospitalized from substance use since pandemic started, report finds

Hospitalizations from opioids, alcohol and stimulants rose during first seven months of pandemic, compared to the same time in 2019, according to a new report by the Canadian Institute for Health Information (CIHI).

Paramedics and first responders work to save a person suspected of having a drug overdose in Vancouver in 2020. (Ben Nelms/CBC)

More Canadians have ended up in the hospital after using substances like opioids, alcohol and stimulants during the pandemic than they have in years past.

In the first seven months of the COVID-19 pandemic (March to September 2020), as many as 81,000 Canadians required hospital care following harmful substance use. That’s an increase of about 4,000 compared to the previous year over the same period, March to September of 2019.

The numbers are outlined in a report released Thursday by the Canadian Institute for Health Information (CIHI), which collects data from hospitals across the country.

“This is not exactly a trend that we’d like to see from a public health perspective,” said Christina Lawand, a senior researcher with the group.

She says the pandemic has created a perfect storm of factors driving up the numbers.

“There is obviously additional pressures the pandemic is causing on mental health of Canadians that may be causing people to use more substances. And secondly, it might speak to a problem of access to the supports and services they need,” she said.

‘A very lethal combination’

In B.C., nearly 2,000 British Columbians have fatally overdosed since the start of the pandemic. The year 2020 saw a 74 per cent increase in overdose deaths compared to the previous year.

The province’s chief coroner attributed the dramatic uptick to decades of criminalization, an increasingly toxic illicit drug market and a lack of timely access to treatment and recovery services.

For those who have been studying the relationship between the pandemic and substance use, the report’s findings did not come as a surprise.

“It’s been apparent for some time that there is a very strong bidirectional and lethal relationship between substance use and the COVID epidemic,” said Timothy Naimi, the director of the Canadian Institute for Substance Use Research.

Across Canada, hospital visits for alcohol-related health issues were up five per cent in the first seven months of the pandemic. (iStock)

Naimi says as the pandemic has driven up substance use, so too have substances — particularly alcohol — helped drive COVID-19 transmission in group settings.

“Together, it’s been a very lethal combination,” he said.

Alcohol use rises

The CIHI report found that lower-income neighbourhoods had the most dramatic increase in hospital visits. For example, alcohol-related visits rose by 14 per cent in low-income areas across the country.

Overall, hospital visits for alcohol-related health issues were up five per cent nationwide.

The report also notes, however, that emergency department visits for alcohol incidents were down.

Lawand says it’s likely because many bars, pubs and nightclubs across the country had limited services, or were closed, which is where a lot of high-risk alcohol consumption occurs and is often reported to first responders.

“We’re hoping that governments and public health authorities will be able to use these numbers to better target their intervention measures for people in need,” she said.


Doctors make life-and-death decisions as India’s battle against COVID-19 rages on

As India’s health-care system teeters on the verge of collapse during a brutal second wave of the novel coronavirus, a young doctor is among the medical professionals forced to decide who will live and who will die at a New Delhi hospital.

Rohan Aggarwal, a 26-year-old resident doctor, puts on personal protective equipment before treating patients during a 27-hour shift at New Delhi’s Holy Family Hospital. (Danish Siddiqui/Reuters)

Rohan Aggarwal is 26 years old.

He doesn’t even complete his medical training until next year.

And yet, at one of the best hospitals in India, he is the doctor who must decide who will live and who will die when patients come to him gasping for breath, their family members begging for mercy.

As India’s health-care system teeters on the verge of collapse during a brutal second wave of the novel coronavirus, Aggarwal makes those decisions during a 27-hour shift that includes a grim overnight stint in charge of the emergency room at the New Delhi hospital where he works.

(Danish Siddiqui/Reuters)

Patients, relatives and staff at Holy Family Hospital know that there aren’t enough beds, oxygen or ventilators to keep everyone who arrives there alive.

‘We are just humans’

Aggarwal says decisions about who should be saved “should be decided by God.”

“We are not made for that — we are just humans. But at this point in time, we are being made to do this.”

(Danish Siddiqui/Reuters)

India has reported a global record of more than 300,000 daily cases for the last two weeks — and experts say those figures are almost certainly conservative.

In the capital of New Delhi there are more than 5,000 COVID-19 intensive care unit beds. Fewer than 20 of those are free at any one time.

(Danish Siddiqui/Reuters)

Patients rush from hospital to hospital, dying on the street or at home, while oxygen trucks move under armed guard to facilities with perilously low stocks.

Crematoriums work around the clock, throwing up plumes of smoke as more bodies arrive every few minutes.

Not yet vaccinated

Aggarwal says he fears what will happen if he gets infected, too. He knows that his own hospital will be unlikely to find him a bed. 

He is unvaccinated. He was sick in January when shots for medical professionals were being rolled out, and then by February, he began to relax.

“We were all under the misconception the virus had gone.” 

(Danish Siddiqui/Reuters)

Aggarwal, who was raised in New Delhi, has wanted to be a doctor since he was six years old. It’s a job that carries huge prestige in India.

He passed his first set of exams when he was 19 and began training at a medical college attached to a government hospital in the east of the capital.

(Danish Siddiqui/Reuters)

But this wasn’t what he expected when he moved to the missionary-founded Holy Family Hospital, where depictions of Christ are everywhere: looming over the main staircase, watching over patients in the ICU, in the cheap plaster idols once for sale in the shuttered gift shop.

“I am vaccinated by the precious blood of Jesus,” one poster reads. “No virus can touch me.”

(Danish Siddiqui/Reuters)

Sumit Ray, the hospital’s medical superintendent and head of the ICU, says staff are doing everything they can.

“The doctors and nurses are demoralized,” he said. “They know they can do better, but they just don’t have the time.”

No matter where Aggarwal is, he hears the sound of heart-rate monitors.

He hears the staccato bursts of their gentle chimes as he naps fitfully at the hospital. But he also hears them at home in his own bed, making it impossible to forget about the deaths under his care, not from lack of trying, but from a lack of resources.

(Danish Siddiqui/Reuters)


‘Preferred vaccines’ messaging from federal panel sparks concern, criticism from health experts

Canadians should take the first vaccine that becomes available to them even though the federal government’s advisory committee on vaccines may have sown confusion with conflicting messaging about preferred doses, some health experts say.

Canadians should take the first vaccine that becomes available to them even though the federal government’s advisory committee on vaccines has sown confusion with conflicting messaging about preferred doses, some health experts say. (Chris Young/The Canadian Press)

Canadians should take the first vaccine that becomes available to them even though the federal government’s advisory committee on vaccines may have sown confusion with conflicting messaging about preferred doses, some health experts say.

“I really worry about a situation where Canada will be the only country in the world where we’ve managed to create buyer’s remorse about a vaccine we’ve provided free of charge to Canadians to protect them,” Dr. David Naylor,  co-chair of the national COVID-19 Immunity Task Force, told CBC’s Heather Hiscox.

On Monday, the National Advisory Committee on Immunization, an independent body of experts that makes recommendations on the use of newly approved vaccines, said Canadians who are less likely to contract COVID-19 may want to wait until an mRNA shot from Pfizer-BioNTech or Moderna is available because those products don’t carry the same risk of very rare, but serious, blood clots.

NACI’s modified recommendations appeared to contradict what health experts have said for months, that Canadians should take the first vaccine that becomes available and not shop around.

“What we’re saying, and what we’ve been saying all along, is that the mRNA vaccines are the preferred vaccines,” said Dr. Shelley Deeks, the vice-chair of NACI.  “Yet given the epidemiology, the viral vector vaccines are very effective vaccines, but there is a safety signal, a safety risk.”

NACI says vaccine-induced immune thrombotic thrombocytopenia (VITT) occurs at a rate of about one in 100,000 people vaccinated with the AstraZeneca vaccine and has a mortality rate of about 40 per cent, although more research is needed — and that number is subject to change.

WATCH | Dr. David Naylor talks about NACI’s conflicting vaccine messages:

Changing guidance on COVID-19 vaccines in Canada could lead some people to regret getting the shot that was available to them at the time, says Dr. David Naylor, co-chair of the national COVID-19 Immunity Task Force. He says all of the vaccines available in Canada are very effective. 10:18

Based on current data, NACI estimates VITT occurs at a rate of one in 100,000 shots rather than the one in 250,000 previously projected.

‘We modified the recommendations’

“When we first provided recommendations for COVID vaccines in Canada, we did not know about the vaccine safety signal. Now there’s been a vaccine safety signal and we modified the recommendations,” Deeks said.

Dr. Peter Juni, scientific director of the Ontario COVID-19 Science Advisory Table, said he agreed with NACI’s modified recommendations.

“I have big respect for NACI that they did that. And it’s absolutely the right thing to do,” he said.

Prime Minister Justin Trudeau looks on as pharmacist Zaineb Hassan administers the COVID-19 AstraZeneca vaccine to Sophie Grégoire Trudeau in Ottawa on April 23. (Adrian Wyld/The Canadian Press)

Juni said while such incidents of VITT are indeed rare, they are now five or 10 times more likely to occur than originally thought. 

“Does this change the picture? Yes it does,” he said. 

Still, other experts such as Naylor expressed concerns that NACI’s new messaging suggests that the mRNA vaccines are superior in efficacy and that Canadians may regret getting an AstraZeneca vaccine.

“That’s a very problematic position to take,” he said.

Naylor stressed that all the vaccines do extremely well at protecting people from serious complications, hospitalizations and death.

And for those who already received a shot of AstraZeneca, “it is an unsettling message [from NACI] because it suggests you got the second-best vaccine,” he said.

Dr. Susy Hota, medical director for infection prevention and control at University Health Network in Toronto, reaffirmed that Canadians should not vaccine shop and that the bottom line of trying to protect people from the hazards of getting COVID-19 has not changed.

WATCH | NACI says Pfizer and Moderna COVID vaccines are the preferred type:

Dr. Shelley Deeks of NACI discussed with reporters the merits of receiving one type of COVID-19 vaccine over another. 2:32

She said she still believes in most parts of Canada where there’s enough transmission of COVID-19, the risks of acquiring the virus and the associated complications outweighs any of the risks from the vaccines.

‘Worries me a lot’

Hota also said she’s concerned how NACI’s recommendations may fuel vaccine hesitancy.

“That worries me a lot,” she said. “I worry about people who’ve been sitting on the fence, just kind of biding their time or waiting for [a vaccine] to become available to them in their category of age or whatever, now feeling like even though they were confident in their decision before, they’re not so confident anymore.”

Timothy Caulfield, Canada Research Chair in health law and policy at the University of Alberta, said the risks need to be put into context. That includes 17 events of severe blood clotting in the U.S. from the Johnson & Johnson vaccine out of eight million doses. And with the odds of getting VITT around one in 100,000 with AstraZenenca, the risks overall are “incredibly rare,” he said.

He said NACI is creating a hierarchy with respect to vaccines and not focusing enough on the profound benefit that the vaccines have for the general public, for hitting herd immunity and for decreasing community spread.

“I am frustrated by the messaging that has emanated from the committee, especially right now when there’s jurisdictions like Alberta and Ontario that are really struggling,” he said.

“It matters a huge amount, especially now, when we’re going to start to bump up against hesitancy. So if poor messaging results in one or two or three per cent of people not getting the vaccine or even waiting to get the vaccine, that matters.”

Poor messaging

Dr. Zain Chagla, an infectious diseases physician at St. Joseph’s Healthcare Hamilton and an associate professor at McMaster University, said he is receiving a lot of questions from people second guessing their decision to get the AstraZeneca vaccine. 

“It’s like no, no, no, you did the right thing. You got it. You’re reducing your risk of hospitalization or reducing your risk of death,” he said.

Chagla said NACI appears to be giving advice for a situation in which, there’s a bubble, where there’s no COVID-19 or very little circulation around. 

“I don’t disagree with the medical sentiment that there is a risk of this clotting issue,” he said. “That’s advice given in a vacuum of not really looking at the world that it is today.”

Still, Juni said he believes some of his colleagues have not understood the seriousness of the type of thrombosis associated with the non-mRNA vaccines. 

With a new understanding that these events are more frequent, much more serious and potentially fatal, combined with more mRNA vaccines available, “the risk benefit balance starts to change.” he said.

“Even if it’s a rare event, it’s now just something which needs to be openly discussed so that people can make an informed decision.”


Alberta woman in her 50s dies of rare blood clot linked to AstraZeneca vaccine

An Alberta woman in her 50s has died from a rare blood clot condition after receiving the AstraZeneca-Oxford vaccine, says the province’s chief medical health officer.

Alberta’s chief medical officer of health, Dr. Deena Hinshaw, says a woman in her 50s has died of vaccine-induced immune thrombotic thrombocytopenia (VITT). It’s Alberta’s first death linked to the vaccine. (Leonhard Foeger/Reuters)

An Alberta woman in her 50s has died from a rare blood clot condition after receiving the AstraZeneca-Oxford vaccine, says the province’s chief medical officer of health.

In a statement Tuesday, Dr. Deena Hinshaw said the woman died of vaccine-induced immune thrombotic thrombocytopenia (VITT). It’s Alberta’s first death linked to the vaccine.

The woman was not identified to protect the “privacy of the grieving family,” Hinshaw said in the statement.

“While any death is tragic, it is important to remember that the risks of dying or suffering other severe outcomes from COVID-19 remain far greater than the risk following AstraZeneca vaccine.”

Hinshaw said the woman was only the second confirmed case of VIIT in the province. More than 253,000 doses of AstraZeneca or CoviSHIELD that have been administered in Alberta.

Though extremely rare, VITT differs from a typical blood clot because it can cause cerebral venous sinus thrombosis (CVST), where veins that drain blood from the brain are obstructed and can potentially cause fatal bleeding.

The National Advisory Committee on Immunization estimates VITT occurs at a rate of one in 100,000 shots. As of Monday, there were seven reported cases of VITT in Canada and just one other death — a 54-year-old woman from Quebec.

Hinshaw said the risk of COVID-19 is far greater than the risk of VITT.

“Albertans 50 to 59 who are diagnosed with COVID-19 are 350 times more likely to die from that infection than to experience VITT after an AstraZeneca vaccine,” she said in the statement.

“They are also at least 1,500 times more likely to be hospitalized from COVID-19 than experiencing VITT after getting AstraZeneca.”

In a statement, Alberta Health said Alberta’s remaining doses of AstraZeneca are with pharmacies and Alberta Health Services.

“They will continue to be administered,” reads the statement issued Wednesday. “This does not change the risk assessment previously communicated to Albertans.

“However, if Albertans currently booked for AstraZeneca wish to reschedule or wait for another vaccine, they are free to do so.” 

Health Canada has said the AstraZeneca vaccine meets its strict safety standards, and that it continues to monitor adverse outcomes to ensure the benefits of the vaccine outweigh risks.


Concerns over common side effects shouldn’t scare you from getting COVID-19 vaccines, doctor says

CBC News has received messages from audience members who’ve reported a range of reactions to their vaccinations, with some hesitant to return for a second dose. But an infectious disease expert said the end result of protection against COVID-19 is worth the common side effects.

A pharmacist administers a dose of the AstraZeneca-Oxford COVID-19 vaccine in Toronto on April 20. Despite concerns over possible side effects to vaccinations, an infectious diseases physician says possible discomfort is worth the end result of protection against COVID-19. (Evan Mitsui/CBC)

Dr. Sumon Chakrabarti empathizes with other Canadians who have reported common side effects after receiving their COVID-19 vaccines. After his second dose of the Pfizer-BioNTech vaccine, he had a low-grade fever and joint pain.

But Chakrabarti, an infectious diseases physician at Trillium Health Partners in Mississauga, Ont., said the end result of protection against COVID-19 was worth the discomfort.

“I don’t want to trivialize the way people feel. I know it’s unpleasant,” he said. “Just remember that these symptoms go away relatively quickly and in the end, you’re going to be immune to COVID.”

The federal government categorizes its reports of vaccine reactions as serious and non-serious adverse events. The Public Health Agency of Canada recommends that anyone who experiences an adverse reaction reach out to their health-care provider, who will file a report on their behalf.

CBC News has received messages from audience members who have reported a range of reactions to their inoculations, with some hesitant to return for a second dose. While there is new research that suggests a first dose offers strong immune protection, experts and officials still recommend getting both doses of the two-course vaccines being offered.

Here is a look at the types of reactions some people have experienced, what to do if you experience these side effects and at what point people should seek medical attention.

What side effects to COVID-19 vaccines have been reported?

As of April 23, there have been 4,128 reports of serious and non-serious adverse events out of more than 12 million vaccine doses administered, according to the latest statistics from the federal government. The severity of reported reactions ranges from common side effects to rare but serious complications from vaccines.

The most commonly reported side effects include different types of irritation at the site of the vaccine, followed by headaches, hives, nausea, fatigue and fever, according to the data.

“The interesting thing is all of these symptoms are actually coming from your immune system that is activated from the vaccine, and that’s what makes you feel that way,” Chakrabarti said.

“Fortunately, from what we’ve seen, even these ones that can put you in bed for a day, they don’t last generally for more than 24, maximum 36, hours and people get better.”

Other side effects that have been reported, but in lower numbers, include chills, vomiting, diarrhea, muscle and joint pain and anaphylaxis.

Each of the vaccines approved for use in Canada — Pfizer-BioNTechModernaAstraZeneca-Oxford and Janssen (Johnson & Johnson) — have published product monographs that show possible side effects to their respective vaccines.

WATCH | Does one vaccine have more side effects?

Infectious disease specialist Dr. Alex Wong answers questions about COVID-19 vaccines, including whether any of the vaccines has more side effects and if vaccines can be mixed. 3:10

What’s the difference between serious and non-serious side effects?

Chakrabarti said aside from some rare complications, most of the side effects that have been reported are considered non-serious in nature. But even ones that are categorized as serious can range from feeling unwell for about a day to requiring additional medical attention.

“It can vary quite a bit across different people. But again, like I mentioned, these things happen very rarely and for the most part, even in older individuals, they don’t last for more than about a day,” he said.

“If you’re feeling really bad, you can always take an Advil or Tylenol. That will generally help.”

What about reports of clots connected to vaccines?

In rare but serious cases, vaccine-induced immune thrombotic thrombocytopenia (VITT) is a possible complication of the AstraZeneca-Oxford vaccine.

The National Advisory Committee on Immunization (NACI) says this rare type of aggressive blood clotting “is most commonly estimated to be between one per 100,000 and one per 250,000 persons vaccinated with the AstraZeneca COVID-19 vaccine,” with a mortality rate of about 40 per cent, although more research is needed — and that number is subject to change.

“The aggressive nature of these blood clots is really the concern,” said Dr. Menaka Pai, a clinical hematologist at McMaster University and a member of Ontario’s COVID-19 science advisory table.

The scientific community believes VITT is driven by antibodies after receiving an adenovirus vector vaccine (like AstraZeneca or Johnson & Johnson’s), can result in low platelet counts and is often present in unusual locations like the brain or abdomen, Pai said.

The key is to know that it’s happening, said Pai, who is also an associate professor of hematology and thromboembolism. “If these clots aren’t treated, they can be very serious. They can be fatal.”

When should you seek additional medical attention?

Pai said to watch for the following symptoms between four and 28 days after vaccination that could be a sign of VITT and should prompt people to seek medical attention:

  • Persistent and severe headache.
  • Difficulty moving part of your body.
  • Seizures.
  • Problems with your vision, including blurry vision or double vision.
  • Shortness of breath.
  • Severe chest, back, or abdominal pain.
  • Swelling or colour change in an arm or leg.

“I’m not talking about a brief headache. I’m talking about something that doesn’t go away,” she said.

A seventh confirmed Canadian case of VITT connected to the AstraZeneca vaccine, of more than 1.1 million doses administered, was reported in Quebec on Saturday; late last month, 54-year-old Francine Boyer died of a cerebral thrombosis in a Montreal hospital after receiving the AstraZeneca shot on April 9.

WATCH | Dr. Zain Chagla talks about rare vaccine-related blood clot death:

Infectious disease specialist puts AstraZeneca vaccine risks and benefits into context after Quebec woman’s death. 1:15

As for people expressing hesitancy, Pai said it’s critical that everyone evaluates their personal situation — including the severity of COVID-19 in their community and risks of contracting the virus — before making an informed decision on whether to take the first vaccine offered or wait for a specific shot.

“When you do get that vaccine, the odds are that you will be fine. It’s a rare condition after all,” she said.

If you have a question of your own about the pandemic, you can send it to COVID@cbc.ca.

With files from Adam Miller, Cheryl Brown, Alisha Parchment and The Canadian Press


‘Big reset’ called for debt-ridden N.L. with release of ground-shaking economic report

A no-holds-barred report that lays out a five- to six-year plan to reimagine Newfoundland and Labrador in order to avoid a “perilous situation” and prepare for the future was revealed in St. John’s on Thursday.

A no-holds-barred report that lays out a five- to six-year plan to re-imagine Newfoundland and Labrador in order to avoid a “perilous situation” and prepare for the future was revealed in St. John’s on Thursday.

As expected, Moya Greene, chair of the premier’s economic recovery team, delivered a ground-shaking plan — proposing everything from tax increases and deep spending cuts to a streamlining of the public service and a focus on transitioning to a green economy — to reverse a course that threatens to send the province into insolvency.

She described the province’s debt and spending practices as a “fiscal crisis” and said “immediate changes are required.”

“What happens when we can no longer borrow? What if interest rates rise? What if we have to quickly and chaotically shut down services? What is the future like under these circumstances?”

Those sobering questions were posed by Greene as she described the contents of her report to the media.

Post-secondary cuts 

In order to rein in a soaring public debt and end the long pattern of deficit spending, Greene recommended a five per cent reduction in core government spending, and that operating grants for Memorial University and the College of the North Atlantic be slashed by 30 per cent, at a rate of five per cent annually.

She also proposed that operating grants to the province’s four regional health authorities be cut and that the province develop new ways of delivering “top quality health care.” 

In referencing the 180 health-care facilities throughout the province, Greene said the province “must reduce our footprint.”

Some of her sharpest points were directed at the health system, which accounts for 37 per cent of public spending.

She said the province spends 24 per cent more per capita on heath than the Canadian average, yet despite this, Newfoundland and Labrador’s health indicators are “among the worst in Canada.”

But she didn’t stop there.

Abolishing Nalcor

She also recommended the abolishment of Nalcor, the province’s energy corporation and the entity that oversees the controversial Muskrat Falls project.

“The current operations model for Nalcor is expensive and includes duplication in many areas,” she said. “The organization’s size and complexity does not reflect the small size of this province.”

Moya Greene delivers the long-awaited final report of Newfoundland and Labrador’s economic recovery team on Thursday, May 6, 2021. (Government of Newfoundland and Labrador)

And since the province has one of the largest public sectors in the country on a per capita basis, she recommended the province re-examine its relationship with unions.

“The compensation and benefits paid to many public sector employees are higher than those received by people doing the same jobs in the private sector workforce,” she said. 

Education shakeup

But Greene is not recommending spending cuts for the K-12 education system.

In fact, she said the system needs a shakeup so today’s generation can be better prepared for a new economy that is built on technology and low-carbon industries.

She said the province has the most teachers-per-student in the country, “but the structures appear unable to adapt” to the changing needs of students.

“Our children have to be prepared to contribute more that the previous generation,” she said in reference to a birth rate that is the lowest in the country.

On the revenue side, Greene recommended “modest” tax increases, including wealth and second home taxes.

She also called for the creation of a future fund, with perhaps 50 per cent of oil and gas revenues and carbon tax revenues being funnelled into the fund. She said the fund should be used exclusively for transitioning to a green economy, and paying down the province’s staggering debt.

Greene said her plan, named “The Big Reset,” is a gradual and deliberate strategy for a province that has the highest per capita revenues, expenditures, deficit and net debt of any province in Canada.

According to Green’s report, the province also has the oldest population, highest unemployment, highest per capita health-care spending and the poorest health outcomes in the country.

Cultural change needed

She said the current governance culture — one that views budgets as “notional” and deficits as something that “do not matter” — has to end.

She said the belief that the federal government will save the province is also misplaced.

“If the province requires outside assistance, we are fearful the feds will have to put measures in place and enforce changes; not the ones we would make, but would be forced on us by bond rating agencies,” she said.

When the province’s full range of liabilities and obligations are totalled, Greene said the overall debt sits at more than $47 billion, for a province of just over 500,000 residents.

When Nalcor’s costs are factored in, she said the debt servicing charges, what it costs to repay that debt, are now above $1.5 billion annually, which is twice the amount spent on K-12 education.

She said the province risks not being able to pay salaries, operate hospitals and other public services, or even pay pensions to retired public sector workers.

Read more from CBC Newfoundland and Labrador


Facebook’s oversight board upholds Trump suspension, but says company must revisit decision

The Facebook Oversight Board has upheld the decision by the social media giant to suspend former U.S. president Donald Trump’s account, though it also had criticism for the company’s policies. 

Former U.S. president Donald Trump speaks to crowd at at Andrews Air Force Base, Md., on Jan. 20, 2021. Facebook’s oversight board on Wednesday upheld the social media network’s decision to suspend Trump’s account. (Luis M. Alvarez/The Associated Press)

The Facebook Oversight Board has upheld the decision by the social media giant to suspend former U.S. president Donald Trump’s account, though it also had criticism for the company’s policies. 

Since the day after the deadly riot at the U.S. Capitol on Jan. 6, Trump’s social media accounts have been silent — muzzled for being used as online megaphones to try to disrupt the peaceful transfer of power following the presidential election.

The board said in its decision that it agreed with Facebook that two of Trump’s Jan. 6 posts “severely violated” the content standards of both Facebook and Instagram. Those posts, it said, contravened the company’s policy by praising or supporting people engaged in violence.

While upholding the suspension, the board faulted Facebook for the way it made the decision.

The ongoing risk of serious violence justified Facebook’s suspension at the time, but it “was not appropriate for Facebook to impose an ‘indefinite’ suspension,” the board said.

“Facebook’s normal penalties include removing the violating content, imposing a time-bound period of suspension, or permanently disabling the page and account.”

The Board has upheld Facebook’s decision on January 7 to suspend then-President Trump from Facebook and Instagram. Trump’s posts during the Capitol riot severely violated Facebook’s rules and encouraged and legitimized violence. https://t.co/veRvWpeyCi


The board says Facebook has six months to reexamine the “arbitrary penalty” it imposed on Jan. 7 and decide on another penalty that reflects the “gravity of the violation and the prospect of future harm.”

It could decide to institute a permanent censure or restore Trump’s access at that time, board members said in a media briefing. But the new penalty must be “clear, necessary and proportionate” and consistent with Facebook’s rules for severe violations, the written decision says.

The board said if Facebook decides to restore Trump’s accounts, the company must be able to promptly address further violations.

On Tuesday, Trump unveiled a new blog on his personal website, From the Desk of Donald J. Trump. The page is little more than a display of Trump’s recent statements — available elsewhere on the website — that can be easily shared on Facebook and Twitter, the platforms that banished him after the riot.

After Wednesday’s ruling, Trump disparaged Facebook, Twitter and YouTube as a “total disgrace and an embarrassment to our Country” in a statement, which did not specifically address any of the oversight board’s findings.

The social media companies, the 45th president said, “must pay a political price.”

Politicians, free speech experts and activists around the world were watching the decision closely. It has implications not only for Trump but for tech companies, world leaders and people across the political spectrum — many of whom have wildly conflicting views of the proper role for technology companies when it comes to regulating online speech and protecting people from abuse and misinformation.

Reaction from Republican House minority leader:

Facebook is more interested in acting like a Democrat Super PAC than a platform for free speech and open debate.

If they can ban President Trump, all conservative voices could be next.

A House Republican majority will rein in big tech power over our speech.


After years of handling Trump’s inflammatory rhetoric with a light touch, Facebook and Instagram took the drastic step of silencing his accounts in January. In announcing the unprecedented move, Facebook CEO Mark Zuckerberg said the risk of allowing Trump to continue using the platform was too great.

“The shocking events of the last 24 hours clearly demonstrate that President Donald Trump intends to use his remaining time in office to undermine the peaceful and lawful transition of power to his elected successor, Joe Biden,” Zuckerberg wrote on his Facebook page on Jan. 7.

Board co-chair clarifies role

Facebook created the oversight panel in 2018 to rule on thorny content on its platforms following widespread criticism of its difficulty responding swiftly and effectively to misinformation, hate speech and nefarious influence campaigns.

The board’s 20 members were named two years later. They include legal and technology experts from around the world as well human rights activists and journalists.

In a media briefing after Wednesday’s decision was released, co-chair Michael McConnell, a Stanford law professor, said the board’s sole duty was to assess Facebook’s performance with respect to its policies.

“We are not cops ranging over social media and solving the world’s ills,” he said.

Facebook Oversight Board member Helle Thorning-Schmidt, seen in Geneva, Switzerland, on Dec. 1, 2017, said the decision on Wednesday was one of ‘enormous complexity.’ (Denis Balibouse/Reuters)

The board’s decisions so far — all nine of them — have tended to favour free expression over the restriction of content. In its first rulings, the panel overturned four out of five decisions by the social network to take down questionable material. It ordered Facebook to restore posts by users that the company said broke standards on adult nudity, hate speech, or dangerous individuals.

Board co-chair Helle Thorning-Schmidt, former prime minister of Denmark, said the Trump ruling was one of “enormous complexity” and that Facebook can make improvements in its transparency and create more rigorous guidelines to prevent arbitrary decisions.

Facebook will have 30 days to formally respond to the board’s ruling.

Reaction from Democratic chair of House energy and commerce committee:

Every day, Facebook is amplifying and promoting disinformation and misinformation, and the structure and rules governing its oversight board generally seem to ignore this disturbing reality. It’s clear that real accountability will only come with legislative action.


Critics of Facebook, however, worry that the oversight board is a mere distraction from the company’s deeper problems — ones that can’t be addressed in a handful of high-profile cases by a semi-independent body of experts.

“To some degree, Facebook is trying to create an accountability mechanism that I think undermines efforts to have government regulation and legislation,” said Gautam Hans, a technology law and free speech expert and professor at Vanderbilt University in Nashville, Tenn.

“If any other company decided, well, we’re just going to outsource our decision-making to some quasi-independent body, that would be thought of as ridiculous.”

Other platforms also censuring Trump

YouTube’s CEO Susan Wojcicki has said the platform will lift its suspension on Trump’s channel when it determines the risk of real-world violence has decreased.

She said YouTube would determine the risk of violence by looking at signals such as government statements and warnings, increased law enforcement around the country and violent rhetoric on the platform itself.

Twitter has said it does not foresee restoring Trump’s account. The social media company in 2020 began affixing warnings on tweets that contained misinformation and did so with Trump messages on several topics, including on mail-in voting and the result of the 2020 presidential election.

In the wake of protests following the police killing of George Floyd, Twitter pulled down a post last year in which Trump said: “Any difficulty and we will assume control but, when the looting starts, the shooting starts.”

Facebook CEO Mark Zuckerberg, seen testifying remotely to Congress in 2020, has generally expressed more reluctance in regulating speech on the company’s platform than has Twitter. (U.S. Senate Judiciary Committee/Reuters)

Twitter said it believed the post glorified violence against protesters, but Zuckerberg said in a lengthy post that while he had a “visceral negative reaction to this kind of divisive and inflammatory rhetoric,” the post would remain on Facebook pages as it contained a needed warning that the government could be deploying force in response to the protests.

Facebook has long granted greater leeway than it allows ordinary users because, it argued, even their rule-breaking statements were important for citizens to hear. Zuckerberg has said the company was not interested in regulating “political speech,” although the divisive 2020 U.S. election saw it provide context on some posts with respect to rules around voting.

The defenders of Trump having a presence on Facebook have pointed to several world leaders, including some autocrats who have stifled free speech, maintaining a presence on the platform. Facebook has also been criticized for helping accelerate campaigns against oppressed minority groups, including the Rohingya in Myanmar.


When will the Canada-U.S. border reopen?

Day trips to the U.S. are a thing of the past. Canada-U.S. relations experts cautiously estimate the border could reopen in the fall, but it might be more complicated than it seems.

It’s been more than a year since Canada and the U.S. barred people from non-essential travel between the two countries. With vaccinations ramping up in both countries, experts weigh in on when the border could reopen. (Ben Nelms/CBC)

Travel across the Canada-U.S. border could resume by late summer or fall, according to the cautious estimates of some experts, but they say the process will be complicated. 

The border has been closed to non-essential travel like tourism and recreation since March 2020, and the closure agreement between Ottawa and Washington is expected to be renewed on May 21

The agreement makes exceptions, for example, on compassionate grounds like attending a funeral, or to apply for refugee status, and enforcement has been less than absolute.

But the question on most people’s minds, says foreign policy expert Aaron Ettinger, is probably “When can I do my day trips over the border once again?

“And my answer to that is, that it’s going to be a long, long time.” 

Ettinger, an associate professor at Carleton University who specializes in Canadian and U.S. foreign policy, says he believes the borders will remain largely shut for at least a few more months.

It’s been more than a year since Canada and the U.S. barred people from non-essential travel between the two countries. With vaccinations ramping up in both countries, experts weigh in on when the border could reopen. (Rob Gurdebeke/The Canadian Press)

“My gut tells me it’s going to be [closed] at least well into the fall of 2021,” he said, “because things are literally ten times worse now than they were this time last year with infection rates, with ICU admissions.”

He says once both countries sort out the public health concerns, they will have to work through the politics.

“Politically, the United States and Canada would have to get on the same page … and that would take an enormous amount of diplomatic cross-border interaction,” he said. 

Given how complicated their relationship is already, Ettinger says he believes the border situation won’t be resolved quickly. He noted that the U.S. has vaccinated a far greater percentage of its residents than Canada.

“The U.S. may not be all that keen on letting Canadian travellers over the border … But I would imagine that any Canadian government would want the same treatment that Canada affords American travellers.” 

WATCH | A year of border closure:

One year after the Canada-U.S. land border was closed to non-essential travel, we take a look at the toll it’s taken on a young family enduring the separation. 7:52

Complex relationship

Melissa Haussman, a political science professor at Carleton University, says both populations would have to achieve a certain threshold of vaccinations, and be satisfied with each other’s levels before engaging in discussions.

“I think that’s probably a few months off,” she said. 

Further complicating matters is that Canada can’t currently make its own vaccine doses. She said Canada’s dependence on the U.S., among others, for vaccine supply adds a layer of economics to the already-complex political relationship.

“I would say my speculative guess is probably [reopening in] late summer, earliest, and I don’t even know if that’ll happen,” she said.

What about quarantine rules?

The rules requiring travellers to quarantine after crossing the border will also likely change, Ettinger says, as more people are vaccinated and cases decline. 

He noted Prime Minister Justin Trudeau hinted at a possible vaccine passport system last week.

“Though he didn’t commit to anything, it’s a signal that he sees a co-ordinated system in the not-so-distant future,” Ettinger said.

“The U.S. and Canada could develop a North American vaccine passport to replace and simplify the ramshackle quarantine rules currently in place.” 

Intergovernmental Affairs Minister Dominic LeBlanc said last month it was too soon to talk about reopening the border due to the pandemic’s uncertain path in the coming months. 

“For the moment, there’s no active discussion [about] adjusting those measures,” he said at the time.

The Public Health Agency of Canada said in an email that the federal government is “continually evaluating the impacts of border measures.”

“Decisions and considerations about lifting those measures will be based on reliable scientific evidence,” said the agency.

What questions are on your mind as vaccination campaigns pick up across Canada? CBC Ottawa is answering one a day this week. 

Monday: When can we start travelling overseas again?

Tuesday: When can we stop wearing masks?