Canada could approve COVID-19 vaccine in 'week to 10 days,' says Health Canada senior adviser

Guests: Dr. Caroline Quach, Dr, Supriya Sharma, Dr. Scott Halperin,

SOUNDCLIP

Most places are not reaching out to people without symptoms in a virus where we know spread happens when people don't have symptoms.

MATT GALLOWAY: Way back at the beginning of this pandemic, the way out, we were told, was to test, test, test. Deep into the second wave of cases are up across Canada. But where is the spread actually happening. In 30 minutes, why doctors are calling for more of what's known as surveillance testings to get a better picture of where Covid is now and where it could be headed. Also this morning, are you ready for some football? The NFL season continues. Pandemic notwithstanding, the teams are racking up covid counts as well as points on the field. And many believe this does not bode well for the rest of the season, let alone the return of the NHL and the NBA. And if you think you're tired, imagine how those at the front lines of this fight feel.

SOUNDCLIP

I'll be really blunt. I had to get a psychologist during this pandemic to help me deal with the potential for burnout and the stress of going through all of this, because I want to be the best that I can so that I can take care of patients.

MG: Health care workers are fried. For years, the renowned Zen teacher, Roshi Joan Halifax, has been giving them the tools to better cope with stress and burnout. In an hour, she'll share some of those lessons that could be helpful for us all nine months in. But we begin with the vaccines. They're coming. Now what? Good morning. I'm Matt Galloway. This is The Current.

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SOUNDCLIP

The whole house will want to join me in welcoming the fantastic news the MHRA has formally authorised the Pfizer vaccine for Covid-19. The vaccine will begin to be made available across the UK from next week.

MG: Fantastic news indeed. Here in Canada, there is much fanfare around the Pfizer vaccine as well, which was 95 percent effective in late stage clinical trials. Health Canada said yesterday its independent review is ongoing and will be completed soon. What exactly does that mean? We'll speak with Health Canada shortly. But first, there are questions around who should get the vaccine first. Dr. Carolyn Quach is a paediatric infectious disease specialist at St. Augustine University Hospital Centre in Montreal and chair of the National Advisory Committee on Immunisation. Doctor, good morning.

DR. CAROLINE QUASH: Good morning.

MG: When the recommendation comes here in Canada, the decisions will be around who gets this vaccine first. You are chair of the Independent Advisory Committee that made the recommendations to the Public Health Agency of Canada about who should be on that list. Tell us who's on the list at the top.

DR. CAROLINE QUASH: Right. So what we did was to try and prioritise groups to fit the first six million doses that are expected in the first quarter of twenty 2021. And so in there with the committee has said was that given the burden of illness, that the first group to immunise should be long term care facility residents and their staff, and then following up with the elderly age 80 plus going down to 70 when doses are available, health care workers and indigenous communities, many of those living in remote areas. But we realised that, you know, this recommendation then needs to be made applicable and that is then left to the provinces and territories that we'll have to see in terms of logistics, how that really fits into the possibility of rollout.

MG: How have you made those determinations in terms of who would be a priority community for this vaccine?

DR. CAROLINE QUASH: So the way NACI works is really looking first at the various elements. The first is burden of illness, including risk factors, and then looking at the characteristics of the vaccine, understanding that we still have not seen the Fizer Phase three data but have seen the phase one and two. And so we have assumed that the Fizer and Moderna vaccines would be as efficacious as stated in the press release. But we are currently going to review those data in terms of burden of illness. We had asked the University of Alberta to do a systematic review on what seemed to be the most highest risk in terms of complication and death. And so the first group that came out of the gate was elderly, age 70 plus. But given the constraints in the scarcity of vaccines, we decided to tweak it a little bit so that it would go to those with the highest risk, which are long term care facility residents, because not only are they usually older, but they usually have also underlying comorbid conditions, as were the others. We know that, you know, health care workers are needed and that they are the ones most exposed. Again, when we do those recommendations, we look at other elements such as ethics, feasibility, acceptability and equity. And so looking at those elements, we came up with the other groups in the first allocation.

MG: So do the provinces have to follow your recommendations?

DR. CAROLINE QUASH: It's a suggestion rates. And you know that in Canada, health is a provincial jurisdiction. I think that most people will use those four categories in some order. In fact, I suspect that most of those categories will be done somewhat in parallel, because once you have enough doses and you deploy, it's not exactly the same people that are going to vaccinate. And so you can start most of those groups more or less at once. At least the long term care and health care workers. So I don't know that there is going to be like a number one. And number two, it's likely going to be more or less a one priority group. But provinces do not have to follow exactly our recommendation.

MG: How much of a role do logistics play in this? You mentioned that indigenous communities are part of this priority group, but if you think of some of the more remote indigenous communities in this country, it could be difficult to get not just one but two doses of this vaccine to people. So. So what would the logistics do in terms of perhaps reshaping that list?

DR. CAROLINE QUASH: So you're absolutely right. Logistics has a huge role to play and also the vaccine at hand. So as much as Pfizer's vaccine requires to be in a deep freezer at minus 70 to 80, the Moderna in a vaccine is stable for 30 days in the fridge from two to eight degrees. But the main intent of our prioritisation is to flag those groups that we consider at highest risk, but also not to have any wastage of vaccine.

MG: The prime minister just finally was on this programme earlier this week and said that Canada has a flu vaccine campaign every year and so that we know how to do this. This is on a completely different scale. When you think of the challenge that's in front of you and in front of us as a nation, how are we going to go about meeting that challenge, given the fact that you're trying to, get vaccines, perhaps two doses to 37 million people, or as many of those people want the vaccine.

DR. CAROLINE QUASH: So it is a different challenge, but we're not starting completely from scratch. So there is this H1N1 pandemic vaccination campaign that was orchestrated 10 years ago. And every year we do vaccinate people in long term care and health care workers. You're right that one of the challenges that this vaccination programme will require two doses. And so there is a need to make sure that that second dose is not forgotten. The other challenge is that eventually we will have to vaccinate a lot more Canadians and the number of Canadians that gets the influenza vaccine every year or so, including other health professionals that can deliver the vaccine, will be helpful. And I have to say that not having the 38 million doses at once and, you know, starting with six million is also something that allows us to start the machine and and see how it goes. But you're right, it is a huge challenge. To say the opposite would be ludicrous. But I think there's a way of doing things in the provinces and territories with the federal currently working very hard on that plan.

MG: Dr. Quach, it's good to speak with you. Thank you very much.

DR. CAROLINE QUASH: Thank you. Have a good day.

MG: Dr. Caroline Quach is a paediatric infectious disease specialist at St. Augustine University Hospital Centre in Montreal and chair of the National Advisory Committee on Immunisation. Of course, before anyone here gets the covid-19 vaccine, Health Canada has to give it the stamp of approval. Dr. Supriya Sharma is part of that process. She is the chief medical adviser to Health Canada's deputy minister. Dr. Good morning to you. Good morning. When do you expect Health Canada will offer approval to this vaccine?

DR. SUPRIYA SHARMA: Well, that's a really good question. What I can say in terms of the the review is that it is progressing well and we're expecting to make a decision soon. And the reason that we don't have a specific date at this point in time is because we're just working through the final stages of the review and we're still getting information coming in from the company daily that we need to assess that really the bulk of the review has been completed and it's really just the fine tuning and the last information, especially around the manufacturing and the lots that are destined for Canada that we really need to do a full assessment on.

MG: So you'll forgive me for asking what soon means. I mean, that's the question that I think Canadians want to know when you say this and when the health minister says the review will be done soon, what are we talking about here?

DR. SUPRIYA SHARMA: Well, that's why it's just it's a bit difficult to say exactly that day because we're still getting, as we said, information submitted by the company. But things have been progressing really well. And we're expecting within the next week to 10 days to be making a final decision.

MG: The UK's health regulator yesterday, give emergency authorisation. We're expecting similar announcements from the United States and the EU this month. What else do we need to know, and I mean, does the fact that the UK approves this means that Canada will definitely approve it?

DR. SUPRIYA SHARMA: It doesn't mean that we really you know, it's really important that people know that we're doing an independent review, but at the same time, all of the regulators around the world are basically looking at the same data packages. And we've been very open to say that the review is going well and that we're in the final stages. Now for the U.K., what they did was that they did a temporary authorisation for a very limited quantity. So one lot of the vaccine and we are looking at it a bit more broadly, we're looking at the vaccine as a whole for an authorisation and for those lots that are specifically expected to come to Canada. We're still waiting for some of that final information. So there's a lot of collaboration that's going on. We're sharing a lot of information. I actually just left a call with 20 international regulators talking just about this before I came on the call. But it's important to know that we really need to finish that review and make sure that it is complete and that the vaccine does meet the standards for safety and efficacy and quality before we give it any sort of authorisation.

MG: Important because you want the vaccine to be safe, but also you want the vaccine to be seen to be safe?

DR. SUPRIYA SHARMA: Well, I think it's both of us. I think when we think about most Canadians don't necessarily think about the regulatory process. So any vaccine that they would take, any medication, whether it's a blood pressure medication or an antibiotic, needs to have Health Canada approval. So this is what we do day in and day out. And it's important to know and for Canadians to know that there will not be any vaccination of any vaccine not justifies a vaccine, that any vaccine until it's met, those standards and those standards are the same for any vaccine. So we've made special provisions to try to do that overall in a more efficient way to do it quicker. But we're still holding these vaccines to the same standards as all other vaccines in Canada.

MG: There is no small matter of politics in this as well. Just in terms of people wanting to get the vaccine out. Opposition parties are criticising the government for being slow, suggesting that other countries would perhaps be opening up before we are able to do that. How do you ensure that there isn't political interference in this process?

DR. SUPRIYA SHARMA: Well, we feel that, I mean, we're all Canadians as well. We know that the vaccine will be a really important part of our fight against Covid and getting us back to somewhere close to normal. So we know that's happening. But this is what our scientists and reviewers do every day. And those decisions are based only on science and evidence. And so, you know, we have there's a group of seven to 10 reviewers that are working on all aspects of the submission. There's hundreds of thousands of pages. And their only criteria is really making sure that the science is sound and that the vaccine is safe. It does what it's supposed to and it's made to the highest quality. So definitely we understand that this is anticipated. We feel that. But we will not make any decision until the science says that it meets those criteria.

MG: Given that, though, are there ways to expedite the process that might not be normal but still would be safe and clearly needed at a time of real urgency?

DR. SUPRIYA SHARMA: Absolutely. And we've already done some of that. So what we did is that there was something called an interim order that was put in place specifically for Covid-19 vaccines and medications. And that gave us some flexibilities around the review process. So, for example, one of the things normally what we would do is that we would ask companies to submit all the entire data package. So everything that they have on the vaccine, including all of the clinical trial results of manufacturing information, and they would only give that to us when all of that was complete on these vaccines. What we're doing is something called a rolling submission to the companies can provide some information we can start to review. And then as new data becomes available, we can look at that as well. So that's one way. We've also have dedicated teams. We pulled our most senior and experienced reviewers and we focussed them specifically on Covid-19 vaccines. And there's a number of other things that we can do to make that a more efficient process that we can in no way compromising on the standards that we need to uphold.

MG: How many Covid-19 vaccines are currently under review by Health Canada?

DR. SUPRIYA SHARMA: So currently we have four under review. We have the Pfizer vaccine, the Moderna vaccine, the AstraZeneca vaccine. And then most recently, we received the submission from Johnson, from Johnson and Johnson for their vaccine.

MG: AstraZeneca said that after releasing preliminary data, there was a dosing error in its trial. So how would an error like that be discovered and how does that influence the approval process?

DR. SUPRIYA SHARMA: Well, it really comes down to what did the data ultimately say. It is different. I mean, the scientific process is, you know, you set up your your clinical trials, you make your hypothesis, you say what you think will happen and then you carry out those results. It's a bit like if you have a dartboard up on the wall and then you try to throw darts at it, you don't throw darts into the wall and then put the target, drug target, around then. So in this case, there was an issue that happened. It was different than what the plan was. Now, the question is, what is the data showing from those studies and what can we draw from that? And do we need to do additional assessment or even additional studies? So we still haven't received all of that information. But when we do get that, will make sure that we're doing obviously a rigorous assessment of that to determine whether or not that data is sufficient or if we need to get more information.

MG: And just before I let you go, who makes the final call at Health Canada that a vaccine is safe for use?

DR. SUPRIYA SHARMA: So within Health Canada, there's a group called the Health Products and Food Branch, and that's the group that really is involved in all the regulation of medications and vaccines and medical devices. Within that, there's a group called the Biologics and Radiopharmaceutical Drugs Directorate and the team that's reviewing vaccines in that group. And there's a director general of that group and she makes the final call sheet and it's her signature on the final authorisation.

MG: And you're suggesting that that could come within the next week to 10 days?

DR. SUPRIYA SHARMA: You know, it really depends on how the review goes. It's I always hesitate to say timing because it depends on the information that we get. And we're expecting some information today and some information tomorrow as well. And then, of course, we'll be working through the weekend and as we always do, to take a look at it. So, you know, I think we're seeing around mid-December at the latest, but it really depends on the data. And as soon as we have information, we have that authorisation. We will share not only the fact that we've made a decision, but we will summarise the data that we've looked at, put all of that online, and eventually we'll put even all the actual raw data that we've looked at available for people to look at. So it's important for us to make sure that we're open and transparent. We know that this these authorisations are eagerly anticipated, that it's important that we take the time to do it and get it right.

MG: Doctor, it's great to talk to you about this. I appreciate it. Thank you.

DR. SUPRIYA SHARMA: Well, thank you for your time.

MG: Doctor Supriya Sharma is the chief medical advisor to Health Canada's deputy minister. Once that vaccine gets federal approval, it's up to provinces to. Make sure that vaccinations happen and happen smoothly. Dr. Scott Halperin is director of the Canadian Centre for Vaccinology and Halifax, professor of Paediatrics, Microbiology and immunology immunology at Dalhousie University. Doctor, good morning to you.

DR. SCOTT HALPERIN: Good morning. How are you?

MG: Well, let's talk about the rollout's. Do you think the Canadians should feel confident that provinces can handle the distribution of covid-19 in the coming months, given what we've seen in terms of fighting this pandemic?

DR. SCOTT HALPERIN: Yes, I think the provinces are the experts in rolling out vaccines and implementing them. They've done it before and perhaps not at this scale, but they've had a lot of practise and have been working on getting their plans together in order to roll things out smoothly. There obviously will be some hiccups, but that's with any programme. But I think it will be a smooth rollout.

MG: Dr. Quach Talked earlier about the recommendations when it comes to who is at the front of the line. Those over 80 long term care residents and workers get vaccinated first. Is your sense the provinces will follow those recommendations?

DR. SCOTT HALPERIN: Yes. I mean, I think those recommendations basically depict what we're all seeing in terms of the highest risk Canadians. So I don't think any of the provinces will vary from that because it's pretty much common sense based on what we're seeing in the pandemic so far once we get beyond those very high risk categories.

MG: Do you expect there to be contentious discussions around who's next, who, for example, constitutes an essential worker?

DR. SCOTT HALPERIN: There they're always contentious issues, but I think it will be based on as much data as we can generate in terms of who is at risk, who already there has been transmission to, both here and elsewhere in terms of workers. And it'll be as much as possible based on those data. We do have now six months, eight months of seeing this pandemic and who is getting infected, who is at highest risk. And we're going to make sure we target those individuals to provide them with vaccine in order to, you know, stop that type of transmission.

MG: And who would you expect those individuals to be? What categories of employment do you think would be part of that next wave?

DR. SCOTT HALPERIN: I think anywhere where because of, you know, essential workers, you know, I think that would be people like emergency medical services. So all health care, broadly spoken police and fire, essential services that you don't want a lot of people off sick. And then in terms of occupations like the occupations where because of the nature of the occupation, there is very close contact without the ability to wear a face mask and without the ability to socially distance. At the beginning of the pandemic, we saw some of those large outbreaks in certain types of facilities. Those are the areas that I think will be targeted because of that crowding.

MG: What about people trying to game the system? We saw this even when it came to testing, trying to get ahead of the line, jumping the queue. Do you expect that that is going to play itself out, given the fact that there are scarce resources and everybody wants this vaccine? Well, a lot of people don't want it.

DR. SCOTT HALPERIN: Yes, I think that's a very important point because I think we have a mixture of people who are very anxious to get the vaccine. So those are early adopters. And then we also have people that are hesitant and want to hold off and wait until they see how it goes with other people before they get it. So I think that there's going to be a mix of those two. Canadians seem to be pretty good about waiting in line for their turn and I think there won't be a lot of problems with that. I think there will be decisions that have to be made. And a lot of it's going to be providing information why someone is, you know, higher on the queue than someone else and explaining that so that people understand the reason behind the decisions, just like with all the other public health measures, people comply with them much better if they really understand the rationale for them and the science behind it.

MG: And part of that's going to be explaining that as well, as you say.

DR. SCOTT HALPERIN: Absolutely. The public health messaging is going to be critical to make sure that people feel that they're part of the decision making process and understand what's going on.

MG: Appreciate you walking us through how this process may unfold. Doctor, thank you.

DR. SCOTT HALPERIN: Oh, my pleasure. Good talking to you.

MG: Dr. Scott Hoffman is the director of the Canadian Centre for Vaccinology in Halifax, professor as well of Paediatrics, Immunology and microbiology at Dalhousie University. Your thoughts on this would be welcome in terms of how this is going to roll out. You can reach us through email thecurrent@cbc.a. Coming up after your CBC News, we're going to talk about where the cases actually are and testing that could be done to help us get a better sense of where covid is spreading in this country. A new strategy on that coming up. I'm Matt Galloway. You're listening to The Current. We're back in six minutes.

We look at whether pop-up surveillance testing can curb COVID-19

Guests: Dr. Lisa Barrett, Dr. Lynora Saxinger, Colin Furness

MG: Good morning. I'm Matt Galloway and you're listening to The Current.

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MG: Still to come, burnout on the front lines of the pandemic and what one woman is doing to help. That's coming up in half an hour. But first, the value of asymptomatic testing to slow the spread of Covid-19.

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MG: As we know, reams of people with Covid-19 symptoms are showing up at testing centres and in hospitals across this country, you've probably seen the pictures of line-ups wrapping around buildings or winding through city blocks. Maybe you've been in one of those lines. Some infectious disease experts say it's not enough to only let those showing signs of Covid-19 come to them. In Nova Scotia this past week and a half, Dr. Lisa Barrett has been leading a new round of so-called asymptomatic testing, asking people without any symptoms or known exposure to Covid-19 to come and get tested at pop up covid testing sites. Thus far, they've set up in downtown Halifax at a bar and near university campuses. Dr. Lisa Barrett is an infectious disease specialist at Dalhousie University in Halifax and joins us now. Doctor, good morning.

DR. LISA BARRETT: Good morning.

MG: Tell me about this. Why did you decide to start testing asymptomatic people in this way?

DR. LISA BARRETT: Mm hmm. So along with Dr. Todd Hatchet and the public health leadership in Nova Scotia, we recognised a couple of things. Number one, we had groups of people who were in social situations who probably didn't have symptoms, who were probably infected, and we weren't going to probably convince those folks to go to a regular testing centre and get tested. And number two, we also saw that it was becoming more difficult to convince people to disclose their contacts, potentially as testing gets more stigmatised, stigmatised and baumol. And so the goal of this particular initiative was to go out to where people are, number one, and use this test as a tool of engagement in the right place for people who may well be asymptomatic and spreading the virus at point of person using a rapid test with volunteers that didn't stress the health care system for several purposes. And they've been done, as you mentioned, in downtown universities, as well as community libraries and community centres.

MG: Tell me about going to the bar in downtown Halifax. How did that go? I mean, what did people say when you go to a bar and you say, hi, would you like to be tested for Covid-19?

DR. LISA BARRETT: Not your typical Saturday night, I will say. It's a very different experience than the last time I socially went to a bar. So this was a bar that was actually closed, but on the street that had a high density of social settings, including bars and other hospitality related industries. And so we used a bar space that was well known, easy to get to, and within metres of other places where people were going for their night out, we brought a group of volunteers, as well as some medical professionals for oversight and set up a sign outside that said Pretty Rapid Covid testing. Come get your Covid test. And in that particular situation, it was some of the bar staff as well as some patrons on the street that came by for their test. And we were also training people who weren't medical professionals to do both the swab, learn to use personal protective equipment and to do the test right on site.

MG: And you say these are rapid tests. How quickly would the people get the results?

DR. LISA BARRETT: So at this particular birth site that we first started and I get to say bar with a good East Coast accent just to make sure we keep the pirate version going here, we had people getting the results within about 15 minutes.

MG: Wow.

DR. LISA BARRETT: There we people waited in another area that was well ventilated. There was tons of room for social distancing and it was a relatively low volume at a time, about five to seven people. We had a space for them to wait out of the cold and then they got their results. We only took their cell phone numbers. So again, this was a very low threshold model. What I mean by that is we're not asking for 15 pieces of ideas like we do at the hospital, especially for people who may not have a lot of ID and then they could just go on their way immediately after we identified them by text. So we just text them an answer. We go out, confirm that they've received it, and off they went.

MG: And what did you find?

DR. LISA BARRETT: We did find a person. So at that first night in the bar, we had 147 people who were completely asymptomatic. And it's also important to note that these folks also did not have known contact or known exposure sites so very much really and truly people who would never otherwise in our current system be getting tested. One person who was positive lived with five other people who have, you know, jobs that put them into the public domain and are fairly essential. And so that person before they were able to spread to the other people in their actual household, we found them. And also important to note that we do a gold standard confirmatory test before we do the full public health investigation.

MG: And again, this is not information that perhaps you would have been able to ascertain that they may not have known. If they're asymptomatic, they may not have known that they have covered without a test like this.

DR. LISA BARRETT: Absolutely. Very grateful people. It's amazing. You know, I didn't anticipate this part. We wanted to use this as much for finding folks when they were asymptomatic and allowing them to self isolate, but also this concept of community engagement that at our point in the pandemic in this province with relatively low case numbers to really shut things down, this is a great way for them to engage and be a part of the Covid effort. People are incredibly grateful to get access to knowing they're positive. Again, a negative test we reinforce means nothing to them. They could be positive tomorrow. They could, you know, be positive at any point. So people are exceptionally gratefu. And so with this person, as well as every other person we've identified subsequently at different sites.

MG: Let me bring some other voices into this conversation, because this discussion over whether to do more asymptomatic or what some people call surveillance testing is playing out across the country. Colin Furness is an infection control epidemiologist at the University of Toronto. Dr. Lynora Saxinger is an infectious diseases specialist at the University of Alberta. Good morning to you both.

DR. LYNORA SAXINGER: Good morning.

COLIN FURNESS: Good morning.

MG: Dr. Saxinger, it's interesting because Dr. Barrett there was saying that in some ways this works best. If you have a population that has low numbers of case counts. Your province is kind of the opposite of that. And I just wondered just before we get into this, we're learning through reporting by our CBC colleagues about what's going on in Alberta and the fact that the province has been planning on these field hospitals, perhaps using the military to help. What do you make of what you're hearing this morning in that reporting?

DR. LYNORA SAXINGER: Well, I am I would say, having watched our case counts and our hospitalisation counts in our ICU counts rising over the last while and having been concerned about, you know, the I guess whether the public health measures that have been applied would be sufficient to slow that down. You know, many people were were concerned earlier in the fall and now we're at a point of maybe having a field hospital. I think that it's somewhat predictable at this point that we would have to really look at where we can get capacity. And I think there's still a lot of questions about whether they would be like how Full-Service, a site that is versus a fairly late care, acute monitoring and isolation type site. So I'm not involved in the planning of that. And I don't know how close it would be to fruition. But in a way, it's it's kind of prudent to look at all the options that might be available, because I can tell you that our hospitals are pretty full right now. So it's not reached a breaking point, but certainly something that is increasing.

MG: Let's go to the issue of trying to figure out where cases are spreading and cases in particular that may not have symptoms. What do you make of what Dr. Barrett has been doing in Nova Scotia? Dr. Saxinger.

DR. LYNORA SAXINGER: Well, I think rapid testing has a lot of promise, if done well and in the right places. And I mean, they've had a defined target population and they're doing it in the setting of low, low prevalence, like there's not a lot of disease right now. And they're trying to find, I guess, people who would be likely to spread the disease unwittingly. And so that's important in our setting right now. Looking at similar testing, like some of the tests performed much better than others. And they should be validated by your local lab people. And so we have to validate the tests here. One is one of the very, very rapid ones that looks like a pregnancy card test in which you can you can't actually really trust a negative, but you can trust a positive. So that can be used to detect people who might be infected and likely to spread. And that may be something that we could do, for example, in like a northern work camp where there have been occasional outbreaks. And, you know, just basically look for that needle in the haystack person who does not have symptoms or has symptoms they're not paying attention to and is capable of transmitting infection. And that could make a big difference. But you do have to have your goals in mind with each one of the other tests. Actually, I think which is the one that Dr. Barrett is using, actually kind of looks like a large blender base. And it's it's it actually performs very much like the lab based PCR, at least when it was tested here. And it takes a little while longer. But you could use that, for example, in smaller health centre and you wouldn't necessarily have to do confirmatory testing in that set setting if you validated the test. And so that would actually be good outreach for smaller communities that, you know, usually have to send all their testing in. And it can be a really slow turnaround time.

MG: Colin Furness. People have referred to this sort of surveillance testing as like a canary in the coal mine. What role do you think it could play in helping to control Covid transmission or at least getting a better sense as to where that transmission is happening?

COLIN FURNESS: Well, I think you put your finger on it right there is right now, especially in Ontario, we've been using a flashlight without a bulb or batteries in a dark room trying to find Covid. And that's pretty tough. We could and should be doing this kind of asymptomatic testing and actually, I would argue, even more targeted sentinel testing. We know very well how Covid behaves now. We know where covid spreads. And the most salient example to me is waita servers, bartenders, they have an incredibly dangerous job because they are mindfully working with people without masks and they're doing it for an entire work shift. We don't have any other workers who do that. That's where Covid spreads. We should be testing waiters. I mean, not forcefully testing waiters, but we should be doing that. That would help us find cases. It would help us find cases before this transmission. And it would also help the public wrap their heads around the idea that restaurants and bars are dangerous places.

MG: What about what about in schools? I mean, there's a lot of attention that's being paid to what was happening in Toronto in Thorneycroft Park Public School in Toronto. There's a pilot project that was happening there. Tell me a bit more about that, Colin.

COLIN FURNESS: That was fantastic to be done. It's a couple of months late. It had been promised since August. The idea that we know that Covid is going to go in schools because we know that there's nobody in the community and schools are a great place to be able to have a population there to be able to test them and and then be able to then to go back into the community and look at the families who are involved, do isolation and prevent transmission. So they found 19 asymptomatic cases, which is why I think it was one staff person, 18 kids from 14 different classes. So that tells you that there's probably not a lot of transmission going on in school. But this is a great way to be able to find out what's going on in the community. And this should be going on in all schools.

MG: It's interesting because, I mean, that was just a third of the school. Would you assume that you would find asymptomatic cases and the other two thirds of the students?

COLIN FURNESS: Quite possibly. Quite quite possibly that happens to be a very high risk neighbourhood where Covid prevalence is higher and that's exactly the right place to start. I'd like to see it in other schools, too.

MG: I guess the question is important because it got a lot of attention just in terms of the numbers. They're focussing on one school and only a third of the school. We've been hearing that schools are perhaps not the centres of transmission that maybe we expected them to be. And I just wonder whether what came out of that testing would, you know, challenge that at all.

COLIN FURNESS: The evidence has been mixed around what risk kids, especially kids under 10, play. On one hand, they seem to be much less infectious than we would have expected based on other respiratory viruses. On the other hand, we may not have been testing kids as much as we should have because they've been asymptomatic. Covid trump card being asymptomatic has really thrown the conventional wisdom on its head. And that's been very difficult, I think, for public health and for the medical community to adapt to.

MG: Dr. Barrett, given what you've learnt in Halifax, what do you make of the idea of asymptomatic testing in schools? What's the best way to go through that?

DR. LISA BARRETT: Yes, so I do think it does depend on where you are and coming back to the test characteristics, we actually are using the pregnancy test looking one, not the smoothy Bendery type sized one, mainly because we can get results and we can train again volunteers to do this. I think there's a very important point that Dr. Furness just made and that we have to start thinking about this virus differently. We've got a lot of people with Covid fatigue. So this is not just about numbers and finding canaries in coal mines, it's about community engagement. And when you take rapid tests that give people results, to an area where they can or don't perceive it to be high risk, but should you're actually offering the ability to engage community in a different way of thinking about this virus. And, you know, it's not only public health that's had trouble with this asymptomatic spread concept, it's the public. We haven't done a great job of messaging that in a very sustainable way. So I think to your point, how should asymptomatic testing be used in schools? I don't think it's a bad idea in terms of the community engagement to use rapid tests. You're going to miss some positives, but these are people you weren't going to test at all before anyway. And so to me, that's an acceptable risk as long as it's messaged well. People worry about this concept of risk compensation and doing riskier things because you get a negative test. We've certainly not witnessed that in the conversations we've had with other people. They very clearly understand that they could still get Covid and, you know, even the next day they could be positive. So I do think that schools are a good place to do it. The challenges the test itself does still require a nasal pharyngeal swab. One of them can have nose and throat swab done. But really getting people to do that seriously is a bit of a challenge and hopefully will be able to come up with something that's a little more nostril friendly over the next few months. But the concept here of the concept of going forward with volunteers, not regulated health professionals, embedding in community the idea of Covid living that includes some testing for a while, I think has to become part of what we do.

MG: Dr. Saxinger, where are we at when it comes to rapid tests? The prime minister on this programme earlier this week said that the federal government had sent out, he said, five million rapid tests. There were some jurisdictions that are using them, including in Alberta. There are some jurisdictions that aren't using them. Where are we at when it comes to the deployment of rapid tests?

DR. LYNORA SAXINGER: Well, I think this conversation kind of tells us that we're at varying stages of adoption for different reasons. And, you know, in places with high, high rates of Covid, it is very important to validate these tests. And it is very important not to just to buy any test that's available as some companies are, because some of them are literally no better than flipping a coin. So you have to know what you're dealing with and you have to test it in your setting. And once you have that in hand, you have to just be, you know, very mindful about how you're going to use it and what you're going to use it for. And the biggest risk, as has been mentioned, is if people will trust a negative on a rapid test. And so they get their rapid test on their way to visit grandma or something. Well, that's the wrong way to do this. But if you are a rapid testing to identify people who might infect others in a close quarters, unavoidable close quarters in a workplace, for example, that's a good way to use this test. Or, as some people have advocated and has not really been studied in the real world yet, frequent, low sensitivity testing, so frequent, easy home rapid testing could be something that you could deploy within the community. We are not at that point with these tests, but there might be some that become useful for that. And again, that would have to just be set up properly. So they're not going to, we're not going to able to test our way out of this, just like we can't just mask our way out of this. We have to do all of the things. And I think that we really do have to ramp up our access to testing and that these tests offer a way to do that. But we have to make sure they're the right test in the right place.

MG: The U.S. has approved at home covid tests, but they aren't available in Canada. Do we need them here? Do you think?

DR. LYNORA SAXINGER: I think that, you know, there's some attraction to that idea because we know if we do a less good test more frequently, we end up finding things a little more accurately. But they haven't been subject to any kind of wide scale evaluation and so I think it's very promising and I'm interested by it. But I really do think people have to go through the steps of documenting that for sure. This is how well the test itself performed and this whole programme, this is how this programme performs before you start implementing it widely. But those things will be done. And it might be the case that at some point we will have like a saliva based test that you can do in your own home as kind of like a temperature check and that that might offer value on a population basis. But there's a lot of steps between now and then.

MG: And again, as you say, I mean, people will react in different ways to a positive test versus a negative test in terms of how they behave. And that's something to be cautious of.

DR. LYNORA SAXINGER: Exactly, so, I mean, it's not that people wouldn't be capable of doing this the right way, but people love to trust tests. And so it is something that we have to message very, very carefully.

MG: Colin Furness, you mentioned, the idea of testing bartenders, who else, if you're doing surveillance testing or what you called sentinel testing, who else do you think we should be testing if we do need to test more people? And again, I that this isn't going to be the way that we get out of this, but it's going to be a way that we understand what we're in. Who else should we be testing?

COLIN FURNESS: It depends, again, where you are. But from what we have learnt so far and we've done in Ontario a really poor job of actually being able to compile that list because we do so little, so little research, a little measurement. But I would add teachers to the list. I would add I would add store clerks to the list. Those are factory workers in certain conditions. Depends on on what that looks like. I would be absolutely testing personal support workers in long term care homes. That's been done sporadically. I would do that routinely. So that would be amongst my top list. We could look at other populations like truck drivers who cross the border. They probably aren't a huge risk factor because that's solitary work. But that kind of measurement would let us know. So I would favour trying it broadly, at least to help discover where Covid is lurking in places where maybe we haven't thought.

MG: And once we know if we know the people who are working in grocery stores or who are teachers or who are working in bars, if we know information that comes out of the testing, what do we do then with that information?

COLIN FURNESS: Well, as a thought experiment, let's imagine that we had a test result for every single teacher in Ontario right now, 170,000 teachers, we could start to look at. What are the school characteristics that predict teachers being effective. Is it schools where the windows don't open? Is it schools that don't have force there? Is it schools where the principal is not leaning hard on mass compliance? So we'd start to be able to find some of those factors and then we could adjust our interventions and we could we could actually respond in real time to that. So that's what I'd like to be able to do, is to learn more about our foe at the same time that we're finding it and dealing with it.

MG: Dr. Barrett, what are you hoping to do with the information that you learn from your testing pop ups in Nova Scotia?

DR. LISA BARRETT: Mm hmm. So right now, we're just going through the first literally week and a half and the plan would be to move with virus around the province in a quasi targeted way, as you mentioned, in higher risk groups to go around those folks. What we do next in terms of the model is is as interesting, I think, as it is the what population do you test. And that's, again, as I mentioned, part of the community basis of this; putting testing out there, seeing who shows up and learning as we go and modifying. You know, if we just tested three days in a small town that had a small signal of a case and we went out there and tested a bunch of people, but that petered out pretty quickly. We got through most of the people that we wanted to engage. And so I think as we go forward, we can't wait. Unfortunately, it would be lovely to wait until we completely validate programmes, completely validate tests. But while we can't test our way out of this, we can action our way out of this and build community. And I think the provinces have seen that when we don't engage community in a real way, for example, with a testing programme, they can volunteer to do things, don't go well. So we hope to keep community engaged, build that part, modify the programme. But we can't wait till we've already tested programmes and already tested everything to start doing this, we have to do it now.

MG: Dr. Saxinger,, in a province where things don't seem to be going well, calling for us compared this to being, you know, in the dark with a flashlight, without a bulb. I know you have concerns around this, but is there the possibility that this could get the bulb into the flashlight, that this could help give some guidance in a situation that we find ourselves in right now?

DR. LYNORA SAXINGER: I think there's two things. One is I think that, you know, the programme that's going on right now is a test of this approach, and I look forward to its results. So, yes, we can learn some things that have been done elsewhere and we wouldn't necessarily have to, you know, wait to engage. Our biggest problem right now is down. But in terms of having people who actually can do this work, pretty much everyone who's working in fields of public health and diagnostics are pretty much 110 percent flat out already. And so there does become a bit of a capacity issue in terms of bringing new things online. And that has been a problem in a number of places because we have the same number of people doing all of the things. And, you know, it's quite a challenging thing. So we are starting some some rapid test pilots already. I haven't seen results from them. I'm not directly involved, but they're targeting high risk areas. There is actually going to be some rapid test actually augmenting our current testing because we're having problems with turnaround times being fast enough. They're, you know, pretty good compared to some places, but not good enough to identify things more quickly. And so we're trying to take the supplies of rapid tests we have right now and put them in the places that are most urgent right now. And once things simmer down here, I very much would like to see, you know, more widespread use of rapid tests and actually more developments and rapid tests that make them, you know, more easy and more reliable. I do have a bit of caution about making sure that the tests that are being used because we have seen people using nonrelated tests are are the correct ones. So I think that's another thing to just be aware of, is that people think that they buy them, but they really should be going with the approved ones and they might really be able to add a lot here and elsewhere.

MG: To use your phrase, you are all people who are doing all of the things. I appreciate you stealing some time from doing those things to talk to us. Thank you very much, all of you. Dr. Lisa Barrett, infectious diseases specialist at Dalhousie University in Halifax, Colin Furness epidemiologist at the University of Toronto, and Dr. Lynora Saxinger is an infectious diseases specialist at the University of Alberta. Your regional update is next. And then.

SOUNDCLIP

You feel they are looking to you. I don't really have definitive answers to just stressful. And then you come home and I just feel really dirty, like I don't want my son touching me until I clean up. And even then, it's like, well, don't kiss me. My husband is just like, I don't want to get you sick.

How those on the front lines could better cope with burnout. We'll get some suggestions coming up in 90 seconds. This is The Current.

As health-care workers face 'soul-destroying' pandemic, Zen teacher offers tips for coping

Guests: Roshi Joan Halifax, Kurt Streeter

MG: Hi, I'm Matt Galloway, you're listening to The Current.

SOUNDCLIP

You know, people are- people are tired, you know, we're not quite as fresh as we were back in March. You know, we need to check in with each other, physicians, nurses, respiratory therapist, all health care workers, because we know that when you get fatigued, that's when mistakes can happen. And so we certainly don't want that to be happening. And so, you know, everybody is tired. We're looking at this as we're not even at the peak yet. What is it going to look like for the next few months? And how do we make sure that collectively we've got the best people on the job and the people that are not burning out?

MG: That is Dr. Nedra Bakhshi. She's an internal medicine physician in Edmonton and one of many health care workers raising the alarm about burnout and exhaustion. There's the work itself, the growing number of hospitalisations, the daily risk of infection, the difficult emotional work of giving bad news to patients and their families. And unlike in March and April, neighbourhoods are not cheering health care workers on with those pots and pans at seven p.m.. My next guest has spent decades teaching health care workers practical ways to sustain themselves in the face of pain and suffering work that has become all the more important in this difficult year. Roshi Joan Halifax is the Zen teacher, medical anthropologist and founder of the Upaya Zen Centre in Santa Fe, New Mexico, Roshi Joan. Good morning.

ROSHI JOAN: Good morning, Matt. Very good to be with you this morning. I'm grateful for the work that you're doing. I think it's very important right now that the support of health care providers in the midst of this pandemic is taken into deep consideration by the wider public.

MG: When you listen to Dr. Bakhshi speak about burnout, what do you hear in in her voice?

ROSHI JOAN: You know, what I hear is in a way, moral injury, that is to say, the experience of not having the resources available to support both health care providers and families and people who have the diagnosis of Covid and having to face situations that are really morally compromising. So I think we're in a real crisis in health care culture right now in relation to what is happening in the pandemic. And what the pandemic has revealed is profound cracks in the culture of medicine. And I feel that this clinician reflects that fragmentation.

MG: When you see those cracks, what are you most concerned about?

ROSHI JOAN: You know, I'm concerned about actually a number of things. You know, one of my concerns is directed toward the well-being of clinicians. How do we train clinicians in this time? How do we provide the internal resources and also the external resources to make it possible to actually provide good medical care? And how do we actually create the conditions where clinicians can feel morally elevated and existentially elevated by entering into this great challenge of the pandemic and being able to meet that challenge in a resourced way? I also feel great concern for the well-being of patients and their families. We know clearly that burnout compromises a clinicians ability to deliver good health care. And also, it shows a deficit in both the institutions of medicine and also in medical education, that it's not just the delivery of stem of science education, but it also has to do with values, ethos and views. You know, what is it to actually be a clinician, a health care provider, which is not just to cure, but also to care?

MG: You've been doing a series for frontline health care workers over the course of this pandemic called Being with Suffering. What does that mean in the context of what you've been talking about?

ROSHI JOAN: Well, it means exactly this, Matt. What we realised as the pandemic was ramping up was that health care providers were suffering from many challenges, including challenges related to moral suffering, moral distress, moral injury, which I mentioned, and also moving to, you know, into the experience of moral disengagement. And so what we did was to craft a three part programme that address the challenges clinicians are facing. And the programme also addresses resources that clinicians can use in order to strengthen themselves as they face this very complex and in a way soul destroying pandemic.

MG: One of the things that we hear, and I've heard this in the conversations that I've had with health care workers, is that they worry that the system, as you've said, is overloaded. They don't have the resources that they should have, that the crisis continues to grow. And the real concern is that they're not going to be able to help everybody and that they and by default, we as a society will have to make these awful choices about who gets care and who doesn't. What advice do you give people who are struggling with those choices and with those emotions?

ROSHI JOAN: So, one of the things that I think is really important to recognise is that moral suffering is very much a part of the life of any caregiver. That is, we do the best we can to alleviate pain and suffering. And yet the outcome is often not what we wish. Now, in the case of what's happening now, this pandemic is putting an enormous added pressure on clinicians and so recognising when moral distress is happening is important. So when we say moral distress, we have to understand that this is the pain or anguish that arises in the mind or in the body or in our relationships when we're aware of a moral problem that we feel that we have a responsibility to address. And we might have determined remedy. Say, for example, we know that this patient would benefit from a blood product, but there aren't sufficient blood products to go around for all who need. We feel that we have this responsibility we've determined to remedy, but we're unable to act on it because of internal or external constraints. And it ends up that we participate in moral wrongdoing and this causes us suffering. You know, moral residues is that experience when obligations and commitments that we feel toward our patients, that we're not able to actually meet those obligations and commitments and that we have to make hard choices and that we have to end up prioritising one value over another. So this is a situation I think, that many of us have encountered in our service to others, and part of the work that Dr. Black, Dr. Rushton and I have done is to assist clinicians in coming to work more skilfully with the experience of more residue.

MG: How do you do that?

ROSHI JOAN: You know, part of it has to do with having insight into the fact that we cannot meet everyone's needs. We do the best we can under any given circumstance. You know, it's not like any clinician says, well, I'll only give 50 percent today or it's 20 percent today. Some days our best is not the greatest, but it's all we have to give or it's all the resources that are available to us. And as a result of that, we feel compromised and then there's the experience of moral residue, if we have insight about the first, we've done the best that we can. Second, that we cannot control outcomes. And the third is that this the sense of we have met as many obligations as we can under these current circumstances. So that kind of process of insight is very important. And what makes that insight possible? It has to do with the capacity to actually be in a nonreactive state. And how do we do that? Well, one of the ways is to develop a practise that allows us to be intentionally stabilised so that we can perceive things more clearly. And that is to say more clearly with a much wider and deeper perspective on this is how things are.

MG: Can you give me an example of how that practise would work, because I think this could apply, yes, to people who are right there on the front lines, but all of us feel this sense of being overwhelmed and of wondering whether we're doing enough in this moment that that to so many of us just seems like it came out of the blue and is not so much of what we took for granted out the window. So what is an example of that kind of practise that would get you to that place?

ROSHI JOAN: Well, for example, when one experience is what is called up regulation, in other words, a sense of anxiety or inadequacy, it's actually being able to notice what your subjective experience is. It's to be able to track what your somatic you're emotional and also your cognitive experiences. In other words, you know, being aware of your own subjectivity. When you're aware of your own subjectivity, when you're able to track your own experience and you find yourself up regulated, then you can actually allow yourself to reallocate your attention in such a way that you can get grounded. So one of the most simple and important things is to get grounded and how do you do that? Well, it's in a way it has to do with withdrawing your attention for a very brief period, like, you know, one breath worth. And allocating your attention to the body or to the sensation of your sitz bones on the chair or your feet on the floor, or bringing your attention to your breath just to take a moment to actually come into presence. And another thing, Matt, I think that is really critical. Which often gets lost in the fray is that we lose the thread of why we are here in service to others. So recalling your intention is really critical in this experience of serving others. As you know, most clinicians and most of us entered into this stream of service to others of caregiving from an altruistic base, and that out, in a way, can be squeezed out of us in the process of our education or in meeting the demands of the institutions that we're serving in. And it is actually to reinvestigate or reinitialize why we are in this vocation of clinical medicine, of nursing, of chaplaincy and so forth know it's a kind of calling to enter these service professions. Another thing is that it's a very poor use of our energy and it's actually toxic for us to spend time railing against the reality of any given situation. That is putting pressure on us is better for us to have what is called a metacognitive or a meta aware position, being able to step out of the experience of feeling victimised by circumstances and to look at things from a wider and deeper perspective. Another thing I think that is really important, Matt, is to let go of our expectations of ourselves and of others and to reset our expectations in a more realistic way.

MG: And what have you found in ensuring that what have you found the reaction to be? Because you can imagine that there are some people who say that, in some ways, they're treading water. They're just trying to keep their heads above water, let alone be able to stop for that moment and take a breath. What have you found in response?

ROSHI JOAN: I think that we are, if you will, an emergency oriented society. In other words, there's a kind of heroic meme that we feel gives our actions and also our identities value. The cost of that, however, in terms of operating from that perspective over a long period of time, the cost is tremendous because we don't engage in fundamental self care, fundamental self respect, and then the cost to our patients begins to show as well. So we cannot sustain this heroic model, we really have to develop the capacity in a certain way, and I like this term clinical humility, understanding that we can only do the best we can when we are adequately resourced. And that we have the commitment and the discipline to actually keep ourselves as resourced as possible so we can meet suffering in a way characterised by greater integrity.

MG: For you, what does it give you personally to be able to, as a teacher, to be able to share these teachings with health care workers and others?

ROSHI JOAN: You know, I would just say my own experience of not meeting my expectations when I was very active in care of dying people taught me a lot. What I feel in sharing these teachings is, you know, this is an endeavour that I feel is related to a bigger assignment, which has to do with transforming the culture of medicine at this time, that the suffering experienced by clinicians, by caregivers has become untenable. And the outcome of this, of course, is to affect not only patients, but caregivers themselves. So when our team begins to work with clinicians, I feel a sense of humility, a sense of relief, a sense of deep care, because these physicians have stepped into a learning process that could possibly enhance their capacity to care for others and also to do it in such a way that they maintain self-respect and they express fundamental human dignity. So I feel good about it.

MG: What do you see just finally as the opportunity of this moment? People have said that that this event that we're in the midst of right now gives us a chance in many ways to rethink things. And, yes, that that includes those who are right at the front lines. But broadly, you see people in the midst of a pandemic who are turning to a meditation practise or another practise to give themselves that space and that distance and that perspective that you've been talking about. What do you see as the opportunity of the moment?

ROSHI JOAN: Well, I think you've articulated the opportunity. I feel that the breakdown in our medical institutions, at least in my country, in the United States, has created, for example, a really powerful platform for chaplains to engage not only with patients, but with clinicians. I also feel that the value of various contemplative processes that we've been teaching for decades has been revealed in a really interesting way. And it's being incorporated more and more into medical training, in part because the work in neuroscience and social psychology has produced fascinating evidence about the benefits of these mind transforming practises. Benefits that are mental, but also that are physical, that are somatic and also social. I also feel that, from the point of view of looking at things systemically, we know that when systems break down, if they learn from the breakdown process, they can reorganise themselves at a much higher and more functional level. So, I think we're in a big phase shift right now. We don't know what what's going to happen. But needless to say, it is, you know, a wide open field, but we're in the middle of a kind of catastrophe. And what we make of the catastrophe will really depend on all of us not to take the position of victim, but to really look at it as creating a field of possibilities that will make it possible for clinicians and medical institutions to operate in a more effective, more ethical and more caring way in the future.

MG: Roshi Joan Halifax, it's a real pleasure to speak with you. Thank you very much.

ROSHI JOAN: Well, thank you, I'm grateful to have this time and thank you for your wonderful questions.

MG: Roshi Joan Halifax is the founder of the Upayaa Zen centre in Santa Fe, New Mexico. Her books include Being with Dying, Cultivating Compassion and Fearlessness in the Presence of Death and Standing at the Edge, Finding Freedom Where Fear and courage meet.

[Music]

MG: You're listening to The Current on CBC Radio one. My name is Matt Galloway.

SOUNDCLIP

The Ravens and Steelers will not be playing tomorrow night on Thanksgiving because of covid issues with Baltimore. The Ravens, about five players and four staffers that are positive.

MG: That much anticipated matchup between the Baltimore Ravens and Pittsburgh Steelers ended up being delayed three times before finally being played yesterday. Months ago, when professional sports started coming back, there was a lot of talk about how to return safely. And while leagues like the NBA and the NHL decided to go with a bubble system to keep Covid cases low, the National Football League is operating much as the same as any other year started on time. The Super Bowl should happen on time, and some teams even have fans in the stadium between positive tests and scheduling nightmares. Some people are beginning to think that the league is fumbling this one. Kurt Streeter writes the sports of the Times column for The New York Times. Kurt, good morning.

KURT STREETER: Good morning.

MG: For people who aren't following the NFL closely, tell me about that game that was postponed and postponed and then postponed again. What was going on?

KURT STREETER: Well, the Baltimore Ravens had just a cascade of Covid positive tests, and you know that caused the game to initially be postponed. It was initially going to be played on Thanksgiving Day in the state. So last Thursday and then it got moved to Sunday and there were more tests. But then again, the game was moved to Tuesday. Then there were some positive tests on the Pittsburgh Steelers side that the Baltimore Ravens opponent and finally the game was moved to Wednesday. So unusual in the extreme. And we're in obviously extreme times right now in the NFL as just just another indication of how poorly things are going for the NFL right now in terms of trying to control infections within teams.

MG: Tell me more about this. You wrote about it saying that it looks like it's running. The NFL looks like it's running a circus. How bad is the situation when it comes to covid cases in this league?

KURT STREETER: Well, right now, I believe we're close to about 300 infections across across the entire league through through this season. So that's a pretty high rate, much higher than I would have or anybody would have wanted. And that includes not only players, but coaches, staff members, many of whom are in high risk areas in terms of age, you know, in their 50s and beyond. So, you know, it's and it's only getting worse early on in in the training camps seem to be fairly controlled. But that was when the teams were sitting at home and training without travelling. And once the season really started getting going and teams started crisscrossing the country, much more activity- things have just steadily gotten worse. And, you know, this this is really the high point right now. So we're at a real crossroads at this point.

MG: Why did the NFL think that it could run things essentially business as usual when other leagues went into a bubble and tried to isolate their players and their staff and the people who work for the teams, the NFL just kind of rolls things as normal with fewer fans in the stands. But beyond that, it's kind of business as usual. Why did the NFL think it could do that?

KURT STREETER: Well, one of the things is that it is logistically very, very difficult to get have of these teams are, you know, with with staff and coaches, you're talking about often over 100 people and on each team. And compare that to basketball, which is much smaller. So it's much easier to get everybody together as they did, let's say, in the NBA, NBA or the WNBA did it as well. So that's one of the reasons. But really, the bottom line is it all comes down to money. The NFL just wanted to, I believe, wanted to just force its way into the playing and have as regular season as it could and have it look good on television or look as normal as it could on television because television really and broadcast rights, that's what really runs everything in the end. And that's the bottom line. Follow the money. Always is a truism here, as is everywhere else.

MG: You wrote a column and the headline was, Do we really need football this badly? And your answer was, no, it's not worth it at this cost. What should happen now if the league is being run like a circus and cases are popping up and it's difficult to play a game because you have players who are testing positive, what should the league do now?

KURT STREETER: Well, I proposed in my column and it's an opinion column, so I get to say this, you know, I propose that the league at the very least, take a pause right now for at least several weeks and wait until January, maybe late January, and then see if it can resume the season and then just play, let's say, immediately start in playoffs and do that in a bubble fashion, much more controlled fashion, maybe have a Super Bowl with, you know, hold the Super Bowl but with no fans. Right now, they're pointing out, you know, there's talk of having fans at the Super Bowl. But really, in the end, I think the actual better option is just to stop. Stop entirely, wait until next year, wait until the end of next year when hopefully we're going to have a vaccine and things will be returning somewhat to normal. And, you know, we seem so close to getting some some control and by close, obviously, and several months away. Why not wait now? The infection rates in the states and the death rate absolutely skyrocketing. We had something on the order of I believe was 2800 roughly deaths yesterday in the U.S. because of Covid. This is absolutely getting out of control in a way that had been predicted. But it's upon us now and it's only going to get worse, according to the experts.

MG: Well, and given that sort of we just have a few seconds left. But given that and given the fact that the NBA season is meant to start later on this month, but 48 players have tested positive so far, the NHL is trying to figure out which it should do. Should all these sports leagues just push the pause button?

KURT STREETER: I think that needs to be taken and taken very seriously and looked at absolutely with where we are right now. This is much bigger than sports. And we've got to think of the hole. We've got to think of public health and all of us right now. And I just think it's not sending a good message to continue. And it's also just putting people at risk. When these players get infected, they go back into their communities, they infect others. How does that help stem this is this incredible scourge. It's time to really take a look at we've got to do something differently.

MG: Kurt, it's great to talk to you about this. Thank you.

KURT STREETER: Appreciate it.

MG: Kurt Streeter writes the sports at the Times column for The New York Times that is The Current for today. Coming up next on CBC Radio One its Q, Tom Power speaking with David Chang, who is the chef and founder of the Momofuku restaurant chain, has a great memoir out in which he talks about mental health, mental illness and more. And you'll hear that conversation coming up on cue in just a few moments. In the meantime, a Matt Galloway. Thanks for listening to The Current and take care.

The Current Transcript for December 3, 2020

STORIES FROM THIS EPISODE

Prologue

Canada could approve COVID-19 vaccine in 'week to 10 days,' says Health Canada senior adviser

We look at whether pop-up surveillance testing can curb COVID-19

As health-care workers face 'soul-destroying' pandemic, Zen teacher offers tips for coping

Thursday December 3, 2020 Transcript

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