Kodak shares slump as US loan is suspended

Shares of Eastman Kodak plunged after a US agency suspended activity on a $765 million loan to support the company's shift into pharmaceuticals

Shares of Kodak plunged Monday after a US agency suspended a loan intended to support the former photo giant's launch of a new pharmaceutical venture.


The US International Development Finance Corporation's (DFC) said Friday it will halt further action following controversy that has surrounded its July 28 announcement of a $765 million loan to Kodak.

The loan is part of a program to boost US pharmaceutical capacity in the wake of the coronavirus pandemic.

Shares of Eastman Kodak dove 28.3 percent to $10.67 in afternoon trading.

The Wall Street Journal has reported that the Securities and Exchange Commission is investigating Kodak's disclosures about the loans and is expected to probe the company's awarding of stock option grants to executives on July 27.

Trading volumes in Kodak surged the day before the DFC announcement and shares rocketed up as much as 500 percent on July 28 after the loan's announcement.

"On July 28, we signed a letter of interest with Eastman Kodak," DFC said on Twitter on Friday. "Recent allegations of wrongdoing raise serious concerns.

"We will not proceed any further unless these allegations are cleared."

Kodak on Friday appointed a special committee to oversee an internal review "of recent activity by the Company and related parties" connected to the DFC announcement.

The DFC loan to Kodak would be the first to be made after President Donald Trump in May signed an executive order aimed at encouraging domestic production of materials needed to fight COVID-19.

Senior House Democrats have also questioned the loan.

A group of lawmakers including Maxine Waters, chairwoman of the financial services committee, and Eliot Engel, chairman of the foreign affairs committee, sent a letter last week to the DFC noting that Kodak's prior attempt at pharmaceutical manufacturing was "unsuccessful."


Explore further  Kodak lands loan to bolster US-produced drug supply

The brains of nonpartisans are different from those who register to vote with a party

by University of Exeter

Credit: Pixabay/CC0 Public Domain

The brains of people with no political allegiance are different from those who strongly support one party, major new research shows.


The largest functional neuroimaging study of its kind to date shows nonpartisan voters process risk-related information differently than partisans.

The findings show nonpartisan voters are a distinct group, not just people reluctant to divulge their political preferences.

Experts found functional brain processing differences between partisans and nonpartisans in parts of the brain which help people to socialize and engage with others—the right medial temporal pole, orbitofrontal/medial prefrontal cortex, and right ventrolateral prefrontal cortex. As people completed a simple risk-related decision-making task there were differences in the blood flow to these regions of the brain between the two groups.

Dr. Darren Schreiber, from the University of Exeter, who led the study, said "There is skepticism about the existence of nonpartisan voters, that they are just people who don't want to state their preferences. But we have shown their brain activity is different, even aside from politics. We think this has important implications for political campaigning—nonpartisans need to be considered a third voter group.

"In the U.S. 40 percent of people are thought to be nonpartisan voters. Previous research shows negative campaigning deters them from voting. This exploratory study suggests US politicians need to treat swing voters differently, and positive campaigning may be important in winning their support. While heated rhetoric may appeal to a party's base, it can drive nonpartisans away from politics all together."

The study, published in the Journal of Elections, Public Opinion, and Parties, was conducted by Dr. Schreiber, Gregory A. Fonzo from the University of Texas, Alan N. Simmons and Taru Flagan from the University of California San Diego, Christopher T. Dawes from New York University, and Martin P. Paulus from the Laureate Institute for Brain Research. The team of political scientists, neuroscientists, and psychiatrists scanned the brains of 110 participants in the U.S. with magnetic resonance imaging (MRI) while they completed the task. Some were registered with one of the two main parties and others were not. The differences in brain activity came when people had to choose whether to make a safe or risky decision, suggesting nonpartisan voters engage differently with nonpolitical tasks.

The experts now hope to carry out more research to discover what the differences in brain activity shows about the personalities and social traits of nonpartisan voters.

During the brain scanning the participants, who lived in San Diego County, had to decide between options which would have provided a guaranteed payoff or those that provided a chance for either losses or gains.

After the experiment the researchers matched participants with publicly available voting records to see if they were registered as Republicans or Democrats, or with no party preference. In total 73 were partisan—56 Democrats and 17 Republicans—and 37 were nonpartisan.

The right medial temporal pole, orbitofrontal/medial prefrontal cortex, and right ventrolateral prefrontal cortex have been shown to be important for human social connections in hundreds of brain imaging studies. They help people to connect to their social groups, understand the thoughts of others, and regulate the reactions we have to others.


Explore furtherStudy: Political parties sideline minority voters, leave other orgs to pick up the slack
More information: Darren Schreiber et al. Neural nonpartisans, Journal of Elections, Public Opinion and Parties (2020). DOI: 10.1080/17457289.2020.1801695
Provided by University of Exeter

Identification of stomach flu culprit

by Leigh MacMillan, Vanderbilt University

Credit: CC0 Public Domain

Norovirus is a major cause of acute gastroenteritis, with at least 49 different norovirus genotypes. GII.4 genotype is responsible for the majority of norovirus epidemic outbreaks. The genotypes associated with medically-attended sporadic acute gastroenteritis are less clear.


Zaid Haddadin, MD, Einas Batarseh, MD, and colleagues compared the clinical characteristics and distribution of norovirus genotypes in children who sought medical care for acute gastroenteritis in three clinical settings (outpatient, emergency department, inpatient) over three years.

In 2,885 children, norovirus was detected in 22% of stool samples. Nearly 90% of the norovirus-positive samples were GII-positive, and GII.4 viruses were detected in 51% of the genotyped GII-positive samples. Seasonal variations were noted among different genotypes, and children with GII.4 infections were younger and had more severe symptoms requiring more medical care compared to children with non-GII.4 infections.

The findings, reported in Clinical Infectious Diseases, highlight the importance of continuous norovirus surveillance and could guide strain selection for candidate norovirus vaccines.


Explore furtherAsymptomatic infection helps norovirus to spread in Indonesia
More information: Zaid Haddadin et al. Characteristics of GII.4 Norovirus versus other Genotypes in Sporadic Pediatric Infections in Davidson County, Tennessee, USA, Clinical Infectious Diseases (2020). DOI: 10.1093/cid/ciaa1001
Journal information: Clinical Infectious Diseases


Provided by Vanderbilt University

1 in 5 medics reported for sexual misconduct have multiple complaints against them

WHITE MALE PRIVILEGE ESCAPES THE MALE GAZE

by Medical Journal of Australia

Credit: Unsplash/CC0 Public Domain

A landmark study of sexual misconduct notifications to health regulators against health professionals shows that around one in five notified practitioners were the subject of more than one complaint.

The study, published online today by the Medical Journal of Australia, found that regulators received 1,507 sexual misconduct notifications for 1167 of 724,649 registered health practitioners (0.2%) during 2011-2016, including 208 practitioners (18%) who were the subjects of more than one report; 381 notifications (25%) alleged sexual relationships, 1,126 (75%) alleged sexual harassment or assault.

Lead author of the study, Associate Professor Marie Bismark, professor of Public Health Law at the Melbourne School of Population and Global Health, said in an exclusive podcast that the multiple complaints against some individual practitioners begged the question of whether sexual misconduct could be remediated or whether those practitioners needed to be removed from the profession.

"We do need to assess which interventions are effective, which group of practitioners can be remediated and which groups of practitioners are likely to continue engaging in this conduct," Associate Professor Bismark said.

"That's an incredibly important question. You sometimes hear about regulators imposing conditions like requiring a practitioner to attend an ethics course. I'm not sure of any good evidence that forcing somebody to attend an ethics course against their will has ever really changed their practice."

Bismark and colleagues analyzed data from the Australian Health Practitioner Regulation Agency and NSW Health Professional Councils Authority on notifications of sexual misconduct during 2011–2016.

They found that:
notifications regarding sexual relationships were more frequent for psychiatrists (15.2 notifications per 10,000 practitioner-years), psychologists (5.0 per 10,000 practitioner-years), and general practitioners (6.4 per 10,000 practitioner-years);
the rate was higher for regional/rural than metropolitan practitioners;
notifications of sexual harassment or assault more frequently named male than female practitioners—male practitioners were 37 times more likely to sexually harass or sexually assault a patient than a female colleague;
a larger proportion of notifications of sexual misconduct than of other forms of misconduct led to regulatory sanctions (242 of 709 closed cases [34%] v 5,727 of 23,855 [24%]).

Bismark and colleagues highlighted three areas that need further investigation.

"First, we need strategies for reducing barriers to notifying regulators of sexual misconduct," they wrote. "The Medical Board of Australia has recently established a national committee for responding to sexual misconduct notifications and has trained investigators with specialist expertise. Second, the connection between sexual misconduct and sexual harassment of colleagues should be investigated, with the twin goals of training practitioners to practice ethically and professionally and providing trustworthy processes for reporting and investigating unacceptable behavior in the health professions. Finally, we need robust information about the effectiveness of regulatory interventions for preventing recurrent sexual misconduct. Patients, health care practitioners, and the public deserve focused efforts to prevent sexual misconduct in health care, fair and thorough investigation of allegations of sexual misconduct, and prompt and consistent action by regulators when allegations are confirmed."


Explore further

Universities are failing to deal with serial sexual predators on their staffs, according to new report

More information: Marie M Bismark et al. Sexual misconduct by health professionals in Australia, 2011–2016: a retrospective analysis of notifications to health regulators, Medical Journal of Australia (2020). DOI: 10.5694/mja2.50706

Journal information: Medical Journal of Australia

Provided by Medical Journal of Australia

Poor mental health in lockdown most common among young women

by Erin Johnson, University College London

Credit: mikoto.raw from Pexels CC BY 2.0

Young women are the most likely to have experienced high levels of depression, anxiety, and loneliness in lockdown, compared to older adults, according to new research from the UCL Center for Longitudinal Studies (CLS).

The study, published today as a briefing paper, also found that young women (aged 30) have shown the biggest increase in mental health problems since they were previously assessed some years before compared to middle-aged (aged 50) and older adults (aged 62).

The research team at the UCL Institute of Education carried out a survey in May 2020 of over 18,000 people born in 1958 (aged 62), 1970 (aged 50), 1989-90 (aged 30), and 2000-02 (aged 19), to explore the impact of the COVID-19 pandemic on the mental health and wellbeing of four generations of people. The survey was completed by participants of nationally representative longitudinal cohort studies, which have been following their lives since childhood.

The researchers found that poor mental health in lockdown was most common among the 19-year-olds surveyed, followed by the 30-year-old millennials. Across all four age groups, women were more likely than men to experience mental health problems. Among 19-year-olds, just over one third of women and just under one quarter of men had symptoms of depression during lockdown in May, and 45% of women and 42% of men had felt lonely during this time.

These problems were also widespread among millennials, with 20% of women and 14% of men showing signs of depression and just over one third of women and one quarter of men experiencing loneliness. By comparison, 7% of 62-year-old men and 10% of 62-year-old women had symptoms of depression.

The team were also able to analyze the new lockdown survey data alongside survey information collected from participants several years before COVID-19, for all but the 19 year olds in the survey, in order to identify changes in the prevalence of mental ill-health among them. They found a significant increase in levels of poor mental health during lockdown among women aged 30 compared to when this group was last surveyed, at age 25.

Study co-author, Professor Emla Fitzsimons (UCL Institute of Education), said: "This change in mental health between age 25 and 30 will reflect change that may naturally occur at this stage of life, as well as change attributable to the pandemic, however this finding chimes with other studies which have also shown that young women have experienced the largest increase in mental health problems due to COVID-19."

Among the older generations surveyed, there was little change in the prevalence of mental ill-health, compared to assessments taken in the same group several years before. However in a sub-set of 900 Baby Boomers (aged 62), for whom data immediately prior to the pandemic was available, there was a small decrease in reported levels of poor mental health during the pandemic compared to immediately before, although life satisfaction did appear to have dipped. The researchers found that the average life satisfaction score of these 62-year-olds dropped from 7.8 to 7.4 (out of 10) on the ONS scale between January to March 2020.

One limitation of the study design is that it includes adults at a set of specific ages, rather than at all ages. However the findings about high levels of difficulties especially among young women at the ages of 19 and 30 are likely to apply to young women in their twenties too.

Co-author of the briefing, Dr. Praveetha Patalay (UCL Institute of Education), said: "Our findings clearly highlight high levels of difficulties being experienced by young people aged 19 and 30, especially young women. More needs to be done to support these age groups and limit the impact of the pandemic on their future health and wellbeing."


Explore further

Women with young children, key workers and BAME groups losing sleep during coronavirus pandemic

More information: Mental health during lockdown: evidence from four generations: Initial findings from the COVID-19 Survey in Five National Longitudinal Studies.

https://cls.ucl.ac.uk/poor-mental-health-in-lockdown-most-common-among-young-women/

Provided by University College London

Gulf War illness, chronic fatigue syndrome distinct illnesses, study suggests

by Georgetown University Medical Center

Credit: Unsplash/CC0 Public Domain

A brain imaging study of veterans with Gulf War illness (GWI) and patients with chronic fatigue syndrome (CFS) (sometimes called myalgic encephalomyelitis), has shown that the two illnesses produce distinctly different, abnormal patterns of brain activity after moderate exercise. The result of the Georgetown University Medical Center study suggests that GWI and CFS are distinct illnesses, an outcome that could affect the treatment of veterans with Gulf War illness.


The findings were published today in the journal Brain Communications.While it is estimated that CFS affects 0.2-2% of the U.S. population, GWI is a multi-symptom illness that affects about 25% to 30% of the approximately 700,000 military personnel who participated in the 1990-1991 Persian Gulf War.

The two illnesses share many symptoms, including cognitive and memory problems (often described as "brain fog"), pain, and fatigue following mild to moderate exercise. Some medical institutions, including the U.S. Department of Veterans Affairs (the VA), list CFS as a symptom of GWI (called chronic multisymptom illness associated with service in the Gulf War by the VA).

"Our results strongly suggest that GWI and CFS represent two distinct disorders of the brain and therefore CFS is not a symptom of GWI," says Stuart Washington, Ph.D., a post-doctoral fellow and first author on the study. "Combining of two different disorders could lead to improper treatment of both." Washington works in the laboratory of James Baraniuk, MD, professor of medicine at Georgetown.

In the study, functional magnetic resonance imaging (fMRI) revealed that the brains of veterans with GWI and those of patients with CFS behaved differently when performing the same memory task after moderate exercise. Veterans with GWI showed a decrease in brain activity in the periaqueductal gray, a pain processing region within the brainstem, and in the cerebellum, a part of the brain responsible for fine motor control, cognition, pain, and emotion.

On the other hand, patients with CFS showed increased activity in the periaqueductal gray and in parts of the cerebral cortex related to maintaining vigilance and attention. In healthy subjects, these areas of the brain had no changes at all.

A previous study published by this same research group also suggested that the two illnesses are distinct. It showed that exercise causes different changes to the molecular makeup of cerebrospinal fluid in veterans with GWI and patients with CFS.

"Now that CFS and GWI have been shown to affect different regions of the brain, these regions can be more closely examined using neuroimaging and other techniques to further our understanding of the similarities and differences between the two illnesses," says Baraniuk. "Once this new information is adopted broadly, diagnoses and treatments for both disorders should improve."

Explore further Veterans study suggest two sub-types of Gulf War illness

More information: Stuart D Washington et al. Exercise alters brain activation in Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, Brain Communications (2020). DOI: 10.1093/braincomms/fcaa070

Journal information: Brain Communications

Provided by Georgetown University Medical Center

New aged care funding model offers reform for Australians

by Medical Journal of Australia

Credit: CC0 Public Domain

The profile of Australian aged care residents has changed markedly in recent years, and the developers of a new system for classifying residents, published today by the Medical Journal of Australia, say their model is better than the current Australian aged care funding system.


"Since the introduction in 2008 of the current aged care funding model, the Aged Care Funding Instrument (ACFI), the profile of people entering residential care has changed substantially, partly because of the success of programs that enable people to stay at home longer," wrote Professor Kathy Eagar, Director of the Australian Health Services Research Institute at the University of Wollongong, and colleagues.

Residents are now typically older and frailer on entry (about half are over 84 years old), and their annual mortality rate is around 32%. Consequently, about half of those who enter residential care will live there for two years or less. The 2017 review of the ACFI found that it does not sufficiently discriminate between the care needs of residents, that it is administratively inefficient, and that it provides perverse incentives; for example, if a resident's functioning improves, ACFI funding can be reduced. It concluded that the ACFI is "no longer fit for purpose."

Eagar and colleagues conducted a study of resident characteristics in 30 non-government residential aged care facilities (RACFs) in Melbourne, the Hunter region of New South Wales, and northern Queensland, between March and June 2018.

They used that data to develop the Australian National Aged Care Classification (AN-ACC), a casemix classification of 13 classes for residential aged care based on the attributes of aged care residents that best predict their need for care: frailty, mobility, motor function, cognition, behavior, and technical nursing needs.

"The AN-ACC is based on these key cost drivers, reflecting the functional consequences of health conditions rather than the conditions themselves," Eagar and colleagues wrote.

"It captures not what a resident does, but rather their physical capacity (including pain), cognitive capacity (including ability to communicate, sequence, interact socially, and solve problems, and memory), mental health problems (including depression and anxiety), and behavior (including cooperation, physical agitation, wandering, passive resistance, verbal aggression)."

Implementing the AN-ACC is now being considered by the Australian government in the context of the major structural and funding aged care reforms expected after the Royal Commission into Aged Care Quality and Safety publishes its final report in March 2021.

"We recommended the AN-ACC not only for residential aged care but also that it be extended into aged care at home. The AN-ACC is not an end in itself, but an essential element in the broader reform of the national aged care funding system. This includes protocols for re-assessment that allow a resident to be assigned to a different class as their needs change," they concluded.

"The AN-ACC enables the community, care providers, and governments to make meaningful judgements about the quality and outcomes of residential aged care and to fairly compare the quality of care provided at different facilities."


Explore further

Almost 6 in 10 Aussies living in aged care are in inadequately staffed facilities

More information: Kathy Eagar et al. The Australian National Aged Care Classification ( AN ‐ ACC ): a new casemix classification for residential aged care, Medical Journal of Australia (2020). DOI: 10.5694/mja2.50703

Journal information: Medical Journal of Australia

Provided by Medical Journal of Australia

Schools mull outdoor classes amid virus, ventilation worries

by Terry Spencer

This 1911 photo from the Library of Congress shows schoolchildren on the ferry boat Rutherford, across the river from Manhattan, and near the Brooklyn Bridge, at right, in New York. Poor ventilation in school buildings across the U.S. will limit the ability of in-person instruction to resume safely. Some districts are warming to the idea of outdoor classrooms. (Library of Congress via AP)

It has been seven years since the central air conditioning system worked at the New York City middle school where Lisa Fitzgerald O'Connor teaches. As a new school year approaches amid the coronavirus pandemic, she and her colleagues are threatening not to return unless it's repaired.

Her classroom has a window air conditioning unit, but she fears the stagnant air will increase the chances that an infected student could spread the virus.

"Window units just aren't going to cut it. We don't want to stay cool, we just want the air to flow properly," said O'Connor, a science teacher who has worked at the Patria Mirabal School in Manhattan since 2009. "We are really super stressed out about it."

Schools around the country are facing similar problems as they plan or contemplate reopening this fall, dealing with aging air conditioning, heating and circulation systems that don't work well or at all because maintenance and replacement were deferred due to tight budgets. Concerns about school infrastructure are adding momentum to plans in some districts, even in colder climates, to take classes outdoors for the sake of student and teacher health.

Nationwide, an estimated 41% of school districts need to update or replace their heating, ventilation and cooling systems in at least half their schools, according to a federal report issued in June.

This 1900 photo from the Library of Congress photo shows an open air school in New York. Poor ventilation in school buildings across the U.S. will limit the ability of in-person instruction to resume safely. Some districts are warming to the idea of outdoor classrooms. (Library of Congress via AP)

There is no evidence that the disease can spread through ventilation systems from one classroom to the next, according to Dr. Edward Nardell, a Harvard Medical School professor who specializes in airborne diseases. The danger, Nardell said, is from ineffective systems that don't remove floating viruses and let them linger in classrooms after they are expelled in an infected person's breath, sneeze or cough.

"Most schools are designed for comfort, not for infection control. So there is a danger that if you put 20 kids in a room, that if one of them has asymptomatic COVID and is infectious, you now have 19 more kids who are exposed," Nardell said. Healthy children almost always recover from COVID, if they become ill at all, but they can pass the disease to teachers, parents and other adults.

Nardell believes schools should consider installing ultraviolet lights along classroom ceilings, a technology some used in the 1950s and earlier to combat measles, tuberculosis and other airborne diseases and that is still used in hospitals and homeless shelters. Viruses and bacteria are destroyed using a spectrum of UV light that is safe for humans. Manufacturers say the devices would cost $3,000 per classroom.

Some, including Education Secretary Betsy DeVos, say one solution to air circulation problems may be teaching classes outdoors, which was done during tuberculosis and influenza outbreaks in the early 1900s, even in cold weather. The coronavirus spreads less efficiently outdoors and students could more easily sit 6 feet (2 meters) apart.

Having classes outdoors has other benefits, said Sharon Danks, CEO of Green Schoolyards America, a Berkeley, California, nonprofit that advocates for outdoor education. Children actually are less distracted and feel better emotionally when taught outdoors, she said.

This 1900 photo from the Library of Congress photo shows schoolchildren waiting for lunch at open air school, PS 51, in New York. Poor ventilation in school buildings across the U.S. will limit the ability of in-person instruction to resume safely. Some districts are warming to the idea of outdoor classrooms. (Library of Congress via AP)

"Nature has been shown to restore the ability to pay attention," she said.

Several schools in the Northeast have bought large event tents like those used at outdoor weddings and plan to use them to teach outside through November.

The White River Valley Middle School in Bethel, Vermont, spent $50,000 on tents and another $20,000 on port-a-potties, hand-washing stations and other equipment. While some schools have equipped tents with propane heaters, White River Valley Principal Owen Bradley said his students can handle the expected November daytime temperatures in the 30s (about 0 Celsius) without them.

Bradley said one upside will be an opportunity to help students better understand and appreciate nature.

"We hope they value it forever and help us save the planet," he said.

Schools bringing students back this fall will require or at least strongly suggest masks, but officials say they can only be so effective during six-hour school days indoors. Air circulation is needed.

This 1912 photo from the Library of Congress shows an open air school during rest period in Rochester, N.Y. Poor ventilation in school buildings across the U.S. will limit the ability of in-person instruction to resume safely. Some districts are warming to the idea of outdoor classrooms. (Library of Congress via AP)

This 1911 photo from the Library of Congress shows children wrapped in blankets, at a fresh air class rest hour at Public School No. 51, in New York. Poor ventilation in school buildings across the U.S. will limit the ability of in-person instruction to resume safely. Some districts are warming to the idea of outdoor classrooms. (Library of Congress via AP)

This 1912 photo from the Library of Congress shows an open air school during rest period in Rochester, N.Y. Poor ventilation in school buildings across the U.S. will limit the ability of in-person instruction to resume safely. Some districts are warming to the idea of outdoor classrooms. (Library of Congress via AP)

This 1911 photo from the Library of Congress shows children wrapped in blankets, at a fresh air class rest hour at Public School No. 51, in New York. Poor ventilation in school buildings across the U.S. will limit the ability of in-person instruction to resume safely. Some districts are warming to the idea of outdoor classrooms. (Library of Congress via AP)

Stephen Murley, the school superintendent in Green Bay, Wisconsin, said most of his district's 42 campuses have older air systems. When there is high humidity, they are set to recirculate drier indoor air to prevent unhealthy black mold from growing on the walls—but battling the coronavirus requires fresh air.

"We have two things working at odds with each other," Murley said.

Janet Robinson, the superintendent in Stratford, Connecticut, said some of her district's 13 schools were built between 80 and 100 years ago and aren't capable of handling modern air systems—"they are a challenge." There are also crowding issues—one has classrooms built for 15 students but that typically have 25, making social distancing impossible.

"It is kind of naive for politicians and whoever to say, 'Just bring (the students) in and keep them at 6 feet (2 meter) distance,'" she said.

Brian Toth, superintendent of the Saint Marys Area School District in northern Pennsylvania, said his district's five schools' air systems have no exit vents to circulate fresh air in and the virus out. He estimates it would cost at least $600,000 per school to replace the systems. When his schools reopen Aug. 31, students will be asked to wear masks, but Pennsylvania law exempts children whose parents claim they have a physical or mental condition.

"You look at the way schools were built, nobody expected to have a classroom with a 6-foot radius around a student," Toth said. Instead, classrooms "pack them in like sardines and now we are facing the consequences."


Explore further Cuomo clears New York schools statewide to open, carefully

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Why CANADIAN Indigenous communities seeing few cases of COVID-19
NOT IN THE USA THOUGHby Jolene Banning, Canadian Medical Association Journal

Indigenous communities have fared better than the rest of Canada in the first wave of the pandemic despite facing major challenges to infectious disease control. Credit: Canadian Medical Association Journal
Like most people, Tania Cameron was watching the news intently as the first cases of COVID-19 were reported in Canada. A member of Niisaachewan First Nation and regional coordinator for Indigenous Sport & Wellness Ontario, she worried that no one was talking to Indigenous communities about the pandemic heading their way.

"When I called a couple of [personal protective equipment] supply companies, they told me 'We're not allowed to announce it, but we're sold out and if we do get any, priority goes to the hospital.' So that to me was a warning," Cameron says. She texted friends in the community, chiefs and council members to raise the alarm and offer help updating pandemic plans.

It wasn't the first time Cameron has had to prepare for a public health crisis—she and a handful of local health directors developed her community's first pandemic plan in response to the 2002 outbreak of severe acute respiratory syndrome.

Then as now, many people feared that the virus could devastate communities already contending with the legacy of colonization—poverty, overcrowding, limited health infrastructure and poor access to clean water—ideal conditions for the spread of disease. But despite these challenges, Indigenous communities have fared better than the rest of Canada in the first wave of the COVID-19 pandemic.

As of August 6, the percentage of people living on First Nations reserves who have tested positive for COVID-19 was one-quarter that of the general Canadian population. Of a total 422 confirmed cases of COVID-19 on reserves, more than 80% have recovered. Six people have died—a fatality rate one-fifth that of the general population. According to Indigenous Services Canada, "First Nations communities are flattening the curve."

British Columbia is a case in point—the province reported just 90 cases of COVID-19 among First Nations people in the first six months of 2020. Health officials attributed these low numbers to the "extraordinary" public health measures taken by Indigenous communities.

According to Dr. Nel Weiman, acting deputy chief medical officer for the First Nations Health Authority, the memory of past epidemics in which entire villages were nearly wiped out made people especially cautious about COVID-19. "Communities recognized the need to really take this seriously and install their own versions of public health measures," says Weiman.


Indigenous people got creative to stay connected virtually, set up trailers for self-isolation, and made roadblocks to control access to their communities. Now, as the rest of the province has reopened, many of these communities are fighting to remain closed. "Some people find it controversial, but I don't think people can argue that by limiting access… the communities have been able to keep themselves safe to a certain extent," says Weiman.

The First Nations Health Authority also put out special public health messages specifically recognizing Indigenous strengths and the sacrifices made by communities during the lockdown. Many have put on hold or modified ceremonies, funerals, and rites of passage.

Robert Bonspiel, director of First Nations Paramedics, the only Indigenous private ambulance service in Quebec, attributes low infection rates among Indigenous people to communities taking a proactive approach to the pandemic.

As co-director of the emergency response unit for the Mohawk community of Kanehsatà:ke, Quebec, "we asked people to go back to their roots, to go back to the way it was years ago, to be caring about their neighbors like their family," he says.

In addition to setting up roadblocks like in B.C., the community encouraged people to stay at home by delivering meals for Elders, food hampers and prescriptions. Keeping Elders at home may have been protective, given the high number of deaths in long-term care, Bonspiel adds. "If you look at the general Quebec population, their Elders are placed [in nursing homes.] In the Mohawk community, and First Nations communities, we don't do that."

For the Inuit, experience fighting tuberculosis (TB) has prepared communities for COVID-19. "Inuit communities, unfortunately, have become adept at contact tracing and isolation for TB," so pandemic measures were "not a new phenomenon," says Deborah Van Dyk, senior policy director with Inuit Tapiriit Kanatami, the non-profit representing over 60,000 Inuit in Canada.

"Strengths-based" strategies to mobilize communities, reduce poverty and implement Inuit-specific solutions to eliminate TB may also support the response to COVID-19, Van Dyk says. Inuit communities have also been working on building up their public health staff, "so it was a lot easier for that kind of staff to redeploy."

Van Dyk says shutting down travel quickly may have helped to prevent the spread of COVID-19 among the Inuit but it's still too early to say without any evaluations of the public health response. Meanwhile, "there is still a lot of work to be done in terms of impact… around mental health, around businesses, education and that kind of thing," she says.

Courtney Skye, a research fellow at the Yellowhead Institute, a First Nations-led think tank, cautions that COVID-19 data are not being collected in a granular way that would show which Indigenous communities are affected at what rates. Without those data, "we lose the ability to hold decision-makers responsible for the actions that they're taking on behalf of the community."


Explore further

Why Indigenous communities are taking COVID-19 measures into their own hands

Provided by Canadian Medical Association Journal

Coronavirus lessons from when the 1937 polio epidemic delayed school reopenings

by Tara Abraham, The Conversation

Ontario schools plan to reopen after being closed since March 14, 2020. Credit: Shutterstock

In September 1937, the Toronto Daily Star and the Globe and Mail began publishing lessons for high school students who had already lost four weeks of school due to the polio epidemic that raged that summer. Soon, the Star reported that children had eagerly taken up their studies at home. Teachers were available by telephone if students needed them.


Indeed, COVID-19 is not the first time we've considered closing schools to prevent the spread of disease. After Ontario's worst polio epidemic in the summer of 1937, schools were closed in the fall to protect children, who were the most vulnerable to polio's ravages.

Psychologists assured parents that the extended holiday was likely to be beneficial, but for some families, school closures were stressful. As the mother of nine school-aged children put it in a Globe and Mail article from Sept. 18, 1937: "The children are very restless," even though she had kept them busy playing ball, pole-vaulting and boxing in the backyard.

Stressful epidemics

Of course, school closures were not the only source of stress. Parents were terrified of polio. Polio season regularly took place in late summer, and between July and October, parents, especially mothers, watched their children closely for any signs: neck stiffness, headache, stomach upsets.

Mothers were instructed:

"Don't be afraid. Be watchful. Look for indisposition, sickness, nausea, headache, back or neck ache, sore throat, tremor, prostration. On the appearance of any out of the way symptoms, put the child in bed and call the doctor."

During the summer of 1937, mothers kept their children off the streets. Sunnyside Beach, despite the warm water, had only a few bathers. Streets in the central part of Toronto—described by the Toronto Daily Star as "the playgrounds of hundreds of poor children"—were deserted. Survivors of polio epidemics remember a deep-seated fear of infection.


Delayed reopening

In 1937, Toronto schools had been set to open on Sept. 1, but in light of the severity of the polio epidemic, Gordon Jackson, Toronto's medical officer of health, decided to delay the return to schools until Sept. 13. After several further delays, schools finally opened on Oct. 12.

Across Canada, several municipal health officials felt that schools should remain open. John W.S. McCullough, Ontario's chief officer of health, noted that with proper medical inspection and the "watchful eyes" of teachers, nurses and doctors, children would be safer in school rather than roaming around the streets unmonitored.

While public pressure forced closures, the issue divided Torontonians.

Front page stories from the Toronto Star on Sept. 28, 1937 looked at schooling during the polio epidemic. Author provided

Quoted in an article in the Toronto Daily Star from Sept. 27, Toronto School trustee C.M. Carrie denounced doctors who lent themselves to "panic" regarding the polio epidemic. "Why are the children kept out of school and not kept out of anywhere else?" he said. "You can see them running round everywhere."

Another Toronto trustee—Dr. W.H. Butt—was more sympathetic with medical officials who decided to close schools: "Medicine is not an exact science … the less crowding of children, the better."

Broadly, these debates reflected parental anxiety, confusion over the mode of transmission of the disease and tension between health officials and school authorities.

Protecting children

In an article from Oct. 10, 1937, Toronto Mayor William D. Robbins justified the closures, declaring: "They can catch up on their lessons, but you can't restore a child."

Parents responded in ways that reflected their own fears and confusion. Some mothers who led Home and School clubs in Toronto were not alarmed by schools reopening, and felt kids were safer in schools than roaming the streets.

In a Toronto Daily Star article published on Oct. 16, another parent claimed that "children have been in just as close, if not closer contact with each other when the schools were closed than at present."

Other articles from September and October of that year showed that mothers who had kept their children out of crowds and away from playgrounds, theaters, and public pools were worried that schools were opening too soon.

One mother hoped that "city schools are not opened until all danger of contagion is definitely and surely passed.… Even if there is only one new case of polio developed after school opening, remember that one may be your child, or mine." Pupils, on the other hand, were said to be "eager for school" and on the first day back, attendance was high with students waiting outside of school ahead of the bell.

COVID-19 school plans

Today, Toronto parents are paying close attention to the question of what school will look like in September. Working parents, particularly single parents, have felt the emotional strain of balancing full-time work and caring for and schooling their children.

Children of all ages have responded to lockdown and school closures in varying ways. Some thrived in the online environment and adapted quickly. Others found online learning challenging.
Premier Doug Ford announces that Ontario schools will re-open as planned in September.

Demands for mental health services for children and adults alike have increased.

A Statistics Canada study reveals that balancing child care, schooling and work was a top concern for families, with worries about managing loneliness and anxiety a major stressor. In July, a growing number of parents put pressure on the Ontario government to open schools safely and fully in September. The Ford government announced its school reopening plan on July 30, but for many parents it does not go far enough to ensure safety.

Ensuring safety

To be sure, there are numerous contrasts between the polio epidemic of 1937 and COVID-19.

Unlike COVID-19, which disproportionately affects older people, polio struck the very young. While COVID-19 has meant that Ontario children spent the last three and a half months of their school year at home, polio was a summer disease, and when it did affect schooling for the general population, it usually just extended summer holiday.

School closures in 2020 seem indefinite or undetermined. During the 1937 polio epidemic, students just lost a few weeks, while students today have already lost 13 weeks, with potentially more to come.

While anxieties during the polio epidemic often stemmed from fear of the disease, parental anxiety during COVID-19 stems not only from fear of infection (markedly lower than polio for children) but also from the stress of having to balance full-time work and caring for and homeschooling their kids.

This stress is particularly felt by mothers during the COVID-19 pandemic, who are a much greater part of the workforce than they were in 1937.

This burden also falls more heavily on essential workers and lower-income families.

School closings affect parents differently. Single parents who do not have relatives nearby find balancing working from home and home schooling their young children particularly challenging, if not impossible.

Going back to school in 2020 has different stakes: parents must face striking a balance between their sense of collective responsibility towards public health and their personal responsibility to maintain their own mental health and the health of their children.

And this is not to say that a return to school would mitigate emotional stress: for some, lockdown and the fear of a dreaded second wave of COVID-19 means parents will choose to keep their children home despite any school reopening scenario.


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