NICOTINE IS A PESTICIDE

Tobacco Market is estimated to reach $262.8 billion by 2027, registering a CAGR of 6.7% from 2021 to 2027

By Allied Analytics
Published May 26, 2022


Tobacco demand has recently shifted from developed regions to developing regions such as Asia and Africa. This can be attributed to the growing population, rising consumer income levels, and tax government regulations.

According to a new report published by Allied Market Research, titled, “Tobacco Market by Type, Product, and Distribution Channel: Global Opportunity Analysis and Industry Forecast, 2021–2027,”

The tobacco market size is expected to reach $262.8 billion by 2027 at a CAGR of 6.7% from 2021 to 2027.

Tobacco is a plant that contains nicotine, which is a psychoactive (mind-altering) drug that stimulates the brain but also relaxes the central nervous system. Tobacco has been used by humans for many years for a variety of reasons. It has traditionally played an important role in ceremonies and served to mark special occasions for some. Others have used it to boost alertness or to relax and connect with friends and acquaintances at social gatherings.

Tobacco can be smoked, chewed, or sniffed. Cigarettes, cigars, bidis, and kreteks are examples of smoked tobacco products. Some people also use a pipe or hookah to smoke loose tobacco (water pipe). Chewing tobacco, snuff, dip, and snus are all chewed tobacco products while snuff can also be sniffed.

The market is segmented on the basis of type, product, distribution channel, and region. On the basis of type, the market is categorized as virginia, burley, nicotiana rustica, oriental, and others. As per product, it is divided into cigar, cigarette, kretek, snuff, and others. According to distribution channel, it is divided into hypermarkets & supermarkets, convenience stores, specialty stores, and online sales channel. Region-wise, the tobacco market is analyzed across North America, Europe, Asia-Pacific, and LAMEA. By considering these segments, the tobacco market analysis is done effectively.

Various types of tobacco available in the market include aromatic fire-cured, latakia, cavendish, corojo, criollo, dokha, habano, maduro, perique, and shade tobacco.

The tobacco market forecast is accomplished by considering fastest growing and largest segments. By type, the burley tobacco segment was the highest revenue contributor in 2019, as it contains some amount of sugar and has better taste as compared to other types of tobacco. By product, the cigarette segment held the largest tobacco market share due to constant product innovation in terms of flavor, size, ingredients, and nicotine level of cigarettes. Depending on the distribution channel, the specialty stores segment led the market, owing to availability of large variety of tobacco in these stores.

Globally, the number of smokers has been increasing. This trend is being accelerated by the introduction of new products such as clove cigarettes and menthol cigars. These factors are expected to drive the market over the next few years.

Furthermore, with consumers gradually shifting toward smoking alternatives in recent years, the introduction of innovative tobacco products in a variety of flavor options has become critical. As a result, manufacturers have shifted their focus to premium tobacco products made from flue-cured tobacco and fine whole leaf.

The introduction of numerous premium tobacco products by manufacturers, such as flavored, long & skinny, colored, and e-cigarettes, has created a strong outlook for the tobacco market growth. Increased investment in R&D has resulted in the introduction of products with lower levels of toxicants. This has aided in attracting a larger consumer base for tobacco products.

Higher levels of education as well as growing awareness about health concerns related to tobacco consumption, such as various types of cancers, cardiovascular diseases, and pulmonary diseases, has hampered the market growth. In addition, stringent regulations in developed countries further limit the market growth.

The major drivers of the tobacco market are surge in consumer knowledge and increased awareness of products & services through digital media and other sources combined with the advent of social media, which are educating consumers about the benefits of organic products. As a result, the demand for tobacco products is increasing. Furthermore, companies offering these products are increasing their investments in R&D, marketing, and expanding their distribution channels to maintain their market position.

The increased focus of market players on targeting young consumers through the launch of flavored cigarettes and tobacco products will support the regional market growth. Furthermore, leading tobacco manufacturers have implemented plans to improve retail infrastructure and brand campaign strategies.

There is strong evidence that smoking is linked to negative outcomes and increased COVID-19 severity. Smokers are more likely to contract coronavirus infection than nonsmokers. Smoking may also increase the risk of COVID-19 by increasing the enzymes that allow the virus to enter and damage lung cells. As a result, the consumption of tobacco was reduced during 2020, which had a negative impact on the market growth.

Product launches, mergers & acquisitions, joint ventures, and geographical expansions are key strategies adopted by players in the tobacco industry. The key players in the global tobacco market include Altria Group, British American Tobacco, Eastern Co. SAE, Imperial Brands, ITC Ltd., Japan Tobacco International, KT&G, PT Gudang Garam Tbk, Scandinavian Tobacco Group, and Swisher.

Key findings of the study The global tobacco market was valued at $183.1 billion in 2019, and is projected to reach $262.8 billion by 2027, registering a CAGR of 6.7%.
Asia-Pacific was the highest revenue contributor, accounting for $68.1 billion in 2019, and is estimated to reach $103.0 billion by 2027, with a CAGR of 7.4%.
By type, the burley segment was the highest contributor to the market, with $64.1 billion in 2019, and is estimated to reach $100.2 billion by 2027, at a CAGR of 7.9% during the forecast period.

On the basis of product, the cigarette segment was the highest contributor to the market, with $66.4 billion in 2019, and is estimated to reach $104.7 billion by 2027, at a CAGR of 8.0% during the forecast period.

In Asia-Pacific, China was the highest revenue contributor with $17.2 billion in 2019, and is estimated to reach $30.5 billion by 2027, registering a CAGR of 9.5%.

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CHIMERIC CAPITALI$M

Is it time to rethink what ESG investing means?

Adele Peters - May 25,2022
Fast Company


When Tesla was booted off the S&P 500 ESG Index —an index that ranks companies based on environmental, social, and governance data—Elon Musk responded by tweeting that ESG was a “scam,” and pointing out that Exxon, one of the most polluting companies in the world, was ranked in the top 10 best companies in the index.

In a blog post, the S&P explained that Tesla was cut in part because, despite making electric cars, it didn’t have a low-carbon strategy. They cited Tesla’s lack of codes of business conduct, along with reports of discrimination and dangerous working conditions at its California factory, as well as its handling of a National Highway Traffic Safety Administration investigation. (The EV company was also listed on the Toxic 100 Air Polluters, ranking last year for pollution from its battery factories, fined in Germany for not meeting laws requiring it to recycle used batteries; and earlier this year, fined by the EPA for violating the Clean Air Act with hazardous pollution from its California factory.)

It’s clear that Tesla has flaws. But if other ESG funds continue to hold Tesla, while S&P’s ESG index includes an oil company, and the Dow Jones Sustainability Index includes the tobacco giant Philip Morris, what does ESG investing really say about corporate responsibility overall? The first thing to understand is what ESG investing means: Most ESG ratings aren’t actually looking at the impact a company has on the environment or society. Instead, it’s a way that investors are evaluating the financial risk companies face because of environmental or social issues. And as ESG investing keeps growing—with assets that could reach $41 trillion by the end of 2022—it’s worth questioning if it’s measuring the right things.

“There’s a sort of obscure language that ESG raters use to talk about this stuff,” says Thomas Lyon, director of the Erb Institute for Global Sustainable Enterprise at the University of Michigan’s Ross School of Business. “They like to talk about ‘materiality,’ which means, is this particular thing going to have a material impact on our bottom line? It’s not asking the question, ‘Will it have a material impact on the planet, or on people?’ It’s all about the bottom line.” For example, MSCI, one of the largest companies that rates companies for ESG, says on its website that its ratings are “not a general measure of corporate ‘goodness'” or even “a synonym for sustainable investing”; instead they “provide a window into one facet of risk to financial performance.”

The concept of ESG investing grew out of socially responsible investing, a strategy that investors use to make more ethical choices; but the ESG approach focused on profits. In 2005, a UN report argued that investors needed to consider how companies were handling environmental, social, and governance risk more broadly because it had financial implications; companies that are managed more responsibly, the theory went, will ultimately make more money. (Many studies have, in fact, now shown a positive correlation between ESG and financial performance.)

Multiple rating systems now exist to score companies on long lists of factors, from recycling strategies to human rights. But some of the choices can seem arbitrary. For example, the S&P index screens out companies that extract oil sands, but not oil companies generally. It also screens out tobacco companies, though the Dow Jones Sustainability Index does not. The S&P index is designed to reflect the same industries included in the S&P 500 in general, so it includes fossil fuel companies—despite the fact that analysts have warned that those companies face financial risks because of climate change.

Each of the firms producing ESG ratings uses different criteria, and they aren’t transparent about the details of their methodology. A company’s rank might be very different from one list to the next. “The thing that’s pernicious is that each of the raters wants to keep their secret sauce—you know, ‘I’ve got the magic method that will help you make a lot of money, and I can’t tell you what it all is, but trust me, it will make you more money than the other guy’s secret sauce,'” Lyon says. “And because they have the incentive to keep their methodology secret, there’s unlikely to be a full convergence in these ratings over time.”

Because most indices aren’t measuring the actual impact that companies are having, their scores might go up even as performance worsens. Even though McDonald’s emissions went up 16% between 2015 and 2020, “McDonald’s is getting ESG upgrades,” says Hans Taparia, a clinical assistant professor at NYU Stern School of Business. “That’s because those emissions . . . are not considered a risk for the company. Right now, everything’s being judged on financial risk to companies, which is extremely disingenuous.”

Also, the scores often don’t include criteria like corporate political activity. Exxon, for example, spent millions lobbying to slow down climate action by spreading disinformation, including op-eds arguing that climate science was “unsettled” and decrying the “media hype” about climate change. Among other things, Exxon funded the Competitive Enterprise Institute, an organization that ran an ad that promoted CO2, saying, “You call it pollution. We call it life.” Lyon says, “Exxon has a terrible track record in its political engagement. But most of these ESG raters don’t pay any attention to that.”

While a smaller subset of ESG funds exclude fossil fuel companies, and according to Lyon, the ESG world is beginning to talk more about ranking companies based on impact along with financial risk, there are also trends moving in the other direction. The Global Reporting Initiative, an organization that helps companies report their impact on climate change, human rights, and other issues, may be replaced by a broader effort between the World Economic Forum and large accounting firms aimed at standardizing sustainability reporting, with a result that may look more like ESG ratings do today.

“What they’re doing is zeroing in on just the handful of things that investors care about the most, and that are easiest to measure,” Lyon says. “If the GRI standards get pushed aside, and we focus only on what investors care about, then we’re missing that broader picture of what do we actually need to protect the planet.” The same is likely true in terms of missing the broader impacts on people.

The ESG space should evolve to track whether companies are reducing negative impacts on the world, Taparia argues. And for now, rather than relying on outside ESG ratings, it may make sense for investors to compare corporate ESG performance themselves. “They should make their own judgments, and do their own research,” he says.

Go green or go home: Employees want their 401(k)s to reflect ESG goals

By Paola Peralta

May 24, 2022,

Alena Koval from Pexels

Putting away retirement savings has been common practice for employees for decades, but where that investment goes and what it supports has often been a mystery. Today’s employees, however, don’t just want to secure their own future. They want to help save the world.

In 2020, a total of $2.3 trillion was invested in impact funds, which support companies, organizations and funds that aim to generate a measurable and positive social or environmental impact — along with a financial return. That’s equivalent to just about 2% of all global assets under management, but the interest in these funds is gaining momentum, especially among the youngest and globally-minded generations in the workforce.

“We have a really clear theory of change,” says Zach Stein, co-founder of Carbon Collective, an online investment advisory that prioritizes investing in sustainable businesses. “What is the world that we’re trying to build and how do we get there through investing?”

Only 37% of 401(k) and 403(b) plan participants said they were offered ESG-related investment options — which prioritize environmental, social and governance goals — by their employer, according to the Schroders 2021 U.S. Retirement Survey. Of the employees for whom ESG-focused options were available, nine out of 10 chose to invest in them, the survey found, and 69% said they would or might increase their overall contribution rate if ESG options were offered.

Read more: Your 401(k) plan could be burning down the rainforest

“We’ve had a lot of people who have said, ‘it’s not my fault — I was born into a world run by fossil fuels. It’s corporations’ and governments’ fault, they’re the ones who caused all of this. I shouldn’t have to do anything,’” Stein says. “[But] you can make change, and the ability and the magnitude is really extreme.”

In fact, Stein explains, most of the social causes employees care about — climate change, gender equality, queer issues and gun control — can be supported through existing retirement funds and programs. But the average employee often has no idea, and may feel confused or misled by the wide-reaching term “ESG.”

“ESG was built as an ethical risk evaluation tool,” Stein says. “It was not intentionally used for values-based [impact investing] and it doesn’t really deliver.”

The kind of modern-day ESG investing that is going to change the world, Stein says, is called impact investing, and it’s when the target date fund isn’t just aiming to do no harm, but rather to actively fix a social, political or environmental issue. According to a recent survey by LRN, an ethics insights research company, 94% of employees said it was “critical” or “important” that the company they work for is ethical.

“We’re seeing a whole shift in power,” says Andrew Behar, CEO of As You Sow, a California-based non-profit that advocates for more transparency and sustainability in retirement investments. “And it’s going to shift the entire nature of capitalism and allow an economy based on justice and sustainability to emerge, because that’s what people want.”

Read more: The former CHRO of Equifax and Coca-Cola talks DEI, ESG and company culture

For years, employees have trusted their companies and large custodians like Vanguard and Blackrock to invest their 401(k)s for them. But as the concept of sustainable investing becomes more popular, employees are realizing that the default investment options offered by most companies are potentially putting their money into funds that support deforestation and mass incarceration.

“They‘re becoming aware,” Behar says. “And the structure of the corporations, the structure of the boards, and the priorities of the boards will shift, because people on the board are going to see that without a climate plan, without a path toward racial justice, they will be removed. They will be replaced.”

But the question remains: once employees have identified the problem, will they be able to find the resources to fix it? Brian Haney, certified fund specialist and the founder of insurance agency The Haney Company, is working to make sure that they can.

“I encourage clients to think about what kind of vision and mission they want for their money,” he says. “One question I have started asking clients is, ‘Are you funding what you’re fighting? Can supporting companies that operate by certain values not only be good for our conscience, but for our portfolio as well?’”

Despite industries’ hesitance to incorporate sustainable options due to the fear of low performance, the return data has actually shown the opposite. Roughly 90% of studies find a non-negative relationship between ESG funds and financial planning, according to the Journal of Sustainable Finance of Investment. In fact, the majority of studies see a positive trend.

“Studies of longer-term historical performance suggest that ESG strategies have performed similarly to comparable traditional investments on an absolute basis and a risk-adjusted basis,” Haney says. “And several have outperformed.”

Companies like As You Sow and Carbon Collective — which offer employees a corporate 401(k) sustainability scorecard and provide employees with sustainable plan options, respectively — can help on the path forward, but the grunt work starts in the office. Change will start if enough employees come together and question their retirement plans, bringing those questions to HR and demanding change in their own ecosystem.

“The world only changes when enough individuals decide to change it,” Stein says. “The world won’t change until enough people can imagine what a changed world looks like — where you can taste it and smell it and hold onto it.”

Paola Peralta
Associate Editor, Employee Benefit News
Twitter

GM slashes price of 2023 Chevy Bolt, making

it the cheapest EV in America

Pras Subramanian
·Senior Reporter
Fri, June 3, 2022, 

Chevrolet Bolt EV

The 2023 Chevrolet Bolt will be the cheapest EV you can buy in America — with a caveat.

Earlier this week General Motors (GM) revealed pricing for the 2023 version of the Bolt EV. The base 1LT and better equipped 2LT models are now priced at $26,595 and $29,795 respectively, which GM says is a price cut of $5,900 per model compared to last year.

The larger Bolt EUV is getting an even bigger price cut, at least nominally speaking, of $6,300.

For the regular Bolt EV, that price represents a massive 18.5% price cut from a year ago, at a time when everything from components to labor costs are rising considerably in this country.

GM says even with the big price cut, no features have been removed or trimmed compared to last year’s model.

"Nothing has been removed," GM product specialist Shad Balch told the Detroit Free Press. "This reflects our ongoing desire to make sure Bolt EV/EUV is competitive in the marketplace. As we’ve said, affordability has always been a priority for these vehicles."
Pricing and tax credits

Though 2023 pricing hasn't been announced yet, the 2022 Nissan Leaf, which was the cheapest EV offered in the U.S., starts at $27,400. If you don’t include the $7,500 federal tax credit (that Nissan still qualifies for, but GM does not), the 2023 Bolt EV is the cheapest car in America.

So technically the Bolt EV is the cheapest EV in America when it goes on sale in 2023, not including the federal tax credit (which brings the Nissan Leaf down to a whoppingly low $19,900). The bad news for Nissan (7201.T) is the Leaf’s cumulative total sales in the U.S. are around 175,000 units, and when the 200,000 threshold is reached the federal tax credit is halved.

TANGERANG, INDONESIA - NOVEMBER 12: Nissan Leaf electric car displayed during the GAIKINDO Indonesia International Auto Show (GIIAS) at Indonesia Convention Exhibition on the outskirt of Jakarta, Tangerang, Indonesia on November 12, 2021. This first auto exhibition during pandemic COVID-19 organized by the Association of Indonesian Automotive Industries GAIKINDO open for the public from 12 to 21 November and joined by more than 300 brands in the supporting industries and highlighted around 150 new vehicles.

 (Photo by Anton Raharjo/Anadolu Agency via Getty Images)More

Also on the con side for the Nissan Leaf is that it only has 149 miles of range (EPA rated), whereas the cheapest Bolt EV has GM-estimated 259 miles. A buyer needs to step up to the Nissan Leaf S Plus to get 226 miles of range (EPA rated), but that model starts at $32,400.

The big point here is GM is doing what it can to bring an affordable, mass market EV option with decent electric range to middle-class buyers who want to go electric. This is a part of the market with a dearth of options, with only the Nissan Leaf S Plus as its only competitor, though Fisker (FSR) is promising that its Ocean EV SUV will start under $40,000 when it arrives sometime next year.

If the country is to hit the White House’s goal of having 50% of vehicle sales be all-electric by 2030, U.S. buyers will need many more cheaper EV options.

Ford Unleashes Heavy Artillery Against Tesla and GM

Ford unveils big plans as it looks to transform 'for the next era of American manufacturing.'

• ROB LENIHAN
• JUN 2, 2022 

And now comes the seventh generation...

Ford Motor Co.  (F) - Get Ford Motor Company Report said on June 2 that it plans to build the next generation of the Mustang Coupe, the iconic vehicle that hit the road in 1964 and kept on going.

The latest version of the Pony Car is one of several announcements that Ford made on June 2, as the automaker looks to hire more people, expanded its facilities and introduce a new electric commercial vehicle.

'Transforming Our Company'

Ford didn't go into detail about the new EV, other than to say that production will begin mid-decade at an existing Ohio plant, but the news is sure to catch the attention of Tesla  (TSLA) - Get Tesla Inc Report and other automakers looking to get a piece of that action.

Ford said it will invest $3.7 billion in new facilities in Michigan, Ohio and Missouri, most of it focused on EVs, while creating an estimated 74,000 new direct and indirect new jobs.

The company will adapt plants to build the new commercial electric vehicle and new versions of the gas-powered Mustang and Ranger.

The company and the United Auto Workers announced plans to add more than 6,200 new U.S. manufacturing jobs in the Midwest, convert nearly 3,000 temporary UAW-Ford workers to permanent full-timers and provide all hourly employees healthcare benefits on the first day of employment. 

“Transforming our company for the next era of American manufacturing requires new ways of working, and together with UAW leadership, we are leading the way and moving fast to make improvements to benefits for our hourly employees and working conditions for our factory team,” Ford President and CEO Jim Farley said in a statement.

The spending forms part of Ford's previously-announced $50 billion in new EV investments, spread over the next five years, that were unveiled in March. 

CRIMINAL CAPITALI$M

Woodford Fund Administrator Faces Lawsuit, Financial Times Says

Colin Keatinge, Bloomberg News

(Bloomberg) --

The administrator of a collapsed fund run by once-feted investor Neil Woodford is facing a multi-million pound lawsuit, the Financial Times reported, citing the claim.

London law firm Harcus Parker is bringing an initial claim against Link Fund Solutions on behalf of 1,500 investors in the Woodford Equity Income Fund, according to the newspaper. The total value of the claim may reach £100 million ($125 million), the FT reported.

The lawyers are filing the suit after many investors were unable to access trapped savings following the suspension of Woodford’s fund, the newspaper said. Harcus Parker says there will be more claims with around 7,000 already signed up and expectations that others will join, according to the newspaper.

Link told the FT its key responsibility is to “act in the best interests of all investors” in the fund. Link “considers it has acted at all times in accordance with applicable rules, as well as in the best interests of all investors, and it will continue to do so,” according to the newspaper.

Woodford is not himself a target of the legal action, which will be determined in the UK’s High Court, the FT said.

The director of Link Fund Solutions resigned in February, according to a filing with Companies House.

©2022 Bloomberg L.P.

Neil Woodford investors sue administrators of collapsed fund

Law firm brings group litigation aiming to recoup at least £18m on behalf of 1,500 people

Neil Woodford’s fund was suspended and eventually collapsed in October 2019. 

Photograph: Troika/Alamy


Kalyeena Makortoff

Banking correspondent

THE GUARDIAN

Fri 3 Jun 2022 

Investors who lost millions in the collapse of a fund run by the former star stockpicker Neil Woodford have brought group litigation against the administrator in hopes of recouping at least £18m.

The law firm Harcus Parker lodged its first batch of claims on behalf of 1,500 savers at the high court in London on Friday morning. Woodford himself is not the target – the claim is against the administrator of his fund, Link Fund Solutions, which is accused of failing in its duty to protect investors. Lawyers expect to expand the suit to represent at least 7,000 claimants.

The case will pile pressure on Link, which is also facing a claim from another law firm, Leigh Day, which could represent up to 12,000 investors.

UK regulations put administrators such as Link in charge of monitoring and supervising the investments executed by the fund managers.

Harcus Parker claims Link breached UK rules that require the firm to monitor financial risks and the liquidity of the fund, referring to how quickly investments could be converted to cash in order to pay investors. Poor performance of a number of Woodford’s investments, combined with his decision to put money in a number of private unlisted companies that were harder to sell, led to the fund’s suspension and eventual collapse in October 2019.

The once-star fund manager was subsequently removed as investment manager, and its administrator, Link, wound it down, returning money to many investors at a steep loss.

Harcus Parker is now suing Link for at least £18m, which it says is based on calculations of what investors would have earned through their investment had the firm not collapsed. The figure is also understood to take into account money that has been returned to investors through the winding-down – worth about £2.4bn. The fund was worth about £10bn at its peak.

About 300,000 investors were affected by the equity fund’s collapse three years ago.

Daniel Kerrigan, a senior associate at Harcus Parker, said: “Three years on from the suspension of the … Equity Income Fund, our clients are disappointed that it has become necessary for them to issue proceedings in order to reclaim their lost investments.

“We are confident, however, that this will mark an important step in their fight for redress. With so many affected by this issue, we encourage investors who have not signed up to do so.”

A spokesperson for Link said it planned on “vigorously defending” itself once served with the case, and that Link “considers that it has acted at all times in accordance with applicable rules, as well as in the best interests of all investors, and it will continue to do so”.

The first court hearing for Harcus Parker’s case is expected in September, though a trial may not take place until at least 2024.

The City watchdog, the Financial Conduct Authority, launched its own investigation into the fund’s collapse but has yet to publish its findings.

Woodford, who received dividends worth millions of pounds from the firm shortly before its collapse, used an interview in the Sunday Telegraph last year to issue a public apology over its failure. He has since launched a new venture advising professional investors rather than retail customers.

Woodford’s fall from grace followed a spectacular career in which he had become one of Britain’s most prominent fund managers, earning the moniker “the oracle of Oxford” after 25 years at Invesco Perpetual. Strong returns garnered him a significant following among retail investors and savers, allowing him to start his own investment business in 2014, with assets worth £16bn under his control by 2017.

BESIDES CHINA MANY COUNTRIES HAVE SLAVE LABOR
A new U.S. forced-labour law is about to test our consumption habits

CHOCOLATE EXPORTERS COME TO MIND

LONG READ

Alexander Panetta - CBC

Here's an uncomfortable thought experiment for the next time you're standing before your wardrobe, running your fingertips through your garments.

Count five items containing cotton. Stop at the fifth garment. Now imagine an enslaved human being. Because by this point, you're statistically likely to own their work.

Rayhan Asat thinks about this constantly. She's a U.S.-based lawyer who comes from an oppressed minority region of China where forced labour is systemic and which produces one-fifth of the world's cotton.

Asat hasn't seen her brother in six years. And when she looks at clothing, she remembers people like him in forced detention and wonders if it was spawned from their suffering.

"I often think about it," said Asat, a fellow at Yale Law and the Atlantic Council in Washington, D.C.

"Every time I'm mindful: Is this made in China? Does it mean it's tainted with forced labour? Is it one of my family members?"

Soon, we'll all be confronted more directly with this reality, courtesy of U.S. lawmakers. Our clothing and our conscience are on a collision course this month.

There's a mounting pile of detailed evidence of human rights abuses against ethnic Uyghurs in China's Muslim region of Xinjiang, a hub for cotton, tomato paste and solar-panel production.


© Jeenah Moon/ReutersU.S.-based lawyer Rayhan Asat hasn't seen her brother in six years and says he's suffering in a Chinese detention centre.

And there's a specific date when things are supposed to change: June 21.

That's the day a new U.S. law takes effect, aimed at reordering international supply chains by altering the behaviour of any company that sells goods to the U.S.

Critics of the measure warn it will cause economic chaos.
What happens June 21

The Forced Labor Prevention Act would penalize importers and seize their goods by toughening older forced-labour laws with unprecedented new measures.

It reverses the burden of proof: guilty until proven innocent.

From now on, if you're shipping anything into the U.S., and if U.S. officials find out that any of it — even a bit of it — comes from Xinjiang or from any entity on a future watchlist, it'll be seized unless you can prove there was no forced labour involved.

Needless to say, it won't be easy.

Importers call it a logistical nightmare and have been pleading with the U.S. government to delay implementation.


© Leah Millis/ReutersSeen here is a protest last year outside the Canadian embassy in Washington, D.C., where people demanded that countries label China's actions in Xinjiang as a genocide.

Companies say there's no clarity about how this will work; warn it could raise costs and worsen inflation; and say it's mind-bogglingly complex to weed out every forbidden fibre from fabrics that get sold, and re-sold, across several countries before becoming a final product.

One firm that tracks these illicit goods says its artificial intelligence software counts millions of buyer-seller relationships around the world involving entities linked to forced labour in Xinjiang.

The firm's co-founder says his software sees nearly one million direct business-to-business connections with forced labour, and seven million second-hand connections.

"It's in everything," said Evan Smith, whose company, Altana, works with government agencies and companies to map those networks. "Your razor blades, your T-shirts, your antibiotics, your spice rack, your diapers. This stuff is really touching so much of the everyday economy."
Spillover effect on Canada

Make no mistake: this change will have a spillover effect in Canada. Partly because we operate in a trade area with so many cross-border businesses.

This country also has legal obligations under the new North American trade deal: it's committed to stopping forced-labour imports, and the deal also created a forced-labour task force to monitor the issue in the U.S.

Canada enters this era lagging behind; it has not prevented a single shipment since the new North American trade pact took effect, according to a report in The Globe and Mail.

Canada is now looking to tighten its rules with a bill that's nearly passed through Parliament that would force companies to produce annual reports on their supply chains.


© Octavio Jones/ReutersThe Forced Labor Prevention Act passed through the U.S. Congress last year with support from both parties. Republican Sen. Marco Rubio, seen here, was one of its co-sponsors. The law's toughest provision takes effect this month.

The United States has had a forced-labour law on the books for nearly a century — since 1930. It's progressively toughened that law, and has been stopping or seizing hundreds of shipments in recent years.


But importers sound panicked about the newest change. Some voiced their worries last week at a U.S. briefing session for industry.
U.S. Customs deluged with panicked questions

CBC News listened in on an online briefing where businesses flooded U.S. Customs officials with far more questions than could be answered in the allotted time.

More than 700 people participated in the briefing, typing out questions like: What proof of innocence is sufficient? How do you define a Xinjiang product — with an address? Will there be DNA testing on cotton fibres? Will companies be liable for the actions of their suppliers' supplier? And what happens to seized goods — can companies get them back and sell them elsewhere?

Some participants expressed frustration. One said supply chain problems are already a major drag on the U.S. economy and that this could worsen shipping delays.


© Thomas Peter/ReutersSecurity guards stand at the gates of what is officially known as a vocational skills education centre in Xinjiang, China, in 2018. The region's forced-labour camps and re-education facilities are aimed at diluting the Uyghur identity.

Others vented about the reversed burden of proof: "Proving a negative is nearly impossible. How would someone prove that all presenters [in this briefing] are NOT forced to be here?"

U.S. officials promised more specific guidance will be released on June 21, the day the new law takes effect. Officials insisted the new law will be applied immediately.

Compounding the complication is pressure from China.

That pressure includes threats. Companies that raise concerns about rights abuses are hit with boycotts in China. H&M was forced to close numerous stores.

China also has a new law allowing it to punish companies deemed to interfere in its internal affairs — the consequences include possible asset seizures; denial of entry into China; and a ban on Chinese citizens working with the company.

"[These competing U.S.-Chinese threats] have companies in an impossible situation," said Eric Miller, a Canadian-born, U.S.-based trade consultant who has clients in the clothing industry.
China fights back

The Chinese government position: That claims of genocide are a fabricated scandal, being used by the West as an economic weapon to hurt China.

In Beijing's description, its crackdown on Uyghur identity, with suspected nationalists sent to re-education and work camps, is an effort to bring national unity following past separatist terrorism. And it calls the U.S. a hypocrite given its own use of prison labour in various states.

China is also making it harder to trace products to Xinjiang.

For example, Uyghur prisoners are being moved to work in factories elsewhere in China: one Australian study found more than 80,000 Uyghurs were transferred out of Xinjiang between 2017 and 2019, and other reports say those forced transfers keep happening.

Mapping transactions was challenging even before this change. Miller counts 101 steps to make a simple T-shirt, from gathering the cotton to shipping the final product, across multiple factories, in different countries with different legal systems.

All this helps explain why Xinjiang cotton keeps showing up even in products of companies that say they've changed their practices. It's reportedly happened to Adidas, Puma and Hugo Boss.


© Thomas Peter/ReutersA guard stands in a watchtower of Kashgar prison in Kashgar, Xinjiang, last year.

According to several surveys on hundreds of U.S. fashion products by the forensic analysis company Oritain, around 16 per cent contained traces of what appeared to be Xinjiang cotton.

The head of a Canadian industry lobby group said the U.S. policy is creating maximum confusion.

"Lots of doomsday scenarios," is how Bob Kirke, executive director of the Canadian Apparel Federation, described the industry mood. "We're now less than a month away. And we have no guidance."
'It really upsets me'

Rayhan Asat, however, has little patience for complaints about how complex this will be. She said the challenge for companies pales in comparison to what her people face — being forced into re-education camps; tortured in so-called tiger chairs; enslaved; and having their culture beaten out of them.

"For these companies to cite difficulty? Let me tell you what's difficult," she said in an interview with CBC News.

She said that after his years in solitary confinement, her brother Ekpar looks like a shadow of the buoyant tech entrepreneur she once knew.

Asat said he's only granted a video or phone call a few times a year. The calls typically last a minute, and if he hasn't said goodbye at 59 seconds, he gets cut off with no farewell.


© Parliament of Canada Rayhan Asat is seen testifying before the Canadian House of Commons in a 2020 virtual hearing. Pictured in the background is her imprisoned brother Ekpar Asat.

"It really upsets me, to be honest. … The difficulty of doing due diligence is nothing compared to the human suffering taking place in the Uyghur region."

Asat said international companies have been on notice for years that the Uyghur region is awash in forced labour, and they could have acted sooner if they cared.
New law could create a new industry

New technologies could be part of the solution.

Oritain, for example, does DNA analysis. Altana, which maps out supply chain relationships and warns clients if they're working with a firm linked to forced labour, was co-founded by Alan Bersin, a former U.S. customs commissioner under Barack Obama, with the specific goal of cracking down on forced labour.

Bersin's partner, Evan Smith, describes one encounter a few weeks ago with a major apparel brand Altana has begun working with.

He said the company believed it had weeded forced-labour goods out of its supply chain. But it was stunned to hear that a Sri Lankan garment mill it worked with had a Vietnamese supplier working with a Chinese company partnered with a Xinjiang entity.

An executive called the Sri Lankan mill, which, Smith said, at first insisted it had broken off any Xinjiang ties — then admitted there might have been an exception.

This sort of tracking will carry new costs for companies. Smith's firm charges six-figure fees for now, and will add less pricey services eventually.

He said companies better get used to this new reality.


© Lindsey Wasson/Reuters Protesters held a sign against China's Uyghur camps outside the Vancouver home of Huawei executive Meng Wanzhou during her detention in Canada in 2020.

Smith compares it to the post-9/11 moment when the U.S. toughened financial-disclosure laws for banks as part of its anti-terrorism efforts.

"It's hard. But it's possible," he said.

"And the private sector should assume it will have no choice. … This is going to become the norm, and not the exception. … All things are pointing to a new paradigm: Thou shalt know your supply chain."

NOT WHITE BABIES

Birth alerts have ended but babies still being apprehended in Manitoba: data

WINNIPEG — Manitoba’s families minister has touted a significant drop in the number of newborns seized by social services since the province ended the controversial practice of birth alerts, but government data shows hundreds of babies are still being taken into care every year.


© Provided by The Canadian PressBirth alerts have ended but babies still being apprehended in Manitoba: data

“We have reduced … childbirth apprehensions by 75 per cent since that policy was implemented," Rochelle Squires said during question period on Tuesday.

Data obtained by The Canadian Press through freedom-of-information requests shows, on average, a baby is still seized in Manitoba nearly every day.

Birth alerts were used to notify hospitals and child-welfare agencies that a more thoroughassessment was needed before a newborn was discharged to a parent deemed high-risk.

The province stopped the practice in 2020 after a review found it discouraged pregnant women and their families from reaching out for prenatal support.

The province clarified the minister's numbers later in the week. It said there had been a decrease in newborn apprehensions, but it was not what the minister reported. There were 101 babies up to three days old seized in 2020-21, a 46 per cent decrease from 186 newborns the year before.

The province said the minister had been including children up to a year old who had been taken into care.

The data obtained by the news agency shows there has been a gradual decrease of apprehensions involving babies under a year old, but it doesn't match what the minister said.

In 2019, 496 babies were apprehended. That dropped to 386 babies the following year when birth alerts ended. Last year, 339 were apprehended.

That's a decrease of 32 per cent from the year before and after birth alerts stopped.

The minister’s office further clarified that newborn apprehensions decreased by 65 per cent since the Progressive Conservatives took office in 2016. And, it said in an email, a 75 per cent reduction is expected this year.

“Those are staggering numbers of babies being apprehended," said Cora Morgan, First Nations family advocate for the Assembly of Manitoba Chiefs.

Morgan said ending birth alerts was the right move.

The practice has long been criticized by Indigenous leaders who say birth alerts are stacked against families. The final report of the National Inquiry into Missing and Murdered Indigenous Women and Girls said the alerts are “racist and discriminatory and are a gross violation of the rights of the child, the mother and the community.”

There are about 10,000 children in care in Manitoba and about 90 per cent are Indigenous.

Morgan said it's clear ending birth alerts has not stopped babies from being seized. She said mothers are still telling her they are scared to get prenatal support and she hears of babies and children being apprehended regularly.

“I still believe that they are still flagging mothers.”

The province needs to do more to support women who are pregnant or who have just given birth to keep families together, Morgan said.

Squires said in the legislature that “there has been a lot of damage done stemming back decades” around child welfare. She said all levels of government must move forward together.

Bernadette Smith, a legislature member for the Opposition NDP, said babies should not be seized unless there’s a threat to the child.

“We do more harm than good by apprehending kids,” she said.

Smith agrees ending birth alerts was a good decision. But, she pointed out, it means the number of babies being taken into care should have been closer to zero.

A bill Smith introduced in 2018 amended the province’s apprehension laws so that no child could be seized solely because of poverty. Smith explained that when she was a teenager she was placed in care because her mom couldn’t afford the supports needed to help her.

With more than 300 babies seized a year, it's clear there are other families who need help, she said.

“Moms should get the support before, during and after they have their children."

This report by The Canadian Press was first published June 4, 2022.

Kelly Geraldine Malone, The Canadian Press

BIBLE BELT ALBERTA = UCP
'Barely surviving': Wait times, limited information keeping trans Albertans from health care

Brittany Gervais - Yesterday- CALGARY HERALD


Before he could get his surgery, Lindsay Peace would put her son Ace to bed at night and wonder if he would still be alive in the morning.


© Provided by Calgary Herald

Lindsay Peace, executive director of Skipping Stones, poses for a portrait at her office in downtown Calgary on Thursday, May 26, 2022.

Ace was 16 years old when he came out as transgender. He told Lindsay top surgery to remove breast tissue was one of the medical procedures he needed to feel comfortable in his body.

When Lindsay and her son began exploring options through Alberta Health, they quickly hit a wall.

“There was no information, no phone number, no email, no waitlist, other than, maybe you’ll get it in four years,” Lindsay said. “It sounds dramatic, but he didn’t have four years. He couldn’t have done it.”

There are more transgender people living in Alberta than the national average, with at least 12,480 transgender or non-binary people having lived in the province, according to unprecedented data released from Statistics Canada in April. In Calgary, that includes about 5,000 people, or 0.39 per cent of the population.

However, advocates and health professionals say patients are struggling to access health care due to limited information, long waiting lists, travel and a lack of training. Thousands of people in Alberta are waiting anywhere from two to five years for surgeries, including breast augmentation or mastectomy, phalloplasty, metoidioplasty and vaginoplasty.

Lindsay said she knew her son’s mental health would deteriorate if they had to wait years. The family decided to forgo Alberta’s funded plan and paid $20,000 for top surgery in Ontario instead.

The difference she saw in her now-22-year-old son after the surgery was dramatic, she said.

“After the surgery, he’s leading the Pride parade without a shirt on. I have this picture of him carrying this banner, and he’s smiling. It was incredible,” she said. “Three years before that, we couldn’t get him out of his bedroom.”


Pictured is a photo of Ace Peace leading the Calgary Pride parade in in 2019 in his mother Lindsay Peace’s office, executive director of Skipping Stones on Thursday, May 26, 2022. Photographed photo is by Benjamin Laird.

Long process

All provinces and territories offer varying levels of care for transgender and non-binary people . Right now, Albertans are able to get top or bottom surgeries covered by the province through the Alberta gender surgery program with a referral from a physician or family doctor.

Patients must be diagnosed with gender dysphoria for coverage — for bottom surgery, patients are required to get two diagnoses from two physicians who have expertise in gender dysphoria. Advocates and medical professionals say few physicians, including only five psychiatrists in the province, are able to do this.

There are no medical facilities in Alberta that provide gender-affirming bottom surgeries, meaning patients are sent to a private hospital in Montreal instead. Though publicly funded, the gender surgery program does not cover personal expenses or medical supplies for recovery.

Dr. Joe Raiche, psychiatrist and clinical lead at the adult gender clinic at Foothills Medical Centre, said the clinic currently has a waiting list of two years for health-care referrals, with between 1,500 and 2,000 active patients at any time.

“That’s pretty abysmal for health care,” he said. “It just feels like there’s this never-ending supply of patients and an inability to catch up, even if we could hire five new physicians tomorrow.”

There is $2 million allocated for the gender surgery program for 2022-23 according to the province, but Raiche said that won’t be enough to alleviate delays. Instead, Raiche said medical professionals have advocated for a surgical centre in Alberta to deal with the bottleneck.

“We have the necessary clinicians, the surgical specialists, gynecologists, plastic surgeons, urologists … but the lacking piece has been the institutional buy-in from AHS or Alberta Health, so we’ve been stuck with this broken system,” he said.

“For a province the size of over four million people, there should be something here.”

In an emailed response to Postmedia, Alberta Health spokesperson Chris Bourdeau said bottom surgery requires “specific surgical expertise not available in Alberta or other provinces outside of the Montreal clinic, with the exception of B.C.”

“As with some other specialist procedures, provinces do send patients to other provinces to receive these procedures,” Bourdeau said.

Alberta Health did not respond to specific questions about whether the province will consider reviewing the current system, or how the province plans to make gender-affirming surgery more accessible to Albertans.

Trans and non-binary people in Canada were more likely to experience unmet general and mental health care needs during the first seven months of the COVID-19 pandemic, according to a report from Trans Pulse Canada.

For comparison, about four per cent of the general population and 45 per cent of trans and non-binary people reported an unmet health care need pre-pandemic, the report reads.
‘This is about our survival’

Kim Fuery, 52, said she was told it would take two years before she could see a psychiatrist at the gender clinic at Foothills Medical Centre for a referral. She estimates it would take another two years before the actual surgery.

“The treatment is available, and it’s covered but the waiting seems interminable. It’s like being able to see water but not drink it and the longer it goes on the worse it gets.”

Fuery said she knew she was a woman at the age of 15. She didn’t have the words to describe it at the time but knew her body did not match who she was.

“That realization was followed very quickly by me trying to end my own life. Being a queer kid in the suburbs in the mid-’80s, in southern Alberta, was not safe or healthy. In my head, I really did not see any kind of future or place for myself.”

Fuery kept her identity hidden for decades, policing herself to fit in with what society expected of her. She struggled with multiple addictions from early adolescence, but her alcoholism rose to dangerous levels during the pandemic, she said.

Near the end of 2020, she said to herself “anything but this.”

“I let myself unfold, to think what I thought, and feel what I felt, and do what I wanted to do.”


Lindsay Peace, executive director of Skipping Stones, shows her tattoo, which she had changed after her son came out as transgender, at her office in downtown Calgary on Thursday, May 26, 2022. Peace has tattoos of her three children on her arm and the one of her son Ace used to be wearing a pink dress. She had the tattoo changed by the help of her husband Steve Peace who is a tattoo artist.

Now 16 months sober, Fuery still remembers the first piece of clothing she bought for herself — a bright magenta tank top.

Fuery emphasized not all gender and sexually diverse people need to access medical procedures to transition. However, she said she struggles with gender dysphoria and needs bottom surgery for her own journey.

“The physical dysphoria is a major mental health issue. I’m speaking in my own context, but having that mismatch between brain and body is punishing,” she said.

“No one who needs top or bottom surgery does this frivolously. We don’t do this because we’re bored. We do this because this is about our survival.”

Other surgeries, including breast augmentation and mastectomy, are also covered under the provincial program. These procedures can be done locally, but not every surgeon is willing to include transgender health care in their scope of practice.

Mag Benard, 30, is non-binary and on the two-year waiting list for top surgery consultation. They said there has been no word on their referral since it was sent to a surgeon in Calgary last June.

“I’m probably going to be waiting for over another year, minimum. A lot of folks who are in my space right now are often hoping that there’s a cancellation,” they said.

Benard said it’s frustrating to be forced to wait for relief from gender dysphoria. Having to bind their chest every day as a temporary fix is exhausting, they said.

“I feel like I can’t fully authentically express myself and be comfortable with myself,” they said. “When I look in the mirror, I don’t see myself. I have to cover up that part of me because it makes me physically ill to my stomach.

“Gender affirming surgery is life-saving surgery, because when you are stuck living in a prison where you feel so disconnected from your physical self, it takes a toll on your mental health and well-being. … Nobody wants to live every single day barely surviving.”

Bourdeau said in an email wait times for the province’s two gender clinics in Edmonton and Calgary vary from six to 24 months, “generally similar to, or shorter than, before the pandemic.”

“The wait list for a referral from an Alberta licensed physician depends on the physician’s appointment schedule,” the email reads, adding wait times for surgery depend on the surgeon’s availability at the time.

Along with long wait lists, traditional health-care spaces in the province are not seen as safe for transgender or gender-diverse people. When Benard had their appendix taken out this year, none of the doctors or nurses asked them for their pronouns or what name they wanted to use.

“There needs to be more opportunities for professional development so more professionals are trained and experienced to actually support and help people who are transgender.”
Limited information

Benard, Fuery and Lindsay said it was extremely difficult to find information about transgender health care in the province.

Information about applying for the program is currently limited to one page on AHS’ website . The link for an application for lower surgeries includes a health bulletin dated back to 2012 .

“People shouldn’t have to be stumbling through and figuring out how to get the care that they need. It should be easily available to them in a process that is well-defined with credible sources, supported by Alberta Health and AHS,” said family physician Dr. James Makokis from the Saddle Lake Cree Nation.

He said the biggest change needed is for the province to have a co-ordinated network that aligns all practitioners in the province working in trans health care.

Physicians used to be able to list their practice on the College of Physicians and Surgeons of Alberta website, so patients could search for physicians with a trans health care background, he explained. He said the college removed that search function two years ago.

“My trans patients can never find a family doctor who does this. Usually, it’s by word of mouth, or researching on social media.”

Other provinces like B.C. or Ontario have a province-wide system navigator specifically for trans and gender-diverse people. For example, the Rainbow Health Ontario website has a service provider directory, education and training for health-care providers, and research.

“I think that we have the ability to have credible information where people and families don’t have to be navigating in the dark to access life-saving care.”

Training and education in transgender health care is not mandatory for physicians, but Makokis said he highly encourages other family doctors to open up their scope. There are “huge gaps” for trans health care physicians across the province, including Fort McMurray, Grande Prairie, Edmonton and Calgary, which can add on to wait-times for patients, he said.

“We need more family doctors doing that type of medicine. There’s nothing to be fearful of, and you will definitely change, and probably save, someone’s life by doing this medicine.”

A Trans PULSE Canada survey published in 2020 found one in three trans, two-spirit or non-binary people considered suicide in the last year. One in 20 respondents said they had attempted suicide.

Transgender health care varies by province

Gender-affirming health care is recognized as medically necessary and life-saving by international medical experts, with standards of care set out by the World Professional Association for Transgender Health.

While Alberta stalls on reviewing policy, other provinces and territories have made improvements to access and delivery of gender-affirming health care.

In 2021, the Yukon government expanded health-care insurance coverage to include a wider list of surgeries and other procedures, including voice training and facial feminization surgery. The territory now has the most comprehensive coverage in Canada for gender-diverse residents by aligning with WPATH standards.

Trans Care BC works with partners and stakeholders, including the Ministry of Health, transgender communities, individuals, non-profits, regional health authorities and the First Nations Health Authority for a provincial network of services.

In Ontario, the government-funded Rainbow Health program creates opportunities for the health-care system to better serve LGBTQ+ communities by training health-care providers, providing information and spurring research.

Lindsay is also the executive director of Skipping Stone in Calgary, a non-profit offering support for transgender and gender-diverse people. She said the non-profit has two support groups specifically for people waiting for top surgery.

“It is so frustrating to see other provinces are moving forward. They’re listening, and in many of those provinces, they’re working with community organizations,” she said.

“We’ve had a few conversations, and people just pass the buck. There’s a ton of that between Alberta Health and AHS. Nobody will take responsibility to do this.”

Twitter: @BrittGervaisAB

CANADA

‘We are absolutely destroyed’: Health workers facing burnout, even as COVID levels ease

Dr. Laura Hawryluck was seized with a sense of overwhelming panic so great she couldn’t focus, couldn’t sleep.

© Submitted photo.Dr. Laura Hawryluck at Toronto Western Hospital, where she has spent the last two-and-a-half years treating waves of COVID-19 cases.

Teresa Wright - GLOBAL NEWS


This time, the cause wasn’t the faces of the many patients she has witnessed take their last laboured breaths in the intensive care unit at Toronto Western Hospital, where she has spent the last two-and-a-half years treating waves of COVID-19 cases. This time, it was a deadline keeping her awake.

She had been asked by a colleague to edit some teaching materials. A routine task for her any other time. But suddenly, she began to realize the toll the pandemic’s grinding workload has taken on her.

“That sense of overwhelming anxiety of being asked to do one more thing was the near sense of panic that I've never felt before,” she said.

Read more:
Health workers call for radical changes to health care to treat pandemic burnout

This episode made Hawryluck realize she would have to step back from some of her commitments. It wasn’t an easy decision, but the burnout she was feeling was just too much.

“I had to give up on some projects that I love doing,” she said. “But, you know, if I didn't, I realized that I was not going to be able to get through this.”

Life may be back to normal for many Canadians now that COVID-19 cases are on the decline, but the same is not true for many health care workers who are still dealing with hospital outbreaks and COVID-19 patients.

Now, after two years of extreme pandemic workloads, doctors and nurses say they are experiencing more burnout and emotional exhaustion than ever before – and it’s leading some, like Hawryluck, to re-think their commitments and career options.

Dr. Darren Markland, an Edmonton physician who also works in the ICU, recently made the difficult decision to close his practice as a kidney specialist after experiencing what he calls a “crisis situation.”

One day, he published a tweet saying he had just finished working 36 hours straight managing a dialysis shift while also covering the ICU for critical care.

“I was proud of that. That was just me with absolutely no insight. And when you lose your insight as a physician, you become a dangerous one.”

Markland says he ended up making a few “profound” mistakes, which made him realize he couldn’t continue working at that pace.

Read more:
Doctor closes specialty clinic in year 3 of pandemic to focus on critical care: ‘I had to make a choice’

Physician burnout has never been higher in Canada, according to the Canadian Medical Association (CMA).

More than half of physicians report high levels of burnout—nearly double pre-pandemic levels and nearly half say they are likely to reduce clinical hours in the next 24 months, CMA president Dr. Katharine Smart told a federal committee studying Canada’s health workforce in February.

Even though the rate of COVID-19 case numbers have started to ease in hospitals across the country, the workload and stress facing health-care workers hasn’t abated. Because even though there are fewer patients, the ones who do need care are sicker, after two years of being unable or fearful to seek medical care for non-COVID ailments.

This is now coupled with another challenging reality in many hospitals, clinics and family practices: many health-care workers are leaving the profession entirely, due to burnout and exhaustion, according to the CMA.

That means there are more critically-ill patients who need more care but fewer people to care for them.

Video: Peterborough health officials say workplace burnout is becoming more common

“We are absolutely destroyed,” Markland said.

“We are literally seeing people with chronic illnesses who have not seen a primary caregiver for years and now are presenting with end-stage, third-world type manifestations of diabetes or high blood pressure or renal failure. We're seeing young people having strokes because of a combination of unmanaged stress and substance abuse.”

Read more:
‘A pandemic of its own’: How COVID-19 is impacting mental health

It’s a crisis that has hit the health-care system so rapidly, Markland believes many are unprepared to deal with it.

“You combine that with just the mental and emotional stress of being worked to the literal bone, and it generates an environment that's tricky – I’ll say tricky because I often try not to think too hard about what's going on in the hospital.”

Nurses across Canada are also experiencing burnout to such an extreme degree they are at a “breaking point,” Canadian Nurses Association CEO Tim Guest told the same federal standing committee last month.

“This is an urgent national issue,” he said.

He also noted that many hospitals and primary health centres are experiencing an exodus of nurses leaving their jobs for other, higher-paying positions in other provinces or leaving the profession entirely because of unsustainable working conditions.

A report from Statistics Canada released Friday found one in four nurses surveyed between September to November 2021 said they intended to leave their job or change jobs in the next three years. Over 70 per cent of nurses who plan to leave cited job stress or burnout as a major factor, the study found.

Read more:

Hospitals grapple with ‘historical’ staff absences, burnout amid 6th COVID wave

Rachel Muir, a front-line nurse in Ottawa and bargaining unit president for the Ontario Nurses Association, says burnout “doesn’t even begin to describe” how she and her colleagues have been feeling.

“We were burned out before this all started because we were short-staffed. We were making do. And then the extra stressors and expectations, the disrespect we've been shown, have all compounded.”

Muir says she’s heard from nurses who have told her they sit in their cars before going into work, chanting, “You can do this, it’s only 12 hours, you just have to get out of the car.”

She echoed the concerns of physicians about patients who are sicker and needed more arduous care.

“For the nurses and the health-care providers on the front line, the care that they're providing is not only more intense and more acute and more mentally difficult because these patients are more critical – there are more of these patients,” Muir said.

Video: Pandemic health-care burnout not deterring nursing students

Nurses who may have had to care for four-to-six patients two years ago are now caring for six to 10, she said.

“When somebody is critically ill, that's a big number. And when it's not just one of your patients who is critically ill, it's two or three of them, and you are supposed to provide the care that you are trained and want to give – not only is it causing (nurses) to be burnt out, it's a moral injury to us.”

National associations that represent doctors and nurses have called on federal and provincial governments to take immediate, medium and long-term steps to address critical gaps in the health sector across Canada, and have submitted their ideas about what needs to be done. These include calls for more investments in recruitment and retention, training and education and for an expansion of support for community health care so more Canadians have access to family physicians and other primary care providers.

Read more:

Rate of doctor burnout in Canada has doubled since before pandemic: survey

But burnout levels among health workers should also remain a top priority for governments and health agencies to address, says David Gratzer, an attending psychiatrist at the Center for Addiction and Mental Health in Toronto.

Many health professionals don’t like to admit when they’re feeling overwhelmed or unable to cope because they prioritize their patients’ needs, Grazter said, whose patients include doctors and nurses.

“Over time, this could have consequences … people being less available to listen to patients; more mistakes have been found in some studies.”

Solutions like more flexible work hours, offering better quality work and career options and ensuring health workers are getting adequate vacation time are areas that should also be explored, he added.

“The most important thing is for us to remember burnout is something that's going on that we need to address it. And certainly at the hospital level, on the clinic level, making resources available to people who feel burnt out to get care is extraordinarily important,” Grazter said.

“We need a vibrant and healthy workforce because otherwise we’ll all pay the price.”