Awaiting the Double Whammy, Flu-plus-COVID

"It [intervening early and more aggressively in those whose COVID-19 condition is heading toward a bad outcome] also gives us an opportunity to have really frank and honest conversations with substitute decision makers and loved ones."  Dr.Douglas Fraser ICU physician, lead researcher, Lawson Health Research Institute

"They're testing really aggressively in Australia and they're just not finding cases. As far as we know people don't transmit influenza virus unless they have symptoms. It would be almost societally unacceptable right now to be walking around with those kinds of symptoms. And that's when you're transmissible for flu. We would expect there to be much more prompt isolation of cases of infectious influenza [than usual]."                                                                                                    Dr.David Buckeridge, professor, School of Population and Global Health, McGill University

"[The southern hemisphere's experience is, in some ways] a good reflection that all of the good public health measures that people are continuing to practise, the hand-washing, the physical distancing as much as possible, the use of non-medical masks and so on, that help prevent or limit the transmission of COVID-19, would also work equally well for other respiratory infections, including influenza."  Dr.Howard Njoo, deputy chief public health officer, Canada

Getty Images

"Why are critically sick COVID-19 patients clotting"?, posed one of the more puzzling questions doctors grappled with. And now, thanks to the research of a team of scientists in London, Ontario, led by Dr.Douglas Fraser, the answer has arrived. The body's immune system, responding to an invasion of the novel coronavirus, churns out enzymes shearing off minuscule sugar-coated hairs leaving blood vessels to become inflamed and exposed, causing platelets to grab, causing tiny clots in the lungs and in the body. 

Apart from which the identification of six molecules that seem to predict who is at the highest risk of death with severe COVID-19  to alert doctors when to intervene might result in a scenario guiding doctors to intervene at an earlier date in the disease's progression and more aggressively in recognition of those people destined to have a very serious outcome, with increased risk of death. And those breakthroughs were attributable to the research work of Dr.Fraser and his colleagues who identified the critical six molecules predicting who is at the highest risk of death.

Should similar research with corroborative results support the claims for these two research projects, the results of the two studies may lead to improved treatment for a new disease on the cusp of converging with an old familiar one. The collision of COVID and flu is on everyone's mind with the approach of winter and traditional flu season. Some, like Dr.Howard Njoo, take comfort in the fact that Australia is experiencing a relatively mild flu season, hoping that this will become the norm everywhere, this year of SARS-CoV-2.

"Influenza is predictably unpredictable", Dr. Mark Loeb, professor of pathology and molecular medicine at McMaster University observed. "Almost nothing is known" about co-infection with flu and COVID-19, wrote U.S. epidemiologists Michael Osterholm and Edward Belongia reporting in Science. They note that most people are vulnerable to the pandemic virus and should a surge in COVID-19 occur in the fall, overlapping with a surge in flu, the resulting stress on hospitals could become catastrophic. The hope would be that the number of those infected with each virus will tend to peak at different times, not simultaneously, reducing the strain on the medical system.

The potential of a "twindemic" looms as a possibility, creating unique challenges in having the vaccine administered in a timely manner to an awaiting population. In May, a Pollara survey of 1,912 Canadians saw 57 percent claiming they would "definitely" or "probably" get a flu shot, an increase from 45 percent over last year. With many buildings remaining shuttered, fewer office flu clinics will be available. The question of sufficient PPE for vaccinators in pharmacies and other places also presents as a dilemma.

The Public Health Agency of Canada is urging provinces and territories to think outside the box to arrive at working strategies, including multiple, smaller  clinics; administering inoculations outdoors in parking lots or drive-thru clinics; mobile clinics in vans or buses, fly-in teams in remote and isolated communities; all measures that could presage the day if and when COVID-19 vaccines become available. This year's flu vaccine has been tweaked from last year's but sufficient information has not yet emerged to determine which circulating strain will be dominant this fall and winter.

The risk of a dual or co-infection of flu along with COVID-19 is there, it is a risk, particularly to those with underlying illnesses. Early testing will be critical to enable doctors to know what they're dealing with; whether flu or COVID. Symptoms overlap, while treatments differ; a matter of testing early,   diagnosing, for identifying which is which "will be an essential component for public health surveillances".

Dr. Loeb points out how critical it is that people continue to practise social distancing. "On the other hand there's a lot of return-to-normal activities such as school" which could make it increasingly difficult to contain both the flu and COVID.  "We're seeing a spike in infections just as schools are opening up. Schools will send children home if the school is unable to determine whether a child has COVID-19 versus a cold or flu. For many families that means parents will have to try to work from home", observed Dr.Steven Taylor, professor and clinical psychologist at the University of British Columbia.

 

Neurological-Degeneratve Brain Effects of COVID

"...If we're ever going to understand this, this is something we need to do, now."
"We can't wait a year from now when potentially we'll have eight million or more people who have survived COVID-19."
"We're going to see many, many people with profound cognitive impairment a year from now. We have enough experience that we know that this is going to produce cognitive deficits. Many different things are likely to contribute to the cognitive profile of people coming out of this."
"...There are plenty of reports of people reporting what in a clinical context we refer to as delirium.There are people coming out of the ICU recovering from COVID and saying they don't feel themselves. They've got fuzzy thinking. They can't really concentrate. And this is sort of the typical profile that we know goes on to produce long-term consequences."
"I do most of my work with ICU clinicians, and they'll often tell you, no one leaves the ICU in good shape, cognitively."
"The priority, and this is not specific to COVID, the priority in most ICUs around the world is to get the patient out the door alive. They're not trying to get them out making sure they're cognitively intact and they have no memory impairments. People are typically fighting a battle between life and death. Cognitive deficits might not be a high priority at that point."
"You don't want to put all your eggs into giving people memory training if it's not fundamentally a memory problem that people have."
"It's important we understand exactly what the problems are: Is this something that affects people's memory? Their concentration? Their ability to make high-level decisions?"
Dr.Adrian Owen, neuroscientist, Western University

A world renowned neuroscientist has instead launched a study that aims to recruit 50,000 people with a confirmed positive diagnosis of COVID-19 to study the disease’s impact on brain function. Getty Images

Under normal circumstances, Dr.Owen focuses on studying the minds of people who have suffered severe physical trauma that has resulted in severe brain trauma; his specialty is 'understanding' severely injured brains, analyzing and interpreting what has occurred and whether -- although it appears that the individual with the brain trauma is no longer in possession of a functioning brain, by carefully studying the brain's neural responses -- he can detect brain activity however suppressed it is.

His studies and experiments came to a screeching halt, however, with the presence of SARS-CoV-2, the virus that results in COVID-19 contagion. "I have a whole team of people sitting in my lab, unable to directly assess patients", he said. With the escalation of the crisis and heroic protocols undertaken to save peoples' lives in hospital ICUs with the use of respirators, the invasive methods have produced a situation made to measure for investigation by one of the world's top neuroscientists.

What the medical community began to realize was that some patients stricken with COVID-19, receiving life-saving treatment, emerge from that treatment with neurological consequences not quite foreseen when those protocols were embarked upon. He has launched a huge study for the purpose of investigating the impacts COVID-19 infections have on the brain, called COVID-19 Brain Study, an online study hoping to recruit 50,000 participants.

Ideally, people who were given a confirmed, positive diagnosis of the novel coronavirus. With the use of questionnaires and pop-down menus, Dr.Owen and his colleagues plan to collect information "completely anonymized and secure" while enquiring about medical history of participants, of any underlying heart, lung or other health issues, and what happened to them following their COVID-19 diagnosis.''

Participants will be asked to perform cognitive games to assess memory, decision-making, planning the problem-solving, with results to be compared against an immense database of millions of tests that had been completed by a healthy, normal population. Stroke neurologist Dr.Rick Swartz of Sunnybrook Hospital in Toronto has partnered with Dr.Owen both anticipating a large and diverse group involvement of a study available in English, French and Spanish.

With an anticipated 50,000 participants, the hope is that sufficient statistical power will emerge to enable them to identify "all of these little nuances", giving answer to questions such as are there certain proportions of the population more vulnerable to developing cognitive deficits such as fuzzy thinking, brain fog, problems concentrating, and are there differences identifying with men and women? The elderly and the young? Does cognitive impairment only strike those who were placed on ventilators, is this an issue that everyone emerges with?

A recent article appears to have raised the question of whether SARS-CoV-2 is neurotropic -- toxic to brain tissues -- and to what extent the virus may impact on the central nervous system. In an earlier coronavirus invasion with SARS in early 2002-03, survivors commonly saw long-term neurological complications and since the novel coronavirus shares some of the same features of its predecessor, both using spike proteins to bind to a protein called ACE2 on the host, the fact that some scientists have discovered ACE2 receptors scattered through the brain offers a clue.

It is known that delirium, a type of brain dysfunction capable of leading to a serious state of confusion and paranoid delusions, can result with the use of high doses of some sedatives in the ICU. One-third of COVID-19 patients of all ages and two thirds of those with severe disease show signs of delirium, according to Harvard Medical School researchers; recognized as early evidence of a correlation.

 Spending time on ventilators leads patients to experience cognitive deficits which result from uneven delivery of oxygen to the brain, explains Dr.Owen. Use of the study's data to design therapeutic strategies "to work out what we need to do to deal with this", represents the hope that spurs this research.

The COVID-19 Brain Study looks to recruit 50,000 individuals who received a confirmed positive diagnosis of the virus in order to answer pressing questions about the disease’s direct and indirect effects on the brain.

"Is this something that's going to affect ten million in a year's time, in which case that is a massive social and economic problem."
"Or is this something that's going to affect 20,000 people a year from now, in which case it's something much more manageable."
Dr.Adrian Owen

COVID Stress, as Universal as the Pandemic

"[It's vital to identify environmental threats from a] fitness survival perspective."

"We only became predators much later in evolutionary history [leading us to over-interpret risks to survival because the human mind is poor at probability-estimating; a heritage of our hunter-gatherer brains]."

"[With COVID-19, there is uncertainty] because the medical news changes every day."

"...Generation Z and millennials were already very vulnerable, they were already prone to anxiety and depression and for many of them, I fear the confinement has made it much worse."

"We're still not sure what happened, where the virus came from and COVID conspiracy theories are spreading."

"Just the simple act of being able to share food and stories with your friends has become very special."

"The constant state of anxiety and uncertainty, the isolation, the lack of meaning and purpose, these are all things that are accompanied with negative affect, which make us more prone to being victims of our own emotions."

"We're constantly missing out in these tiny little micro actions, but these micro actions eventually amount to us becoming better persons for the sake of others. Doing things that people had lost track of because of the rat race of our daily lives."

Samuel Veissiere, anthropologist, assistant professor of psychiatry, McGill University

"We don't really know, especially because we don't have that comparator to say, this is how many would be experiencing lifetime anxiety prior to the pandemic."

"But it's important for people to understand that if you are experiencing those symptoms, you're not alone. This is an unprecedented time."

Tara Elton-Marshall, scientist, Centre for Addiction and Mental Health

"These are stressful times and there are things to be concerned about. But a healthy level of anxiety gives people agency."

"It's when the feelings start to impair functioning in your ability to work, to parent, to be present in a healthy way in your relationships, that a  health professional needs to be involved."

Dr.Valerie Taylor, chief, department of psychiatry, University of Calgary

Experts in the field of mental health swiftly became concerned about the impact of fear, isolation and pandemic policies on the human psyche when the global pandemic was declared, the series of shut-downs in various countries in response to the invasion of the SARS-Cov-2 virus which began to spread COVID-19 in populations, altering peoples' lives in ways never before encountered, taking an unheard-of toll on society in general, on the business world, on governments and the international community.

Our vulnerabilities, once the scaffolding of civilizational norms and our habitual place in the order of things were suddenly reversed and social-isolation mandated, struck people with a sense of total helplessness and uncertainty how to respond, in a growing sense of psychic dislocation. "It's sad, but not surprising", to see that outcome, commented Dr.Veissiere, co-director of the Culture, Mind and Brain Program at McGill, of the fact that a new national survey indicates a sizeable number of people have been severely affected psychologically.

One quarter of Canadians, according to the survey results, experienced moderate to severe levels of anxiety, another quarter experiences occasional or frequent loneliness, and 20 percent reported depression. Close to a quarter of the 1,005 survey participants reported at least once-weekly binge-drinking. Women, parents with young children, 18- to 39-year-olds appear to be faring worse than others, and notable numbers report being nervous and edgy, unable to relax.

People are irritable, readily annoyed, with a problematical number of days spent concerned that "something awful might happen", over the coronavirus hanging over society, like a Damaclean Sword. This survey represents the first in a planned series by the Centre for Addiction and Mental Health, collaborating with Delvinia, a research tech and data collection company, offering access to the survey data "to help mental health professionals get ahead of what's coming".

Angus Reid

Within any population there are people whose minds are geared to accept or struggle against situations, so that "if you're a 'no-big-deal' kind of person, you'll find the information confirms that bias", while catastrophizers who believe something is far worse than it actually is, react otherwise. When the World Health Organization first declared the death rate of COVID-19 at 3.4 percent, that data caused a frisson of fear. 

The U.S. Centres for Disease Control and Prevention this week released their 'best estimate', placing the overall death rate at 0.4 percent, a more reasonable, less fear-inducing figure for those who show symptoms, at the same time estimating 35 percent of infected people will never develop symptoms. Because of the shut-down conditions Canada imposed in an effort to 'flatten the curve', two million jobs were forfeited in April.

Resulting in a large segment of the population left to struggle with feelings of boredom, frustration and fear. Younger adults appear to be the most anxious, with people 60 and older less so, even as it is the older population that is more susceptible to the more serious effects of COVID than the younger demographic in one of those peculiar twists of irony in human nature. Experts hazard the opinion that people given to anxiety under normal circumstances now stressed under COVID have simply become more anxious.

According to the survey, it is women more than men who have ended up struggling more over the conditions they now find themselves in. More likely to have lost employment, to be shouldering child and elder care, and for many women home isn't quite the haven it should be. "We're seeing an increase in domestic abuse", notes Dr.Valerie Taylor. A 50 percent increase in texts and calls has been reported by Kids Help Phone, a national support service for youth.

Angus Reid

Anxiety represents uncertainty about what might happen. The more one thinks about possibilities and dwells on worst-case scenarios, the likelier they are to have heightened anxiety and depression. The very fact that SARS-CoV-2 remains a universal planetary threat speaks to our susceptibility and uncertainty. And when people feel helpless to avoid disaster fear and panic can set in, and spread. The antidote to that is to find comfort, reassurance, to restore feelings of safety.

And those can be found in re-establishing contact with those who have a meaningful impact on our lives, in a relaxation of the shutdown, and opening up of opportunities to once again be together with people we know and care about. To share experiences, meals, the meaning of life as social creatures dependent for our happiness and satisfaction on our contact with others, deriving pleasure from ordinary things that under normal circumstances are taken for granted.

A woman wearing a mask talks on her phone during the COVID-19 pandemic in Toronto on Tuesday, April 28, 2020. THE CANADIAN PRESS/Nathan Denette

Notes On A Second COVID Wave

"No one in Canada still alive is used to these types of sacrifices or public policy moral quandaries. Things will not be normal until we get a vaccine."
"There's an overwhelming sense internally that people won't take to a second lockdown. One thing is for certain, we need to give the public some freedom or they won't accept even basic limits."
Name-protected Ontario government official

"An issue of concern is, the longer this drags out, the more restrictions are applied, then lifted, then applied, the more people are going to get social distancing fatigue, and we can probably expect to see an increase of non-compliance with social distancing."
"People are resilient and will eventually adapt to new restrictions, but it's important that they have a realistic idea of how long it's going to last. That requires good data to forecast the trajectory of the pandemic and governments willing to level with their citizens."
"That's going to scramble the system. It's going to confuse people [different messages from the federal government and the provinces]. People are going to downplay or dismiss the messages they don't want to hear." 
"So people might say, well, we're locked down but people in the other province are out partying. That's going to diminish the credibility of the last message."
Steven Taylor, psychologist, expert, psychology of pandemics, University of British Columbia

Medical staff in protective gear work at a 'drive-thru' testing centre for COVID-19 in Yeungnam University Medical Centre in Daegu, South Korea, on March 3. Because Asian nations experienced the outbreak much earlier, Canada can take lessons from them about preventing a second wave of infections. (Kim Kyung-Hoon/Reuters)

"People say that's a very distinct possibility [tackling hotspots as they arise, as opposed to closing down the entire country], it's standard, and we're gonna put out the fires."
"We're not going to close the country, we're going to put out the fires."
"There could be, whether it's an ember or a flame, we're gonna put it out. But we're not closing our country."
U.S.President Donald Trump, Washington

"We know particularly in those areas that are still working to get the spread of the virus under control it is going to be important to increase testing now ... but also make sure that as we move forward through the summer and into the fall, we are ready to act extremely quickly, so that the population at large won't be in situations of having to go back into confinement."
"But that depends on citizens doing their part, and also depends on having that testing capacity."
"We need to continue to do everything we can to prevent the need for any further lockdowns the way we've had up till now."
Prime Minister Justin Trudeau, Ottawa

A woman is tested at a temporary COVID-19 test clinic in Montreal, on Friday, May 15, 2020. (THE CANADIAN PRESS / Paul Chiasson)

There certainly are differences in attitudes and outcomes respecting the SARS-CoV-2 virus causing COVID-19 between the two countries. Where Donald Trump hasn't self-isolated, continues to make public appearances, balks at wearing a face mask, and goes out of his way to encourage States of the Union to begin to open their economies and their societies to bring both back to normal in hopes of rescuing their financial situation, along with those of the U.S. He defies both public opinion and scientific recommendations by making use of a malarial drug whose usefulness against COVID is unproven.

And then there is Justin Trudeau, who wears a mask, daily addresses the Canadian public from the steps of his 'cottage', urging caution, and who has shut down Parliament but for virtual sittings, and who has self-isolated for the past two months, preferring to run his minority government like a majority government, issuing new news of new sectors of society and business becoming eligible for public-supported financial assists. Justin Trudeau is operating the country like a private fiefdom, throwing loaned money at every problem due to COVID-19 as a solution. In isolating himself he makes no public appearances in pursuit of his position as prime minister.

The United States has been hit particularly hard in the number of COVID cases being racked up, including a huge death toll, particularly in New York State and City both acutely impacted by COVID. In Canada, with about one-tenth the population of its southern neighbour, both case load and deaths have been much lower per capita population base, but both countries have suffered devastating losses to their economies, suffering high unemployment and have been borrowing heavily to shore up industries in trouble, and people whose livelihoods have vanished.

And though both countries now appear to feel that they've succeeded in 'flattening the curve' of infection, they also acknowledge the possibility that what has thus far occurred may be but an initial flush of the disease -- which until a reliably efficacious and safe vaccine is discovered, produced and mass inoculation taken place -- rebounds of additional waves can be expected with equally devastating effect. Both countries know that to effectively protect their vulnerable populations, testing must be increased to contain their outbreaks.

In Canada and in the United States, each federal government enacts pandemic-reactive legislation, but both the provinces and the states have taken their own separate interpretations of how they will proceed. Since some provinces and states have been impacted more seriously than others, it makes sense that coming out of total lockdown the lesser-impacted will be more aggressive about opening up. Yet there is also the knowledge among authorities that populations are likely to react with resistance against schools, daycares and businesses opening, then closing again with a second viral wave.

Canadian cases

CONFIRMED

83,608

(Today: +1,139)

DEATHS

6,355

(Today: +105)

RECOVERED

43,084

(Today: +477)

1,493,327 tests administered  (Today: +19,572)

Retaining physical distancing will continue to present as a problem in opening workplaces, whether offices or production centres where the option of working-from-home is not viable. A diminished number of work stations will have to be addressed on its impact on the workforce and on the economy. And should the situation continue to fester, by next winter it is anticipated that the wearing of face masks may become mandatory everywhere. Aside from which the danger of mental breakdowns with a continuation of uncertainty and isolation measures represents a real danger.

Science, one of the world's top academic journals, published a paper evaluating the outcome of a possible second wave, and governments' possible reactions. The paper recommends thresholds for enacting strict physical distancing measures to be reinstated, should infection numbers reach 35 cases per 10,000 people, a threshold determined by local factors, including area hospital capacity. A study by the Center for Infectious Disease Research and Policy at University of Minnesota looks at the variety of forms by which a second wave can manifest.

Where a "fall peak" scenario was examined, of the possibility of a massive, single wave of infections, greater in impact than the initial wave the world has and continues to be occupied with. Where a "slow burn" might still be manageable to contend with -- if difficult to comprehend how that might be possible -- with a series of "peaks and valleys" bringing along three or four additional waves each approximating the size and impact of the first one the world is trying to recover from.

At Novavax labs in Rockville, Maryland, Dr. Nita Patel lifts a vial with a potential COVID-19 vaccine. (AFP)

The Liberal Government of Justin Trudeau to the Rescue!

"I very much understand that many organizations were forced to make very quick decisions. And when we have to make decisions quickly, there is a chane that there are mistakes. When we'll arrive to audit the [financial aid] programs, what we'd expect to find is a mechanism to identify mistakes."
"And if there were mistakes, that there be a mechanism to rectify those mistakes, which includes having that money reimbursed if necessary."
"Making payments properly to Canadians is important. When we approach any audit, you have to look at the risk of fraud. As soon as we suspect an incidence of fraud, or we suspect fraud, it increases risk. In that case, it means it will increase our sample size or the work we will do."
Karen Hogan, nominee as Auditor General of Canada

"The capacity for abuse or opportunistic behaviour in this program is enormous."
"If you advertise that you're going to be approved -- no questions asked -- you're going to get pensioners applying for it [the Canada Emergency Response Benefit]."
Philip Cross, former Statistics Canada economist, fellow, Macdonald-Laurier Institute

"It's close enough that it's likely a timing issue."
"You probably could have caught that one out of a hundred that's trying to defraud the system. But the trade-off would be that 99 legitimate applicants didn't get their money for a month-and-a-half and therefore had to go to a food bank."
David Macdonald, senior economist, Canadian Centre for Policy Alternatives

"Getting that help to the 99 percent of Canadians who needed it quickly and rapidly -- even if it means accepting that one or two percent might make fraudulent claims -- was the choice that we gladly made [as opposed to rigorously checking each application for CERB]."
Prime Minister Justin Trudeau

A sign warns about the global COVID-19 outbreak in Toronto, Ontario. April 5, 2020. Steve Russell/Toronto Star

Well, isn't it a truism that when people are disbursing funds from a general account, not their own personal funding source, they exercise less judgement, are more profligate, and in this particular instance when a prime minister unrestrained by a Parliament that has been placed in abeyance as a response to a global emergency with a health pandemic laying people low and closing national business and trade infrastructure, leaving millions without employment, can play the saviour and receive plaudits from grateful Canadians while placing Canada deeply in debt.

Asked about the spectre of widespread fraud when the government rolled out its emergency benefits program, Justin Trudeau suggested to his questioners: just look at the unemployment figures, and most certainly they were sobering. Rendered unemployed by the pandemic a vast swath of Canadians faced economic ruin, unable to pay their bills, their mortgages, feed their families. Something had to be done, and planning for a massive rescue through borrowing to fund a plan to send out monthly cheques to the unemployed to keep them afloat, was it.

Sometimes, things simply do not compute. Last month's labour-force survey released by Statistics Canada had it that three million people lost their jobs while another 2.5 million were faced with working less than half their normal hours since the beginning of the pandemic; both totaled 5.5 million Canadians, alarming and shocking. Yet by mid-April CERB claims from 6.7 million people had been received by government; a million differential from the total for unemployed Canadians.

The Benefit is available to workers:

• Residing in Canada, who are at least 15 years old;
• Who have stopped working because of reasons related to COVID-19 or are eligible for Employment Insurance regular or sickness benefits or have exhausted their Employment Insurance regular benefits or Employment Insurance fishing benefits between December 29, 2019 and October 3, 2020;
• Who had employment and/or self-employment income of at least $5,000 in 2019 or in the 12 months prior to the date of their application; and,
• Who have not quit their job voluntarily.

Economists are of two minds over the discrepancy in numbers; one that the difference represents a statistical anomaly, the other that there are some Canadians taking advantage of a no-holds-barred open benefits scheme, the legality of their decision to declare themselves unemployed if they were not qualified under the conditions set out on applications. irrelevant to them. The gap in statistical numbers does indicate something is awry.

People who "have stopped working" and qualify for the financial aid, and have made application to register for the CERB, receive $2,000 monthly as long as they earned $5,000 within the previous year and did not leave their employment voluntarily. All political parties that form government had agreed that such an assistance program was well justified by a situation that evolved relentlessly destroying economies even as it took countless lives globally.

Despite which, a growing realization that government failed in its duty to due diligence in handing out taxpayer-funded resources has raised quite a few questions. Why it was that Employment and Social Development Canada saw fit to alert its employees to ignore any possible abuse, to approve payments even for those who had voluntarily left their employment, even those who were fired for cause; instructions that actually contradicted the rules of eligibility for the CERB. Employees in the Department claimed to have found 200,000 claims that should have been disqualified.

Anecdotal evidence of cheating abounds. People who have reported no income for years possibly working under the table, now routinely receive CERB, according to one source familiar with the system. A client of mortgage broker Ron Butler, preparing to buy a new house had received a CERB payment while fully employed, explaining that two relatives urged him to apply as they had, fraudulently. When the man's mortgage was cancelled because the real estate company reported the fraud to the bank, "His reaction was extreme disappointment", reported the broker.

Who went on to relate that to his experience other instances of questionable use of the program had occurred, as for example, a friend living in a $2.5-million house, with $3 million in liquid assets having closed her business during the lockdown, experimented by applying for the CERB, and a day later a $2,000 payment was deposited directly to her account. Indicating that irrespective of personal assets, eligibility for CERB is not ruled out. Much like the universal payment scheduled to go out under COVID conditions to all Canadian seniors receiving Old Age Security when only low-income seniors should be awarded that payment.

By April 19, 6.73 million Canadians had successfully made application for CERB; consequently $19.8-billion had made its way from government coffers to applicants' bank accounts; the number of applicants whose total figure has since increased to close to 8 million. The government rescuing the unemployed from defaulting on mortgages and making use of food banks. Now Canada requires a rescue from its incompetent government.

A cyclist rides past graffiti stating “People Over Profit No Jobs = No Rent in Toronto during the Covid 19 pandemic. More than 7.1 million Canadian residents have applied for the $2,000 monthly Canada Employment Response Benefit since April 6.

Governing On-The-Cuff By Remote Decree

"The Liberal government has presented social distancing measures as a stark choice -- either selflessly shut down the economy to save lives or selfishly worry about the economy and condemn thousands to a vicious illness."
"[That approach] is being pursued at an almost incalculably large cost to the well-being of Canadians."
"The rationale for the lockdown seems to have morphed subtly from managing the outbreak by 'flattening the curve' to preventing the illness from infecting Canadians at all, pushing the timeline for a return to some economic activity into the summer and a return to 'normal' a year or more into the distance."
Macdonald-Laurier Institute letter: 24 scientific and industry representative signatories

"What's happening now is they're convincing people to continue being afraid, when what we need is a message of reassurance and confidence from government."
"They're contributing to an atmosphere of fear and uncertainty that is completely unhelpful as we try to move toward a more measured response to the virus."
"It's becoming clearer and clearer that the fear we experienced at the beginning, when we knew so little about the virus, is exaggerated."
Brian Lee Crowley, managing director, Macdonald-Laurier Institute

"More people are taking the view that the risk-benefit calculation here, where you avert the risk of transmission in return for suppressing the economy, that it's not a worthwhile sacrifice."
"We spooked people so well into staying home, to avoid social contact, that it is extremely difficult now to reverse that message."
"[There is a] growing chorus [of medical professionals beginning to question strict lockdowns that have carried on for months]."
Dr.Neil Rau, infectious diseases specialist, medical microbiologist, Oakville, Ontario

According to critics who take umbrage at Prime Minister Justin Trudeau's penchant for slamming critics of his policies as illiberal, racist and selfish, when they question his decision-making and claim that with the shutdown of the economy due to the novel coronavirus threat, having gone on to 'shifting the goalposts' for opening the country back to normalcy, his wildly disparaging comments and unwillingness to listen to advice from the source of the criticism has motivated a coalition of health experts and business executives to sign a joint letter of discontent.

Debate surrounding the severity and length of economic shutdowns cross-country which has resulted in the majority of Canadian business being shuttered, millions of people being put out of work, and the corporate and government balance sheets having been effectively eviscerated. No one disputes the initial necessity to effect a lockdown as a measure to respond to the COVID outbreak, but at the present juncture people question why a more limited shutdown hadn't been considered, in its effectiveness to keep from overwhelming the health care system.

Economic restrictions enforced under provincial emergency orders were the responsibility of provincial governments, yet the provinces and the federal government have been at loggerheads, with Ottawa failing in its responsibility to guide the country as a whole toward returning the economy to full capacity. While fully realizing the real risks to the public from the pandemic, it is vital, the letter-signers indicate, to rescue the country from its current predicament.

To that end, economic concerns should not be dismissed by the federal government as callous in the face of evidence suggesting the economic shock has deprived millions of people of a sense of stability as they have undergone a sense of shock, the question of whether a more limited shutdown might have been equally effective to ensure the health-care system was not overwhelmed. A heavy psychological toll has been taken on people's mental and physical health, alongside forms of violence such as a rise in domestic abuse.

Close to eight million Canadians have applied for federal financial support, having lost employment. Stock markets and public pension funds have suffered a beating in recent months, with vast sums of wealth and savings lost. Hospitals across the country remain below capacity, the expected surge of COVID patients suffering respiratory distress failed to arise, thanks in large part to the population's having adhered to the social isolation policy to 'flatten the curve'.

Sweden, which had taken a relaxed view on social restrictions, allowing bars and restaurants to remain open for business, along with schools for younger children, has become a focal point in the debate regarding the degree of lockdown required for a successful outcome. Where at present, though COVID-related deaths are higher than that of its neighbours, health experts in Sweden anticipate mortality rates will even out.

Governing by casual remote.

Prime Minister Justin Trudeau holds his daily COVID-19 briefing at Rideau Cottage in Ottawa on May 15, 2020. Sean Kilpatrick/The Canadian Press