Letters & Op-Ed, August 12 2020

It’s great to see articles related to nature and especially related to animals that don't get much press such as the frog [Once in a Blue...Frog?, August 5, p. 1].

This is indeed a rare condition as your article indicated and correctly referred to as "axanthism," but the photo shows that it was a Green Frog and not a Bullfrog that was found. They are two different species.

I lead a group of Herpetologists that study this phenomenon. Should you need any information on amphibians or reptiles that occur in Ontario for future articles feel free to contact me. Hope this is useful.

Dr. Stephen Hecnar Thunder Bay

Seven-fifteen PM EDT last Wednesday, August 5, marked the exact 75th anniversary of the cataclysmic Hiroshima atomic bombing. Three days later another bomb was dropped on Nagasaki. Hundreds of thousands of people died from the explosions and the subsequent injuries and radiation sickness.

Then aged 13, and now living in Toronto, Setsuka Thurlow is a rare survivor of the bombing, a retired social worker. She saw the devastation and suffering which followed, and she vowed that never again should such dreadful weapons be used. She has worked passionately to remind people of the immense and indiscriminate horrors caused by their use, to which there is no effective medical response. Her efforts led to her being chosen to accept the Nobel Peace Prize given in 2017 to the International Campaign against Nuclear Weapons (ICAN).

Since then nuclear weapons have proliferated and become vastly more powerful. Nine countries have them now, and attempts to limit and reverse this situation have been weakened by the politics of today. “A nuclear war cannot be won and should never be fought,” said President Ronald Reagan. He went on to say, “Would it not be better to do away with them entirely?”

Hope for the future lies in the groundbreaking UN Treaty to Prohibit Nuclear Weapons (TPNW),which was signed by 122 nations in 2017 and comes into force when 50 have ratified it. This number has reached 40. Although not applying to non-signatories, it will stigmatize all their leaders and likely affect commerce as well.

So Setsuka, we honour your vow, we commemorate the victims of 1945 and we seek to reawaken resolve to banish these hideous weapons from all countries, the only way to free ourselves from the risk of their use.

Ron Hubbard and I rang the bell of Holy Trinity Church in Fonthill 75 times on Wednesday, starting at 7:15 PM.

Dave Nicholson Fonthill

It has now been five months since COVID-19 arrived in Niagara, and over seven months since Public Health commenced protecting Niagara from this infection. In those few months, we have experienced a level of disruption to our lives not seen in decades. Tragically, 64 members of our Niagara community have passed away from this virus. Fortunately, thanks to efforts by all of us together, we have slowed the spread of COVID-19, protecting many more lives, and enabled a safe reopening of most of our economy. As we head into the fall and the next chapter of this pandemic, I want to share what we can expect, and how all of us can help to keep our communities safe.

At the most basic level, there are three ingredients to having an infection spread through our community: (1) the pathogen (e.g. the virus) must be introduced into our community; (2) there must be close interaction amongst us so that pathogen can move from an infected person to an uninfected person; and (3) members of our community must have low enough immunity so that the infection can make us sick.

Our response to this pandemic has attempted to prevent each of these in turn. From January until late March, our focus was to prevent the COVID-19 virus from coming into and taking hold in Canada. That involved federal government efforts to track people arriving from risk areas around the world. Locally, Public Health worked with healthcare providers to identify returning travelers who had symptoms of illness and get them tested. Efforts in this regard prevented establishment of COVID-19 in Canada for about two months, buying time for us to learn more about the infection and for our healthcare systems to prepare. Unfortunately, as COVID-19 established itself in many other countries across the world, particularly in the United States, most travelers to Canada became at risk of bringing infection with them, overwhelming our ability to hold the infection at bay. Pelham was particularly affected with the largest number of travel-related COVID-19 cases per capita in Niagara, and thus the highest overall per capita case count through the spring. With risk now everywhere in the world, border closures and general travel advisories have been put in place to limit introduction of new infections into Canada.

By mid-March, with COVID-19 now taken hold across Canada, focus turned to preventing the close interaction that allows the infection to spread. A big part of this is the on-the-ground work of local Public Health: finding people with symptoms, referring them for testing to diagnose if it is COVID-19, isolating infected persons so they have no interaction with others to spread the infection, and tracing contacts so that they can also be isolated before they become ill and can spread the infection further. Provinces complemented this by instituting emergency measures to prevent large gatherings and close businesses and services where individuals might be in close contact. Many of us began to work from home. By reducing the close interactions amongst us in society, COVID-19 could no longer spread as easily, and infection numbers have fallen. Thanks to the Ontario government acting early with such measures, coupled with our healthcare system having prepared during the previous two months when travel-related cases were held at bay, our hospitals and ICUs were never overwhelmed the way they were in New York, Italy, and many other locales. Today, the province is reopening our economy and allowing some more close interaction again, but keeping other restrictions in place to find the balance where we can have as much close interaction as possible, while not seeing infections grow uncontrollably.

Ultimately, we hope to shift to managing COVID-19 by that third element: addressing immunity in our population. Unparalleled global efforts are underway to develop vaccines that can provide us that immunity, which would, in the perfect case, allow close interactions to fully resume and all restrictions in our economy and society to be lifted. While we hope for this outcome, we should temper our expectations as the first vaccines will be first attempts, and likely not yet perfect. Governments and researchers are rightly prioritizing that any vaccine must meet all our usual extensive safety requirements. But ensuring safety and speed in roll-out will make it hard to perform the hat trick of also achieving high effectiveness at the same time. However, even an imperfect vaccine will allow more interaction and fewer restrictions in society, and hopefully over time, vaccines will be refined towards being highly effective, in addition to extremely safe.

While we await a vaccine, we are heading into the fall still relying on limiting close interaction in our society to slow the spread of COVID-19. Meanwhile, travel restrictions and border closures insulate our efforts from being undermined by what is happening in other countries.

There is often talk about a “second wave in the fall” and needing to prevent that. This is informed by observing past pandemics such as the 1918-19 Spanish Flu pandemic or the 2009 H1N1 Influenza pandemic. We should be cautious about such comparisons to influenza pandemics. Influenza viruses seem to be very sensitive to the hot weather, so infections go away through the summer before resurging in the fall. Coronaviruses don’t seem to be so affected by the hot weather. This summer, areas most heavily affected by COVID-19 include the southern US (Florida, Texas, Arizona, California), the Middle East, Mexico, India, the Philippines, and Indonesia—all warm areas in the midst of hot summers. Spain, Israel, and Iran are currently experiencing second waves during their hot summers. The lesson we should take is that a second wave for us in Niagara can arrive at any time.

This means that, unfortunately, there is no point at which we can let our guard down. All the ingredients that allow COVID-19 to spread are still here, right now: the infection is in our communities; with businesses reopening, we are now having more opportunity for close interaction than we have had for several months; and thanks to so few of us having had COVID-19, almost all of us have no immunity yet.

In the face of those growing opportunities for interaction, it is more important than ever that we each do our part to limit the kinds of interaction that allow infection to spread, so that the province can keep our economy and society as open as possible. In particular, keeping our children safe as schools and childcare reopen depends on us doing what we can to keep the spread of infection low in the community so that it cannot spread into schools.

We all therefore need to continue working hard to keep two metres distance from each other. We should keep washing or sanitizing our hands often. We’re now required to wear a face covering when indoors, but if we’re forced to be within two metres of others outdoors, we should wear it then too. And we should always be mindful of our health, and if we get symptoms of illness, we must stay home and get tested. Keeping this up after so long is understandably hard for all of us. But by practicing these measures, we’ll be avoiding the kinds of interactions that create the greatest risk of infection spreading. Our social lives will be able to continue, but with some modifications that keep our friends, neighbours, and loved ones safe and healthy.

One of the themes of this pandemic has been how central communities are to it. As the virus has threatened us, it has disrupted the normal in-person interactions we have within our communities. However, our communities have also been a source of strength: supporting vulnerable elderly members with groceries, errands, and other support. And it has been through collective action as a community to keep distance, wash hands, and wear face coverings that we have and continue to protect each other. Niagara has the distinct advantage of well-defined communities like Pelham that have been resilient enough to endure the disruption of losing physical interaction, and strong enough to pull together to support each other. It is therefore no surprise that we have had more success in managing COVID-19 than other parts of the province like the GTA. I believe this will be our greatest strength as we head into the fall and the rest of the pandemic: remaining united as a community to practice measures that protect each other, and to exercise compassion in supporting each other. ◆

M. Mustafa Hirji is the Medical Officer of Health (Acting) for Niagara Region