USA & CANADA (870)
Latest News
Canadians should be able to access dental care with a health card instead of a credit card
Friday, 09 April 2021 00:49 Written by theconversation 
Hasan Sheikh, University of Toronto
The COVID-19 pandemic has raised Canadians’ anxiety levels: anxiety about contracting the virus, financial hardship and isolation. But one thing Canadians don’t have to worry about is how they’ll pay for essential health care if they need it. For that, at least, all we need is our health card.
Actually, that last part is only partially true. Vital areas of health care were excluded from medicare, our universal health-care system. And for many Canadians, access to these health services has worsened since the start of the pandemic. Many have lost their jobs, and with that, essential health benefits like dental care.
The COVID-19 pandemic has reinforced just how foundational medicare is. As we recover from the effects of the pandemic, we must strengthen that foundation. It’s time for Canadians to start using their health card, not their credit card, to access dental care.
Health and oral health
Dental care is not luxury. Oral health is a critical part of overall health. Dentists and emergency physicians see the consequences of poor oral health on a daily basis.
Poor oral health can cause or worsen other medical conditions due to chronic inflammation. Providing dental care improves diabetic control, reduces the risk of aspiration pneumonia in long-term care homes, improves completion of treatment for substance use disorder and increases drug abstinence.
It has even been shown to increase employability. It’s hard to confidently interview for a job if you’re afraid to smile.
One in three Canadians lack dental insurance and one in five avoid seeing a dentist each year due to cost. In terms of dental care, our “universal” health-care system is anything but. Of all dental care spending, only five per cent is public. That’s less than the United States, where 10 per cent of dental care spending is public, and not even close to the United Kingdom, where it is 46 per cent.
This already dire situation was worsening before the pandemic, with more seniors retiring and losing their work-related benefits and more people working in the precarious gig economy. COVID-19 has only exacerbated this.
If Canada’s health-care system were a mouth, it would be too embarrassed to smile for fear of showing the large gap that is our missing dental care system.
The cost of forgoing dental care
Many Canadians forgo routine care because they can’t afford it, leaving small problems to fester and grow. Our current system not only stresses our individual wallets, it also puts additional strain on our health-care system.
With four in 10 low-income Canadians avoiding seeing a dentist due to cost, many end up relying on our emergency departments. Every nine minutes in Ontario, someone visits an emergency department for dental pain, when they really need to see a dental professional. The cost of these visits across the country is estimated to be more than $150 million a year.
The Canada Health Act makes the objective of Canadian health-care policy very clear:
“to protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers.”
Given this, we must guarantee access to essential dental care for every Canadian.
Expanding public spending to guarantee dental insurance for all would help Canadians access routine care, reducing the need for more costly and complex procedures later. This would benefit individuals, reduce costs for employers and give businesses a competitive advantage similar to the way medicare does now.
Challenges beyond public financing
While public financing is important, it doesn’t guarantee access to a provider. The private delivery model has left many poor and rural communities significantly under-resourced. Public delivery of some dental care can ensure that people actually have a provider near their community.
Many dentists in private practice have historically been hostile to universal dental care and public delivery. That’s no surprise because it cuts into their monopoly on care.
Doctors were once the same too. Doctors were the biggest opponents of medicare when it was first introduced in Saskatchewan. On July 1, 1962, the day medicare was born, most of the province’s doctors went on strike. But now, very few would want an American-style health-care system like we currently have for dental care — especially during the pandemic.
The COVID-19 pandemic hasn’t given Canadians many reasons to smile. Investing in a universal, publicly-funded dental care system would ensure that a healthy, pain-free smile is in sight for every Canadian.
This article was co-authored by Brandon Doucet, a dentist practising in Newfoundland with interests in surgery and public health and the founder of Coalition for Dentalcare.
Hasan Sheikh, Lecturer, Department of Family and Community Medicine, University of Toronto
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Ontario's ‘choice’ of fully online school would gamble on children for profit
Tuesday, 06 April 2021 03:16 Written by theconversation 
Lana Parker, University of Windsor
Despite the lack of data documenting benefits to children, and emerging evidence of several drawbacks and harms, the Ontario government is discussing making full-time online schooling a permanent “choice” in public education.
Read more: 'School choice' policies are associated with increased separation of students by social class
This idea is being introduced without adequate research, and stands to become the latest measure that raises inequality and threatens the viability of education as a public good.
The Globe and Mail obtained an Ontario Ministry of Education presentation dated March 22, 2021, detailing the prospect of continued virtual learning after the COVID-19 pandemic. The province aims to partner with TVO to offer “fully independent online learning” for “Ontario and out-of-province secondary students” and also mentions continuing “synchronous remote learning” for elementary students.
The proposal coincides with apparent plans to continue to help fund Ontario education by selling curriculum abroad. In 2015, Ontario reported it had agreements with 19 international private schools that pay the province to deliver the Ontario curriculum.
Unpacking the known harms
While the COVID-19 environment has produced unique challenges, many of the greatest difficulties for young people have been associated with the forced shift out of schools and into online learning. Online learning does not replace the complex, relationship-oriented learning and social environment in schools.
Fully online learning has had consequences for mental health, with increased feelings of social isolation. There have also been challenges to physical health, as youth grappled with a lack of physical activity and deteriorating eyesight. Even among older youth learners, motivation and engagement prove difficult to sustain online, with a higher potential for dropping out and worse outcomes for disadvantaged students.
Despite the negative outcomes associated with full-time online study for youth and without sufficient data to support its rationale, the Ontario government is introducing an unasked for “choice” that would set a detrimental precedent for public education.
More screen time?
Some might argue that getting students comfortable with online technologies prepares them for future study and the workforce. In my research on youth literacy and online engagement, however, I explore how student proficiency in navigating technology should not be mistaken for understanding complex information.
My work is part of a wider body of emerging research that examines how students make sense of the online environment — and how being online affects their literacy skills, including their capacities to form critical questions and navigate misinformation and disinformation.
I have also determined that literacy learning can be strengthened when students and teachers explore the emotional implications of contentious issues in a classroom community. In other words, leaving students alone in front of screens for even more of their already online-immersed day does not improve their critical thinking or engagement.
For adolescents, learning online doesn’t replace in-person interactions with teachers, other students and community members. These interactions, far from superficial or inconsequential, are at the heart of how students learn well. In the pandemic, many teachers have voiced concerns about how an online environment hampers their ability to tailor learning and to support their students with the full range of strategies that are available in the classroom.
Yet another worrying aspect is the risk to student privacy. There is ongoing concern about how tech companies may be gaining unprecedented insight into children’s lives and how data may be used.
Read more: Children's privacy is at risk with rapid shifts to online schooling under coronavirus
There are also issues of tech monopolies that muddy the line between public education and private enterprise.
Generating revenue
Students have opportunities to engage with online learning in Ontario’s current framework. There is no need to introduce compulsory online courses or the option of full-time online learning.
With all the issues implied by full-time online learning, why would Ontario consider making this a permanent feature of public education? Before the pandemic, in February 2020, the government was striving to introduce mandatory online learning in secondary school.
In a confidential Ontario government document written sometime between March and August 2019 and obtained by the Toronto Star, the current Ford government detailed a plan to dovetail cuts to school board funding with the opportunity to “to develop (a) business model to make available and market Ontario’s online learning system to out-of-province and international students.” It is telling that the document did not foreground the benefits of full-time online learning for students.
The reasons for this shift can be attributed to the ongoing drive to privatize public education through the twin aims of reducing costs and generating new revenue. The 2019 document also mentioned examining “feasible options for selling licensing rights to courses/content to other jurisdictions.”
Curriculum sales
The current discussions should be seen in the context of Ontario’s drive to create revenue streams through international student tuition and sales of curriculum to international schools.
Ontario’s March 22 proposal for online schooling describes a plan to develop curriculum and offer an education “with little teacher support.”
This “business plan” follows Minister of Education Stephen Lecce announcing the appointment of a former CFL commisioner to the role of TVO’s CEO. TVO’s website has been recently retooled to include an emphasis on “digital learning.”
Potential future harms
For children, fully online learning creates the conditions for further educational inequality. It is a particular risk for children with special education needs.
It can also produce unintended consequences: a recent study based in Ecuador showed female students working online were more likely to spend time doing housework than their male counterparts. It is not unimaginable that some families could select online schooling for their children so they could help with household work, care for family members and potentially supplement family income by entering the labour market earlier. The move also risks limiting opportunities for extra-curricular socialization and learning, including experiences with the arts and sports.
Once poorly researched educational policy comes into practice, it is difficult to undo irrespective of data that details its harms. Such has been the case with the introduction of standardized testing in Ontario, which marginalizes newcomers and students with exceptionalities, and encourages a narrow curriculum.
Over time, a policy of “choice” for full-time online schooling weakens public education by diluting in-person opportunities for students and eroding funding. An impoverished public system drives families into private schools, which further erodes the public good. Defunding and marketization will leave public education in a race to the bottom.
Lana Parker, Assistant Professor, Faculty of Education, University of Windsor
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Nigeria is being looted with impunity under Buhari – US
Friday, 02 April 2021 12:56 Written by correctngThe United States has said that “widespread and pervasive” corruption is being perpetrated under the watch of President Muhammadu Buhari.
The U.S. in its 2020 annual report on human rights said Buhari’s government has failed to take action to stem widespread looting using existing laws that criminalise theft in public service.
The report read in part; “Although the law provides criminal penalties for conviction of official corruption, the government did not consistently implement the law, and government employees frequently engaged in corrupt practices with impunity.
“Massive, widespread, and pervasive corruption affected all levels of government, including the judiciary and security services.”
The report also noted that the president, vice president, governors, and deputy governors have continued to enjoy the immunity clause in the Constitution that shields them from facing charges while in office.
The search for a new governor general is tough in a disparate nation like Canada
Sunday, 21 March 2021 13:45 Written by theconversation 
Thomas Klassen, York University, Canada
The federal government has kicked off its efforts to choose a new governor general to succeed Julie Payette, who resigned in the face of allegations she created a toxic workplace at Rideau Hall.
The long delay in appointing Payette’s replacement illustrates how difficult it is to fill the job. Whoever is ultimately selected by Prime Minister Justin Trudeau must represent Canada’s past, especially its linkage to a monarchy that’s currently in a state of crisis following recent allegations by the Duke and Duchess of Sussex. But the new governor general must also exemplify its future.
Read more: Will the Meghan/Harry revelations change Canadian attitudes about the monarchy?
Even more importantly, the individual must grasp Canada’s difficult and in some ways accidental road to nationhood.
In rejecting the siren call of the War of Independence in 1776, the northern colonies that became Canada cemented their allegiance to the British Crown.
British oversight
Over the next century, the British offered protection against the expansion of the United States. Even after Confederation in 1867, the interests of the British Empire guided Canada’s foreign policy for decades.
The political culture and traditions inherited from Britain — a parliamentary system of government (House of Commons and Senate), common law, a strong degree of conservatism and emphasis on collective responsibility — have shaped contemporary Canada.
The very position of governor general, inherited from Great Britain when Canada was but a collection of independent colonies, is one of the features that differentiates Canada from other large countries settled by European powers in the Americas.
American influence
Although Canadians rejected the allure of republicanism, politicians over the centuries have felt free to borrow from their American counterparts. Canada pirated federalism (strong regional governments, namely provinces) and a reliance on a written constitution, with the Canadian Charter of Rights and Freedoms’ emphasis on individual rights.
At the same time, the U.S. has been useful as a model of what to avoid: a presidential system of government, slavery, an aversion to gun control and too great a reliance on the free market.
Québec culture
The defeat of France by Britain that resulted in Québec becoming an English colony is a defining event in Canadian history. However, the decision by the victors to guarantee the French their traditional rights and customs, and the political means to protect their culture, was just as important to Canada’s future.
This approach resulted in bilingualism and biculturalism, ultimately becoming multiculturalism, and it distinguishes Canada from many other nations.
But Québec has had historical grievances against the rest of Canada, leading to the 1995 sovereignty referendum that came within a few thousand votes of tearing Canada apart.
Québec separatism, even when in decline as it appears to be now, is an existential threat that surely features prominently in the darkest nightmares of every prime minister — and the governor general.
Indigenous population
Life for Indigenous people in what is now called North America has drastically changed since settlers appeared and did everything in their power to wipe them out, including with longstanding colonial policies like residential schools, the ‘60s Scoop and numerous cases of land dispossession in the 19th and 20th centuries.
Starting in the 1970s, court decisions, changes in federal government policy and determined efforts by First Nations, Métis and Inuit communities and individuals have slowly enlarged the political influence of Indigenous Peoples.
Defining events included Indigenous activist Elijah Harper’s opposition to the Meech Lake Accord in Manitoba, and the Oka crisis, a 78-day standoff over the proposed expansion of a golf course and development of townhouses on a Mohawk burial ground in Québec.
More recently, federal government policy has shifted toward reconciliation with Indigenous people, exemplified by the Truth and Reconciliation Commission and the national inquiry into Missing and Murdered Indigenous Women and Girls.
Although most policy is largely symbolic, such as land acknowledgements, efforts are being made to improve the living conditions in many First Nations communities. The federal government, while missing the March 2021 goal of ending drinking water advisories that last more than a year, has made a dent in providing some communities with safe drinking water.
Read more: Water crisis in First Nations communities runs deeper than long-term drinking water advisories
Yet Indigenous people make up only a small strand in national politics, culture and power structures. Only in Nunavut, with a population of 40,000, do Inuit comprise a majority that allows them to enact laws to protect, sustain and advance their culture and interests.
The new governor general will have to fuse the British, French, American and Indigenous elements of Canada that together are at the core of the country. It is not an easy job, especially given the position is mostly ceremonial and one that not all Canadians see as even necessary.
Thomas Klassen, Professor, School of Public Policy and Administration, York University, Canada
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Popular News
Closing some of the U.S.-Canada land border crossings could help control the COVID-19 pandemic
Sunday, 21 March 2021 13:28 Written by theconversation 
Kelley Lee, Simon Fraser University; Anne-Marie Nicol, Simon Fraser University; Julianne Piper, Simon Fraser University, and Valorie A. Crooks, Simon Fraser University
During the COVID-19 pandemic, attention to travel measures has largely focused on air travel. This includes the potential use of “vaccine passports” to open up international borders again. However, for countries with extensive land borders, there are special challenges.
Canada and the United States share the world’s longest undefended land border. While the U.S. is Canada’s most important trading partner, it is also the world’s epicentre for coronavirus infections and deaths.
COVID-19 variants of concern are now present in almost all U.S. states. The spread of these variants in the U.S. points to the need for Canada to review the adequacy of public health risk management at land crossings.
Current land border policy
Since March 21, 2020, non-essential travel has been restricted at Canada-U.S. land crossings. Outbound travel for Canadian nationals and permanent residents, and inbound and outbound travel for non-nationals (except Alaska-bound U.S. citizens) are not permitted.
On Jan. 29, 2021, the Canadian government announced new measures for non-essential travel in response to variants of concern. Arrivals by air now have testing and hotel quarantine requirements, and those by land have testing requirements but can self-quarantine or isolate.
Given that hundreds of thousands of essential and non-essential travellers continue to enter Canada by land each month, differences in policy for air and land travel have been questioned.
According to Canada’s Public Safety Minister Bill Blair, the main reason for this difference is logistics. With 117 two-way land crossings, comparable measures “simply aren’t possible, given the existing infrastructure that’s available.”
As a team of travel health and pandemic experts, we suggest that there are solutions to this seemingly insurmountable challenge.
Less land border crossings
There are insufficient resources to provide screening, testing and quarantine measures at all land crossings comparable to air arrivals. Based on our study of travel-related measures during COVID-19, one option is to substantially reduce the number of crossings kept open. This is similar to the funnelling of air arrivals through four airports, and has been a successful strategy in other countries.
After closing some land crossings, the government can then designate selected crossings for incoming non-essential travel only. This prevents bottlenecks hindering essential travel. Given around seven per cent of land crossings during the pandemic are deemed non-essential, and that the volume of land travel has declined by around 90 per cent during the pandemic, temporarily closing some border crossings is also practical.
Crossings remaining open for non-essential travellers should be those that had higher vehicle volumes pre-pandemic such as the Peace Arch, B.C., and Rainbow Bridge, Ont. High traffic crossings already have the necessary inbound and outbound road networks to allow ease of access. They generally also have hotels nearby. This can enable an extension of mandatory quarantine at designated sites for travellers entering by land. These crossings should also be within a reasonable driving distance of a hospital should there be a need for health care. The border crossings themselves would need to have sufficient staff to accommodate any enhancements made to testing protocols.
Tailoring approaches
By streamlining land border crossings, on-site public health resources available can be tailored to specific types of travellers. For non-essential travel, alongside enhanced screening, testing and quarantine, arrivals should be provided with tailored information.
For example, in the coming weeks thousands of “snowbirds” are expected to return to Canada by land. These long-stay travellers should be directed to reliable sources of information regarding vaccine roll-out in their province as many will fall within priority groups. Those who were inoculated abroad should be given details on how to register this information in their personal vaccination record.
Read more: Why some snowbirds are flying south despite the COVID-19 pandemic and travel restrictions
Transport workers comprise a large proportion of essential travellers crossing by land. The World Economic Forum ranks transport workers as being at highest risk among approximately 950 non-health occupations during COVID-19. Many Canadian truckers have been concerned about potential exposure to the coronavirus in the U.S. and risk of infecting family members upon their return.
We agree with calls for transport workers to be vaccinated as a priority group. In the meantime, rapid testing should be provided at land crossings designated to serve essential travellers.
All entry points
A more coherent Canadian strategy on border management requires consistency in the measures applied for air, land and sea arrivals. At a time when COVID-19 and its worrisome variants are being brought into Canada via travel, reducing points of entry has several benefits.
Limiting the number of crossings enables us to concentrate resources and enhance public health risk management. This would also facilitate any plans to introduce more testing or even vaccine passports for essential travel. And the incentive for travellers to circumvent air travel measures by diverting to land crossings would be reduced.
Kelley Lee, Professor of Global Health Policy, Canada Research Chair in Global Health Governance, Simon Fraser University; Anne-Marie Nicol, Associate Professor, Health Sciences, Simon Fraser University; Julianne Piper, Research Fellow, Health Sciences, Simon Fraser University, and Valorie A. Crooks, Professor, Department of Geography and Canada Research Chair in Health Service Geographies, Simon Fraser University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Joe Biden understands the modern-day American presidency
Sunday, 21 March 2021 13:22 Written by theconversation 
Growing up in the United States, I was not a big fan of Joe Biden.
I remember Biden at the Clarence Thomas confirmation hearings in 1991, looking out-of-depth as his colleagues berated and belittled Anita Hill. I recall him during the Bill Clinton and George W. Bush years, holding forth in Senate hearings and casting about for middle ground that no one really wanted.
Biden was the face of establishment “meh,” the epitome of could-be-worse complacency. He vaguely sympathized with working people but went along with the neoliberal mania for lower taxes, fewer regulations and “freer” markets. He assumed the Civil Rights era had put America’s demons to rest, and he never saw the dark forces gathering behind his predecessor, Donald Trump, until it was too late.
One year ago, during a bruising primary against more progressive rivals, Biden looked like a man history had left behind.
Recently, however, Biden has shown that he understands how the modern U.S. presidency works, both in terms of policy and the nation’s psyche.
First among equals
Early U.S. presidents mostly focused on America’s relations with non-Americans. The Constitution of 1787 assigned domestic policy to Congress, not to the president. Besides, the early United States was a chaotic and ill-defined country, requiring most presidents to focus on enforcing federal law as best they could.
This changed for good under Franklin Delano Roosevelt, who held the office between 1933 and 1945. In the face of the Great Depression and fascism, FDR moved away from his centrist impulses and shifted U.S. social and economic policy well to the left. His New Deal vastly expanded the executive branch of the U.S. government and made it far more relevant to most Americans.
To be sure, congressmen resisted, not just as rival Republicans but also as members of a separate and equal branch of government. So did governors who embraced the American tradition of local self-government over centralized rule.
The modern-day president lives with these duelling legacies. On one hand, he now sets the priorities for domestic as well as foreign affairs and wields enormous discretionary power over a sprawling federal government. On the other hand, he must work with allies in the House and Senate and respect the stubborn independence of each of the 50 states.
Biden gets this.
He knows how and when to propose a bill and how and when to let others fight out the details. He understands how and when to frame an issue and how and when to let the arguments unfold on MSNBC and Fox News.
Most importantly, he understands that the dominant ideologies of the past 50 years, especially the neoliberal dictum that markets know better than nations, simply won’t do in the face of a pitiless virus and the human wreckage it has left behind.
This is why Biden, the ultimate moderate, was able to pass the $1.9 trillion American Rescue Plan, arguably the biggest decision made by the U.S. government since the the FDR era.
Consoler-in-chief
Besides making policy, the modern American president must console the people in times of trauma. This, too, traces back to FDR, who was the first president to address the people by radio. During his “fireside chats,” FDR spoke directly to a mass audience, trying to preserve some kind of emotional unity among the American people.
Canadians may well pause here to ask why such unity is necessary. Why does America require such emotional togetherness? Why can’t its 330 million people just feel what they feel and still agree to get along? Why can’t they live together as a big and complex society, different but not divided?
It’s complicated.
But after studying American nationalism for many years, I think the reason is that Americans aren’t nearly as nation-minded as we long to be. Our nationalism isn’t obvious or intuitive. We don’t have a distinctive language or ancient culture. We don’t even have a clear or stable sense of any homeland, a common patrie to which we can feel attached.
Much of American history and culture is about moving away from wherever we’re from to settle in the U.S., usually at the expense of Indigenous populations. (This is especially true for white settlers, although Black Americans also sought freedom by heading west or north.) Our cherished individualism and mythic frontier spirit makes us isolated and alienated, even — or especially — from other Americans.
That’s why someone needs to address us when something terrible happens. They need to look us in the eye and share our distress, in effect telling us that we’re not as alone as we feel.
Here again, Biden understands his job.
Read more: When 'hope and history rhyme': Joe Biden quotes an Irish poet to inspire healing in America
Presidential behaviour
In many ways, he became president the day before his inauguration, when he led a memorial for those lost to the virus.
He did the same thing when the death toll passed 500,000. And after recently signing the Rescue Plan into law, he talked about our shared hardships and common sadness.
“I carry a card in my pocket with the number of Americans who have died from COVID to date,” he said.
He’s not the most eloquent man. But over his long career, Biden learned a thing or two about making policy. And at some point over his long life, he found the strength to carry on through tragedy, to walk through dark canyons in hope of dawn.
All of this makes him the right person to steer America out of its recent calamities and towards a better version of itself.
Jason Opal, Associate Professor of History and Chair, History and Classical Studies, McGill University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Closing some of the U.S.-Canada land border crossings could help control the COVID-19 pandemic
Sunday, 21 March 2021 13:11 Written by theconversation
Kelley Lee, Simon Fraser University; Anne-Marie Nicol, Simon Fraser University; Julianne Piper, Simon Fraser University, and Valorie A. Crooks, Simon Fraser University
During the COVID-19 pandemic, attention to travel measures has largely focused on air travel. This includes the potential use of “vaccine passports” to open up international borders again. However, for countries with extensive land borders, there are special challenges.
Canada and the United States share the world’s longest undefended land border. While the U.S. is Canada’s most important trading partner, it is also the world’s epicentre for coronavirus infections and deaths.
COVID-19 variants of concern are now present in almost all U.S. states. The spread of these variants in the U.S. points to the need for Canada to review the adequacy of public health risk management at land crossings.
Current land border policy
Since March 21, 2020, non-essential travel has been restricted at Canada-U.S. land crossings. Outbound travel for Canadian nationals and permanent residents, and inbound and outbound travel for non-nationals (except Alaska-bound U.S. citizens) are not permitted.
On Jan. 29, 2021, the Canadian government announced new measures for non-essential travel in response to variants of concern. Arrivals by air now have testing and hotel quarantine requirements, and those by land have testing requirements but can self-quarantine or isolate.
Given that hundreds of thousands of essential and non-essential travellers continue to enter Canada by land each month, differences in policy for air and land travel have been questioned.
According to Canada’s Public Safety Minister Bill Blair, the main reason for this difference is logistics. With 117 two-way land crossings, comparable measures “simply aren’t possible, given the existing infrastructure that’s available.”
As a team of travel health and pandemic experts, we suggest that there are solutions to this seemingly insurmountable challenge.
Less land border crossings
There are insufficient resources to provide screening, testing and quarantine measures at all land crossings comparable to air arrivals. Based on our study of travel-related measures during COVID-19, one option is to substantially reduce the number of crossings kept open. This is similar to the funnelling of air arrivals through four airports, and has been a successful strategy in other countries.
After closing some land crossings, the government can then designate selected crossings for incoming non-essential travel only. This prevents bottlenecks hindering essential travel. Given around seven per cent of land crossings during the pandemic are deemed non-essential, and that the volume of land travel has declined by around 90 per cent during the pandemic, temporarily closing some border crossings is also practical.
Crossings remaining open for non-essential travellers should be those that had higher vehicle volumes pre-pandemic such as the Peace Arch, B.C., and Rainbow Bridge, Ont. High traffic crossings already have the necessary inbound and outbound road networks to allow ease of access. They generally also have hotels nearby. This can enable an extension of mandatory quarantine at designated sites for travellers entering by land. These crossings should also be within a reasonable driving distance of a hospital should there be a need for health care. The border crossings themselves would need to have sufficient staff to accommodate any enhancements made to testing protocols.
Tailoring approaches
By streamlining land border crossings, on-site public health resources available can be tailored to specific types of travellers. For non-essential travel, alongside enhanced screening, testing and quarantine, arrivals should be provided with tailored information.
For example, in the coming weeks thousands of “snowbirds” are expected to return to Canada by land. These long-stay travellers should be directed to reliable sources of information regarding vaccine roll-out in their province as many will fall within priority groups. Those who were inoculated abroad should be given details on how to register this information in their personal vaccination record.
Read more: Why some snowbirds are flying south despite the COVID-19 pandemic and travel restrictions
Transport workers comprise a large proportion of essential travellers crossing by land. The World Economic Forum ranks transport workers as being at highest risk among approximately 950 non-health occupations during COVID-19. Many Canadian truckers have been concerned about potential exposure to the coronavirus in the U.S. and risk of infecting family members upon their return.
We agree with calls for transport workers to be vaccinated as a priority group. In the meantime, rapid testing should be provided at land crossings designated to serve essential travellers.
All entry points
A more coherent Canadian strategy on border management requires consistency in the measures applied for air, land and sea arrivals. At a time when COVID-19 and its worrisome variants are being brought into Canada via travel, reducing points of entry has several benefits.
Limiting the number of crossings enables us to concentrate resources and enhance public health risk management. This would also facilitate any plans to introduce more testing or even vaccine passports for essential travel. And the incentive for travellers to circumvent air travel measures by diverting to land crossings would be reduced.
Kelley Lee, Professor of Global Health Policy, Canada Research Chair in Global Health Governance, Simon Fraser University; Anne-Marie Nicol, Associate Professor, Health Sciences, Simon Fraser University; Julianne Piper, Research Fellow, Health Sciences, Simon Fraser University, and Valorie A. Crooks, Professor, Department of Geography and Canada Research Chair in Health Service Geographies, Simon Fraser University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
We grew human tear glands in the lab, and now we're making them cry
Thursday, 18 March 2021 03:02 Written by theconversationMost organs in the adult human body are capable of regeneration, which means they renew their cells to keep the tissue healthy and functional. This capacity is enabled by adult stem cells, which are present in most organs and divide to create new cells that replace older, damaged ones.
It turns out these stem cells can be isolated and grown in the lab. When we do this, the stem cells form tiny replicants of the organs from which they were extracted, which we call “organoids”.
Alongside our colleague Yorick Post, who recently moved from Utrecht to the Silicon Valley commercial sector, we’ve produced a human tear gland organoid, which we’ve been able to make cry organoid tears – not by being nasty, of course, but by subjecting the organoid to adrenaline, which is released in humans when they’re subjected to pain. By studying our organoid tears, we might be able to help develop treatments for dry eye disease, including by transplanting our organoids back into human patients.
Mini organs
Until recently, it was very difficult to study stem cells in the lab as they could not be cultured in a Petri dish. Then, in 2009, the perfect recipe was found to culture stem cells of the intestine, which grew into tiny replicates of the intestine: a mini organ. Because of this resemblance, we now call these in vitro models “organoids”.
Since then, most organs have been made in organoid form, used to study the physiology and illnesses associated with that particular tissue. More recently, organoids have been used to study how SARS-CoV2 affects different organs, finding that SARS-CoV2 could infect the human intestine, explaining why some patients with COVID-19 experienced diarrhoea.
With more and more organs being created as organoids in the lab, we searched for an organ that hadn’t been considered yet: the tear gland. The tear gland is actually a very important organ: it produces the tears that lubricate the eye and protect it from infections.
When the tear gland doesn’t function properly, people experience itchiness and pain, a disease known as “dry eye”. This occurs in at least 5% of the adult population worldwide. Until now, studies of this disease were hindered by the lack of a good human tear gland model. We set out to establish one, by creating tear gland organoids.
Gland designs
To start an organoid culture, you need tissue directly from a patient. We obtained tear gland samples from the hospital and processed them into small pieces.
These pieces were placed in a droplet of gel, like a cushion. Importantly, this gel allows stem cells to grow in a three-dimensional environment, enabling them to organise into any shape. By stimulating the tear gland stem cells to divide, we made our culture grow. A few days later, we could actually see the first tear gland organoids in a dish, shaped like a sphere.
This was only the first step, as these tear gland organoids mostly contained stem cells. Tear gland stem cells are different from the mature cells that are present in the tear gland. Importantly, the stem cells themselves are not capable of making or shedding tears.
But tear gland stem cells do give rise to mature tear gland cells that are capable of crying. This process is called “differentiation”, and it takes place as soon as we stop stimulating stem cells to divide into other stem cells. We found it took at least seven days of culturing before our tear gland organoids could produce tears.
Tearjerkers
The final step in our experiments was to make our organoids cry. In humans, crying upon feeling pain is induced by stimuli such as adrenaline. To recreate this process in a dish, we exposed our tear gland organoids to adrenaline. Adrenaline made our tear gland organoid spheres swell like balloons. The organoids were secreting their tears on the inside: crying, but with nowhere for their tears to go.
What can now be done with these tear gland organoids? First, scientists can use them to study how the tear gland works: how it makes tears, what kind of tears it can make and what happens when the tear gland does not produce tears anymore.
At present, people with dry eye disease must constantly apply eye drops to lubricate the ocular surface. With tear gland organoids, scientists can now screen for better, more effective medicines that could help treat dry eye disease. Tear gland organoids could even eventually be transplanted back into patients with dry eye.
This strategy is already being applied in a clinical trial with salivary gland organoids. Patients treated by radiotherapy following head and neck cancers often lose their salivary glands, resulting in dry mouth. It’s hoped that transplanted salivary gland organoids could treat this affliction.
One other tissue we have our eye on is the tear gland of a crocodile – which is remarkably similar to human tear glands, but with some interesting differences. One day soon we may grow crocodile tear gland organoids in our lab, producing “crocodile tears” in the clinical environment of a Petri dish for the very first time.
Marie Bannier-Hélaouët, PhD Student, Hubrecht Institute, Utrecht University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
