1. Could cheap repurposed drugs help provide a way out of the pandemic?
The Halifax Examiner is providing all COVID-19 coverage for free. Please help us continue this coverage by subscribing.
One phenomenon I was not aware of before the pandemic was people being fans of specific drugs. My attitude towards pharmaceuticals generally involves listening to my doctors and trying to make an informed decision. I don’t root for one drug over another.
Maybe there have always been people cheering on one drug or another, but I never paid attention until the pandemic came along and suddenly whether you thought hydroxychloroquine was a miracle cure or useless became a symbol for so much more. (Hydroxychloroquine, by the way, is useless in treating COVID-19, but that doesn’t prevent folks who read about people dying of the disease speculating online that they would have survived if they had been given the drug.)
A couple of months ago I noticed a writer I follow on Twitter was pretty consistently touting the benefits of ivermectin — a drug normally used to treat parasitic infections. I mentioned something about this in the Halifax Examiner Slack and, wouldn’t you know it, it turned out Linda Pannozzo had been wondering about ivermectin and other cheap, easily available drugs and what potential they might have to treat patients with COVID-19.
Pannozzo’s piece on the subject is now published, and well worth your time. Pannozzo interviews Dr. Edward Mills, principal investigator in the largest randomized trial underway to determine if existing drugs can be repurposed to treat patients in the early stages of COVID-19, thereby preventing some of the more serious consequences of the disease.
The trial is taking place in Brazil, and has been running since June 2020. Mills tells Pannozzo that so far the trial has found hydroxycholoroquine, metformin, and a drug called Kaletra “don’t work.”
Mills tells Pannozzo about the reasons potential COVID-19 treatments remain important, despite vaccine uptake, why effective treatments might turn out to use several different drugs, and the advantages of repurposed over new drugs. He also does not mince words when it comes to the people who think ivermectin is a miracle cure. LP below is Linda Pannozzo, and EM is Edward Mills:
LP: In my research of some of these repurposed drugs I located a review of ivermectin in the May/ June issue of the American Journal of Therapeutics. Have you seen that?
EM:I know of it because the people who published it, overcall the importance of that article.
LP: I was just wondering if you could comment on it, because it concludes that ivermectin should be “globally and systematically deployed in the prevention and treatment of COVID-19.”
EM: I’ll wait for our clinical trial before I would make that recommendation. That particular group who authored that article have a well understood agenda promoting ivermectin, and no amount of evidence is likely to change their mind — whether that be favorable or negative evidence — I don’t think it’s going to change their mind. So one of the problems with the ivermectin topic is that the advocate groups around ivermectin have overcalled the importance of this drug. You can’t go around promoting a drug, calling it a miracle drug that will end the pandemic, when you don’t even have a good clinical trial to support it, and that’s exactly what they did. If indeed this drug has a treatment effect — and I am very optimistic that it will — it will just be one component of the interventions that we need. It’s not going to end the pandemic. And that’s illustrated in India at the moment where Goa did recommend ivermectin, and just over the last few days it was recommended that it actually should stop being used.
LP: Why is that?
EM: They said they’re going to wait for the results from clinical trials like ours.
LP: Ivermectin has a long history of being a safe drug, and medical practitioners regularly prescribe drugs “off-label” to treat illnesses, but prescribing ivermectin to treat high-risk COVID patients who have not yet been hospitalized, is, I believe, prohibited in Canada. Given what you know about the drug, what do you see as the danger in it being used off-label to treat early COVID in high-risk patients?
EM:I am not advocating the use of ivermectin until we have good, quality evidence from clinical trials that it is effective.
Here’s the thing: The people who wrote that article [in the American Journal of Therapeutics] claimed that this drug [ivermectin] is a miracle drug that has an effect of about 75% of reducing mortality. That is not far off the effect of a parachute when you jump out of a plane. It would not take much of a clinical trial to know whether that was true or not, and almost every physician would be able to spot really quickly whether there was a drug that miraculously was helping people. But we’re not getting that feedback from physicians and every decent clinical trial that is done on it concludes that there might be a treatment benefit, but it’s not obvious. Whether the drug has an important treatment effect or not, it’s just not going to be as large as what they claim.
I was also struck by Mills’ comments on how investigating drugs like ivermectin and other relatively common medications could lead to huge benefits. He tells Pannozzo:
So the appeal to repurpose drugs is several fold. The main thing is you already know about their safety profile, so they don’t require the same sort of concerns about safety, because if you take a drug like — let’s just pick Tylenol — if Tylenol worked for COVID, it would be great because we already know all the safety details about it, and you know who should get it and who should not and how much should be prescribed. So the appeal of repurposed drugs is very strong because you know so much about the drugs already, because they were used for whatever their original purpose was.
Whereas when you’re looking at a new drug like the monoclonal antibodies, we know very little about them, we know very little about their safety, whether particular populations are going to react differently to toxic aspects of them, things like that. But with repurposed drugs, we would already have all of that knowledge.
2. One more COVID-19 death; new cases in the single digits
One more Nova Scotian has died of COVID-19, Tim Bousquet reports, and the province announced eight new cases, three of which are under investigation. Six people are in hospital with the disease — four of them in the ICU.
I’ve noted people online wondering why rapid testing is not available in their communities and seems to be focused on Halifax. As Bousquet has noted before, the rapid testing sites are primarily staffed by volunteers, so the key to getting rapid testing into a particular community is to have people from the community volunteer. Halifax has a large pool of potential volunteers in the thousands of students who live in the city and have flexible schedules, allowing them to give some of their time, so it makes sense that most of the pop-up testing takes place in the city. Students and other young volunteers may also not have access to cars, allowing them to travel to test sites in other areas. (Whether the sites should be run by volunteers or not is another question, of course.)
Check out Bousquet’s piece for all the current rapid-testing locations, vaccination data, and potential COVID exposure advisories. I see people posting stuff in one of the community Facebook groups every couple of days, wondering why such-and-such a business is closed if it’s not on the advisory list — or, worse, assuming that these businesses have closed because of COVID but not informed public health. The answer is far more benign. As Bousquet has pointed out in his useful COVID-19 FAQ:
Public Health only issues potential COVID exposure advisories when they think they may not have been able to contact all close contacts at that locale. The large majority of potential exposure sites never make it onto a public advisory.
3. Blackface effigy yet another symbol of ingrained racism
This morning El Jones brings us a story that starts with a blackface character outside a home near Parrsboro, moves through the history of minstrelsy, and draws attention to related incidents in Nova Scotia over the past several years.
Minstrel shows, Jones notes, were common in Canada and the US, and “were largely performed by white people in blackface makeup and costuming that mocked Black people as lazy, unintelligent, and foolish.”
The figure referenced traditional minstrel show symbols including the white glove and painted features exaggerating the lips and staring eyes. These elements of blackface costuming were intended to exaggerate African features and represent African people in a dehumanized, grotesque way.
(Note: Look at Mickey Mouse.)
Jones speaks with Dr. Cheryl Thompson, an assistant professor at Ryerson University. Her research looks at blackface in Canada over the years:
Since I’ve been doing this work, studying Canada’s history of blackface, numerous white Canadians have reached out to me with tales of blackface in their past. For some, it was 40 years ago living in small town Nova Scotia, for others, it was as a child or via a parent in the ’50s and ’60s in churches and social clubs in Toronto.
That a person(s) in 2021 would erect a cutout of a blackface figure — this can be deduced by the white gloves, which is a standard feature of blackface repertoire — is a loud proclamation that they are clinging to racist ideologies of 70+ years ago.
Read the story and stick around for reader Tim Jaques’ comment on blackface in New Brunswick in the recent past.
4. Carcinogenic cement kiln dust is finding its way onto farmers’ fields
More Linda Pannozzo! Following up on her series on the Lafarge cement plant in Brookfield burning tires as a “low-carbon” fuel (here are Part 1, Part 2 and Part 3 of the series), Pannozzo investigates what’s in the plant’s cement kiln dust (CKD). An analysis of six samples (pre-dating the burning of tires) she notes, “revealed that all six samples of CKD exceeded the detection limit for NDMA, a human carcinogen that is believed to pose a significant risk to human health even in very small concentrations. ”
The material can’t be disposed of in municipal landfills. But, Pannozzo notes, the company sells it as a “limestone derivative” to be spread on farm fields:
When asked about the sale of CKD as an agricultural amendment in the province, NSE officials pointed me to the Canadian Food Inspection Agency (CFIA) and to Lafarge.
Robert Cumming, the company spokesperson, downplayed any potential harms associated with the CKD, despite the fact that company publishes this safety datasheet, which states the product can cause severe skin burns, eye damage, respiratory irritation, damage to organs, and cancer (if inhaled). It can also be harmful to aquatic life. “Avoid release to the environment,” reads the safety datasheet.
As previously mentioned, the CKD is currently sold as a limestone derivative, approved by the CFIA for its use in fertilizer products. As previously reported, since 2008 a patented technology called N-Viro has been used at a Walker Industries facility located in Aerotech Park near the Halifax Airport to process Halifax’s sewage sludge — or biosolids — and turn it into fertilizer. In the process, cement kiln dust (CKD) is added to the dewatered sludge, as what’s called an “alkaline admixture.” The product is spread on farm fields in the province.
Pannozzo’s piece reminds me of the book Toxic Sludge is Good For You, a 2002 history of the seamier side of the PR business whose title comes from the transformation of waste containing toxic materials into “biosolids.” The Publishers’ Weekly review notes:
The new euphemism for sewage sludge, “biosolids,” is part of a campaign to convince the public that municipal sludge, replete with an astounding array of toxic substances, is good for farm soil.
See also: tar sands/oil sands and countless other examples.
Read all of Pannozzo’s piece, and look for Environment and Climate Change Canada’s astounding take on the loophole that makes it acceptable to include a highly carcinogenic substance in material destined for fields.
Pannozzo’s story is available for all, but this type of reporting takes a lot of work and needs your support. Please subscribe here.
5. Ambulance fees waived for adverse COVID-19 vaccine reactions
Michael Gorman reports for CBC that the province is waiving ambulance fees for those who have adverse reactions to vaccines. He writes:
Last month, the provincial government announced ambulance fees would be waived for anyone with a COVID-related emergency. The move was intended to ensure people who needed help called for it as soon as possible, without worrying about the $146.55 bill.
But Gorman talks to two people who experienced adverse vaccine reactions and were billed anyway, because their situation was not considered a COVID-related emergency. One of them is Angela Seaboyer, who experienced a powerful reaction after getting the AstraZeneca-Oxford vaccine. (Kudos to Gorman for using the full name; I use just AstraZeneca far too often). From Gorman’s story:
Her symptoms escalated quickly, with a crushing headache followed by a burning sensation in her legs. Then her stomach became upset and she had difficulty breathing…
An ambulance was called and Seaboyer was taken to hospital. She was discharged with orders to return if her headache got worse or her other symptoms returned. She found herself short on energy and easily tired for the next few days. Eventually she returned to hospital, although this time she drove herself.
I understand the argument against making ambulances free is people will call them all the time as a taxi service, or otherwise use them inappropriately. But surely there are ways to mitigate that. For instance, we don’t charge to call 911, but we fine people who abuse the service. This nibbling away at the fees for one circumstance or another seems ludicrous.
6. Facebook users reading CBC stories will have to keep their racist and other abusive opinions to themselves
CBC is closing comments on all news stories posted to Facebook for a month, starting tomorrow. In an editor’s blog, Brodie Fenton explains why:
…As the conversation has degraded on these platforms, we find ourselves limiting what we post there. We know certain stories will draw out obnoxious and hateful comments. The truth is we spend a considerable amount of attention and resources attempting to moderate our Facebook posts. It takes a mental toll on our staff, who must wade into the muck in an effort to keep the conversation healthy for others.
The piece talks about the toll horrible comments and harassment can take on journalists:
Compounding the stress and anxiety of journalists is the vitriol and harassment many of them face on social media platforms and, increasingly, in the field. As André Picard wrote in a recent column, “For journalists, platforms like Twitter can be a great way to find sources and promote their work, but also a cesspool of hatred. Increasingly, reporters are also physically attacked.”
The president of CBC/Radio-Canada, Catherine Tait, has also written about the increased abuse of journalists on social media, especially women and journalists of colour, and the threat such attacks pose to free speech and democracy.
The piece has 533 comments as I write, this, including many, many truly awful ones that serve as fine examples of why CBC is closing comments on its Facebook stories.
The financialization of housing
Housing has become an asset class to be bought and sold like any other, and we are just starting to deal with the effects of what that will mean for renters.
As Tim Bousquet has noted, the Examiner is going to be diving into the housing crisis in Nova Scotia in the coming months, so I thought I’d point you to a piece that appeared earlier this week in Policy Options. It’s called “The rise of financial landlords has turned rental apartments into a vehicle for profit” (catchy, I know) and is written by Martine August, a professor of planning at University of Waterloo.
The multi-family apartment rental sector in Canada is being transformed by the rise of “financial landlords” — huge corporate firms that acquire properties as investment products. They include private equity firms, asset managers, publicly listed companies, real estate investment trusts (REITs) and financial institutions.
While the structures of these firms differ, they are united in their treatment of apartment homes as financial assets. This shift toward financial ownership matters.
The rise of the sector has been dramatic:
Over the past three decades, financial landlords have consolidated an increasing amount of the country’s multi-family apartment homes. REITs alone have grown from owning zero suites (units in apartment buildings) in 1996 to nearly 200,000 last year. In total, the largest 25 financial landlords (REITs and other types of firms) held about 330,000 suites last year – nearly 20 per cent of the country’s private, purpose-built stock of rental apartments.
I’m not one to get starry-eyed about small landlords, but clearly we are dealing when rental units become financialized, affordability becomes a huge problem. August writes:
Financial landlords… have thrived during the pandemic. CAPREIT posted “record performance” in 2020, with revenues up 13 per cent and $578 million in net operating income. In the first three months of 2021, Boardwalk REIT had already generated $130 million in profits. Minto REIT also delivered positive growth and raised rents throughout the pandemic. Starlight Investments bought and sold $8.9 billion in real estate. Many firms also profited from the record-low interest rates brought on by central bank actions. Firms were able to refinance debt to pay less, accessing very low rates backed by the Canada Mortgage and Housing Corporation (CMHC)…
Financial firms have not always owned rental housing, and their recent involvement in the sector is driven by what they can take from it, not what they can put in. With business strategies that are based on displacement and eliminating affordable housing, these firms have no place in progressive plans to rebuild inclusive post-pandemic cities.
But Phil, you may argue, your RRSP or pension plan or whatever is tied up in these firms and so their success benefits you. You know what? I’m willing to take a hit on my meagre RRSP if it means fewer people are being thrown out onto the street or facing unaffordable rent increases.
My dad was a book collector. (“Nice hobby, but hard to move,” said one of the movers we hired to move boxes and boxes and boxes of books out of his office after he died.”) One of his favourites — or at least one that delighted him — was a slim book called Plato’s American Republic, by Douglas Woodruff. It was published in 1926, and my dad’s copy (which he bought in April 1945), is a 1929 reprint. I’ve got it sitting on my desk in front of me as I write this.
The conceit of the book is that Socrates and Xanthippe (“Xantippe” in the book) have returned from lecture tours of America. Xanthippe’s tour is much more successful than Socrates’. He pisses off a bunch of Rotarian-type people who have invited him to speak to them as one of the top men in his field.
The book is written in the style of a Platonic dialogue, and opens with Socrates and friends in the Athenian agora:
As we were sitting there we suddenly saw Agathon approaching, and called to him to join us. When we had made room for him he turned to me and said: “Listen, Socrates, to a strange thing which happened to me today as I was going down to the Piraeus … A stranger came up to me outside my office, proposing to buy the Parthenon and all the buildings on the Acropolis and remove them to his own land, and re-erect them there.”
“Truly a strange way of honouring the Athenians,” I said.
“I think,” answered Agathon, “that it was less his idea to honour the Athenians than to make his own countrymen pay him many denari to behold the sight”…
“Without doubt he was an American”, I exclaimed.
There is much in the book that has not aged well. One of the things that Socrates complains about is that Americans seem to let women have far too much influence in public life, for instance.
On the other hand, there are some passages that seem nearly as apt today as when Woodruff wrote them. I like this one, on university presidents:
“Why”, I said, “of all who suffer from the present ill-ordered life there, none suffer more than do these teachers. But if you will be patient with me I will describe how they live”.
“The best”, I said, “are much above their fellows and seek this life from a noble love of noble things. Do you know what happens to a great number of such men in America ?”
“What?” they asked with apprehension.
“You do well to look frightened”, I said gravely. “They are made Presidents of universities and colleges, and after that there is no peace for them at all… Moreover, they are driven to associate with the men of commerce and to flatter them for their great wealth”.
“Why in the world should they have to do that ?’ Lysis demanded.
“To make the college bigger”, I replied. “For the Americans estimate a President by his power to obtain benefactions and so to build new wings and offices, and leave a larger institution than he found. They are soon to build in America the tallest university in the world. And there is a worse consequence even than this waste of fine men in presidential duties”.
“What can be worse than that ?”
“Why “, I said, “with all the colleges competing for the gifts of rich men will not those colleges obtain most whose teachers teach what the rich men like to have believed ?”
“And where a college has much to hope from wealthy persons will it not hesitate to lose large sums of money rather than discourage free inquiry into everything ?”
“I think it will do more than hesitate, it will sacrifice the inquiries for the gold”.
But I think my favourite bits of the book are the ones that have to do with cars. This is 1926, remember, so the automobile has not come to dominate cities yet, but it is well on its way. Socrates never refers to Henry Ford by name, but quotes him in the book a couple of times as “The Oracle of Detroit.”
[Americans] declare it to be that there shall be made as great a number as possible of all objects that men make, but principally of the machines that are called ‘‘autos’” or “‘cars”, which move men quickly from place to place”.
“It is often a fine thing to go quickly from place to place”, said Lysis.
“Why, yes”, I said, “and in addition the control of these machines gives great joy to the Americans. So that it may well happen that they will live altogether in their cars. For at present they must endeavour to find some place in the city where they can leave their car while they go to an office, and he who is successful in doing this is said to have parked his car, and is held in honour. And as among many peoples a youth is not granted the dignity of manhood until he has slain an enemy, so among the Americans must he first prove himself by parking a car”…
“And it is my belief that the present state of affairs cannot endure and that to park will soon be beyond the wit of any save a true philosopher, who will guard his place by his presence upon it night and day.”
Socrates goes on to say that he thinks Americans will eventually transact more and more of their business in cars, keeping their papers in them, and possibly eventually living in them too. He also notes that cars are a useful way for manufacturers to keep people working, because the desire to afford a car “could be trusted to spur them on.”
Audit and Finance Standing Committee (Wednesday, 10am) — live on YouTube
Community Design Advisory Committee (Wednesday, 11:30am) — live on YouTube
Virtual Public Information Meeting (Wednesday, 6pm) — Case 23512, application by FBM Ltd. for the property at 65 Dellridge Lane, Bedford to add ‘Dog Care Facility’ to the list of uses allowed on the property within a previously-approved development agreement.
Bring your own dog.
Veterans Affairs (Tuesday, 2pm) — “Veteran Physician Assistant’ Role in the Health Care System”, with Peter Thibeault, Erin Sephton, and Dr. DA (Gus) Grant. CART services available.
Primary Health Care Learning Series (Wednesday, 12:30pm) — Via Zoom, Robin Urquhart and Cynthia Kendall will present “Innovative navigation programs to help individuals and families affected by life-limiting chronic illnesses navigate end-of-life: a realist evaluation.”
Breaking the Dogma. NPC2 deficiency does not induce cholesterol accumulation in neuroblastoma (Wednesday, 4pm) — PhD candidate Aaron Woblistin will explain.
Open Dialogue Live: Design and our Healthcare System (Wednesday, 6:30pm) — livestreamed discussion with Bryan Langlands and Benjie Nycum, about how Canadian and United States healthcare designers are impacting how health centres function and how this has impacted healthcare delivery before, during and after the COVID-19 pandemic.
In the harbour
02:30: Taipei Trader sails for Kingston, Jamaica
10:00: Asterix, replenishment vessel, sails from Dockyard for sea
12:00: Acadian, oil tanker, moves from Irving Oil to Imperial Oil
16:00: MIA Desgagnes, oil tanker, arrives at anchorage from Saint John
18:00: Thorco Liva, cargo ship, sails from Pier 9 for sea
20:00: Asterix returns to Dockyard
21:00: Helena G, bulker, sails from Pier 9 for sea
23:00: Siem Commander, offshore supply ship, sails from Dartmouth Cove for sea
16:00: Niagara Spirit, barge, with Tim McKeil, tug, sail north through the causeway from Aulds Cove Quarry for sea
17:00: Thunder Bay, bulker, arrives south through the causeway at Aulds Cove Quarry from Sept-Iles, Quebec
19:20: Acadia Desgagnes, cargo ship, arrives at Sydney Berth TBD from Long Pond, Newfoundland
It seems we could have had an MV Obelix as well, but it was not to be.
I need to check the Montreal-Vegas playoff schedule before putting in my requests for which days I’d like to write Morning File.