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Karen Restoule: We need to confront our history with humility and courage

Commentary

Many Canadians are embracing the moment to stand with Indigenous communities as they uncover the truths of the unmarked graves of Indigenous children at the sites of former residential schools and question what can be done to remedy an awful history.

Others are opting to focus on the supposed positives of the policies that formed the schools, claiming that policymakers “thought they were doing the right thing,” and that, “the residential schools for native children were devised to take the young from the grinding poverty of their early years and equip them to participate in society,” and that, “[t]he goal was, in its bumbling Victorian colonialist manner, a positive one […].”

And others yet have taken to tearing down statues of Conservative leaders and burning down churches.

In the best of times, reconciliation — which requires focused and arduous effort to bust through a complex, outdated, over-reaching policy framework and a staggering amount of incremental funding to address the baseline inequities — would be challenging to address.

Could it be that leaders engage in symbolic battles because the issue, the people, are not within proximity and mostly invisible to them?

While we will never know the answer to that, what we do know for certain is that underplaying the detrimental and fatal impacts of residential schools on Indigenous children and families by focusing on the “good intent” of the policymakers is problematic.

Denying the horrible impacts of residential school altogether is also not helpful. Doing so perpetuates the same mindset that led to the creation of the policy. It doesn’t reflect Canadian values, nor does it help us to get ahead as a country. This type of minimization contributes in only one way: it prevents us from moving forward.

On June 11, 2008, Prime Minister Stephen Harper stood on the floor of the House of Commons and delivered a statement of apology to survivors of residential schools on behalf of the Government of Canada. In his speech, he was clear as he acknowledged the objectives of residential schools: “Two primary objectives of the residential schools system were to remove and isolate children from the influence of their homes, families, traditions and cultures, and to assimilate them into the dominant culture. These objectives were based on the assumption Aboriginal cultures and spiritual beliefs were inferior and unequal. Indeed, some sought, as it was infamously said, ‘to kill the Indian in the child.’ Today, we recognize that this policy of assimilation was wrong, has caused great harm, and has no place in our country.”

Dr. Peter Bryce, a physician appointed as the chief medical officer of the Departments of the Interior and Indian Affairs in 1904, and later in 1907, submitted his Report on the Indian Schools of Manitoba and the Northwest Territories that shed light into the staggering death rates at the schools, concluding that the children had died from the poor conditions and lack of sanitation within the schools.

Toppling John A. Macdonald doesn’t help move the dial on reconciliation.

According to the Canadian Encyclopedia, the report was leaked to journalists, who published the story. Despite public rage and calls for reform, the schools were not closed. When Bryce retired in 1921, Indigenous children continued to die of disease at disproportionate rates while attending residential schools across the country.

Toppling John A. Macdonald doesn’t help move the dial on reconciliation. While there’s no denying that the founding leader of Canada played a pivotal role in the establishing the policy and ensuring its rigorous implementation, the residential school system was also supported and upheld by their successors over the course of more than 150 years — including Liberal governments.

Each Canadian political party was responsible for it, and each party must be responsible to fix it.

There’s no room for denial, minimization, or partisan plays when it comes to the tragedies experienced by Indigenous children and families. Canada doesn’t move ahead when Indigenous peoples are politicized. It should never be done, and especially not now.

The work that is being undertaken now is bringing answers to families who have been left with questions for decades. It’s also bringing knowledge to the forefront of Canadian consciousness.

It is time for everyone to recognize the moment for what it is: to face and accept our shared truth with humility and courage. Truth is key in order to move forward and we can only have truth with transparency. That’s what this period is about.

The 2008 apology, delivered on behalf of all Canadians, concluded by recognizing the opportunity created for Canadians — through the implementation of the Truth and Reconciliation Commission — to be informed and educated by survivors about the truth: “It will be a positive step in forging a new relationship between Aboriginal peoples and other Canadians, a relationship based on the knowledge of our shared history, a respect for each other and a desire to move forward together with a renewed understanding that strong families, strong communities and vibrant cultures and traditions will contribute to a stronger Canada for all of us.”

Why don’t we focus our energies on doing just that.

Harry Rakowski: Will we need vaccine booster shots for COVID-19?

Commentary

Canada is finally reaching highly protective levels of full vaccination. Why then do we need to consider whether booster shots may still be needed this year?

All approved vaccines have high levels of protection against hospitalization and death, their most important benefit. It therefore is not surprising that almost all hospitalizations and deaths in the U.S. and Canada are now occurring in those inadequately vaccinated (85 percent of bad outcomes are in those foregoing vaccination and the rest in those not fully vaccinated).

Vaccine protection comes in two important ways namely antibody production and memory T-cells. The most immediate protection is the vaccine antigen-induced production of antibodies able to bind and neutralize the viral spike protein.

These antibodies rapidly develop after vaccination and await exposure to the SARS-CoV-2 virus. If exposed they then neutralize the virus by binding to its spike protein, restricting cell entry via the ACE2 receptor thus preventing further replication and cell damage.

Antibody levels are easy to measure and have been shown to increase dramatically following a second vaccine dose. Maximum protection is achieved about two weeks after the second shot. Vaccine induced antibody levels are lower in older people and those who are immune compromised. Antibody levels also decay over time both from natural infection and following vaccination.

The key issue is at what point the decay in antibody levels reaches a critical threshold whereby adequate protection from infection and its complications is of concern.

The mutation of the virus into more infectious and dangerous variants of concern (VOC) has also made it more resistant to vaccine induced spike protein antibodies as they work best to neutralize the original rather than the mutated form of the viral spike protein.

The mRNA vaccines had about 95 percent reduction of infection risk for the original strain (almost complete protection against death) and only about 88 percent for the now dominant Delta VOC.

Recent Israeli data shows further slippage of protection over time in their early vaccinated population with recent 93 percent effectiveness against serious infection and 64 percent against breakthrough infection.

There is currently very little Delta plus (Delta plus an additional spike protein mutation) or Lambda VOC disease in North America and we don’t yet know if this will be a further issue (but hopefully not).

The combination of lower antibody production in some vulnerable groups, natural decay of levels over time and lower specificity and effectiveness in targeting VOCs has raised concerns about when vaccine boosters may be required to further ramp up antibody levels. 

Pfizer has already requested emergency-use authorization from the FDA to approve the use of a booster for a third vaccination dose in vulnerable people. While a modified vaccine targeting the Delta variant is being developed and tested, the proposed initial booster would be the current vaccine since in trials this has been shown to further increase antibody levels by a factor of five to 10 times against the Beta variant and likely also as effective against the Delta variant.

The proposed need for booster shots has raised concerns about pharmaceutical companies hyping the shot for financial reasons. As well there is concern particularly in the U.S. that talk of boosters will further increase vaccine hesitancy which is already a major risk for a developing fourth wave.

Current complication rates for vaccine induced blood clots, myocarditis and now Guillain Barre, a neuromuscular syndrome recently rarely associated with the Johnson & Johnson vaccine are low enough to still recommend primary vaccination for everyone. It is not clear whether these risks are amplified following a booster shot. The risk benefit almost certainly favours booster shots in high risk people at some point but not necessarily in low risk groups.

As always decisions about the need and timing of booster shots requires us to follow the science which is not yet mature. Studies of efficacy and safety of boosters are being carried out both by the manufacturers and independent bodies. Israel and France have allowed emergency use of boosters in highly-compromised people such as those who have received donor organs or cancer therapy. Other countries may follow their lead.

For now disease levels are low in North America, vaccines remain highly effective against all VOCs and boosters are not yet necessary except possibly for those at highest risk. As well our adaptive humoral based immunity from memory T-cells may provide longer protection even if antibody levels decline.

It is hopeful that if boosters are needed, for most people it would be offered a year or more after initial full vaccination. For those over 60 with risk factors it may be sooner. It is too early to be certain about timing and it awaits the outcome data and whether case rates start to rise dramatically in vaccinated people.

The boost we currently need is from life returning to a more normal level and focusing on primary vaccination for as many people as possible all around the world. We have to trust that the worldwide regulatory agencies will review the science as it becomes available and advise on when, if, and in whom booster shots may ultimately be appropriate.

Let’s hope our government has secured early options for them if needed.