Category "Family & Child"

29Nov

COVID-19: B.C. kids aged 5-11 get their shot at vaccine on Day 1 of rollout

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Health Minister Adrian Dix said about 104,000 children out of the eligible 350,000 are now registered.

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Vancouver mom Jenny Puterman called Monday morning and managed to get an early afternoon time on Day 1.

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Her two sons, Ari and Josh, were among the first kids, aged five- to 11-years-old, to get their COVID-19 vaccinations at the Italian Cultural Centre in East Vancouver.

Their plan was to get the shots and then get ice cream, said dad Steve Rosenzweig.

“We’re going to Dairy Queen,” said Josh, who is 11. “We have this coupon and we’re probably going to buy something with it.”

The family had registered on Oct. 9 and thought they would receive an invitation by text or email to make a booking.

These were to go out Monday, but there may be some frustrations on Day 1 for parents as other people are booking booster shots or making appointments for their first or second vaccinations, according to B.C. Health Minister Adrian Dix.

Over a three-day period, B.C. is reporting 970 new cases of COVID, including two epi-linked cases, for a total of 218,068 cases in the province. There are currently 2,882 active cases of COVID in B.C., and 212,704 people who tested positive have recovered. Of the active cases, 303 individuals are currently in hospital and 115 are in intensive care. The remaining people are recovering at home in self-isolation.

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Dix said that about 104,000 children out of the eligible 350,000 are now registered for a vaccine, and that thousands of invitations are going out this week.

“We just feel like we are trying to stay ahead of it. The sooner we can get them vaccinated the better,” said Puterman. “Their grandparents are older and we have little cousins who can’t get vaccinated (because they are younger than five years.)”

“I have another friend who is getting it today, too,” said Ari Rosenzweig, 8.

Some parents and young children in the lineup Monday were, understandably, more focused on holding emotions together through the process instead of chatting about it with Postmedia News.

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Ari and Josh, however, were talkative about getting the vaccine “to prevent COVID-19.” They had some questions about how long it would take to get the shot and if they would “have to look.”

They did several rounds of “rock, paper, scissors” to decide who would go first, and also strategized about using mom’s phone to watch Minecraft memes on YouTube as a distraction.

“We’re thrilled that they’re so agreeable and we just want to get back to normal,” said Puterman. “We have friends where the parents are double-vaccinated and they’ve still been getting breakthrough infections. So we want to have more peace of mind.”

She’s also happy that Josh got a smaller, modified dose of the Pfizer-BioNTech vaccine that is the one Health Canada has approved for younger children.

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By January, he would have turned 12 and qualified to get the vaccine for youth aged 12-to-17, which involves a larger amount.

“I don’t think this guy needs a full adult dose,” she said, squeezing his slight shoulders.

After letting Josh read a short comic story about a COVID superhero who gets vaccinated, Vancouver Coastal Health volunteer Dr. Francis Lee said to the boys: “I’m going to ask you the question, ‘Is it OK if I give you the vaccine?’ ”

They nodded, along with their parents. (A parent or legal guardian has to give verbal consent ahead of a child being vaccinated.)

“How often have you been told that you are mature?” asked Dr. Lee.

“Like, never,” beamed Josh.

— With files from The Canadian Press

jlee-young@postmedia.com


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28Nov

COVID-19: Children between five and 11 are eligible for vaccinations starting Monday

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Health Canada approved the Pfizer vaccine for children aged five to 11 on Nov. 19. This vaccine uses a lower dose of 10 micrograms — one-third of the dose given to older children and adults

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Children in B.C. between five and 11 years old start receiving the first doses of their COVID-19 vaccines on Monday.

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More than 90,000 out of the 350,000 eligible children, or 26 per cent, in that age category were registered a week before the rollout, according to the B.C. government.

The government’s own surveys show that most parents support getting vaccines for their young children, but there are some whose views might keep the vaccination rate lower for this age category.

Of B.C. parents who responded, 58 per cent will register to vaccinate their children right away, while another 18 per cent planned to wait, and nearly 25 per cent said they are not sure they will do it, according to Penny Ballem, the executive lead for B.C.’s immunization efforts.

A parent or legal guardian has to give verbal consent ahead of a child being vaccinated, according to Ballem.

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Health Canada approved the Pfizer vaccine for children aged five to 11 on Nov. 19. This vaccine uses a lower dose of 10 micrograms that is one-third of the dose given to older children and adults.

COVID-19 information from the B.C. Centre for Disease Control from Nov. 25 shows that 80 per cent of British Columbians at the next age group up, aged 12 to 17, are now fully vaccinated and more than 87 per cent have a first dose.

There are varying rates in different health authorities, however. In Fraser, Vancouver Coastal and Vancouver Island, it is higher at 82 per cent, 89 per cent and 83 per cent, respectively. In Interior, it was 70 per cent and in Northern, it was 59 per cent.

Within authorities, there is also a wide spectrum. As of Nov. 23, Enderby and Kettle Creek in the Interior authority had only 38 per cent of 12- to 17-year-olds double vaccinated, while Kimberley posted 80 per cent. In Vancouver Coastal, Bella Coola Valley had 59 per cent of 12- to 17-year-olds double vaccinated, while North Vancouver was at 93 per cent.

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Between Oct. 27 to Nov. 25, the number of average daily cases per 100,000 people among the double vaccinated for this 12 to 17 age group across B.C. was 2.5. Among those who had one vaccination, the number of average daily cases per 100,000 people was 8.2. And for the unvaccinated, the figure was 46.8 per 100,000.

For that same period, in the category of 0-11 year olds, who are all unvaccinated, the number of average daily cases per 100,000 people was 16.8.

“I think the most important thing is that vaccinations be readily available for all children and families,” said Teri Mooring, president of the B.C. Teachers’ Federation.

“For families where it’s not convenient for them to book an appointment in a separate clinic or perhaps they work long hours or there are other various individual circumstances, we think there should be an option (for COVID-19 vaccination) in schools as well.”

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Mooring said that “it was a concern with the 12- to 17-year-olds as well and what we’re seeing in some parts of the province, where we have vaccine hesitancy, we are still those (vaccination) numbers lag behind. We don’t want that to be the case for the five to 11-year-olds.”

Youth aged 12 to 18 have to carry a B.C. Vaccine card, or have a trusted adult carry one for them, to go to restaurants and attend indoor, organized events. Unlike adults, they don’t have to also show government-issued identification. Children aged five to 11 are not be required to show proof of vaccination.

jlee-young@postmedia.com

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29Oct

Daphne Bramham: Will a ‘safe’ drug supply ease Vancouver’s overdose epidemic?

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Opinion: As a harm reduction measure, Vancouver Coastal Health and others want Ottawa to allow drug clubs to give free, tested drugs to members.

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Harm reduction’s truism is hard to argue with: You can’t help drug users if they’re dead.

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In fact, it’s usually a conversation stopper. But it is also a convenient cudgel when someone suggests that in the midst of the long-running overdose crisis that governments have leaned-in rather too hard on reducing harm and not hard enough on addressing the root causes fuelling the drug-use epidemic.

So it is with a proposal that Vancouver city council endorsed that urges Health Canada to allow drug clubs or co-ops to buy heroin, cocaine and methamphetamines, test them, repackage them, and give them away to members.

This is harm reduction pure and simple, untethered from health-care providers and any pretense that it is part of a treatment plan. These would be pharmacies without pharmacists, providing users with the drugs they crave in the quantities they want.

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With an average of six British Columbians a day dying from illicit drugs with increasingly high concentrations of fentanyl, carfentanil and benzodiazepines, there is no disputing that Vancouver and most other B.C. cities have a deadly problem.

Desperate times, they say, require desperate measures.

But if Health Canada accedes to the request from the city and Vancouver Coastal Health to exempt the Drug Users Liberation Front (DULF) from the Controlled Drugs and Substances Act, would drug clubs work?

Nobody knows because it’s never been done before.

“It wouldn’t make drug use safe. But it would make it safer than what (users) are currently doing,” Mark Lyshyshyn, the deputy medical health officer, said in an interview.

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“We don’t know if it would be a successful program, but I felt it had the potential to reduce the risk of overdose. … The whole point is for them to get safer drugs.”

He sees DULF’s proposal as an extension of Vancouver Coastal Health’s drug-checking services and supervised injection sites.

The whole idea of a “safe supply” or even a “safer supply” is a relatively new one first used by groups like the Vancouver Area Network of Drugs Users (VANDU) more than a decade ago before the illicit supply was rife with synthetic opioids like fentanyl and before a public health emergency was declared in 2016.

Critics of “safe supply” say that there is no such thing, pointing out that the genesis of the emergency was the false and aggressive marketing of OxyContin as non-addictive followed by its over-prescription.

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Even before that, Vancouver’s drug problem was bad enough that in 2001 the city approved a “four pillars” approach — prevention, treatment, enforcement, and harm reduction. Over the years, the policy debate has devolved into harm reduction versus treatment.

“It comes down to a matter of philosophy of what the right balance is,” Lyshyshyn said. “And right now people are dying, so the most important pillar is harm reduction, to stop people from dying.”

He said governments spend “100 times as much on addiction treatment” as on harm reduction, as well as more on enforcement even after a decade of de facto decriminalization in Vancouver.

Police are going after drug traffickers and illegal drug producers, Lyshyshyn said. And that only “incentivizes people to create more potent drugs.”

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Still, he hopes that with a safer drug supply, more users would seek treatment. Unfortunately, that doesn’t quite line up with users’ letters appended to Vancouver council’s motion. For them, the treatment isn’t working.

Greg Fresz gets diacetylmorphine (heroin) twice daily from Crosstown Clinic, which is licensed by Health Canada to provide it. But he wants a take-home supply (aka “carries”) and has been denied that.

“You can’t use crack if you’re going to get carries. … For me, that’s not feasible because sometimes I can’t get anything else, so I’ll buy pills, dilaudids, benzos, something to help me sleep because I’m in pain.”

Martin Steward quit Crosstown Clinic because it was “too tedious.”

“I had to wait for my turn, wait for my medication, after the medication, I had to sit for 20 minutes before I could leave.”

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A man identified as Steel, who described himself as a “social user”, tried and quit the B.C. government’s “safer supply program” that allows doctors and nurses to prescribe opioids (including fentanyl patches), alcohol, stimulants and benzodiazepines.

“The government supply is weak. It doesn’t satisfy. Yes, it might be free, but it doesn’t do what the drugs are meant to do for many of us.”

Steel also complained about the drugs that DULF has handed out freely on three occasions in the Downtown Eastside: “I found that I needed more.”

Samona Marsh, an “ethical use substance navigator” with VANDU, wrote: “I don’t go to the doctor at the best of times. Why would I go to the doctor to get high? Existing safe supply programs give you pills. I want to get high on drugs, not on their pills.”

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Lorna Bird complained about being in an opioid replacement program that requires daily witnessed ingestion of drugs such as methadone and suboxone at a pharmacy: “It was a real hassle and interfered with my life a lot.”

Before that, she quit an injectable heroin program. She didn’t like being watched as she used.

VANDU “peer navigator” Laura Shaver spends about $100 a day on “a range of street and safe supply drugs” that includes heroin, hydromorphone, Dexedrine, metadol-D, Seroquel and gabapentin.

She has asked for prescription benzodiazepines, but her doctor refused because there were traces of fentanyl in her urine.

“The feeling (on benzos) can be euphoric — and reminds me of the type of high I would have before I was on methadone.”

For more than two decades, the Canadian consensus has been that addiction is a health issue, not a moral failing, and ought to be treated like every other chronic, recurring disease.

But the challenge set before Carolyn Bennett, Canada’s new mental health and addictions minister, is deciding whether harm reduction includes the right to get high.

dbramham@postmedia.com

Twitter: @bramham_daphne

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28Oct

Daphne Bramham: Vancouver’s support for drug clubs’ free-for-all misses the mark

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Opinion: Vancouver has endorsed a drug club plan that would provide members with free drugs in unlimited quantities. “F—ing crazy,” say critics.

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When Vancouver’s city council unanimously agreed to ask Health Canada to allow “clubs” or “co-ops” providing heroin, methamphetamines and cocaine to drug user members, one can’t help wonder if they actually read and understood the proposal before them.

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Loosely based on the 2019 report by the B.C. Centre on Substance Use, this is a more radical plan that would allow a group of drug users with no medical training to buy and sell drugs in unlimited amounts to other drug users.

No medical oversight. No safeguards. No consequences.

The only thing that council balked at was endorsing the purchasing, testing and repackaging of drugs bought from the dark net, which is what the Drug User Liberation Front (DULF) has done in the past.

Not that any of this matters.

DULF co-founder Eris Nyx rallies the crowd at a march calling for the safe supply of street drugs, on East Hastings Street in Vancouver.
DULF co-founder Eris Nyx rallies the crowd at a march calling for the safe supply of street drugs, on East Hastings Street in Vancouver. Photo by Jason Payne /PNG

“We’re going to run this program by hell or high water because it will save lives,” DULF co-founder Eris Nyx told The Tyee. “We’re a radical organization. We don’t need state sanctioning. But it helps.”

The differences between what the BCCSU recommended and what council endorsed point to myriad potential problems.

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The BCCSU report was only about heroin. There was NOTHING about cocaine and methamphetamines. It made it clear that health-care providers should be involved in the screening of members. Membership would also require taking overdose prevention and naloxone training and receive education on various risks from overdose to mixing drugs.

“Due to the inherent risks involved” the BCCSU said clubs should operate alongside other public health and social services.

It also insisted that members would pay for drugs to limit the risk of diversion, citing evidence that when drugs are free, it’s more likely that people will sell them. And to limit risk of bulk purchases from organized criminals, BCCSU said individuals should only be allowed enough for short-term personal use.

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None of that is reflected in the council-endorsed proposal.

DULF’s only criteria for membership is that people would need to be over 18 and currently using illicit drugs.

“People would access the compassion clubs through their local drug user groups who would act as the main point of contact,” under DULF’s plan.

Drugs would be sent to the clubs “on an as-needed basis to drug user groups to distribute to members.” Those distributors would need to keep active membership lists, ensure secured and double-locked storage, keep records for amounts distributed and to whom, and maintain financial records.

There is no indication of who would be monitoring the clubs. No mention of who would bear the liability for any overdoses.

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While the BCCSU report said clubs would pay for themselves through membership fees and sales, DULF would rely on donations or some undefined “parallel revenue streams to subsidize the cost of substances.”

Alternately, DULF said, it could produce its own heroin, meth and cocaine and “significantly undercut market prices”.

It’s an open question how these clubs would protect themselves against their organized crime competitors.

But it’s worth noting that Vancouver has had de facto decriminalization for more than a decade, and that British Columbia has been providing a so-called “safer supply” of pharmaceutical drugs to opioid users since March 2020 under a special pandemic-related exemption from Health Canada.

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B.C. expanded that program in July even though it has acknowledged that there is limited clinical evidence to support it. In fact, the only evidence available is for heroin provided in highly supervised, clinical settings.

Because of that, physicians have been slow to register as prescribers. As the College of Physicians and Surgeons told members , “The need for caution is heightened in the absence of clinical practice guidelines or strong clinical evidence.”

It urged doctors to prescribe in a way that “minimizes the risk of harm and the introduction of unintended consequences that may negatively impart patients or the public more broadly (e.g. diversion).”

If access to pharmaceutical drugs is the answer to the overdose crisis, the B.C. experiment has yet to prove it. Since July, overdose deaths have continued to rise, with an average of six people dying every day.

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DULF’s proposal and testimonials from drug users provides an answer to why it’s not working: It doesn’t give users exactly what they want, when or where they want it.

Two addictions experts, who asked not to be named, described the drug club proposal as ‘”f—ing crazy”.

Others said they aren’t opposed to trying new and different things, but providing free drugs in unlimited quantities is a step too far.

“From where we started, this has truly crossed the line from harm reduction to harm facilitation,” said Carson McPherson, an adjunct professor in Simon Fraser University’s health sciences department.

SFU psychology professor Julian Somers was disappointed that Vancouver council wasted time on this but has done little to push for a large-scale strategy that includes a continuum of care from harm reduction to housing and other psycho-social supports and services.

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His own peer-reviewed research published nearly a decade ago concluded that, given options, even hard-core users with mental health issues made choices that resulted in less-frequent drug use, less crime and fewer hospitalizations.

But instead of dealing with the “glaring social needs” of drug users, he said, Vancouver council has chosen to support “a relatively desperate action.”

“In some ways it’s a charming story: People doing things for themselves in the spirit of camaraderie,” Somers said of DULF’s proposal.

“But those in a position of responsibility ought to know there is a science of addiction from the molecular level on up to the psycho-social. To do something because it’s a charming story? That’s not a good look for an elected official.”


In my next column, Vancouver Coastal Health’s Mark Lyshyshyn makes an argument for why these are desperate times that may demand desperate measures.


dbramham@postmedia.com

Twitter: @bramham_daphne

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20Oct

Abbotsford mom confused by ‘mixed messages’ from contact tracers

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“There’s a lot of our world right now that seems inconsistent, and if you’re getting mixed messages from health authorities, it can be very overwhelming.” – Marie Haak

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After two of her four kids tested positive for COVID-19, Marie Haak divided her living room with painter’s tape and worried about whether she should go back to work.

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Because she is fully vaccinated, the Abbotsford educational assistant was given the all-clear to return to her students by the first contact tracer she spoke to last week. But a second contact tracer, who called after another one of her children tested positive, was more hesitant and advised her to call 811, the provincial health advice hotline, to discuss it further.

Haak said she struggled with the decision as she and her husband pulled apart their dining table to make two eating areas, posted signs reminding their kids to mask up in the hallway, and used green tape to separate their living room into zones.

“In the end, it was basically my own choice,” she said Tuesday. “There’s a lot of our world right now that seems inconsistent, and if you’re getting mixed messages from health authorities, it can be very overwhelming.”

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As COVID-19 cases among children aged 5 to 11 jumped with the start of school , more parents have been forced to navigate pandemic-related challenges, from having a sick kid to isolating them after an exposure. But some say their experience with Fraser Health has left them confused.

Haak decided to use her sick days to isolate herself and manage isolation plans for her four kids, all of whom are under the age of 11 and must follow slightly different guidelines due to the nature of their contact and health issues.

During her calls with two contact tracers, she said she was asked for different information. One asked about her daughter’s contacts 14 days before she tested positive, while one didn’t ask about that period of time at all.

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Another Abbotsford mother, Crystal Mauthe said she contacted Fraser Health herself upon learning her two children had been exposed to the virus after a friend was over at their house and later tested positive.

“My friend was contacted by Fraser Health after her positive test, but she wasn’t asked about close contacts in the days before,” she said. “I told my friend to call the contact tracer back and tell them she had seen us so we could be told the proper information on how long we had to isolate.”

Mauthe eventually reached Fraser Health and was told her kids needed to isolate, while she had to monitor her own health because she is fully vaccinated.

“I had to seek that out for myself,” she said.

Crystal Mauthe and her daughter. [PNG Merlin Archive]
Crystal Mauthe and her daughter. [PNG Merlin Archive] PNG

Trina Enns said she, too, had to go above and beyond to determine if she should isolate after a COVID-19 exposure. She and her 12-year-old son were fully vaccinated when they were exposed through a close contact earlier this month, but because Enns takes an immune-suppressing medication, she asked the contact tracer if she should isolate rather than monitor.

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“I know that I may not have had a strong immune response to the vaccine,” she said. “Should I act like I haven’t been vaccinated?”

While the contact tracer told her she could continue to go out if she was vaccinated, the Abbotsford mother chose to isolate.

In a statement, Fraser Health spokesperson Vanessa Woznow said contact tracers have two main priorities: to determine where someone may have picked up the virus, and if they may have passed it on.

In general, she said, unvaccinated people who have had contact with the sick person and meet “close contact criteria” are told to isolate. Fully vaccinated close contacts can typically self-monitor if they do not have symptoms.

Woznow said those guidelines have been established by the B.C. Centre for Disease Control.

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But not everyone who has seen the sick person in the two days prior to them showing symptoms may be contacted and told to isolate.

Contact tracers “work to identify clusters of cases in the community and notify those people at high risk of developing COVID-19 due to the nature of their contact with the case,” she said.

While they follow standardized scripts and use provincial criteria to determine isolation periods, how far back to trace, and who is identified as a close contact, contact tracers face “many different scenarios and settings” and must sometimes tailor their recommendations.

In those situations, they consult with nursing team leadership and medical health officers for guidance, said Woznow.

A situational report posted by the B.C. Centre for Disease Control on Tuesday noted that while diagnosed cases of COVID-19 among school-aged children too young to be vaccinated rose when school started, the number peaked in late September and is now trending downward.

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The increase occurred primarily in regions with lower community vaccine coverage. “Not only does vaccination help protect the individual, it can also help protect others in the community, including younger children who are not yet eligible to be vaccinated,” the report noted.

Between Oct. 6 to 13, there were 877 new COVID-19 cases among children aged five to 11 across B.C., compared to 204 kids under the age of four, and 267 aged 12 to 17. Only 44 kids in the five-to-11 age group have been hospitalized due to the virus, including one during the week of the report. There have been no deaths in that age group.

The report also noted there were 1,388 postings of potential exposure among 510 schools, or about a quarter of all schools in B.C., between Sept. 7 and Oct. 9.

There are over 500,000 children under age 12 in B.C. who remain unable to receive the COVID-19 vaccine. Earlier this week, Pfizer-BioNTech said it had asked Health Canada to approve the first COVID-19 vaccine for children aged five to 11 years old.

gluymes@postmedia.com

twitter.com/glendaluymes

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17Oct

SAD plus COVID: A bit of light and a bit of exercise can make all the difference

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The best way to prepare for the winter blues is to anticipate, prepare and plan to add light and exercise, say experts.

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As the season of darkness and rain descends, the spectre of lowered mood, heightened anxiety and seasonal depression looms. The global pandemic has added an additional stressor to those vulnerable to mood disorders.

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“Stress plays a role,” said Dr. Raymond Lam, an expert in seasonal affective disorder. “People who have clinical depression can have their depression start earlier, have symptoms worsen, and people with mild or winter symptoms can have major symptoms such as sadness, lowered mood, oversleeping, overeating.”

According to a recent Ipsos Reid poll , nearly three in 10 Canadians have reported a deterioration in mental health since the beginning of the pandemic, and according to Stats Canada , more Canadian adults screened positive for anxiety or major depressive disorder in 2021 than in 2020.

Lam, professor and B.C. leadership chair in depression research at UBC, said the best way to prepare for the season is to anticipate it, and understand our defences may be down due to the pressures of the pandemic.

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“Not having the usual things that help with our resilience, such as exercise, gatherings, and friendships, means our coping behaviours are reduced,” said Lam.

Raymond W. Lam, professor and B.C. Leadership Chair in depression research, UBC, in his office.
Raymond W. Lam, professor and B.C. Leadership Chair in depression research, UBC, in his office. Photo by Handout /PNG

For those who have seasonal affective disorder, or SAD, a mood disorder that strikes during the autumn and winter seasons, light therapy , or exposure to 30 minutes of bright, artificial light a day, is a well-known, safe and effective treatment. However, Lam said research shows that even when skies are grey, exposure to natural light is beneficial.

Lam also suggests we get moving. “Exercise by itself helps depression, even clinical depression, and specifically for winter depression it is helpful.”

So what happens when restrictions, fear of COVID-19 infections or a dislike of being outdoors in bad weather keeps us from staying active?

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New research by Dr. Eli Puterman has found that at-home exercise through fitness apps is an effective tool in managing depression.

At the beginning of pandemic restrictions in 2020, Puterman, an associate professor in the school of kinesiology at UBC, said that he heard countless stories from people he met who were suffering from isolation, loneliness and depression.

Puterman, a health psychologist, had maintained his workouts during lockdown using Down Dog, an app that provides a variety of exercise programs. He researched whether at-home exercise apps could provide some relief.

The results of his study, published last week in the British Journal of Sports Medicine , showed that at-home app-based workouts, especially those using a combination of high intensity interval training and yoga, provided significant reductions in depressive symptoms.

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The study randomized a group of 334 women and men between 18-64 years old who were not involved in high levels of exercise, and assigned them to either yoga, HIIT, or both, and a control group was asked to maintain their current level of exercise.

Participants using the app all exhibited a steady decrease in their depression symptoms regardless of the type of exercise they did, and those with the most significant depression symptoms had the most dramatic improvements.

“The people in the study group categorized as having some kind of significant depression saw a drastic change,” said Puterman. “A good 70 per cent of them could no longer be categorized as having significant depression by the end of the study.”

Twenty minutes of vigorous exercise, four times a week, was enough to make a difference, said Puterman with those who used a combination of yoga and HIIT training receiving the greatest benefit.

Puterman said he hopes that public policy will shift to providing tools, tax incentives and education programs to help people incorporate more exercise into their routines.

At the individual level, Puterman reminds people to start slowly.

“Even a walk around the block can help,” he said.

Puterman also suggests using covered spaces in parks and school grounds to exercise outdoors, to get the added benefit of natural light exposure and fresh air.

dryan@postmedia.com

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1Oct

Dementia and wandering: Finding a way forward

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“We know we will see more and more deaths.” Experts say an aging population and rising rates of dementia may lead to more cases of missing seniors.

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The day Shin Noh went missing, he was seen by a member of his Coquitlam church who didn’t realize he might be lost.

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Several others also encountered the retired pastor on that day, Sept. 18, 2013, although his family didn’t learn of the sightings until several days later. By then, the odds of finding him alive and in good health had significantly diminished, said his son, Sam Noh.

Shin Noh had been diagnosed with Alzheimer’s disease several years earlier. He sometimes forgot dates, or when he last ate. Out of respect for his privacy, his family kept his dementia confidential. On good days, they hoped he might be returning to his old self.

“My family was very ill-equipped to deal with it,” said Sam Noh. “For years he’d gone for walks. If you tried to stop him, he could get quite upset.”

When his dad didn’t return from his morning walk that morning, Noh contacted police, although he privately wondered if it was too soon to sound the alarm.

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In the days that followed, searchers, including family and friends, chased every lead, including an unconfirmed report that homeless people living on Burke Mountain may have given the missing man food.

But Shin Noh was never found.

“It took a long time to realize there’s no way he could be alive,” said Sam Noh. “As a family, you have this hope that he might still be out there. After eight years, we want closure, but I think we might never get it.”

Noh’s family is not alone in their loss.

In May 2020, an 88-year-old Delta senior with dementia was found dead in a wooded area near the Alex Fraser Bridge after he went missing from his nearby home. In 2019, two missing seniors with dementia, both from Chilliwack, were found dead several months apart, while a Maple Ridge man with dementia remains missing.

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Eight years after his father disappeared, Noh has become a lay expert on dementia and wandering.

B.C. Silver Alert, an advocacy group co-founded by Noh and Coquitlam Search and Rescue volunteer Michael Coyle, tracks missing seniors through police press releases. Each year, on average, they issue about 29 alerts over social media asking their followers to be on the lookout for someone.

In a major city like Vancouver, there are sometimes multiple press releases per week, the vast majority ending with a positive outcome.

On Sept. 20, Vancouver Police asked for the public’s help to find an 80-year-old man who had been dropped off near Vancouver General Hospital for a medical appointment, but never made it inside. The following morning, another press release indicated he had been located.

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But while anecdotal evidence suggests missing seniors are a serious issue, a lack of data makes it difficult to know if the problem is increasing.

“You need statistics to inform policy,” said Noelannah Neubauer, a post-doctoral fellow at the University of Waterloo who helped spearhead the development of the International Consortium on Dementia and Wayfinding. “What you’re seeing in B.C. is happening across the country as you have an aging population and there’s more people with dementia. But the data isn’t there.”

There are more than 500,000 Canadians living with dementia today, according to the Alzheimer Society of Canada, with that number expected to rise to 912,000 by 2030. It’s believed that six out of 10 people living with dementia will wander at least once, and many do so repeatedly.

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In her work with first responders, Neubauer said she’s been told missing seniors are quickly becoming the top category of missing people in many jurisdictions.

“That’s scary because seniors often have health complications,” she said. “We know we will see more and more deaths.”

Balancing safety and autonomy

As a police officer who reviews the files of many of B.C.’s missing people, Cpl. Jennifer Sparkes has a unique perspective.

Across 45 RCMP detachments from the B.C. Interior to the Alberta border, Sparkes sees about 3,000 missing persons files each year. About two per cent of those cases involve people with dementia. In 2021 so far, there have been 43 reports of missing seniors with dementia. All but one was concluded with the person located alive on the same day they were reported missing.

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“These cases are always treated as high risk and high priority because of the nature of dementia,” said Sparkes, the missing persons coordinator for B.C. RCMP E division’s Southeast District. “But I’m very encouraged when I look at the outcomes.”

Compared to other missing people, missing seniors are usually located quickly by police, family, caregivers or the public, while some return on their own.

“This category of files also tends to have an excellent support system, which makes it so much easier,” she said. “Many of the (other) people reported missing don’t have a support system.”

In Vancouver, these cases also tend to be resolved quickly, although there are sometimes several in a week.

“We see about 12 per month, or three or four per week,” said Vancouver Police Sgt. Teresa Wager.

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“It’s very weather-dependent,” added Det. Rebecca Matson. “If the weather is nice, we’ll see numbers increase.”

While cases usually end well, the two members of VPD’s missing persons unit said the experience is traumatic for families and caregivers.

“It’s devastating,” said Wager. “They’re upset, looking everywhere, printing posters.”

For the missing person, the experience may be disorientating. Wager recalled someone who walked almost 30 kilometres and seemed unaware they were lost. Another person took transit to Surrey.

Dangers, particularly in bad weather, include succumbing to the elements, becoming lost in an inaccessible place like heavy brush, or falling.

Yet experts agree autonomy is an important part of well-being for people with dementia.

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“Mobility is a critical part of quality of life,” said Habib Chaudhury, chair of Simon Fraser University’s gerontology department. “Unfortunately, it’s also where wandering becomes an issue.”

In North America, we tend to prioritize safety and security over autonomy and quality of life, he said, pointing to locked dementia wards in some care facilities. In other countries, the scale tips in the other direction, with more innovative approaches to managing patients through building design or technology.

Understanding why someone might desire to wander can help caretakers to find a balance, said Lillian Hung, an assistant professor in the University of B.C.’s nursing department. Many times, wandering is the result of an unmet need.

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“If caregivers have better skills to realize what is happening — ask them, can I help you find something, can you tell me more about what you’re looking for? — it may address that unmet need,” said Hung.

The person might be searching for a place or person from their past, or responding to a change in their environment, she said. They might feel restless and want to move, or have a physical need they can’t express.

“Wander denotes aimless movement,” said Kim McKercher, a provincial coordinator with the Alzheimer Society of B.C. “To the individual, there is meaning behind it.”

The society advises families to remove triggers, such as a jacket or keys from the front door, and to be aware of a person’s past routines, like when they used to leave for work, and engage them during that time.

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Technology helpful but not foolproof 

Stigma around cognitive disorders can sometimes prevent people with dementia from discussing how they want their families to manage the disease as it progresses, said Lili Liu, a professor in the school of public health sciences at the University of Waterloo who specializes in aging and technology.

Experts advise creating a care plan that uses multiple strategies to balance autonomy and safety.

“Do they want technology to be part of their care?” she said. If so, they might get in the habit of carrying a device that could be capable of tracking them in the future. Consent is key. “Some might say no camera, but I’m OK with sensors.”

In 2013, police in the United Kingdom conducted a trial to give seniors prone to wandering GPS trackers. The program cost about $700 per month, but was anticipated to save thousands more by avoiding callouts.

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But the initiative was condemned by the National Pensioners Convention.

“This is trying to solve a human problem with technology. Rather than tagging people we need better social care out in the community,” general secretary Dot Gibson told local media.

University of Waterloo aging and technology experts Noelannah Neubauer and Lili Liu.
University of Waterloo aging and technology experts Noelannah Neubauer and Lili Liu. Photo by AGE-WELL NCE /PNG

While technology is one strategy, it’s not foolproof, said Neubauer. Tracking devices often need to be charged, and the person must tolerate wearing one. GPS can be inaccurate near tall buildings or on underground transit systems.

When Chilliwack senior John Pop went missing in 2019, his daughter told media he usually wore a GPS watch that provided alerts to family members. The watch had recently stopped working and they were in the process of getting a new one when he disappeared. The family also had a door alarm, but his wife was doing dishes in the kitchen and didn’t hear it when he left the house.

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Pop’s body was found four days later near a local trail.

Another approach to keeping people safe involves providing police and searchers with more information.

MedicAlert, a charity that promotes medical ID bracelets, offers a blue version for people with cognitive issues. First responders can access a file of information submitted by the person or their family in advance, including medical information, current photographs, past history and triggers.

All MedicAlert information is self-reported, not from hospitals, said president Leslie McGill. “We’d love to provide that access, but we’re not there yet.”

Since his father’s disappearance, Sam Noh has been advocating the B.C. government to create a geo-targeted Silver Alert system similar to the Amber Alert program, which could be activated by police in specific communities when a senior goes missing.

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During the 2020 provincial election campaign, Premier John Horgan met with Noh and pledged to “continue to advocate” for the system.

But some believe Silver Alert could lead to “alert fatigue” among the public, or might infringe upon a person’s privacy.

“Silver Alert is not the ultimate solution,” Noh admitted. “But we need to use all the tools available for a complex problem.”

Sam Noh’s father, Shin Noh, went missing in Coquitlam in 2013 and has never been found. Noh is the co-founder of B.C. Silver Alert, a citizen-led effort to create a public alerting system to save the lives of missing people with dementia or other cognitive issues.
Sam Noh’s father, Shin Noh, went missing in Coquitlam in 2013 and has never been found. Noh is the co-founder of B.C. Silver Alert, a citizen-led effort to create a public alerting system to save the lives of missing people with dementia or other cognitive issues. Photo by Jason Payne /PNG

Dementia-friendly communities

Perhaps one of the best ways to keep people with dementia safe while promoting autonomy isn’t a tool at all, but rather a societal shift that would make communities more “dementia-friendly.”

Mario Gregorio, a dementia advocate who has worked as a co-researcher on several UBC studies, is proud that Burnaby was among the first communities in B.C. to complete a “dementia-friendly action plan” with the Alzheimer Society of B.C. He’s participated in several “walkabouts” with city staff and first responders in an effort to teach them what it’s like to navigate the city as someone with dementia.

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“I’m very encouraged that people are listening,” he said.

Gregorio’s insights have helped inform the design of new public spaces to ensure “entrances really look like entrances,” sidewalks are clearly delineated from other spaces and that there are landmarks to make it easier to navigate, said Margaret Manifold, senior social planner for the City of Burnaby. Front-line staff have also received training to assist people with dementia.

“I think it raises the level of awareness,” she said. “We want to be more inclusive of people with cognitive impairments.”

Mario Gregorio at the Royal Oak SkyTrain station. Gregorio, who lives with dementia, advises the City of Burnaby on making the community a “dementia-friendly” place.
Mario Gregorio at the Royal Oak SkyTrain station. Gregorio, who lives with dementia, advises the City of Burnaby on making the community a “dementia-friendly” place. Photo by Francis Georgian /PNG

A shift is also taking place in long-term care to recognize people with dementia have a right to independence.

Billed as Canada’s first “dementia village,” The Village Langley doesn’t use the term “beds” or “facility” to describe its long-term care and assisted-living homes, said executive director Adrienne Alford-Burt. Within the seven-acre gated community, inspired by a similar concept in the Netherlands, villagers are free to “self-direct” their movement and move freely around the community, visiting the hair salon or pub, according to their mobility and safety requirements.

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“We make sure people have the opportunity to control their day within a safe environment,” said Alford-Burt.

Adrienne Alford-Burt, executive director of The Village Langley with former villager Bernie.
Adrienne Alford-Burt, executive director of The Village Langley with former villager Bernie. Photo by The Village Langley /PNG

B.C. seniors advocate Isobel Mackenzie said wandering is sometimes the reason someone must move to long-term care, although some families choose to put safeguards in place, such as technology, to “mitigate some of the dangers.”

A more “coordinated approach” to dementia involving various stakeholders and solutions could help people stay at home longer, she said.

“I think there is more we can do with the public to give people greater confidence that someone is watching out for them.”

gluymes@postmedia.com

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twitter.com/glendaluymes


Tips for caretakers

Vancouver Police Sgt. Teresa Wager and Det. Rebecca Matson shared a few simple steps that families can take that can later help police find a lost senior.

• If the person has a Compass Card or transit pass, record the number. “We can track that super easy and that will tell us if they’ve taken SkyTrain or the bus,” said Matson. “Families never have that number, but many people have been found using transit. Bus drivers have actually found a lot people for us.”

• Consider using technology to track the person when they’re out alone. This doesn’t have to be complicated, said Wager. Certain phone apps allow tracking, while GPS trackers, like Apple AirTags, can be sewn into a jacket or hat.

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• Ensure you have a current photo. “If the person always wears a blue jacket and a Tilly hat, take a picture of them wearing that,” said Wager. “Nothing sucks more than when we have to use a passport or drivers’ licence photo. No one looks like themselves in those pictures.”

• Don’t hesitate to report. “It’s a bad TV myth that you have to wait 24 hours to report a missing person,” said Matson. “Never feel bad about reaching out to us.” Police treat vulnerable missing people as a high priority. “If we can get out there quickly, it really helps. We’ve had the helicopter out in some case.”

• Encourage the person to wear a lanyard with their name, address and phone number on it.

• Know the person’s favourite places to visit, including past addresses, workplaces, places they like to shop, familiar parks and walking routes. People are often found close to home.

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15Sep

COVID-19: Police say they hope for voluntary compliance on vaccine cards

by admin

Both the Vancouver police and the RCMP say they’re hoping for compliance rather than confrontation with COVID-19 vaccine cards

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Both the Vancouver police and the RCMP are asking the public for voluntary compliance rather than confrontation when it comes to the new COVID-19 vaccine card.

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VPD media relations officer Sgt. Steve Addison said two gyms called police Monday, the day the vaccine cards came into effect, after two customers refused to show their cards. He said there was “no public safety risk or criminal offence in either case” because the people eventually left without incident.

“We trust that business owners and staff will do their best to resolve conflicts that arise over vaccine passports,” he said by email. “We will attend if there is a public safety issue or a criminal act.”

RCMP Staff Sgt. Janelle Soihet said she’s not aware of any tickets being issued since the card came into effect. Soihet, senior media relations officer for E Division, said the RCMP isn’t tracking incidents where officers have been called relating to disturbances about the COVID vaccine card.

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“We are hopeful enforcement will not be required and that voluntary compliance and co-operation will be the norm,” she said in an email. “The RCMP will continue to use a measured approach when dealing with calls related to COVID-19 non-compliance. Calls will be assessed on a case-by-case basis and our response will be based on this assessment and triaged based on current detachment operations.”

The vaccine card is required to enter restaurants, movies, ticketed sporting events, gyms and other non-essential venues. By Oct. 24, only fully vaccinated people will be able to access all those services and venues.

Businesses and groups that don’t comply with the public health officer order may be issued a violation ticket. Individuals could be fined $230 or $575. For owners, operators and event organizers, the fine could be up to $2,300.

E Division is the largest police body in the province with 144 detachments serving about 3.3 million people. Its 7,100 sworn members provide policing for all but 12 municipalities in B.C.

Soihet said police are asking people to respect the fact that businesses and owners are doing their best to get through the pandemic.

“There is no cookie-cutter approach that can be applied to each call, as such we will make an assessment based on the circumstances surrounding each incident,” she said.

kevingriffin@postmedia.com

15Sep

Police say they hope for voluntary compliance on vaccine cards

by admin

Article content

Both the Vancouver police and the RCMP are asking the public for voluntary compliance rather than confrontation when it comes to the new COVID-19 vaccine card.

Article content

VPD media relations officer Sgt. Steve Addison said two gyms called police Monday, the day the vaccine cards came into effect, after two customers refused to show their cards. He said there was “no public safety risk or criminal offence in either case” because the people eventually left without incident.

“We trust that business owners and staff will do their best to resolve conflicts that arise over vaccine passports,” he said by email. “We will attend if there is a public safety issue or a criminal act.”

RCMP Staff Sgt. Janelle Soihet said she’s not aware of any tickets being issued since the card came into effect. Soihet, senior media relations officer for E Division, said the RCMP isn’t tracking incidents where officers have been called relating to disturbances about the COVID vaccine card.

Article content

“We are hopeful enforcement will not be required and that voluntary compliance and co-operation will be the norm,” she said in an email. “The RCMP will continue to use a measured approach when dealing with calls related to COVID-19 non-compliance. Calls will be assessed on a case-by-case basis and our response will be based on this assessment and triaged based on current detachment operations.”

The vaccine card is required to enter restaurants, movies, ticketed sporting events, gyms and other non-essential venues. By Oct. 24, only fully vaccinated people will be able to access all those services and venues.

Businesses and groups that don’t comply with the public health officer order may be issued a violation ticket. Individuals could be fined $230 or $575. For owners, operators and event organizers, the fine could be up to $2,300.

E Division is the largest police body in the province with 144 detachments serving about 3.3 million people. Its 7,100 sworn members provide policing for all but 12 municipalities in B.C.

Soihet said police are asking people to respect the fact that businesses and owners are doing their best to get through the pandemic.

“There is no cookie-cutter approach that can be applied to each call, as such we will make an assessment based on the circumstances surrounding each incident,” she said.

kevingriffin@postmedia.com

8Sep

‘Modified’ leghold traps being used to cull coyotes in Stanley Park

by admin

Province says traps are designed to minimize chances of physical pain and are monitored continuously

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The province says foothold traps being used to catch and kill coyotes in Stanley Park have been modified to minimize the risk of pain to the wild animals.

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But Rebeka Breder, an animal rights lawyer, said Wednesday she believes the traps will cause “excruciating pain” and “enormous amount of suffering” to the trapped animal.

“They’re baiting leghold traps. They’re saying they’ll be padded. That doesn’t bring me any comfort whatsoever,” Breder said. “These leghold traps essentially slam down on what gets stuck — usually it’s a paw, sometimes it’s a neck.”

Last week, the provincial government said it would kill up to 35 coyotes to protect public safety.

Since December, 2020, there have been reports of 45 attacks by coyotes on people in the park. Five attacks were on children.

The Ministry of Forests, Lands, Natural Resource Operations and Rural Development said in a statement Wednesday that one coyote had been caught and killed overnight.

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The ministry said the coyotes are being caught in “modified foothold traps” which are continuously monitored by camera, so that the amount of time a coyote spends in the trap is minimized.

“The mechanism for these type of traps minimizes the risk of any pain or damage to the animal,” the ministry said.

The province has contracted professional trappers to help catch the coyotes. Once caught, a provincial wildlife officer is called to sedate the animal and then kill it using a bolt gun, a device “used routinely to humanely kill livestock.”

The ministry said the “stomach contents will be preserved and analyzed to determine diet.” The animals will also be tested for diseases.

The ministry was unable to say what necropsies have shown from coyotes that were killed in the park earlier this year. The province did not make anyone available for interviews on Wednesday and is only taking reporters’ questions in writing.

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Breder said she’d like to know what kind of measures the government is planning to take to get at the root cause of what’s going on in Stanley Park between coyotes and humans.

“Probably more important to me is that there has been a lack of enforcement on the prohibition to feed wildlife,” she said.

The B.C. Conservation Officer Service has said no tickets have been issued for illegally feeding wildlife in Stanley Park.

Breder said the lack of enforcement infuriates her.

“It is illegal to feed wildlife. Why on earth have they not enforced this law?” she said.

“Some people need a $500 ticket — I would suggest a very high fine — to learn their lesson.”

Earlier Wednesday, Mayor Kennedy Stewart said Vancouver is playing a supportive role to both the B.C. Conservation Officer Service and the park board.

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“I’m really sad for the need to cull the coyotes,” he said at an online news conference. “I just feel really sad about the whole thing but I understand why because of public safety.”

Stewart said the city will be reviewing “the situation with the park board and B.C. Conservation Officer Service to see what the city of Vancouver can do to make sure this doesn’t happen again.”

The park board expects to have coyote-proof garbage bins in place this week.

As well, there will be multilingual “Don’t feed Coyotes” signs to reflect the largest language groups in Vancouver. Signs will be in Tagalog, the main language spoken the Philippines, and in simplified and traditional Chinese characters.

Stanley Park remains closed to the public from 7 p.m. to 9 a.m. daily. All trails inside the park are closed at all times.

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When the park is open, the public is asked to only use the seawall, open grassy areas, paved roads and businesses.

A study published in 2018 found that the range of coyotes has “dramatically expanded since 1900.”

The study, which looked at where coyotes have been found the past 10,000 years, described Canis latrans (the Latin name for the species) as an “incredibly adaptive carnivore” that’s been able to expand its geographic range by about 40 per cent or “at least twice as much as any other North American carnivore during the same time period.”

It attributed the expansion to factors that included the elimination of predator species such as wolves and cougars.

Traditionally, coyotes have been found in grasslands, prairies and deserts but learned to adapt to forested areas in the early 20th century.

“Coyote expansion began around 1900 as they moved north into taiga forests, east into deciduous forests, west in coastal temperature rain forests, and south into rainforests,” the study’s abstract says.

The Vancouver Sun first reported about coyotes in Stanley Park in 1988.

kevingriffin@postmedia.com

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