COVID-19 and racial inequality

Guests: Celeste Demby, Sharrelle Barber, June Franscis

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MG: It has been described as an equal opportunity infection. For weeks now, doctors have said that everyone is susceptible to COVID-19, regardless of age or gender. But there is growing evidence that some are hit harder than others, particularly people of colour. Celeste Demby lives in Long Island in New York, where she and her husband contracted the disease. She also lost a cousin to this illness. Celeste, good morning.

CELESTE DEMBY: Good morning.

MG: I'm sorry for your loss of your cousin.

CELESTE DEMBY: Thank you. I appreciate it.

MG: Your cousin and your husband both got covered 19 in March and they faced a similar experience at the emergency room. Tell me a little bit about what your cousin Alexis Demby's experience was like, as you understand it.

CELESTE DEMBY: Well, around March 13, she went to the ER for the first time with her symptoms. And she had like a cough. She had a fever, you know, all the, you know, regular symptoms.

MG: Yes.

CELESTE DEMBY: They actually ended up admitting her to hospital because they did a chest X-ray and she had pneumonia in both lungs. And then at that point, they decided to test her for COVID-19, because her two tests have come back negative. So they tested her for the virus about three days later. The results came back and they released from the hospital, told her to quarantine. And, you know, she did that. She was sick for about a week before she passed away. She passed away on the 22nd of March.

MG: And she went back to the E.R. a second time before she died.

CELESTE DEMBY: Yes. So March 21st, she went back to the E.R. because after weeks, although all her symptoms had subsided except for this cough that she kept having. And then she wasn't able to breathe. She was having trouble breathing. So she went back to the E.R. because all the information that we had at the time said that if you can't breathe, go to the E.R. So she went to the E.R. and they dismissed her. They turned her away and she went home and she died in her sleep that night.

MG: They dismissed her. What do you mean?

CELESTE DEMBY: They just didn't- they didn't, you know, take her seriously. And they didn't admit her or do any checks or anything about why she couldn't breathe and so on. I guess they just chalked it up to the COVID and the pneumonia, but apparently with something more serious. And we never got to find out what that was. And with everything going on right now, we still haven't been able to, like, bury her, get autopsy or anything like that. So we really don't know what the cause of death was. But I just know that on March 21st, she went to the E.R. in Georgia and she died the next day.

MG: Around the same time as this is happening, and this is awful, your husband is first diagnosed with COVID-19 and then he has trouble breathing. You call an ambulance for him. What happened when he arrived at the hospital?

CELESTE DEMBY: So when he arrived at the hospital, you know, we had already been sheltering and quarantining for, I would say like 11 days. At that point he had, his results for COVID-19, had come back positive. So on that night, it was March 20th, he has asthma and he was having trouble breathing. So he uses inhaler like three times and he was still having trouble, like still restricted and stuff. So, you know, with everything going on, I just called, you know, my cousin had just died. I was like freaking out. Very anxious about- like I honestly thought that I was going to wake up and he was going to be dead, you know? You know, in the morning, like he would die in his sleep. It was a very scary time. So he went to the E.R. I called the ambulance and they took him to the E.R . And when he gets there, the E.R. doctor looks at him. He's like, why are you here? You know, you're exposing all these people to the virus. And, you know, he explains that like he can't breathe and stuff like that. And, you know, people are just very dismissive of him. And like, really, you know, just, you know, not, you know, nothing. Didn't have a very good bedside manner, I guess so. You know, he had been brought in by the ambulance. The only reason I think they took it a little bit more seriously. So they gave him a chest X-ray and they found that he had pneumonia in both of his lungs.

MG: Wow.

CELESTE DEMBY: So at that point, the doctor kind of like came back with her tail between her legs and was like a little bit more apologetic and helped treat him. But even with the pneumonia in both lungs, you know, he wasn't hospitalized or anything. They gave him a prescription for antibiotics and sent him home.

MG: When you hear these statistics about people of colour faring worse in this crisis and this has been reported widely, certainly in the last couple of days, does that square with your own experience and what you've seen, what you've heard?

CELESTE DEMBY: I mean, I think, you know, I'm a black my whole life. So I've seen this like this is not new. Lack of access to quality healthcare, both socially, economically and like racially has been, you know, in America this is kind of just like a thing. This is what happens, right?

MG: What do you mean? But just briefly, what do you mean this is what happens?

CELESTE DEMBY: So like black and brown people have the highest rates of, you know, maternal death when it comes like childbirth and stuff like that, pain management. We have some of the highest rates with that. And, you know, getting access to medication to manage pain and things like that. Like so like everything in America is racialized. You know, even healthcare where you think, like, you know, these should be equal. Like we're all people. We all experience things in similar ways. But when you come in to make racial bias and like these racial myths about how black people don't experience pain in the same way that others do. Then you get, you know, these mistreatments in health care. And then add in the fact that, like, you know, if you're poor and black, it's even worse, you know? So the numbers are not surprising me. When this thing hit, one of the first things I said is like, this is going to affect people. These are going to affect poor black and brown people more so than it does, like white, affluent people.

MG: Celeste, I appreciate you talking to us about it. We're going to speak more about this and how this is playing out, not just in your own situation, but across the country and here in Canada as well. Take care of yourself. You're feeling a bit better now?

CELESTE DEMBY: I am. I'm like back to almost 100 percent. So doing great.

MG: Excellent. Appreciate you joining us. And thanks. And take care yourself.

CELESTE DEMBY: All right. Thank you for having me.

MG: Celeste Demby is an undergraduate college advisor at Stony Brook University. She joined us from Wheatly Heights in Long Island, New York. Before this pandemic really hit North America, a group of academics predicted high infection rates in the black community along the lines of what Celeste was talking about. Sharrelle Barber was one of them. She's an assistant research professor of epidemiology and biostatistics at Drexel University. She's in Philadelphia. Sharrelle, good morning to you.

SHARRELLE BARBER: Good morning.

MG: As you wade through the data emerging around covered 19 rates of infection and particularly how it plays out within populations of people of colour, what's gone through your mind?

SHARRELLE BARBER: Yes. Thank you so much for that. And first, I just want to just [unintelligible] Celeste, but just, you know, condolences to her and her family. And one thing I will say is that, you know, as we as scholars, as researchers, as epidemiologists, we count deaths. That's part of our job description in some way. It's right. But what the less story reminds us is those deaths are those mortality data are our names, their faces, their people. And so, you know, as you mentioned, you know, colleagues and myself kind of a couple weeks ago, we begin to think about the ways in which structural racism would play out in this pandemic as everyone would say no, it's a great equaliser. But we knew from past experiences you think, you know, go back to instances of tuberculosis, for example, and you had higher rates among blacks, in the early, late 1800s , early 1900s. You know, we saw these racial patterns then. You know, you mentioned that I'm in the city of Philadelphia, W.E.B. Dubois, who wrote the Philadelphia Negro Documented racial inequalities in health outcomes, particularly infectious disease, et cetera. So this isn't new if there's a history of it. And so as we're seeing the higher death rates in, for example, Mississippi, in Louisiana, in places like Chicago and in the lucky, this is really to be expected given as Celeste said some other discriminatory and biased, racially biased practices within the health care system.

MG: Well, tell me more about that, because in New York, you have rates, Hispanic people, a 22 percent per 100,000. That's the death rate for black people is 20 percent per 100,000. For white people, it's 10 percent per 100000. What's happening? Why is this happening?

SHARRELLE BARBER: Yes I think it's a couple of things. I think it's just like the list that we know that within the health care system, blacks and Hispanics and other racial marginalized racial groups do get discriminated against, and I am not shocked this, you know, that people come in with symptoms and not are turned away because of existing biases. That happens. It's documented. We saw this in the, you know, the black maternal mortality rates where these same kinds of stories of black mothers not being listened to as they're giving birth. So all of these things they exist already within the system. I think that's part of it. I mean, when you're in a situation like with you have it with the pandemic and you have limited resources, limited beds, limited ventilators, etc. Folks are going to have to make decisions about who lives and who dies. And unfortunately, because of the discrimination and the bias that already exists in the health care system, that means black and brown folks are going to die at higher rates because of those things.

MG: There's also the issue of social distancing or physical distancing. People have said that this is not something that everybody can do. That the idea of social distinct distancing is in many communities a privilege. What does that mean?

SHARRELLE BARBER: Yes, I mean, absolutely. So New York Times had a really good article on this. But let me just kind of break it down. If you think about who are the kind of low wage essential workers during this pandemic, those who don't even make a living wage in the United States, you know, less than $15 an hour who are now mandated, in some ways to work during this time without the kind of personal protective equipment necessary to prevent contraction of the virus. These individuals are disproportionately black, disproportionately brown, and are having to go into work, even despite the risk that they might be putting not only themselves in, but their families and their communities. So everybody can't work from home. That's just a that is a privilege. And so we're putting literally, not protecting these frontline workers, grocery store folks and janitors and other folks. Now then they return potentially back to their community, which we know in the United States most cities are highly segregated by both race and economic. This is because of racist policies that date back to the 1930s and have continued to today. And we know that we have high levels of racial residential segregation. And within those communities, those communities are the communities that have may be less likely to have access to clean water. Think Flint, Michigan. Right. Or have more housing spaces that are crowded, et cetera. And so it's even a privilege if you get the disease to self-quarantine because perhaps you live in a home where there's no options to do that. So you see, like all of these systems are interlocking and they're creating this kind of really vicious cycle that is making it more likely for blacks, for Latinos or poor folks to both contract the disease and then once they get it, to then subsequently die.

MG: Just briefly, before we turn our attention to what's happening in Canada, how do you want the data that's been starting to come in to be used in the midst of this pandemic?

SHARRELLE BARBER: Well, it's important, this racial data and other demographics, geography, et cetera, in this short term should be used to one showed the disproportionate impact. So hopefully it's sounding the alarm. But then how do we redirect resources in this moment? Because we know there's a disproportionate impact, that the response to this can't be just everyone get the same thing. Certain communities, communities of colours, those who have were in crisis before the crisis need additional assistance, additional resources, and to make sure that we can mitigate the that are happening in these communities. So, funnelling resources to the communities that need it the most. Making sure there are places that they can get the proper testing and the proper treatment. And to be able to kind of ward off death in this moment.

MG: Sharrelle, take care of yourself. And I appreciate you speaking with us. Thank you.

SHARRELLE BARBER: Thank you. Bye.

MG: Sharrelle Barber is an epidemiologist and biostatistician. We reached her in Philadelphia. June Francis is professor at Simon Fraser University. Director of SFU's Institute of Diaspora Research. She's been watching the numbers here in Canada. June, good morning to you.

JUNE FRANCIS: Good morning.

MG: We'll often hear that black people, even before the pandemic, disproportionately suffer adverse outcomes in the health care system in Canada. That applies as well to indigenous folk in this country. What does that mean and what does it look like in practical terms?

JUNE FRANCIS: Well, in practical terms, in Canada, our greatest - and first of all, good morning to everybody from the West Coast where it's really early. And I'm really sad and I must say, you hear the numbers coming out of the United States and to recognise that 10 days ago we were similarly alarmed in Canada. Because in Canada, the problem for us is that we do not collect the same race based data. I was on a call with a senior federal official, a call arranged by the Federation of Black Canadians to see if we could raise alarm at what we saw was a common a problem for the black community. And I was told that Canada, lectured, in fact, that Canada's a race is a color-blind society, and that I shouldn't expect that race based data was necessary.

MG: What would that data tell you?

JUNE FRANCIS: What that data would tell us is exactly what the United Nations, who came to Canada and raised a similar alarm, is trying to tell us. And that is that in Canada, people of African descent just are disproportionately in just about every socioeconomic variable. But they were particularly alarmed that we do not make race based data on most things. And in the health care system as well. And I think ever all of us, our lived experience in Canada, the data we have on pre-existing conditions and who gets the disease, who we thought would get the disease because of the fact, who we thought would get tested, how they were going to be treated and who was going to die. We thought with this recourse, maybe effect black, indigenous and I frankly, also people who were disabled.

MG: And that's I mean, the trouble with this pre-existing conditions. I mean, these are things like hypertension, diabetes, heart disease, maternal mortality, all things that disproportionately affect that- yes.

JUNE FRANCIS: I just wanted to say yes. Most people think we don't have that data here. We actually have the data on pre-existing diseases. We also have mountains of anecdotal data. But as I said, Canada has been reluctant to actually collect the data. So we're flying in the dark. In Canada, there is a denial which makes it even more difficult in practise. You ask me what it is and I'll give you an example. I took my daughter - not in this COVID-19 - but it frightens me. I took my daughter to E.R. and my daughter was, her life was being threatened and we were sent home. And my daughter said at the time that she was in terms of pain, on a scale of one to 10, she was an eleven. Yet the E.R. doctor indicated that she wasn't in that much pain. She was sent home and upon arriving and collapsed and almost died.

MG: And that you believe that that was about race. Why?

JUNE FRANCIS: Because of our continuing experience as black people. I was there in the E.R. I argued with the doctor strenuously. I just didn't think he was taking it seriously. My niece was in the hospital a few weeks later. Instead of treating her, they were discussing with her whether she was drug seeking. We all feel - I was in the hospital recently and I was told that they hadn't practiced on black people, and hence they were struggling to get something inside my veins. And they literally told me that it's because my skin was too dark, it could be [unintelligible].

MG: Well, just before we let you go, if you come back to the issue of the coronavirus, is collecting that data that you think would better help guide treatments to communities that are disproportionately suffering in this pandemic?

JUNE FRANCIS: Yes, because I think we know the same situations occur. Who gets the disease? Frontline workers. Canada has the same situation where in Canada black people are disproportionately represented in jobs where they're exposed because of systemic discrimination in the job market. They fear less well [unintelligible] that data. We also are concerned about who was tested initially. The guidelines said had you travelled. That's a systemic discrimination and we know that pre-existing conditions in Canada also suggests we will die. So the data, yes, I think the data is absolutely essential here because it's not, we can't begin to address the problem.

MG: June, good to speak with you about this. Thank you.

JUNE FRANCIS: Thank you.

MG: Take care. June Francis, professor at Simon Fraser University. Director of S.F. U.S. Institute of Diaspora Research. And the co-chair of the Hogan's Alley Society working to improve the health conditions of people of African descent in Canada. The news is next. And we're going to talk about vulnerability and why it's okay to feel a bit raw in the midst of the time that we're in. That's coming up on The Current. I'm Matt Galloway. Stay with us.

Our adrenaline can't 'outpace' COVID-19, but Brené Brown offers 3 tips to better cope

Guests: Brene Brown, Crystal Blair

MG: Good morning, I Matt Galloway. You're listening to the current.

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MG: Coming up, meet the Good Samaritan who's helping Canada's truckers.

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Some of them are out for weeks at a time. Some of them can't go home because of where they've been.

MG: That's on its way. But first, being vulnerable and daring greatly.

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MG: Usually in a crisis, you get a rush of adrenaline. It's a sign that your body's trying to carry you through what could be a very dangerous time. The danger of this pandemic is ongoing, though, and there is, as you know, no quick ending in sight. It's only natural for life to feel pretty heavy right now. This can be a frightening time. But my next guest has some insight from years of research about how to find the courage to face this moment. She is a professor of social work at the University of Houston and the author of five bestselling books, the host as well of a podcast called Unlocking Us. You may have also seen her. Ted talks about the issue of vulnerability. Brene Browne joins me now. Good morning.

BRENE BROWN: Good morning.

MG: How are you doing in the midst of all of this?

BRENE BROWN: Some weird combination of I think weary and hopeful, optimistic.

MG: The weariness I can understand and I want to talk about that in a moment. But where's the optimism coming from in the hopefulness? We could do with some optimism. I think these days.

BRENE BROWN: Well, I think, I'm in Houston, Texas, and so we just got some news that our flattening the curve social distancing efforts are working. And it looks as if everything goes according to kind of the predictions that we will possibly be able to move through this without overloading our medical system here in the state. And we're doing what we need to be doing right now. And so that makes me hope on optimistic, I think. You know, in the U.S., specifically in Texas, even more so we've got the whole rugged individualism push against the rule staff to our detriment often. And this is one of those situations where we, you know, we get well together, we stay sick together. This is a collective effort. And so I'm feeling optimistic that we're starting to understand that.

MG: But also weary. And we're all, I think a lot of us are feeling wiped out. You talked about this on the podcast that you're seeing tired people kind of everywhere. Why do you think we're so tired in the midst of this?

BRENE BROWN: Well, I think what you talk about in the introduction was really helpful. Normally, in order to get through a crisis, you know, our bodies are built to respond with a lot of adrenaline, a lot of energy, a lot of super coping surge. And then the waters recede or the fires are out or, you know, the crisis ends and we slog our way through kind of cleanup and trying to find our new normal. But we are not going to be able to depend on the adrenaline surge for this, because it's going to out- it's going to outpace us. And I think we are hitting that moment where we are weary in our bones. We are physically tired. We, you know, anxiety, uncertainty take a lot out of us physically. I think, you know, we're on Zoom calls. I don't know what happened. Like, I work a lot to begin with, but I feel like I'm on Zoom calls from 6:00 in the morning until midnight. You know, and then we've got toddlers crawling up our backs and partners trying to, you know, tell us to be quiet. They're also are being called. And we're tired. And I'll tell you, the other thing that's exhausting; that we are not acknowledging - again as a collective - is grief.

MG: And we've talked about that a bit on the program. How do you see grief right now?

BRENE BROWN: Well, I think it's a very a very difficult position we're in right now because I think we are on, we are both grieving the loss of normal and grieving the ordinary moments that make the touchstones for our lives. We're grieving the loss of those at the very same time we're having to find and settle into a new normal. And those two things are very difficult to do. At the same time, not mutually exclusive, but as close as it gets without being mutually exclusive. So there's grief, I think. Grief is the loss of normal.

MG: You said, you were on 60 Minutes, and one of the things you said that would be connected with this in some ways is, is that we don't know how to do this. That this is it. This is a whole different experience for so many of us. What did you mean by that?

BRENE BROWN: Yes, one of my first podcasts, and we just launched the podcast a couple of weeks ago. The first podcast was on FFTs. It stands for 'effin first time' and how difficult first times are, especially for most of us as adults, where we get to the place in our lives, where we don't do things that we're not already great at doing. Now we are thrown into a global pandemic. It's a first time for all of us. We don't know how to do it. There's no, if this was a hurricane hitting Houston, we all know how to do that. Like we don't know how to do this. And you know where our kids are at school, at home here, you know, homeschooling them, basically, we're working. We're afraid to go the grocery store. We don't know how to be new. And so I think when we're new at anything, whether it's that or something, a pandemic or something else, we have to learn how to name what we're in. This is hard. This is new. This is why it becomes awkward and terrible and vulnerable. Number two, give it some perspective. This is not going to last forever. And we will look back at some point, thank God that was hard and I'd do it differently a million ways. And number three is we have to reality check our expectations. We're not going to do this well. We don't know what we're doing. I mean, like, you know, I'm in my 50s and I keep waiting for the grown ups to show up and lead us through this thing. You know, like where are the adults here? Dang it. That's me.

MG: Is the fact that we don't know what we're doing. I mean, you've talked in the TED talks about shame and vulnerability. People feel some shame because they feel as though, well, I have this time off and maybe I should be, you know, learning another language. I got to learn to speak Portuguese and instead I can't. Because as you said, I'm on the Zoom calls all the time. I have kids running around. I'm trying to do the home piece as well. And people feel this sort of sense of productivity shaming. If people are feeling that, how are they supposed to process that?

BRENE BROWN: You know, it's so funny, if you would have asked me that two days ago, I would have said you. You know, I'm giving you the textbook answer, but I'm in that right now because my adrenaline is just coming to an end. And I'm like, hmm, I can't do all this extra stuff. I can't work the sixty hours I've been working since I've been in lockdown. I can't do this. And I'm struggling with a little bit at myself because I think a lot of us have used controlling- were controlling the household, we're controlling what we can as a way to cope with no control in the big world right now. And what I would say is you're not alone, is the first thing you need to know to combat shame. You're not alone. And we all are struggling to find our footing. And I'm not sure, you know, I interviewed Alicia Keys just recently and she said part of my journey is to understand I may not always have my footing and to get used to grand closeness. And that word groundlessness resonated so fiercely with me. I think we're feeling groundlessness right now. No, you're not alone. Know that our efforts are enough right now. They have to be. And the other thing I see shame around a lot is kind of comparative suffering. This idea that I can't feel sad about my child's high school graduation or college commencement because there are people dying. You know, I can't feel bad about being sick in the hospital. I'm not on a vent. Well, you know, like there is- pain is pain, it's all real. All the disappointments real, the sadness is real. We're allowed to feel it. We're allowed to give ourselves permission to feel it. Yes. We need to take perspective and put things in, you know, I would say piss and moan within perspective, but we're allowed to have a hard time and shame and empathy are mutually exclusive. And in terms of ethics, or emotions. And so if we really want to have empathy for people, we have to watch the shame.

MG: Is that why? I mean, the other part of that is vulnerability. And people will often associate vulnerability with weakness that you're being open. But you're not being stoic. You're not. There's no stiff upper lip. Keep calm. Carry on that. You're willing to be open and you're willing to be exposed.

BRENE BROWN: Yes. I mean, the thing is, you know, again, fifth generation Texan. I was definitely raised to believe that vulnerability is weakness, but the definition of vulnerability from the data, very clearly; uncertainty, risk and emotional exposure. To be alive is to be vulnerable, to be in this pandemics, is to be vulnerable every second of every minute of every day. And the thing about vulnerability is it is difficult, but it's not weakness. It's the foundation and the birthplace of courage. There is no courage without risk, uncertainty and exposure. And so, you know, I've asked 10000 people that this question, starting with special forces military: give me an example of courage in your life that did not require uncertainty, risk and emotional exposure. And in probably 15 thousand people at this point, not one person has been able to give me an example of courage that did not require vulnerability. So we need to dispel that mess and we need to acknowledge we are in a lot of vulnerability right now. That means we can be our best, bravest selves or we can be our worst selves, and I think the thing about choosing to be our most courageous s is having to understand this is another method to style that most of us know we're taught growing up that we're either brave or afraid, that the truth is we can be brave and afraid at the exact same time. Most of us are in these moments today.

MG: How do you model that behaviour if you're a parent? Because one of the things that you might be afraid of is being vulnerable and being open and understanding the fact that what we're in is unprecedented. You can be frightened by that, but you don't want it to transfer that anxiety to your kids.

BRENE BROWN: You don't want to transfer that anxiety to your kids. But it is an important opportunity to help your children understand that you're also, we are also uncertain. We also are anxious about things. Because if we send the message that in order to be safe, we have to be certain and we act certain about this, which no one I know in the world, including epidemiologists and the doctors feel certain about anything right now. We don't want to send the message that you have to be certain to be safe. So we can let our kids know that they're safe, but also teach them and model for them how to be an uncertainty, how those feelings drive, not great behaviours, impatience, frustration, blaming, acknowledge all that and talk about that openly while straddling the tension of, but you are safe. You're physically, you're safe. We can keep you safe. We know what we know. We know how to do that. But we don't know how long it's going to last. We don't know that's ever going to happen again. We don't know. And that's hard. We know the need for comfort and the entitlement to comfort is also a pandemic. Like everyone thinks they need to be comfortable, like there is no growth and comfort, there is no courage and comfort. We need to teach our kids how to be uncomfortable and still make good decisions and still create a sense of safety.

MG: What are the strategies that you're offering people who are overwhelmed by what we're in right now? One of the things you talked about on the podcast, you compared it in some ways to playing soccer. What did you mean by that?

BRENE BROWN: You know, both my kids are soccer players when they were little and I used to laugh so hard because, you know, in the beginning they would kick the ball as hard as they can, it would come into another kid's body like, you know, shoulder high. And instead of like using thereby to settle the ball and think about where does the ball go next and get it under your feet and give it a second, kids would just, you know, raise their leg up over their shoulder and kick it back at that height. And it would just go back and forth and it would bounce. You know what I was saying in the you know, in one of the podcasts really on especially if we need to settle the ball. We need to bring it in close. Take a deep breath. Think strategically. You know, I know here in Houston we are going to peak maybe around April 20th. Which means we're going to be in lockdown probably through the end of May. This is a long process and we have to do it. Again, we you know, we follow the rules and get well together. We stay sick together. And so we need to settle the ball a little bit. And reality check expectations for what this is going to be while we're locked down. And we also have to understand that being locked down is a real privilege because a lot of folks are not and can't afford to be. And we need to figure out how we can help there before we can help others. We've got to settle the ball.

MG: Are you limiting the amount of information that you take in about this? It's possible to spend all of your time when you're not on the Zoom calls, scrolling through social media and getting the latest bits of update from people who are experts or people who are suddenly experts on this. Are you kind of trying to temper how much of the firehose comes your way?

BRENE BROWN: Oh, absolutely. I mean, I believe in science. I believe in research. I believe in the people that spent their lives preparing, whether funded to do so or not, preparing for this moment. And I allow myself 30 minutes a day to understand what's happening from places like Johns Hopkins and, you know, the WHO and that's it. 30 minute.

MG: 30 minutes a day. That's all.

BRENE BROWN: That's it. Because that is gasoline on anxiety. The 24 hour coverage is: I'm going to watch it because I'm scared and anxious. That is maybe counterintuitive for folks. But that is saying I'm anxious and scared. So I'm going to chug some gasoline. Am I already burning fire belly. Like that is very, you know, very hurtful. I think we need to be moving our bodies, limiting consumption and reality checking expectations.

MG: That idea of getting healthy together or getting sick together is really powerful. And I think that'll stick with people.

BRENE BROWN: I think if there's anything, it's too early to ascribe meaning to this cause we're still in that suffering and hard part. But I think if anything, I hope we start to understand that we are inextricably connected to each other globally. And, you know, I think good public health, good leadership is when we make decisions that are not good for nations, but good for the world. That is the reality that we live in now. I think it's a it's a beautiful reality, but it's a tough transition for a lot of people. But I think this is proof that. Again, you know, we're in it together.

MG: It's a great pleasure to talk to you. Take care of yourself.

BRENE BROWN: Thank you so much. You, too.

MG: Brené Brown is the best selling author of books like Dare to Lead and the Gifts of Imperfection. She has a new podcast out. It's called Unlocking Us. She was in Houston, Texas.

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MG: This is The Current on CBC Radio One. I'm Matt Galloway, and as you are keenly aware, COVID-19, has brought a majority of businesses to a screeching halt. Not so, of course, for essential workers, people like truck drivers who continue to deliver the goods that you rely on right across this country. Last week we spoke with Steven Kastrantas. He is a man from Montreal. He's been a trucker for 14 years. And he detailed what life has been like during this pandemic, trying to access basic necessities on the road.

SOUNDCLIP

Before we leave, we've got to make sure we got lots of water, lots of food. We need a little bucket for peepee and we've got to do because everywhere we go, it's kind of closed. And even if we get to our customers, they won't let us in.

MG: After that memorable description of what's truckers like, Steven, are up against, we received an email from one of our listeners, Martha Macdonald, who is urging us to speak with the manager of the Glenholme Loop Petro Pass Restaurant in Nova Scotia. Not only is Crystal Blair keeping the truck stop open for drivers, she's providing them with meals for free. Crystal, good morning.

CRYSTAL BLAIR: Good morning.

MG: Why did you decide to keep the doors of your restaurant open when so many people have shut things down?

CRYSTAL BLAIR: Well. We were getting ready to close the restaurant, and I instantly seen on social media the issues that the drivers were going to run into. They were posting signs, you know, closed signs. And I just said to my husband, I can't do this to the drivers, like they need me. I can't turn my back on them. So that evening I just posted on my Facebook page that, you know, there's free showers here, guys, like, come on in. I'm going to be here sanitizing them personally myself. And then I decided I'd offer breakfast the next morning as well. And I was doing this alone because I sent my staff home for their own safety. So that post went viral overnight. Somehow it reached a lot of people. And since then, it just became more and more and more. Now I'm open. Most of the day for the drivers. We had, the next day somebody called me up and said I'd like to pay for ten drivers breakfast.

MG: Wow.

CRYSTAL BLAIR: So that happened. And then I get another call. Somebody wanted to pay for 20. And it just escalated from there. All across Canada, there's so many people reaching out and sending us donations for this cause.

MG: And how busy has it been? I mean, in terms of drivers coming through?

CRYSTAL BLAIR: We're getting pretty busy by times. I wasn't able to keep doing things alone. I had to get some help in the kitchen. She's actually looking after things for me right now. And then we broaden the menu, of course, like it's pretty much a full menu now for the guys. You know, the breakfast sandwiches didn't seem to be enough. I wanted to do more. Well, they're getting turkey dinners and, you know, burgers, fish and chips.

MG: You're going all out. This is a huge thing for you.

CRYSTAL BLAIR: Yes, it is.

MG: What do you care? What are you hearing from those drivers? I mean, we heard from Steven. He's talking about how there's nothing open. He needs a bucket because he can't get into anyone's washrooms. What are you hearing from your drivers about what you're doing?

CRYSTAL BLAIR: Actually, what they've been running into. And it's a shame because these guys are living in their trucks. And some of them, you know, they're in there for weeks on end. They have their reset time. That's they live in their truck. You know, they can't go home. They're travelling all across the country. They can't find a place to use facilities, to have a shower, to get a hot meal. You know, most of them do have a little fridge in their truck. Some of them have a little microwave and stuff. But it's not enough, really.

MG: And so when they get to your spot, I mean, they must be delightful.

CRYSTAL BLAIR: Oh, they're totally blown away and especially the ones that haven't heard what's going on here. We're still getting them coming in daily and it's like, oh, you haven't heard? They're like, no, and they're just blown away by everything we're doing here. And they're so happy and touched.

MG: They would just happen to pull off the road. And it turns out you're not you're not just open, but there's a hot shower and they get a free meal as well.

CRYSTAL BLAIR: Oh, yes, yes. Everything in the store has been free. And I give the guys a bag. They fill up on baked goods where, you know, we have different people that are bringing in, they're dropping off toothpaste, toothbrush, deodorant, shower gels, soaps. Yes. And it means so much to them.

CRYSTAL BLAIR: You've been called a trucker's angel. Was a postman. So there's a poster that somebody dropped off with that written on it.

CRYSTAL BLAIR: Yes. Yes. That's what they're all calling me.

MG: You don't have to do this. I mean and as you said it's a lot. It's busy. People are volunteering and helping out. But you had to decide to do this. What was it in you that led you to take this step?

CRYSTAL BLAIR: Well, I'm in the position to help, and I guess that's just always been my nature. If there is a way that I can help somebody, I'm going to do it.

MG: And the fact that people are also stepping up to help you. It says something about who we are.

CRYSTAL BLAIR: It sure does. Yes. I am receiving so many letters and cards on a daily basis from people all across Canada and on my Facebook page, like the comments and the messages that I got from everybody. It's very, it's very touching. Trying not to cry.

MG: It's really quite something.

CRYSTAL BLAIR: Yes, it is. I have so many people telling me that I've restored their faith in humanity. You know, and some people have mentioned to me like, thank you for pointing this out. You know, how hard life is for the drivers right now. Well, most people, you know, were packed up, gone home, working from home or whatever, it's not that way for they just arrived. You know, they are facing many struggles right now. Their voice has been heard. And I know especially around the Maritimes here, people are really stepping it up here. And the drivers tell me daily, like, you know, the things they thank me for that. There's so many more truck stops that are now open for the drivers and offering them a meal or a shower.

MG: Where you're leading by example. I mean, you're the one who set this out. Congratulations to you. And I appreciate you doing what you're doing. You are the best of what we can offer. So. Crystal, thank you.

CRYSTAL BLAIR: Thank you very much.

MG: Crystal Blair's the manager of the Glenholme Loop Petrol Pass Restaurant and Truckstop in Glen Hall, Nova Scotia. If you know somebody who's doing similarly great work, let us know. Reach us through the Web site Ccbc.ca/thefcurrent and click on the contact link. We're back in 90 seconds. I'm Matt Galloway. This is The Current.

Deciding who gets access to limited medical resources

Guests: Dr. Chris Mendoza, Dr. Merrill Pauls, Dr. Simon Oczkowski

MG: Hi, I'm Matt Galloway. This is The Current. Listen to this.

SOUNDCLIP

VOICE 1: I'd like a mask like yours. I'd like all of us to have masks like yours. And these white suits like you have. And I have what? What is this?

VOICE 2: What is that? It looks like a garbage bag.

VOICE 1: It is a garbage bag.

MG: It is a garbage bag, she says that was a nurse in a Brooklyn hospital admiring the protective gear of a journalist. Supplies are low everywhere, but New York is an extreme case. More than 4000 people have died from the coronavirus in New York City, over 80,000 confirmed cases. New York State recorded a one day high of 779 deaths yesterday. Equipment like ventilators and intensive care beds are in high demand. And with not enough to go around, doctors are making some tough decisions about who gets what. Dr. Chris Mendoza is an E.R. physician and director of quality at New York Presbyterian Brooklyn Methodist Hospital. He is in New York City. Doctor, good morning.

DR. CHRIS MENDOZA: Good morning, Matt.

MG: When you hear a nurse saying she wished that she had the protective gear that a journalist had on, what goes through your mind?

DR. CHRIS MENDOZA: I mean, it breaks my heart, you know, that if there's any advice that we can give for any place that's behind us in this pandemic is definitely making sure you have enough personal protective equipment. You know, a lot of people talk about ventilators as a resource. That's the one that's in the media all the time. And obviously the reason it comes up so much is because it's like a machine that has a discrete number. But the thing that people aren't talking about as much, it is talked about a little bit, is morale and morale as a resource as well. And when people have low morale, it really does affect the care. And the fear of not having what you need to protect yourself, the personal protective equipment that the woman was talking about, it really does affect care, you know, and it's something that we've been struggling with. Luckily, our hospital system has been doing a good job of moving our protective equipment around the system, sharing it between hospitals to keep everyone safe. And we haven't gotten to that point yet where we'll be making our own per say. But it's closed and it's definitely not something we're out of the woods with yet.

MG: You and I spoke a couple of weeks ago just as things were really starting to take off in New York. What has it been like? How would you describe the situation now in your hospital?

DR. CHRIS MENDOZA: You know, it's a different world now than it was a month ago. When I spoke to you last week, it was starting to ramp up. We didn't know how bad it was going to get. We think in the hope that we've reached a little bit of a plateau. But it's different medicine. You know, everything is about COVID, we're barely seeing it. All of us are baffled as to why, where all of the rest of the patients went. Because now the only people coming into our hospital, or at least a good 70, 80 percent of them are all COVID related issues. And the medicine is a different world in the sense that our choices are very different than they used to be.

MG: Tell me about those choices and the choices that you have to make.

DR. CHRIS MENDOZA: Sure. Yeah. I mean, one of the biggest choices which happened pretty early was the first resource that we ran out of that was scarce was ICU beds, critical care settings for patients. And so as soon as you're out of those or near out of those, you have to start thinking about how to use those in a little bit more of [unintelligible] fashion. And what that means is that if you have patients to have a very low likelihood of surviving or benefiting from the critical care medicine we can provide, meaning like elderly people, people who have very significant medical co-morbidities or other medical problems, you have to have conversations with families that a month ago we wouldn't have had these conversations in the emergency department because we had the space to spare as we can take our time to have these conversations normally. But in a setting where we're running out of these critical areas, we're all having these conversations upfront with families to basically guide them in a way that will allow us to conserve these resources for people who may need them more or may benefit from them more.

MG: And are there policies that guides those decisions, or do you have to make them because everything is happening all at once? Do you have to make those decisions in some ways on the fly?

DR. CHRIS MENDOZA: You know, our hospital system is a in been great about providing us with resources. There's no set policy but we do not have strict guidelines on who would and who would not get bedding. I think that's appropriate because in every case is different. You know, you can have someone who's 80 years old who could benefit more from critical care setting than someone who's in their 30s, depending on what else is going on medically with them. So to make strict guidelines would probably not serve patients well. So what they've done for us is they've created a system where we have people who are not directly involved in the care of these patients who we can consent as basically an ethics council to help us make decisions like that. Unfortunately, for some of the patients, we don't have time to go through this round of making phone calls, getting other people involved, because there are a lot of people we've been able to use this system and it's helped them to pick and choose where we can use our resources in a way that makes sense and it's not just to the physicians at the frontline or the providers of the frontline to make these decisions on their own.

MG: What advice would you - in Canada, the numbers aren't anywhere near what they are in the United States, but people are facing those dilemmas as well - what advice would you give emergency room physicians here?

DR. CHRIS MENDOZA: So what I would do, you know, the hospital system in general, any hospital, is that in order to prepare for this, there are certain things you can do infrastructure wise that can really help you. Expanding ICU capacity is something that can be done in most hospitals within days that you just don't want to be- the problem in New York is that this all happened so quickly that we're all playing catch up. We've never been adequate. So the idea of being able to expand the place of care possibly for when this all hits would be, you know, it would directly improve patient care. That's the point. As you run out of resources, everything trickles back down to the next patient who's walking through the ambulance bay doors and to emergency room. If you run out of something upstairs, it then starts to hurt care downstairs in the emergency room, emergency rooms on the bottom floor. My biggest speaking advice would be to start now increasing your critical care capacity as well as your med surge capacity, because we're using every single bed in our hospital. Plus, we've created spaces to put patients that we've never used before. And then really the placement of protecting equipment, you know, making sure all of your staff is safe and healthy and that they feel confident that they will be protected. I mean, is an invaluable resource to try stock up on early.

MG: I hope we have the chance to talk again. In the meantime, you're right in the middle of it. I appreciate the little bit of time that you can give us, Doctor. Thank you.

DR. CHRIS MENDOZA: You're welcome.

MG: Dr. Chris Mendoza is an E.R. physician, director of quality at New York Presbyterian Brooklyn Methodist Hospital in New York. Here in Canada, doctors have been preparing for the worst. And there is a new statement from the Canadian Association of Emergency Physicians that is meant to give the provinces some guidelines as to how to make some of those decisions to get ready in the case that doctors have to make those tough life and death decisions. Dr. Merrill Pauls is an emergency physician and professor at the University of Manitoba who helped create that statement. Doctor, good morning to you.

DR. MERRILL PAULS: Good morning, Matt. Thanks for having me on.

MG: Thanks for joining us. You listen to Dr. Mendoza in New York in the middle of an overwhelming situation. He's talking about some of those choices that doctors are having to make during this pandemic. What's your reaction to that?

DR. MERRILL PAULS: I'm so grateful that he's willing to share some of that information with us. For sure, we know that, as you said, there can be some challenges actually implementing and having guidelines like this in place. Just the notion that sometimes these things come on so quickly and sometimes it feels like it might not be a fair or sensitive enough to the individual patients that are involved who comes for care. But that reality that he described of having the capacity overwhelmed means that we really owe it to the individual patients, we owe to society in general to make sure we've thought through this as carefully as can and that any guidelines that are used to allocate those scarce resources are are fair and fairly applied and and reasonable and transparent. And so those are some of the key things that we've identified as important things to consider.

VOICE 1: Is your sense - just before we get to what all that means in terms of it being reasonable, fairly applied - is your sense that we will get to a point when, I'll use your phrase, when capacity is overwhelmed?

DR. MERRILL PAULS: I think it's hard for us to- this is one of the challenges of this issue that raises is how we discuss it with people so that we actually kind of they feel like we're preparing responsibly and not creating anxiety or distress. So tons of my colleagues across the country know that some people are closer, some places are closer to that than others. When we see around the world, other places like New York, if you'll likely be irresponsible for us not to prepare for that. And then if we're able to avoid that by maintaining our capacity, or if our numbers are low, or people are doing a good job with social, doesn't think that'd be great. But I think, you know, we have to prepare for the possibility. In some places it might only seem like a probability that would happen. And so I think it's just responsible for us to do that.

MG: And so I don't know whether there's a formula that exists, but how do you go about determining in a situation when capacity is overwhelmed, who receives critical care and who doesn't?

DR. MERRILL PAULS: You know, Matt, that the irony to all this is that this is actually a lot of this work has already been done. And one the biggest issue is actually just sharing and bringing it to light. We know that, for example, in B.C., they've been working on this for months. I'm quite certain Ontario this is probably the worst hidden secret there. There's a good number of provinces in Canada that actually already have these plans really well laid out that there's a very smart, critical care physicians, ethicists who've been working hard to make sure there's a reasonable plan there in place. And yet we're having trouble getting these decease in the light of day. I think there's challenges around just making sure that I think provinces and regions are concerned about just the optics. And they don't want to increase anxiety. They don't want to send the message that we're already at that point. I think some problems might have some concerns about the legality, ensuring that there is actually no legal challenges to to how these policies might be rolled out. But so there actually are very worried, well-developed specific clinical processes where we use some combination of what the actual capacity is. And then you actually look at the patients that are involved isn't a very specifically well laid out medical criteria. These go back as long as 15 years ago in Ontario, there was a really well-done policy post, SARS and pandemic influenza that had identified some really important clinical considerations. So the policies exist here and other places to actually do a fairly good job identifying which patients we believe are going to be the most able to benefit from those resources.

MG: How much of it has to do with age?

DR. MERRILL PAULS: So that that's an important part of any of these policies is to identify that there's a number of issues that using those alone or those primarily as the considerations, for example, AIDS will be one that would be straight up discrimination. But we know that some of those things can be included in a formula as because it might be part of what that ultimate goal is, where that person will be able to do well with the treatments that they receive.

MG: And that what does that mean? Do well with the treatments, again, that's that goes back to the idea of being reasonable and fairly applied. What does that mean at the end? If the decision is about, we need to figure out who's going to do well so we can figure out whether they get this treatment.

DR. MERRILL PAULS: So that's one of the most important pieces, is these policies are generally designed to try and help maximize the number of, sometimes we use the term, life years or to optimise the amount of survival or how long people can survive. And we appreciate that as soon as we do that, we have to more clearly clarify those are really important. And sometimes they feel like subjective judgments about who's who has worth and who doesn't. And we're trying to remove that from the equation as much as possible. Try not maybe not worth, but just trying to figure out in an objective way as possible, who do we think can achieve the most benefit? Would you be off misinterpret as the greatest number of life years, the great potential benefit received from this type of treatment? But we recognise that that's part the reason why it's so important to have these policies in place, but also bring his policies to light how these policies published so that the community can be involved, the community can be engaged. I've already seen some comments in the in the papers or in the media around people, for example, with disabilities who are very concerned that they might be systematically kind of discriminated against.

MG: You mentioned this. You mentioned that subjectivity. There was a letter that was signed yesterday to federal and provincial politicians urging people to move away from it - this came from people with disabilities, physical, cognitive - moving away from this idea of what they called discriminatory triaging.

DR. MERRILL PAULS: Exactly. So that that's an important part of all these policies is making sure that they are defensible, that they're as reasonable as they can be, that they don't kind of both kind of things like disability. But also, we know that they can actually help further or foster certain types of systemic kind of racism or discrimination, if we're not careful with how these policies are applied. And even before we apply these policies are the really important things we need to do. And we know there's lots of people out there who don't want intensive care or who wouldn't want it if we just explained to them what their situation would or could be. So there's lots of work even up front to make sure that we've optimised our capacity for providing care and have had good conversations with people who, you know, if just given the choice might say, no, I don't even want that in the first place. So a lot of important work we have to do around these policies, not just in the policies themselves.

DR. MERRILL PAULS: What would that conversation with a family member look like. If you concluded that their loved one wouldn't make it, wouldn't have quality life years and you have to have that conversation because you don't have enough beds or ventilators. What does that conversation look like?

DR. MERRILL PAULS: So that's, it's incredibly difficult. You heard Dr. Mendoza refer to the process may place in the states, have what they call these triage physicians or trust committees, because it is so difficult for a physician to turn our traditional ethical stances that we do all we can for our patient. And now for doing something, if we're denying our patients some that could benefit them, that can be very distressing for physicians as well as patients. And there's a number of resources that have been produced most that policies will stay that we do need to be quite upfront about it. We need to make sure there's a clear policy that backs what we do that we should explain specifically to patients and families that we're doing this because it is an exceptional circumstance and because those resources aren't possibly available to them right now. We also really clear both things we can do is not just what we can't get, but what we can give. And there's actually a number of important policies, some put out by the Canadians, those who've embraced this as well about providing care, providing symptom based care or other types of appropriate care for patients, even if we can't provide that. But at the important pieces is the accountability around the policy and also the honesty and the transparency around how is being applied to everybody fairly.

MG: Can those families appeal if they are told this and this is not something that sits well with them?

DR. MERRILL PAULS: So that's a great question. It depends upon the policy. So remember that these policies would need to be provincial at minimum and even regional. So each place might decide a little differently how to do that. That even if there isn't a formal appeals process that they could always disputed or challenge it. Whether that would be to a provincial college, whether that would be to the courts. And so some places will choose to have a formal appeals process. Some might not. But still clearly would need to be a defensible and transparent process.

MG: And in the midst of a pandemic, how can you do that? I mean, decisions are being made on the fly in many ways.

DR. MERRILL PAULS: I know. Exactly. And so that's the responsibility of us to do this all this work in advance, to advance, we develop kind of what our process would be, what our procedures might be to make sure we understand as much as possible how we put those tools in front of patients and families and physicians so this isn't a shocking conversation when it occurs. But, you know, interesting enough, people are I think provinces or jurisdictions are wary of having these guidelines that can increase anxiety. But people are aware of this. People are aware of this possibility. They see what's happening in New York. And I think that they are ready for this conversation. They want to have this conversation to know what it might look like if I get sick and go to a hospital. What would it look like if I'm being evaluated by a policy like this? What would it look like to make sure I have my fair shot and my fair chance? I don't think most people want more than their fair chance, or at least they're getting their fair chance. And how that's being defined.

MG: Just in a word or two. Could you have ever imagined having to have conversations like this when you entered into the world of medicine?

DR. MERRILL PAULS: It is inconceivable. As an emergency physician. I hear Dr. Mendoza talk and even just seeing the pictures. And it is inconceivable for most of us that we would get to this point in a place like Canada, or I'm sure for them in the United States, to see resources overwhelmed in that way and not to think that we could do all the things that would possibly help the patient in front of us. So, you're right. It does feel like an inconceivable conversation to have, but I think that's all the more reason why we need to make sure we're supporting physicians to do this. There's a fantastic interview, Dr. Henry out of B.C. [unintelligible], discuss the process they're undergoing in B.C. and how important it was for them to develop the guidelines. They could support physicians, support providers in having to do these difficult or have these difficult conversations and do this difficult work.

MG: This is important to talk about. I appreciate you being here to explain it to us. Doctor, thank you.

DR. MERRILL PAULS: No problem. Thanks so much.

MG: Dr. Merrill Pauls is an emergency physician professor at the University of Manitoba. Also part of the Canadian Association of Emergency Physicians, where he chairs their bioethics committee. Let's focus on one key piece of equipment for patients who are very sick. The ventilator, as you know, can be a lifeline. But doctors treating COVID-19 in a difficult position in terms of allocating those ventilators. Dr. Simon Oczkowski is a critical care doctor at Hamilton Health Sciences and an assistant professor of medicine at McMaster University. Doctor, good morning to you.

DR. SIMON OCZKOWSKI: Morning, Matt. Thanks for having me on.

MG: Thanks for joining us. We talk a lot about ventilators. Can you just explain for people who, you know, throw the word around, but they actually don't know what we're talking about. What is a ventilator?

DR. SIMON OCZKOWSKI: Yes. So mechanical ventilator is a device that's used by physicians when a person's lungs are failing, either they're not getting enough oxygen in, they're not getting enough carbon dioxide out or the pump, like the lung muscles are starting to tire out or there's a problem with the nerves or muscles. If you do not have the ventilator and you require one for one of those reasons, breathing absolutely crucial life function. And if you stop breathing even for several minutes, you know, you will die. So it's sort of the last line of defence against a disease like Coronavirus that attacks a patient's lung.

MG: And so in COVID patients, when is that moment when a doctor would say this person needs a ventilator? It's when they're having real difficulty breathing?

DR. SIMON OCZKOWSKI: Yes. So, you know, what we know about coronavirus is about 80 percent of patients have relatively mild disease. About 5 percent are anticipated to require critical care. And of those, somewhere around 90 percent are going to require mechanical ventilation.

DR. SIMON OCZKOWSKI: And physicians do not apply this lightly because along with the ventilator- so we put a breathing tube down and pass the vocal cords into the patient's lungs to do that. It's an invasive procedure, requires sedation to patients now completely dependent upon nursing care. So it takes a incredible amount of resources and it's very difficult for a patient to tolerate. So we really only do it when a patient is absolutely, you know, as sick as they are going to get and have really every other treatment option has failed.

MG: And yet in the midst of this pandemic, I've been reading that there are some critical care doctors in the United States who are wondering whether doctors might be overusing ventilators. Can explain that?

DR. SIMON OCZKOWSKI: Yes. So, you know, the medical community's had to learn and adapt to this virus incredibly quickly. It's been one step ahead of us the whole way. And you know, what we're seeing and learning from our colleagues around the world is that this is not behaving like our typical viral pneumonia. Patients are having very low blood oxygen levels, despite having, you know, not a lot of distress breathing. And when clinicians are deciding about putting someone on a ventilator, we usually look at are they struggling to breathe? Are their oxygen levels low? Their carbon dioxide levels high? And what we're seeing here is very discrepant characteristics of these patients where their oxygen levels are low, but they look like they're fine. They're texting on their phone. And so there's debate about, you know, at what point do you decide, let's do it. Let's put the patient at the risk of undergoing full mechanical ventilation or not. So there's a lot of debate within the community and unfortunately, things are happening so fast. We haven't had time to do the kind of clinical trials we'd like to get a definitive answer.

MG: In the long term, how do those patients who require ventilation do so?

DR. SIMON OCZKOWSKI: That's the important question. That hasn't really been brought up as much in the media. So what we know from our Italian colleagues' most recent data is that, you know, about 26 percent of patients who require mechanical ventilation, from their most recent study, had died. But 56 percent of patients were actually still on a ventilator at the time of publication two days ago. These patients are requiring a ventilator for much longer than with other diseases, often greater than two weeks. And because of that, at the end of the day, they end up with significant, or we anticipate no end up with significant cognitive, physical and emotional challenges that will take weeks and months of rehab if they do, in fact, survive. But we're not even 100 percent sure what the mortality rate is. If someone requires a ventilator, that Chinese data suggest that almost everyone who needed a ventilator died. The Italian data is suggesting somewhere around 20 percent. But it's like. Going to be higher as we get more data from them moving forward.

MG: And so just finally in the last minute that we have, if patients or families are hearing from a doctor about the possibility of being put on a ventilator, what should they be thinking about?

DR. SIMON OCZKOWSKI: So I think the key things are to recognise if a mechanical ventilator is being thought about, this is a person who is at high risk of death. It's very important that patients and families have an important discussion about what kinds of- how long we would be trying to go on a ventilator. What kind of quality of life afterwards someone would be wanting to have and what kinds of treatments they'd be willing to go through to get there. And I think it's also important that, you know, if we're talking about putting someone on a ventilator, what docs in New York are doing and what we try to do in the ICU here is make sure that they have a chance to tell their loved ones, you know, because that might be their last opportunity to speak. So that hug, that kiss, if possible, or at least that goodbye, it's really important to provide people that opportunity because those are really desperate, crucial moments.

MG: Again, as I said to our last guest, these are unsettling times. I mean, it's hard to imagine when you get into medicine that this is the kind of conversation that you're going to be having.

DR. SIMON OCZKOWSKI: Yes, I think all of us in Canada were looking at what our colleagues around the world are going through, and all of us are sort of in a bit of stunned silence and absolutely dreading what may happen here. We're cautiously optimistic that Canada has done a good job with social distancing and other public health measures to reduce the burden of this disease. But to be honest, we're all terrified. This is a once in a lifetime worst case scenario that, you know, we're ready for, in so far as anyone can ever be ready for the worst case.

MG: Doctor, thank you for walking us through some pretty important information. I appreciate it. Thank you.

DR. SIMON OCZKOWSKI: Thanks, Matt.

MG: Dr. Simon Oczkowski is a critical care physician in Hamilton. These are unsettling times. And so in the midst of all of that, we've been asking for you to send us some songs that give you comfort and a bit of hope. This recommendation jumped out. Colin Miles from Vancouver wrote The Sound of the Human Voice. An especially excellent choral music has remarkable healing properties. The Vancouver Chamber Choir created three CDs of music for healing, beautifully chosen, skilfully sung, great choral music for people facing suffering or facing death. It turns out that last week, actually, the Vancouver Chamber Choir posted a note and a song on their YouTube channel. Normally the choir gathers on Friday nights for a concert, but they can't do that. As you know. So instead, joining many other Vancouverites, they gathered on their balconies to support frontline workers and dedicated this song to them. This is Maurice Durufle, Ubi Caritas. It's sung by the Vancouver Chamber Choir.

[Song]

MG: That works. Hopefully, if you have suggestions on music that would help ease anxiety in these anxious times, let us know. You can send us a note through the Web site cbc.ca/thecurrent. Click on the contact link. Coming up after the CBC News, we're going to talk about pandemic turf wars on the sidewalks and streets of our country as runners and walkers try to find some freedom outdoors. We're back in six minutes. I'm Matt Galloway. This is The Current.

Sharing the sidewalk; Indycar racer Robert Wickens back in the driver’s seat

Guests: James Palframan, Oliver Moore, Robert Wickens

MG: Good morning, I Matt Galloway. You're listening to The Current.

[Music: Theme]

MG: Coming up here, nearly died on the track. Now the Canadian race car driver, Robert Wickens, is back, this time in a virtual IndyCar race. You hear from him coming up soon. First, though, a different type of road story.

[Music: Theme]

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All righty. This is Brittney Drysdale and I am going on a walk.

[Music]

You couldn't tell every word there was capitalised. It's fair deal. Fresh air. People! Seeing people never caused a sense of panic ever for me before, but now it's like an obstacle course. I feel like I'm in a video game where the goal is to avoid human contact.

[Music]

MG: Video-game. That sounds familiar. It can feel a bit like you're playing a life-sized version of Super Mario, leaping off curbs, bobbing between cars, dodging your neighbours.

SOUNDCLIP

Okay. There is a runner coming toward me and luckily my street is quite quiet, so he took the road and I took the side walk and we navigated that seamlessly.

[Music]

MG: Frequently, though, Brittney Drysdale faces uncertainty. Who will take the road? Who will take the sidewalk? And then there are unforeseen complications.

[sc].

Okay. Turn the corner on to Calt street and toward me come to human adults walking their bicycle's, pushing their bikes on the sidewalk. Now the sidewalk is not wide enough for the three of us at the best of times. Now add six feet between plus two bikes. That maths doesn't add up.

MG: That's improv comedian Brittney Drysdale on a jaunt around her Toronto neighbourhood. All of this to maintain a good two meter distance and some laments to avoid flying moisture from the joggers who are out on our streets these days. Finding space is a challenge for runners, too. James Palframan knows all about that. He's a runner from Langley, British Columbia. James, good morning.

JAMES PALFRAMAN: Morning.

MG: What role does running play in your life?

JAMES PALFRAMAN: It's a big role. I mean, it's part of my everyday life, actually. So we as a family, we run. My wife runs. I run. And we it's just you know, it's one of the things that helps you escape, helps you manage your health and just keeps you going.

MG: And right now, you're training for a long race.

JAMES PALFRAMAN: Yes. I'm training for a hundred miler in September. So it hasn't been cancelled yet. So fingers crossed. I know a lot of races being cancelled, but this one's still hanging on. So, you know, fortunate, but it is in Oregon. So, you know, it does face some other challenges. But yes, it's been it's been tricky.

MG: Tricky in part because I mean, this is a tricky time to train. You might actually want to get it and run more because it could offer you, you know, a bit of a release from the anxiety that you're feeling. But how is running changed for you since the arrival of this pandemic?

JAMES PALFRAMAN: Well, they shut down a lot of the trails in British Columbia and all the trails have been shut down, so that's been a challenge. So we've had to find a lot of, you know, local roads or local trails and whatnot. And we kind of- it's tough, you know, it's sort of, you know, usually I'll run with like run groups, you know, we'll run with friends. It makes it you know, running is not an individual sport. Right. Although you're out there by yourself, you're usually with a group of people or a team and so forth. So it's kind of challenging in the sense to sort of get motivated at times. But, you know, it's just something you've got to do and you got to get done. So you kind of find those options are available to you.

MG: And so when you go out, how do people react when they see you running by?

JAMES PALFRAMAN: Most people are pretty good. I think that some of them are just sort of, you know, they may see you coming. I think, I was preparing and yesterday I saw a lot of people to just sort of they see you come in, they're like, oh, what do you do? Right. You know, it's like they got the big look on their face and they were startled. I mean, like, I've done a few times that you sort of find an alternate way to go, whether or not I'm like taking a right or left. Your route changes constantly. You're not. You're not. You know, we'd like to go or for myself, I like to go out like planned route around the neighbourhood. But that's going to be completely different by the end of it.

MG: So if you spend any time on social media, you'll know that there are a lot of people who are not very happy with people who are running right now. It means they say that you're, you know, spraying things in our direction, that you're not practicing proper social distancing. You come up behind us quickly on the sidewalk. And what are we supposed to do? Have you heard about that?

JAMES PALFRAMAN: I have heard some situations a lot a couple of runners post in the groups that people are kind of yelling out that are, you know, telling them to go home or whatnot. It is challenging. I think, in terms of what we do and what people do. I mean, we got to do our best right to keep that distance. And for myself, I definitely, you know, I'll go another way or go around them or find some kind of, you know, if we come down- like the other day, actually came down like an alleyway and it was sort of like a standoff. You know what I mean? Between me and another runner. So you just got to get there and you want to turn it. You know, you turn around and go in the opposite way or something. I think that if we keep a maintain the most distance as possible. everybody's pretty good in that sense. But it has been different challenge, especially when you're in small quarters and so forth. And there's not a lot. There's bikes [unintelligible] sometimes.

MG: There was this study that came out from Belgian and Dutch researchers. It hasn't been peer reviewed, but it got a lot of attention certainly yesterday saying that runners might expel droplets further than people who are just walking. Tish Doyle-Bakr is a professor of public health at the University of Calgary. Have a listen to what she says when it comes to tips for runners.

SOUNDCLIP

Think before you do know about your location. So are you running in a place where it's going to be very busy, then that's not going to be okay. Two, think about the time of day. Lots of people run at maybe noon or whatever. So don't run at times when it's going to be crowded. You should be running solo. Think about the fact that going to a really, really hard workout in the sense that if you're training for a marathon, then that's not what you should be doing right now. Give your immune system a break, but know that 30 to 60 minutes, a brisk walk or run does help our immune system.

MG: When you think about that, that may mean now's not the time to be training for a race. We're all in this difficult situation and you don't need to go and be grinding it out on busy sidewalks.

JAMES PALFRAMAN: Yes, absolutely. I mean, you know, fortunately for myself, I'm little bit early in the training program, but, you know, it's definitely something that, you know, people need to to consider of. And, you know, I read that article as well. And, you know, even she's suggesting like ten meters apart if you're going to be running by people or encountered another runner and so forth. I mean, for myself, I tend to like to give everybody as much distance as possible. You know, I think that. I mean, I've come up- if I have to get close to people, I try to hold my breath and just sort of like it's a counterproductive thing. But at the same time, as you said, do whatever you, pretty myself as well as the other people. I can imagine somebody running by. I'm not a heavy breather, but I do know some runners are heavy breather than sort of running by somebody. You want to kind of you got to be considerate. You know, to me, we're out here doing running and people are trying to get some fresh air. You don't want to- everybody is going through a rough time right now.. So, I mean, it's something that we all are. And I got to work together and so forth.

MG: Good advice. James, thank you.

JAMES PALFRAMAN: Yes, for sure.

MG: You know, from James Palframan is a runner and Langley, British Columbia, this pandemic is forcing us new ways to figure out how to share our sidewalks and our streets. Oliver Moore is an urban affairs reporter for The Globe and Mail and joins me from Toronto. Oliver, good morning to you.

OLIVER MOORE: Thanks for having me on.

MG: Our streets. It seems like at least in my neighbourhood, look like marathon courses. There are a lot of people who are out running. There are a lot of people are walking as well. And the sidewalks and the streets can get congested. You tweeted that we need a new walking etiquette. What should that etiquette look like?

OLIVER MOORE: Well, it's hard to say. I mean, I can't be prescriptive about this, and you could argue that, social etiquette is what we all collectively agree on. But I will say that we've got a huge response, including some people who said I just threw out a few ideas off my head as a courtesy. And a lot of people said that's how we should be walking anyway, pandemic notwithstanding. And, you know, maybe that's the case, but perhaps it's even more important now when we're in a middle of a pandemic of an illness is caused by respiratory droplets. And your previous guest talked about consideration as if that's really all it boils down to. I mean, the idea is I put out there were essentially basic courtesy on how to share space. And that's some of it to some extent that what we do anyway, when we're walking, we just need to have a little bit more of a gap than usual.

MG: So what should or we shouldn't be doing? .

OLIVER MOORE: For example, you've got a couple walking on the sidewalk hand-in-hand. You know, I'm not that against someone glad they're happy, but if they're approaching someone else, perhaps they should go single file behind each other as opposed to walking abreast. You know, if you've got a dog, keep it on a leash. And most importantly, don't walk with yourself on one side of the sidewalk and the dog on the leash on the other side, the sidewalk effectively taking up the whole sidewalk. Look ahead, down the sidewalk, you see someone with wheels, your wheelchair, a stroller, a baby buggy, whatever the case may be. Consider that you may be or probably if that [unintelligible] on that person. So give them the space. Give them the right away. You know, in all cases of residential area, that involves going on the road. So I would stress that be very careful where you go on the road because although there was way less traffic than usual, at least in Toronto, a lot of drivers are driving much faster as a result. So the lure of the open road works on the instinct and people are speeding up. So I would be remiss if I didn't say to be careful. On the don't go, a little bit to the point of the runners is, you know, as Justin Trudeau might say don't walk moistly.

MG: Don't walk moistly. Thank you.

OLIVER MOORE: Don't walk moistly, you know, don't [unintelligible]. Don't jet out your nose. I mean, again, arguably, these are things we should be, this should be best practise always. But maybe it's even more important now.

MG: What about running. Again, like people trying to stay fit and people use it as mobile meditation as well. Are there ways to figure out how you can do that and be active without crowding people's space in in a congested area at the best of times?

OLIVER MOORE: That's a tricky one. I mean, I am not a runner. I have like many people who live in cities. I am. I have a walker. I think if you're able, I will definitely look at city walks as part of the daily life. I don't want get involved is it a Walker runner fight over how we use the sidewalk. This is silly, but I will say that I don't know where one should go with onto the sidewalk. I'm sure cyclists don't want them in a bike lane. In a lot of cases, it's not safe for them to be on the road. So where they should be, my guess is they should be on the sidewalk. I think the previous guest had some good ideas about how to not don't startle people. They'll run up beside them and suddenly appear the peripheral vision. Be aware that you are the faster person and it's somewhat on you to move safely around other people.

MG: We've been hearing that some cities across this country and towns as well are looking at changing how their cities work so that there is more space for people to get outside, get a bit of fresh air, but also safely practise the physical distancing. What's been going on?

OLIVER MOORE: Well, that is the good news in all this for pedestrians. And I guess this is the silver lining, if we can call it that, you're right number of cities are recognising that the sidewalks, but the spaces they have set aside for pedestrians is simply not enough this time. If there are fewer pedestrians out, it's still not enough. If you look at, you know, Toronto residential sidewalks, I measured one the other day. It's five feet. So if you're not willing to go on the road or if there's parked cars or traffic, for whatever reason, you can't go on the road, you simply are within that six foot gap. You've got places like Vancouver have closed [unintelligible] to cars. And it was just yesterday and I don't know the geography but I know enough to go so what this indicates. But a road seawall one later traffic one direction traffic is closed to vehicles to create space for pedestrians and cyclists. Calgary has done some of the things. Winnipeg has done it once for all, I think around Mount Royal that close off some space to cars. And yet to create that space for and so they can spread out and walk safely. And we'll be here every day. Stay home. Stay home. But that is, of course, the strong message. We also hear from, you know, the troubles medical officer of health, for example, is that outdoor activity is good for you. It is good for your mental health. It's good for your physical health as long as you can do it safely spread out. So a lot of cities are trying to make that happen.

MG: Why isn't this happening in the biggest city in Canada, in Toronto, where the sidewalks, as you say, are five feet wide and there isn't really space for people to safely get past each other?

OLIVER MOORE: Well, that's an interesting question. What the city has said is, it's a couple of answers. One is that they don't really think it's the best use of staff to create these spaces. And staff are busy doing other things. They argue that it would have to be policed and enforced. And they think they are concerned that it could set some sort of a street festival message that people that congregate in these places, because I've talked to said that that it definitely out to launch in the sense that this is not a street [unintelligible]. There will be no bouncy castle, there will be no face painted or buskers either like that. There's nothing to draw people to accept the fact that they're going to be able to walk safely. And the other thing is that if you spreading throughout the city, you reduce any chance of any one of them becoming a destination. The other reason that some people have speculated about and I don't have a sense that it would as is the case, but there's a debate that, you know, that small C conservatism of Toronto doesn't always like change. And there may be a concern that if this is done, pedestrians might really like having that space and might not be super willing to give it up [unintelligible].

MG: There are some communities that need that space, though. We've been talking about how, you know, the idea of social distancing, physical distancing, working from home is a privilege and a luxury because there are a lot of people, if they live in high rises, if they're lower income, who still need to go to work, how does that idea of physical distancing on roads and sidewalks play in?

OLIVER MOORE: When it comes if you're talking about class, I think it's a hugely important issue because a lot of the messaging around this pandemic and I think it's changing more recently, but it seems to be rooted in the idea of a certain kind of middle class living in a house attitude as you get fresh air in your backyard. Well, a lot of people don't have back yard or across the country or across the country. Exactly. You've got a huge number of people who have moved in around Young Street, downtown Toronto. And the promise effectively there was live in this small space. Give up your personal space from a living quarters point of view and in return you will get the city as your public space. Obviously, we're an unusual situation right now, but that deal has clearly broken down. And if you have people who don't have a balcony, they don't have an open window in a lot of cases, don't have a backyard when they go outside in Young street, the super narrow sidewalks, it is difficult to say to those people- Let me rephrase it. If you have a backyard, it's a bit awkward selection because you don't have a backyard of how there should be outside.

MG: Be considerate and don't walk moistly. That's some good advice. Oliver, thank you.

OLIVER MOORE: Always a pleasure. What safely.

MG: Oliver Moore is an urban affairs reporter for The Globe and Mail. He was in Toronto.

[Music]

MG: My name is Matt Galloway. You're listening to The Current.

SOUNDCLIP

McGlaughlin is slicing time out of Scott Spade. It's down to 6.8 Seconds now with 13 to go. Watch the young Kiwi surge from second place towards the former F1 driver. There go Robert Wickens. Out in the gravel trap. What an the incredible save from Wickens? I can't believe he hung onto that. Still has that left front wind damage. Wow.

MG: It was indeed a close call at points. He was barely hanging on, but Robert Wickens pulled through last weekend. The Canadian driver finished eighth in that IndyCar challenge and didn't even leave his house. Because of COVID-19, the league has started holding online races, using virtual driving simulators. That's not the only thing that made this race special for Robert Wickens. It was his first return to racing after an accident that left him paralyzed below the chest in 2018. Robert Wickens, good morning.

ROBERT WICKENS: Hey. How are you doing?

MG: How did it feel to be back behind the wheel?

ROBERT WICKENS: Just how I imagined it. Now it's such a weird time, right? You know, one thing. I mean, joking aside, I always knew that my return back to a race car was always going to involve a simulator at the beginning. So I think this is an exciting, exciting time for me. Obviously, once I get out of this simulator, you kind of remember what the current world situations in and it takes the fun out of it. But honestly, it felt so good to get back behind the wheel and to drive something again.

MG: What is the simulator rig look like? Can you just describe it quickly?

ROBERT WICKENS: Yes. So it has a full racing seat at the similar angle of how a race car would be positioned. And it's really it obviously doesn't resemble a race car, but it feels like you're in one position now. You're where your legs are, the way you're sitting, the way it's reclined, the position of the steering wheel. And then I have three screens, three monitors set up around me to give me more of a full view experience. But it's, it's not, it's not like you're playing your PlayStation in your basement, you know, it's a really proper piece of machinery.

MG: And when you when you got in there for the first time, I mean, given the fact that you hadn't been behind the wheel since 2018, did it feel like it was a first step? Did feel like this is getting closer to where I want to be?

ROBERT WICKENS: No, you're exactly right. It did. It was such an exciting moment for me because, you know, it's motor sports isn't shy to admit that it's a very expensive industry. And to test an IndyCar on a racetrack, there are so many expenses that people forget about. You need to rent the facility. You need to employ your engineers, your mechanics, airfare, hotels, your tyres, fuel. You need to have someone from Chevrolet to be present to even start the engine. You know, it's a big undertaking to get an IndyCar driving around the racetrack. And for me to try to figure out what I need from my hand controls, because of my paralysis, you know, it's going to be a very expensive undertaking if we go all the way to Florida in the wintertime to try driving it, to try and drive the IndyCar with the hand controls we've developed. And I do half a lap and I realise that something's wrong because that one's in the wrong spot or whatnot. And it's a waste of money. So we always knew simulation was going to be the best trick for that to try figure out until I'm happy with a hand control solution, then we take it full scale.

MG: What's the last thing you remember before the crash in 2018?

ROBERT WICKENS: That's a tough one. You know, I get it. I get that question a lot. And unfortunately, I can never provide a great answer. You know, I remember I remember the start of the race. And honestly, that's pretty much it. But the odd thing is, is I didn't remember the start of the race until I saw the replay.

MG: Really.

ROBERT WICKENS: Which was probably months after the accident. Yes. It's just the weird thing, I don't remember the autograph session before the race. I don't remember waking up. I don't remember anything from Sunday. Really. From race day. Just after I saw the footage of the accident, I remember at the start I remember trying to pass. Well, I'll try. I remember passing two cars around the outside of turn one and then trying to get the third guy on the inside of the second corner when it all went bad. But down, unfortunately, that's really all I remember from the accident.

MG: You come out of this, you're told you're never going to walk again and then you're on this path, try and get back into a car. And one of the things that you said was, was that you vowed to get back into the race car. Why would you say that? I mean, given that this experience nearly killed you, why was it so important for you?

ROBERT WICKENS: Well, I mean, you know, it's my love, it's my passion. You know, if you love real estate and you're a realtor, you give up because you didn't close a house. You know, I mean, the obvious the examples, not exactly the same.

MG: Stakes are a bit higher for your occupation.

ROBERT WICKENS: They are. They are. But it's also as soon as you put that helmet on your understanding the risks that are involved. And I started racing and go-carts with my family when I was seven years old. You know, I quit playing hockey, I had to stop playing basketball, football, baseball, you know. I was an athletic kid and we had to stop it all because of the cost of motor sports. And that was already a sacrifice, my family told me when I was seven. You know, if you want to try racing, you have to stop all of your sports with all your friends. And I was like, yes, let's give it a shot. I really want to do this. And thankfully, I was stubborn back then, as I am now. And it was it worked out. But you know, I want to get back because it's what I love to do.

MG: And is that the plan to get back on the track sometime later? I mean, assuming the world comes back to normal sometime later on this summer.

ROBERT WICKENS: I think that's probably a little premature. It's tough, right? Because from an engineering standpoint, to get a race car first off safe, for me to drive. But then secondly, with hand controls, that can make me competitive. You know, because in in racing, we're talking about tenths and one hundredths of a second. Are big differences. And the biggest undertaking we're trying to figure out right now is with NTT IndyCar, for example, when the driver hits the brake, let's like turn three and turn one in Toronto, four for the Honda Indy. we're hitting the brake with approximately 300 pounds of physical force on the brake pedal. We don't have brake boosters like in a road car. So just think of the sheer power that that goes into that. And for me, with not being able to use my legs, we need to try figure out a way to develop that with my arms.

MG: Put your stubborn guy and have the sense that you're going to get there.

ROBERT WICKENS: I think we're going to find it one way or another. You know, I think there's days where my team's very motivated. And I think the Arrow McLaren, S.P. guys are just as motivated as I am. But there's also days where I can tell I'm really bugging them because they have a big job list. They still have to run their day to day race team. And then I'm constantly giving them options. We do this. We do that.

ROBERT WICKENS: Good luck.

ROBERT WICKENS: Thank you, Matt.

MG: It's great to talk to you about what you're up to. Thanks so much. Robert Wickens, Canadian racecar driver, who is on his way, hopefully back to the track racing virtually now. This is The Current. We're back in 90 seconds. Stay with us.

David Maginley on living well; Online anxiety course, Mostafa Keshvari

Guests: David Maginley, Steve Joordens, Mostafa Keshvari

MG: Hi, I'm Matt Galloway. You're listening to The Current.

SOUNDCLIP

VOICE 1: Good afternoon. How are you holding up?

VOICE 2: Good thanks.

VOICE 1: Isolation isn't getting to you?

VOICE 2: Hasn't been too bad. I've been able to be on the phone a lot and do a lot of face time and it's not quite the same, but definitely helps.

MG: That's David Maginley. He's a Halifax Hospital chaplain visiting a cancer patient. This is a particularly lonely time to be a patient. Many aren't allowed visitors. And for those who are dying, it has to be unimaginably difficult. Over the years, this chaplain has sat with hundreds of cancer patients in their final moments. David Maginley continues his work through this pandemic. And it may be that some what he's experiencing can actually help us all. David Maginley, good morning.

DAVID MAGINLEY: Good morning, Matt.

MG: Welcome back to this program.

DAVID MAGINLEY: Thank you.

MG: How would you describe. This time that we're in this period that we're in right now.

DAVID MAGINLEY: Oh, an existential irony that my patients have been teaching me about all along, that ultimately the simple things are most important to love each other, to be a decent human being. And we can do that by washing our hands and staying six feet away. That the essential things of life have always been consistent. This crisis realigns our perspective, our perception, our priorities, hopefully evoking what is most noble within us.

MG: What has it been like for these patients that you sat with over the last few weeks? These are difficult times for them at the best of times, and then this complicates things. I'm sure in other ways. And what does that been like for them?

DAVID MAGINLEY: Oh, it's some it's quite a contrast. I have, everyone, of course, is aching for their family to be present. They're scared. And when we have deep love, when we feel loved, we feel, you know, safe. Even though the world is scary and our patients are isolated. But time, time again, I witnessed this noble expression from them saying by not having my family here, I'm protecting the staff and my fellow patients, which is lovely, but they also weep and they can get onto this time, as you heard young patients say. So I try to go in there and not a replacement, but to incarnate the compassion I can and help them wrestle with this deep within their hearts and bring the best of themselves to the worst part of life.

MG: What are the rules in Nova Scotia when it comes to patients who are dying? Are they allowed to have any visitors?

DAVID MAGINLEY: Yes. Patients who are dying can have two people with them, but it must be the same to people who can't rotate. And I'm sitting with a patient just last week, and she was saying, how do I choose my children? My husband? How do I choose? Which is utterly heartbreaking for her. But at the same time, she understood the need. It's very difficult. It compounds the loneliness and the feeling of chaos all around them, but it doesn't need to be within them.

MG: What do you say to them? That it doesn't need to be within them, I think is really interesting because people would internalize that, people would bring that in, obviously, because it's happening around them. What do you say to people?

DAVID MAGINLEY: Well, it's really coming from anxiety, right? And anxiety is what we feel when the foundation of life and safety has is crumbling. The patient has been dealing with that since diagnosis. They're really experts in it. And the best way to treat anxiety when you can't change the outward circumstances is to change the quality of your presence with yourself. So we use mindfulness. We use body consciousness. We use authentic expression of the feelings and really just trying, not trying to be good or strong, trying to be real. And in that they're not suppressing any part of themselves. When we're completely real and authentic, we encounter some strength. That's still point, even if it's only for a minute or two. And I do what I can to help the patients encounter that part of himself.

MG: What's the difference between good being good and strong and being real?

DAVID MAGINLEY: Being good and strong is often a mask where patients will use to protect their families from the probable or possible death that is going to come, the suffering. It's an instinct of love. But to be authentic and real is to be totally congruent, not about anything other than what you are. So if you're feeling messed up and scared, it's safe to do that with, you know, try and make it a safe place to feel that. And then it moves through them. It's processed. It doesn't stay stuck. There are cases where it does become the centre of her experience. And I know that so many in the world are now experiencing that with a pandemic. But we can always breathe in deep and identify. What can I do right now? I can love those I'm with. I can maintain social distancing. I can thank and express gratitude to the nurse. I can be kind to my body and my thoughts and my memories. I can be curious even about my dying.

MG: There have been some pieces written recently about how we all have lost control and that that is something in some ways that those who are experiencing cancer could teach us a bit about. Do you see that connection?

DAVID MAGINLEY: Oh, very much. I had a patient say now the world knows what it's like to lose control. I hope the foundation crumble. What's happening out there is a mirror of what has been happening within me all this year. When we lose control spiritually, it's illusions that are often dropping away. We actually have control over that. What do we have control over what is here and now? I have control over my thoughts and I actually have more control over my feelings. I don't need to believe everything I think. I don't need to be controlled by everything I feel. That's quite a surprise. Something that cancer patients work with every day. And now the world has that homework.

MG: You were on the program last year talking about how people are often resistant to speaking with a chaplain like yourself because they may not consider themselves religious. Is what we're in right now changing that? Have people been more open to you now?

DAVID MAGINLEY: Yes. Staff and patients, because they're scared. It's so comforting to have someone to speak with who isn't going to fix the feeling, but can dive deep into it and explore the nuances of it and help you realise this is a temporary thing. I actually I am not powerless against this and it's very hopeful. I love what Rabbi Jonathan Sacks said. He said it is not optimism, optimists. He says optimism is the belief things will get better. Hope is the courage that we can make things better. See, one is passive, the other active and engaged, right? And it doesn't mean we need to be heroic, only that we need to be decent people. Stay at home. Wash your hands. Bless and encourage those from six feet away. Save the world by sitting on your couch.

MG: Is your sense that people are doing that now? I mean, how do you think outside of the setting that you're in, in the hospital setting? How do you think we as Canadians are coping with what we're going through?

DAVID MAGINLEY: Well, I know here in Halifax, as I walk through my daily life, I witness beautiful compassion, gratitude, decency. I see that while everyone is scared. People are encouraging each other. And, you know, it could be lighting a candle in the window, banging your pot in the evening for the healthcare workers. You played Ubi Caritas times in the last hour. I really appreciated that. And that was lovely. So this is a crisis. Cancer patients teach us this. A crisis is an opportunity to connect to the best part of yourself and focus on what is lovely and kind that has astonishing power. I know it sounds soft, but in simple kindness and decency is being evoked by the crisis. Let's not waste the crisis. I hope this stuff sticks.

MG: How do you think, that's an interesting thing, how do you think we'll look back on this? We don't even know when we're going to get out of it, but at some point in time we will and there will be an opportunity to reflect. How do you think we'll look back on what we went through?

DAVID MAGINLEY: Well, while I am hopeful because you do have power. I recognise that humanity is a stubborn and selfish species. I hope that the shift from consumerism to community sticks a little longer. I trust that it will. We look at how neighbourhoods are. People are connecting, you know, virtually or acknowledging each other through the window. We see it every time a crisis comes along. Hurricane, you know, hurricane one came through here and it actually brought out the good in people. We need to breathe. We need to remember this connection to ourself. We need to realise how simple a good life can be.

MG: I think a lot of people will take that to heart. It's a pleasure to talk to you. Stay safe.

DAVID MAGINLEY: Thank you. You, too.

MG: David McGinley is a hospital chaplain. He's in Halifax. This is The Current on CBC Radio One. My name's Matt Galloway. You may have heard the Kentucky Derby is among the things that have been postponed to this year. And right now, the only thing you can bet on is a lot of uncertainty.

SOUNDCLIP

Generalized anxiety is quick out of the gate, followed by fear of the unknown and prone to panic in third. And here comes. Does this cough mean anything? Does this cough mean anything on the outside track? And what's this charging from the back of the pack? Maybe this will all just blow over coming on strong. Maybe this will just blow over. Has put his rider and his running the other way.

MG: Thank you to The Late Show for that. It's your fictional horse race of fears if your inner monologue sounds a bit like that while you are not alone. Managing anxiety, as we were just talking about, is very difficult. Steve Joordens is here to help. He's a professor of psychology at the University of Toronto, Scarborough, and is offering a free course online. It's called Mind Control Managing Your Mental Health during COVID-19. Steve, good morning.

STEVE JOORDENS: Great to be with him and great interview there with David I can see lots of connections between his world and mine.

MG: It leads one into the other. We talk a lot about anxiety. How would you define it?

STEVE JOORDENS: So I think it's really important that people understand the basis of it because it's such a really simple thing. Our body has evolved to kind of have two modes of being in one mode is engaged when we're relaxed. And it's all about long term survival of our body, digesting our food, getting rid of waste, that kind of thing. But we have this special mode that kicks in when a threat emerges. And back in the day, the threats came in forms of things like predators. So a predator would emerge. And our body goes into this mode where it's energizing us for action. It's reducing all of our digestive processes, increasing our heart rate, increasing our breathing. And it's pumping all this oxygen to our muscles. And it kind of it just wants us to fight the threat or flee from the threat. So it has a sort of imperative of do something. And so all of us now feel that sort of energized state. You know, we feel like we should be doing something that we'd like to be running away, but we don't know how to run away and we'd like to fight, but we're not sure the best way to fight. And so we're now in that state long term. And that is not what our bodies were evolved to be. It's supposed to be something that comes up to help you solve a problem and then goes away.

MG: Can you distinguish between people, you know, having real concern about what's going on from clinical anxiety?

STEVE JOORDENS: Well, you know, you can. But I often get this interesting question of is this especially hard on people who are already suffering from anxiety. And I don't know what the answer to that is. We've never encountered anything like this. But it's possible that, you know, I've anecdotally have some friends. And one of them said, I now have company. So she actually feels comforted that more people understand how she feels on a regular basis. In the end, she mentioned to me that she also has coping strategies because she's been living with this for a while. So it's almost like, you know, when David said, you know, these cancer patients are kind of professionals in this world and now everybody's kind of coming to them. There could be an aspect of that for people who have already had issues with anxiety. They maybe understand it better than the rest of us do. And we're just we're all figuring out.

MG: You have, what, 14000 people that have enrolled in this course so far?

STEVE JOORDENS: Yes. Yes. When this all started, I was getting a lot of questions from media. And, you know, it's nice to answer questions with the media, but often you have to be kind of quick. And so I really saw a good opportunity to give a more deep understanding to people about where the anxiety comes from and the relatively simple things they can do to control it, that most of us just sort of don't take the time to do because we don't feel we need to. Well, now I think we feel we need to. And I think that's correct. We do need to. And if we learn these strategies that they can be things that we carry with us after this is all over. So, you know, I'm really hoping that that even things like families are going through this course together and talking about it together.

MG: So what are the strategies not to completely co-opt the course, but what are some of the strategies that people might be able to employ in these anxious times?

STEVE JOORDENS: Yes. So one is I mean, again, as David suggested, we can control our minds. We tend to let our mind and our body go into these spirals. And anxiety can really do that to us where some worried thoughts activate that system. And that tells us we're scared and that promotes more worried thoughts. But the interesting thing is you can step into that in a number of ways. And so one of the things that I won't talk about in detail here, because it's a little complex, is you can learn something called guided relaxation and you can actually push your body into a relaxed state. And you can't be both relaxed and anxious, so if you can promote a relaxation, you can sort of banish anxiety. But even the simpler one, I think, which is good for people to think about now, is a lot of what ends up in our mind comes there through the exterior world and we can use the exterior world and manage the exterior world. And when we do, we manage our mind. So just as a taste of that, you know, one of the things we're doing here is news and sharing information and such. It's very easy to become addicted to news at this time because information is a reward for us and it comes randomly in the news. And so we want to be there when it comes. And we can have this habit of having our news on all day long. But every moment that we're looking at the news, listening to the news, our brain is getting the signal that we're under threat of this thing. And so we're feeding our anxiety at every moment. So something just as simple as saying, I'm going to decide when I watch the news. I heard you use the word control a few times, an important word. You know, I will control when I get access to this information. If I have news apps with notifications, are going to turn those off. I don't want to be surprised into some new thing. I will choose times and I may, even after I watch the news and digest it, I may even choose to do something else afterwards to kind of change the channel on my mind. So if you know what could be a TV show, maybe there's some TV show that just grabs you and takes you somewhere else. Or maybe it's some activity you engage in, whatever it is, after you watch the news. If you can do that for half an hour before going for a walk, then, you know, while you're on the walk, you won't be ruminating about what you just heard on the news. So, you know, literally saying, I'll watch it when I watch it. And then when I'm done getting the information, I will do something that will take my mind somewhere else as this.

MG: Those are really helpful, by the way. As this drags on, do you have concerns about the effects of this anxiety over the long term?

STEVE JOORDENS: Yes. And then that was a major motivator for doing it. There's a couple of reasons to have concerns. And the first one is from the work of John Soliah long ago in Montreal, where he was the first that really shows this interaction of our mind and body and how it can lead to negative things. So specifically, if we have chronic stress, which is what we have now, if we allow this fight or flee system to remain engaged too long. Eventually our immune system becomes compromised. And obviously, that's the last thing we want with a virus floating around. So if you can learn to kind of turn it off now and then an escape from it, then we reduce the likelihood of that happening. There's also the worry that if people are anxious too much and feeling like nothing they're doing is making a difference. They can slip into what we call learned helplessness, which can bring you to depression. And depression is a much scarier place than anxiety. Anxiety might kind of feel scary because it's energising the anxiety, as your body's saying, do something, do something. Depression is your body's saying don't bother doing anything. It won't matter anyway. And in fact, that is the much more dangerous condition to have that than anxiety.

MG: Just in the last minute or so that we have. How are you managing this? I mean, teaching the course is one thing, but it's, you know, [unintelligible] know myself.

STEVE JOORDENS: O of the things when in the whole section of the course where I talk about isolation, I say, you know, try to accomplish something during your isolation that you'll feel better. And so I think, you know, for me, this course as a discussion forum behind it, we're all the students are talking to one another. And these social interactions are really important. And so between, you know, getting the course up there, but now managing it and talking to students, I think that helps me a great deal just to manage my own depression. And that and I have a garage band in the basement and guitars.

MG: Just go downstairs and make a lot of noise.

STEVE JOORDENS: Yes. And then that's what pulls my mind away. And so if we all have something like that, embrace that thing that takes you away from all this and live there now and then.

MG: Steve, be well and stay healthy and safe. And thank you for this.

STEVE JOORDENS: You too, Matt. Thank you.

MG: Steve Joordens is a professor of psychology at the University of Toronto, Scarborough, talking over a free course. He's teaching online. It's called Mind Control Managing Your Mental Health during COVID-19. As I mentioned, it's free and you can find it on the learning platform. Coursera.

[Music]

MG: This is The Current on CBC Radio One, my name is Matt Galloway. Joined now by Tom Power, host of Q in his home studio. Hello, Tom.

TOM POWER: Home the studio is a really lovely way of saying my living room where I keep my banjo.

MG: It doesn't look like Drake's house that was posted up on social media with marble everywhere. And no it's not like that.

TP: I watched. I mean, it's kind of like that. I watched I watched the video of Drake's house, his new song in the video, where he gives a tour of his house, which is just a gigantic palace. I think bigger than the province of Newfoundland and Labrador. And I saw one comment that I really loved, which he said that I've self isolating and Drake's house for four weeks that he hasn't found me yet.

MG: What are you here, aside from architecture to talk about?

TP: Well, I it's a matter of time that I'm here to talk about art and not being made necessarily to distract you during COVID19, but RPE actually made about COVID-19. Check this out. The Canadian filmmaker Mostafa Keshvari completed the first and only feature length film about the pandemic. It's called Corona. It was shot in an elevator in one take. It was begun before the pandemic was declared. It was supposed to debut at Cannes, where he had brought his previous films. But I think he's going to release this thing while we're all stuck at home. I got to speak to Mostafa about the film, how he was inspired and how you might have the first film about this pandemic. Take a listen.

SOUNDCLIP

TP: How are you?

MOSTAFA KESHVARI: Well, hi, Tom. Thank you so much. It's an honour to be on your show. And I think, you know, our film is something that could speak to a lot of people during this time, even though it was made before the pandemic.

TP: It was made before the pandemic. When did you come up with the idea for this film?

MOSTAFA KESHVARI: Yes. So the film I came up with Idea in January. So at the very earliest stage when he was just on as the Wuhan virus or Chinese virus. And, you know, we've finished the film also in mid-February, so long before all this, just the restriction came in before the pandemic. But the film wasn't there to question the origin of the virus but to question, origin of hate and discrimination ever going on around the world against a lot of patients and especially Chinese people. And to me, I wanted to make a film that, you know, it was a small film with a big message rather than being typical small message. We wanted to make the time, make something that against xenophobia and use the virus as a metaphor for the fear of each other, fear of people.

TP: Tell me more about that. How does the film look at xenophobia and racism at a time like this? I mean, obviously, you know, there's been so much anti Asian-American, Asian-Canadian, anti-Chinese racism around this time, you know? How does the film talk about that?

MOSTAFA KESHVARI: Yes, I think, you know, when it comes to the virus, the virus itself doesn't discriminate. So why should we discriminate? And I think the film is basically checking the elevator where the filmmaker, first of all, had to think of an anatomic that's outside of the box. So I literally made it in the box in the elevator and the elevator to represent the society we live in. So we are all showing this right together. And, you know, we're there, you know, different floors to present, different class of society and people from different groups and backgrounds getting to the elevator. But there's a rumour of coronavirus in the building. And when a Chinese woman gets into the elevator, everybody freaks out and, you know, try to mistreat her and not let her in. And the elevator get stuck all of a sudden. And from there, the fear starts, you know, spreading virus. And, you know, we don't know if she has the virus or not. But people assume that she does have the virus based on what they see. And from there it gets really interesting and people's true colour come out. And I think, you know, the film is more of a socialist study on how we behave under very difficult circumstances. And, you know, as a Canadian, you know, all this going into our history, if humanity was a test, you always get A+. And I think myself, as a Canadian in part to make this film not about the discrimination and xenophobia other than making a zombie film that makes fear, add fear to people that which we don't need right now. So I think the message of the film is something after the film people will bring people closer together in the same time, give, you know, help us understand each other during this hard time. It is difficult not to be in this kind of circumstances. And, you know, I think it's a time for more kindness.

TP: Who's in the elevator?

MOSTAFA KESHVARI: There are different people in the elevator. So you have a pregnant lady who's about to go to Labour. And then you have a CEO who owns the building and, you know, represent the upper class. And you have someone who's a poor tenant and, you know, haven't paid his rent for long. You have someone, you know, white supremacists and someone who's in on a wheelchair and basically added to that fear, you have a millennial who's going to spreading rumours and of big news and things like that. And you basically those characters. And in this, the Chinese lady, the characters I wrote this, there was a prediction of what would happen if any kind of pandemic at the time. And, you know, unfortunately, too much that all those predictions came true.

TP: But what would you have done differently had you known then what you know now about the virus and how it would affect all of us?

MOSTAFA KESHVARI: I think I would still make it about, you know, phobia. Because I think long after our battle with this virus is over and writing after corner is old news, our battle with racism will continue as human race. And I wouldn't make it anything about like any horror film or zombie film. I would leave that to Hollywood to make those big budget. So I'm so even a filmmaker wanted to deliver a message. And I think this message would be still relevant after all this virus is gone. Hopefully we can come together as strongly as the human race because now that virus doesn't belong to a certain race. It belongs to the whole human race.

TP: The tag the tag line of the film is fear is a virus. Hope is the cure.

MOSTAFA KESHVARI: Definitely. I think, you know, during this time, it's very important to note that at the end of the day, you know, we don't choose the colour of our skin. We choose the colour of our characters and how we behave under these circumstances. And so I think as a human race, we have to kind of work together like the music notes to have harmony in our society. And I think that what I'm trying to say with this film.

TP: Mostafa, I absolutely cannot wait to see the film. And I think it's well needed at a time like this. Mostafa, thank you so much for your time.

MOSTAFA KESHVARI: Thank you so much. And I hope everybody feels safe at home. Thank you so much for having me on the show.

MG: Tom Power, host of Q, speaking with the filmmaker Mostafa Keshvari about his new film about the pandemic. It's called Corona. CBC News is next. And then coming up in about six minutes time. How are you sleeping? Are you sleeping at all? If you're sleeping, do you remember your dreams and are your dreams about this pandemic? We'll speak about how the pandemic could be triggering more vivid dreams. Matt Galloway. This is an extended edition of The Current on CBC Radio One. Stay with us.

Dreams in the time of COVID-19

Guests: Alice Robb, Andrea Bellemare

MG: Good morning. I'm Matt Galloway. You're listening to The Current.

[Music: Theme]

MG: Still to come, exploiting this pandemic. Why the far right sees opportunity in all of this uncertainty that's on its way. But first, no rest for the quarantined.

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I've always been the kind of person who has vivid dreams, but lately it has been over the top. Every night it seems like I'm having the most bizarre technicolour dreams right up into the point I wake up in the morning and the nature of what I've been dreaming about seems to have changed as well. Usually I'll have dreams like I have magic powers and I'm using them to fight off an army of bad guys who are chasing me through abandoned buildings or something. But the other night, I dreamed I was hanging out in a parking lot with a bunch of old high school friends and decided to go into a nearby convenience store to buy myself some candy. And when I went inside the store, there was a box of jumbo red liquorice, Twizzlers just lying out in the open beside the cash register where people could cough or breathe all over them. But I knew it was safe for me to buy one because the quarantine was over. And I was just so darned happy to be able to buy a piece of candy without worrying about becoming infected or getting sick. It was crazy. Clearly, my definition of magic powers has changed in the past few weeks.

MG: That's Erin Whalen in Gibsons, B.C. And it would seem she is not alone in experiencing a change in her dream life, just as our waking lives have been upended by this pandemic. So to have our nights and whether those dreams have happy endings, like finally being able to eat Twizzlers with abandon or perhaps they have darker themes like this one from one of our producers on the program.

SOUNDCLIP

I had one the other night, I dreamt I was at the stove cooking, as usual these days, and I look at the window and my two year old is somehow in the middle of the street. I run out. I grab him. And as I turn around, I see now the house is on fire. I pull out my phone to call 9-1-1. And instead of an operator, I get a recording that due to the pandemic, emergency services are temporarily unavailable.

MG: Dreaming in the time of COVID-19. This is something that the writer Alice Robb has been looking into. She's the author of the book Why We Dream. Alice, good morning.

ALICE ROBB: Good morning.

MG: You've heard those two clips of recent dreams that people are having. Is that what you're hearing right now, that people are finding that this nightmare in some ways that we're living through in our waking life is intruding into our dream life?

ALICE ROBB: Yes, absolutely. So I'm hearing that there's a big increase in the amount of dreams that people are recalling. So even people who usually don't remember many dreams have suddenly found over the past few weeks that they're remembering dreams very frequently. And part of the reason for that can be that we are a lot of us are sleeping differently. We may be sleeping longer hours if we're suddenly working from home or unemployed. And we also may be sleeping shorter hours and maybe waking up more frequently in the night, if we're very anxious and waking up frequently in the night can also lead to higher dream recall. And then I am also hearing a difference in the type of dreams that people are recalling. There's a lot more stress and anxiety in dreams, which of course, reflects our our new waking reality.

MG: You wrote a piece for New York magazine about this, got a lot of attention, and you were speaking with a researcher from Harvard who's collecting people's dreams here at this pandemic. How would you describe the types of dreams - you sort of hinted at this, but how would you describe the types of dreams that people are having? Are they stranger or are they are they more anxious dreams? What are they like in the broad spectrum?

ALICE ROBB: Yes. Deirdre Barrett has been collecting dreams and she has over 700 now, and she found that there is a lot more anxiety in this set of dreams than in a typical set. And there are a lot of dreams, kind of like the ones that we heard at the beginning of the program just dramatizing these sort of worst case scenarios about our family members dying or people are dreaming about falling ill themselves, dreaming about social distancing and other people violating that or violating it themselves. And she's also found, she's collected some dreams from health care workers who are really on the frontlines of this fight. And those dreams are even more nightmarish, that those look more like trauma and nightmares. And those would be dreams about not being able to save people or, you know, somehow passing COVID to their own family members, and that those dreams involve like guilt as well as anxiety.

MG: You mentioned the recall piece of this. Is that in large part because our routines have changed that because to your point, maybe we're sleeping longer, not sleeping as much at all, sleeping in different types of the day, napping what have you that that is the thing that would trigger a greater recall?

ALICE ROBB: Yes, I think that's a big part of it. And any big change in our routine can lead to greater dream recall. So I think it's a combination of these lifestyle factors. And as well, just that we have so much more to process during the day. So going through periods of big stress or even going through periods where we're learning a lot can lead to higher dream recall. So we're all having to learn these new rules of social distancing and how to share space and how to interact with people. So a lot of the dreams actually reflect those changes.

MG: Because we're learning new things that triggers something while we're sleeping?

ALICE ROBB: It can too. Dreaming plays a role in learning dreams can help us learn, if you ever noticed that you are learning a new language, you might have dreams about that language or in that language. And there can actually be an increase in REM sleep when we're going through it, which is rapid eye movement sleep, which is when we have a dream. You have an increase in REM sleep when we are learning a new skill.

MG: I wonder that we are just kind of moving through this phase of the pandemic. People have been sheltering at home, locked inside or trying to stay inside as much as possible for a couple of weeks now. Whether this marks a change in that, whether perhaps initially we weren't having those dreams, but now those dreams are becoming more common. Is that the case?

ALICE ROBB: I think it varies from person to person. I think, you know, as we adjust to this situation, you know, maybe our dreams will normalise a bit. But I think it's a little early to say.

MG: We asked on Facebook our listeners whether they're dreaming more about the situation they find themselves in. What are the dream lives like right now? Want to play you a couple of clips from what they told us. This is from Victoria, Wolf, who's in London, Ontario.

SOUNDCLIP

My most memorable dream so far is the one that I had most recently. I dreamt that my husband dragged our family to an outdoor concert and I was furious with him because it was a clear violation of social distancing. At the concert, we sat on the grass and hung out with singer Marilyn Manson. All I could think to tell him was that he was very articulate in the documentary Bowling for Columbine by Michael Moore. I can speculate now that perhaps Manson represented some sort of angel of death figure.

MG: There is a lot to unpack there. One is the piece about social distancing. The other is hanging out with Marilyn Manson, of all people, the angel of death. What do you make of that?

MG: Well, after the social distancing part of the dream, I mean, that sounds like the kind of dream that you might have. It almost serves the function of like reminding you how important social distancing is. And one theory of why we dream is that dreams help us prepare for real life. And that dreams, and that's part of the reason that dream, even non-COVID dreams, even under regular circumstances, our dreams often do have a pretty negative tenor. They often are filled with anxiety. And the idea that if we can confront these anxiety filled situations in our dreams, then we'll be more prepared to face similar things in real life and well, we'll feel more confident in real life knowing that, you know, at least we don't have to face this sort of I don't know, Marilyn Manson, death figure or an open air concert even if you bumped into someone at the grocery store.

MG: Want to play one more dream recollection that we received from the listener? This is from Val Cormier in Vancouver.

SOUNDCLIP

During this pandemic, I'm experiencing a general increase in anxiety dreams. Most commonly, I am severely behind in packing belongings and getting to an airport on time. Often I miss the flight, which strangely usually originates in Montreal. Then there's the dreams of being in high school, a few credits short of graduating. Strange because I actually liked high school and I have two university degrees. The worst dreams involve a very large bomb nearby. Being close to detonation.

MG: Again, missing a flight threat of a bomb outside. Does that all of that sound familiar? Does it factor into or play into some of the things that you've been talking about?

ALICE ROBB: Yes, I mean, missing a flight or dreaming up being in high school or jeans that you might see just sort of during any period of stress. Those are recurrent theme for a lot of people. And then the idea of having like a bomb outside your house. I have heard a lot of dreams about metaphorical threats of being inside and feeling safe, that there's something outside like a swarm of bugs or worms, just something sort of a little bit diffuse that is that could attack you, have the potential to attack you.

MG: You were saying earlier about the purpose of dreams and you've written a book about this, about why we dream in talking about how they prepare us for real life. If you think of the dreams that we have outside of a pandemic, you know, it's the dreams that you have a project that's due. You didn't know that it was. Do you get to class and suddenly you have to stand up in front of the class and deliver that project or you show up at school and you forgotten to put your clothes on and everybody laughs at you. What is the purpose of a dream like that?

ALICE ROBB: For one thing, as dreams can do is they can help us. They can sort of desensitize us to anxiety. So even though we're going through this really anxious experience in our dreams and we're kind of we're allowing ourselves to play out like our fears in a way that we wouldn't necessarily let ourselves do in the day. And then when we wake up, we remember that dream. There's often a feeling of relief that, you know, maybe you have to do a stressful presentation, but at least you can get dressed.

MG: The other part of this is that we talk about this being an unprecedented time, but at the same time there have been points of great anxiety over the course of history and disruptive moments. What a dream researchers saying about the dreams that people have had in past in particularly stressful periods of history?

ALICE ROBB: I mean, I think it makes sense that we're having this big increase in in dreaming now. We have seen, you know, during the 2016 election in the US, a lot of people were dreaming about Donald Trump. I mean, we definitely do, our dreams reflect our daytime lives and the concerns that we have in our daytime lives. So it makes a lot of sense if we're all. And I think this is intruded on our personal lives even more than many other races. So it makes sense that we are processing those anxieties in our dreams that we're thinking about.

MG: Is there anything that we can do with this if we're dreaming more? And the dreams are more vivid. Maybe we're not dreaming more, but certainly the dreams are more vivid and we remember them and they seem to square with the reality that we're living in. Or take a part of it and turn it into something different. What should we do with that? Should we write it down? Should we analyse it? Should we just try to figure out a way to forget about it so that we have some period of time when we can sleep and not be paying attention to it?

ALICE ROBB: I would recommend treating this as an opportunity. A lot of us are having extra dreams and if we I would say, you know, write them down, don't just try to forget them because they will come back to you. You'll have flashbacks to them. And they're an opportunity to help us tune into what we're what we're afraid about in this moment. So I would say I mean, I keep a dream journal that I write in every morning, which also really helps with dream recall if you want to remember even more dreams. I would say talk to them with your quarantine partners or people in mind. Lots of people have been tweeting about their dreams. And yes, just use them. Use them as an opportunity to help process this crisis.

MG: You didn't always buy into the idea that there was a therapeutic value to analysing our dreams. Right?

ALICE ROBB: I was before I started writing my book. I was, as I think many people in the West are sceptical that dreams really meant that much. I think there's this idea that's pretty pervasive that dreams are just the residue or damn dresses waking life and they're random and we should just kind of forget about them. But through writing my book, I learned so much about the therapeutic value of dreams and how they can really help us process our fears and our hopes and help us meet more full waking lives.

MG: So I had a dream about an elevator that I was in. And people kept getting in the elevator. And the elevator wasn't very big. And I wanted people to get out because there wasn't enough room for me to physically distance in the elevator. And I don't know what that was about. Are you having different dreams now? Do you find that the pandemic is creeping in to the dreams that you're having?

ALICE ROBB: Yes, absolutely. I've had a lot of those social distancing dreams where I was at a party and someone isn't standing six feet away from me. And I think, yes, it's interesting that we are all going through this together and our waking life and we seem to be processing it similarly at night as well.

MG: People will just want to have normal dreams and maybe a normal life as well. We'll see when that happens. Alice, thank you.

ALICE ROBB: Thank you.

MG: Alice Robb is a science journalist and the author of the book Why We Dream.

[Music].

MG: This is the current on CBC Radio One. My name's Matt Galloway. The CBC is Andrea Bellemare is part of a team fact checking this pandemic for you, separating stories that are true from stories that are completely bogus. And this week, she is looking at groups exploiting the pandemic. Andrea. Good morning.

ANDREA BELLEMARE: Good morning, Matt.

MG: Tell me about this. It's tricky because every time you sort of knock down one of these fake news stories, there's another one that pops up. What does that like to try and keep a handle on this?

ANDREA BELLEMARE: Yes. So, I mean, I guess what I think it's kind of like, do you remember that scene, that very famous scene from I Love Lucy, where Lucy and Ethel are trying to wrap all the chocolates on the conveyor belt and chop keep coming by more quickly. I shouldn't make a joke, but it's I kind of feel like that sometimes. And you're just trying to get to everything and then things are going by. Oh, I want to debunk that, too. And oftentimes you'll see information that, you know, is actually very harmful. And it's there's just all a lot of it. So it's I was trying to do as much as we can, but there's quite a bit out there.

ANDREA BELLEMARE: Which is why, according to the calendar, it was the international fact checking day on the 2nd of April.

That's right. Yes. And that is something that is helmed by Pointers International Fact Checking Institute Pointers, a journalism instruction institute in Florida. And, you know, they actually have a spreadsheet on their Web site. And this is where all fact checks around the world have been submitting fact checks related to covered 19. And on that day, they actually noted that they had over 3000 submissions. So that's quite a quite a lot.

MG: Now, you've been looking into that. People may have heard about this over the course of the news today. Far right groups who are trying to take advantage of the pandemic. Why is this time now such an opportunity for those groups?

ANDREA BELLEMARE: One of the things that's really interesting is I was speaking to people who whose job it is to monitor the far right. And they said something that really struck me. And they said, you know, there's nothing that the far right likes more than a crisis. Those were actually the words of Barbara Perry. She works at Ontario Tech University in Ottawa. She heads up their centre on extremism and fear. And, you know, one of the things that came out was that, you know, people are afraid they might be looking for simple and satisfying answers about what's happening when things get more stressful and confusing. If you're trying to, you know, sow discord or you're trying to take advantage of that for your own means. You might be able to get away with it or you might feel that you might be able to get away with it. And, you know, here's something that Barbara said to me that I thought was really, really interesting. And I'll just let her say here.

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I think what we are seeing, though, is that these sorts of narratives are no longer restricted to the far right. If they ever were, in fact, and some of those sentiments, those narratives that are flowing so, so easily or in online venues in particular. Well, this is the other piece, right? I mean, there's a bigger audience for folks for the far right now. So many of us are online. That's where we're living our lives right now. So we're so vulnerable, I think, to this sort of messaging.

ANDREA BELLEMARE: And, you know, the things that you really probably are seeing, a lot of those might be, well, hateful and xenophobic posts. There may be posts that are blaming Asian Canadians or Jewish people for the pandemic. And then there are quite a few conspiracy theories. And you and I have chatted about some of these conspiracy theories before. So those are things that you might come across as you're spending your day on the Internet.

MG: Are there examples that would be rooted here in Canada of those conspiracy theories that are swirling around online now?

ANDREA BELLEMARE: Absolutely. Jacob Davies. So he's with the Institute for Strategic Dialogue in London. He specifically mentioned to me a conspiracy theory that the coronavirus had been created in the national microbiology lab in Winnipeg or had been worked on in that lab, in that lab, and then stolen by Chinese researchers and taken to China. And so that conspiracy theory actually is a distortion of a story that CBC News broke in July. And that's when we revealed that a researcher husband and some of their graduate students were escorted out of that lab. The RCMP had opened an investigation and they described it as a possible policy breach and an administrative matter. And both the RCMP and Health Canada told us they stress this there was never any danger for public safety. And our reporting never said that those scientists were spies. And, of course, you know, that is something that has just sort of spiralled. And, of course, you know, the other aspect of that is and we've talked about this as well, is that the coronavirus that one is currently causing this pandemic was created in lab. We know this because scientists have been able to sequence the genome and they've been able to look at it and tell us that it has not been. But that remains probably one of the most popular conspiracy theories out there.

MG: The prime minister himself, Justin Trudeau, has been the subject of some conspiracy theories as well when it comes to COVID-19.

ANDREA BELLEMARE: Yes, a common conspiracy theory might be that he is not doing enough to prevent the spread and he's doing that on purpose, or it might be because he, you know, wants to use this, sees this as an opportunity to consolidate more of his power. Or that he might try to bring in martial law. These are all conspiracies around him. Then, of course, there's a lot of posting that might be very critical of him or, you know, that might be very aggressive towards him. And I mean, obviously, as the leader, he has a focal point. And then, of course, you know, Trudeau has done things such as when he went to the airport to welcome refugees from Syria. So there may be people that really objected to that.

MG: What do you ask yourself when you're trying to figure out if the things that you're reading online are true or false?

ANDREA BELLEMARE: One of the things that I think about, especially with conspiracy theories, is who does the conspiracy theory benefit? Are there real leaps of logic there without evidence or something really far fetched? Also, sometimes, is it someone trying to tell you something? Sometimes people who are conspiracy theorists who have a large platform may also be pushing products of dubious value. But there may be that angle as well, or they may be trying to scam you out of money. I mean, the other thing, of course, is, is it always does this seem too good to be true or does this hit me in a really emotional place? Is it really stoking fear or panic or sadness? And so if there's an emotional trigger, that's something else to really ask yourself about. And lastly, does it just seem like a really unbelievable.

MG: In the last minute or so that we have let's talk about what Health Canada is doing to crack down on these companies that are selling some of those fake remedies?

ANDREA BELLEMARE: Yes, that's right. In the past week or so, Health Canada has gotten dozens of complaints from Canadians that are reporting advertisements for products that claim they can prevent or treat or cure their coronavirus. And they actually provided us with a list of 27 cases where information was withdrawn and they actually detailed some of those advertisements. So, for example, you know, there were some sellers on Amazon Canada that were touting that they had a special anti dust, anti fog, anti coronavirus hat that could isolate infected saliva.

MG: Hat.

ANDREA BELLEMARE: Yes, hat. I've also seen a claim about a necklace as well. A necklace or a hat cannot prevent you from getting coronavirus. There's also a mix of mushrooms that is meant to boost your immunity and prevent COVID-19. That was something else that Health Canada flagged. That was not correct. There was a natural Pethick office in Toronto that claimed it had a specific oregano oil that had the ability to halt virus replication in host cells infected with the human coronavirus. And that is not correct either.

MG: All things that have caught the eye of Health Canada. Andrea, thank you.

ANDREA BELLEMARE: Thanks, Matt.

MG: Andrea Bellemare is a reporter with CBC's COVID19 fact checking unit. It's time to say goodbye to our listeners in Newfoundland and Labrador for everyone else The Current is back after a 90 second break and you'll hear why COVID-19, is not just a public health crisis. It is an issue of racial justice in the United States and here in Canada as well. Stay tuned for that. I'm Matt Galloway. This is an extended edition of The Current on CBC Radio One.

The Current Transcript for April 9, 2020

STORIES FROM THIS EPISODE

Prologue

COVID-19 and racial inequality

Our adrenaline can't 'outpace' COVID-19, but Brené Brown offers 3 tips to better cope

Deciding who gets access to limited medical resources

Sharing the sidewalk; Indycar racer Robert Wickens back in the driver’s seat

David Maginley on living well; Online anxiety course, Mostafa Keshvari

Dreams in the time of COVID-19

Full Transcript for April 9, 2020

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