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The Current Transcript for May 11, 2021

Host: Matt Galloway

STORIES FROM THIS EPISODE

Prologue

VOICE: I'm not going to give up, I mean, seniors are demanding something that's different, and I think this is one of the good alternatives to what we have right now.

MATT GALLOWAY: No matter when this pandemic ends, it feels like one of the legacies of covid-19 will be a reckoning on how we treat our elders. Reforming long term care is one thing, but what about a completely different concept of where seniors could live? In 30 minutes inside the growing movement of naturally occurring retirement communities and what it means to ask seniors themselves what they want? Also this morning, your pandemic poetry on the promise offered by the vaccination. Plus, it sounds like something out of a horror movie, to be honest...

PAULA SHREWSBURY: It gets thick to the point where you just see them everywhere and you're trying to step around them and they're buzzing all over the place. And I remember I was outside talking to a friend. There were so many of them. One actually just flew into my mouth.

MG: No, thank you. Etymologists, let's call it cicada palooza. Why exactly are trillions of insects about to emerge from the ground after 17 years? We'll find out in an hour. But we start with medical marijuana. It's being used by hundreds of thousands of Canadians. Does it actually work? Good morning. I'm Matt Galloway and this is The Current.

[Music: Theme]

Calls for more clinical trials on medical marijuana products

Guests: James MacKillop, Aly Benson, Rebecca Zak

MG: A growing number of people are turning to medical cannabis to help manage their health conditions. Right now more than 375,000 Canadians have a physician's authorization to medicate with cannabis, but only a fraction of users actually have that official document. It is estimated that there are closer to a million Canadians using cannabis for medical reasons. The trouble is, all of these people are taking a drug without evidence that it works or that it is safe. Researchers are lined up wanting to gather that evidence, but getting a research licence is a difficult task. Now, a group of some 200 scientists and clinicians have signed a letter to Health Canada urging that body to make this research more feasible. James MacKillop is one of those scientists. He is the director at the Michael G. DeGroote Centre for Medicinal Cannabis Research at McMaster University in Hamilton, Ontario.

MG: James, good morning.

JAMES MACKILLOP: Great to be with you, Matt.

MG: How much scientific study has there been into the use of cannabis for medical purposes?

JAMES MACKILLOP: Well, there's been a lot and I don't want to understate that, but the problem is most of it is observational, which means just asking people their impressions of their experiences or studying those experiences over time. What we need a lot more of are randomised controlled trials, which are the gold standard for testing whether or not medical cannabis works or not.

MG: People have been taking medical marijuana for 20 years legally. How is it that there's not more science behind it?

JM: One of the reasons is that medical cannabis really exists in a very different regulatory framework from traditional medicine. It wasn't approved by Health Canada as a specific medication for a specific indication or condition, it was approved by the courts for people to have access to it. And for that reason, it's in this grey area. And that same grey area makes it very difficult for us to study using clinical trials because of Health Canada's guidelines.

MG: Help me understand that. I mean, how did it happen that what, maybe a million Canadians are using a substance for medical purposes that hasn't been studied?

JM: Where this started 20 years ago was a very small number of patients who advocated to have access to medical cannabis for compassionate purposes. And that has really evolved over time. And now there are dozens of licenced producers who have products that people are using for many different conditions, not just the conditions that the legal cases were based on. And so, unfortunately, I think that this unusual process has led to a very different landscape in terms of medical cannabis relative to health care in general.

MG: What concerns you most about that?

JM: What I'm troubled by is... I think that unfortunately there are a lot of myths about cannabis being completely benign with no side effects or downsides. And I'm concerned that patients may be delaying or ultimately not accessing evidence based treatments if they're using products that are ultimately not shown to be effective.

MG: But just to be clear. Is there evidence that this works?

JM: That's a great question, too. So there's evidence that's quite strong in some areas. So, for example, the evidence supporting CBD cannabidiol for rare paediatric seizure disorders is very strong. That's the basis for why that's been approved by the FDA in the U.S. And I think that in some cases, the evidence for pain and other conditions, spasticity, for example, in MS is at least moderate. In other areas, anxiety, depression, PTSD, the evidence ranges from nonexistent to actually negative.

MG: I just wonder whether there would be any other substance that people would be legally allowed to take or the evidence that supports, you know, the use of this would be, as you say, nonexistent or negative.

JM: I can't think of another example. It's the exception to most rules in modern contemporary medicine, and that's why there are such challenges in conducting trials.

MG: So what is the challenge in terms of getting the trials done in Canada now?

JM: Well, it's not a lack of scientists who are interested in doing the research or a need from the perspective of patients or physicians or even indeed the medical cannabis industry. What's really difficult is getting the research licences to conduct these trials because the same products that are approved for manufacture and sale by Health Canada don't meet their standards for being studied in trials. And that's the disconnect that's really tripping up a lot of researchers nationwide.

MG: Health Canada's position and this is the words of Health Canada, is that "clinical research is essential to understanding the effects of cannabis in a therapeutic context, and that high quality research helps guide practitioners in making evidence based decisions when prescribing and managing patients using these drugs". So given what you've said, when you hear that, what goes through your mind?

JM: Well, I think that that's another disconnect because you're exactly right. Health Canada does agree that there's a tremendous need for more good evidence. And I don't want to paint with too broad a brush here. I think that Health Canada in some ways has got regulations that they believe will create the best evidence. But unfortunately, that will also create an ongoing disconnect between what people are actually consuming, what they're smoking, what they're vaping, what they're using in oils or edibles and what's being studied. And just as an example of that, my colleague here at McMaster just recently did a systematic review on cannabis for pain and found all the trials that are out there are on oral medications using cannabinoid products, not on the inhaled products that virtually all patients say that they use. So unfortunately, I think this is where even though there is endorsement of the need for evidence by Health Canada, there remains this really difficult gap between what they require and what's actually happening in the world.

MG: I mean, you run a medical cannabis research centre. Are you licenced to do any clinical trials at all?

JM: So fortunately, there are two investigators affiliated with the DeGroote Centre whose applications went in before the current regulations took full effect. So actually, they have their research licences approved. But the large majority of investigators who put in research licences have had them rejected on these grounds. And this isn't just a McMaster thing, this is a national thing. There's a reason more than 200 scientists and clinicians signed our letter because over and over again, unfortunately, scientists are getting funding to do the trials but are then running into roadblocks on the Health Canada side of things and can't go forward with those peer reviewed trials.

MG: James, stay with us. We have two people with personal experiences with medical marijuana that we want to speak with. First, Aly K. Benson. She's in Abbotsford, British Columbia, has been taking medical cannabis for six years now.

MG: Aly, good morning to you.

ALY BENSON: Good morning.

MG: What condition are you treating with medical cannabis?

AB: There's a few. I've been using CBD for anxiety and depression, but also for some nerve damage. I began using it after an injury to my shoulder when I was playing university volleyball. And most recently, actually, today marks the eight week recovery from spinal surgery, which I used an all cannabis based zero opioid recovery.

MG: What does the use of medical cannabis mean for the symptoms that you are facing?

AB: It means that my life is just so much easier being able to opt out of something that could be potentially dangerous and also has had such a negative effect on people in my life with addiction, with opioids. Cannabis was a better option for me and just making my life much, much easier with my ability to function throughout the day. So high anxiety, take one milligram of CBD and figure it out that way. But a huge part of it has actually been topical. Topical's completely rid me of the sciatica that I was experiencing. So not being able to walk actually turned into, hey, let's go for a little bit of a 10k walk.

MG: Wow. Did a doctor authorise that for you and give you kind of guidance on when to use it and how much to use?

AB: No, so I was able to propose my own cannabis program to my surgical and healthcare team, but there is no way to give dosage amounts to patients. So sometimes you get a cheat sheet on dosage, but there's no direct know how and the thing is, medical patients have to know their own body and almost do it with self teaching moment, which is what I had to do.

MG: Pause for a sec, how did you learn this? How did you know how much to take and when to take it?

AB: It was about a year and a half of studying, lots of reading, a couple of different private courses available in Canada and the US and then being able to apply it to, OK, I know this works, this doesn't and then breaking it down myself.

MG: If that scientific study were to be able to move forward, what are the questions that you would want answered through it?

AB: Having proper dosing would be so helpful, not having to overload on one thing when there could actually be another product or prescription item that I could take. You know, another thing too is, where is the health care coverage? I don't get that covered. I can accept it on my taxes. But for someone like me, I don't have compassionate pricing.

MG: Just finally, I mean, can you imagine what your life would be like if you were not using medical cannabis?

AB: Very painful, very, very pain filled, and I would guess, given the history around my family and the situations that I know bring upon from opioids, that opioids would play a lot bigger role in my life.

MG: Aly, take care of yourself. I'm glad to have had the chance to speak with you. Thank you very much.

AB: Thank you, guys.

MG: Aly K. Benson in Abbotsford, British Columbia. James McKillop has been listening into that. What do you make of what Aly's doing? In some ways, she's trying to figure this out on her own and it's working for her, but she's going blind in some ways.

JM: That's exactly right, Matt. I think that the clinical care can be very murky. Patients often have to look into a lot of different products and see what might work for them. Her story also shows why people believe there's so much promise and why, indeed, we believe that medical cannabis needs to be studied more extensively. And this is particularly important in the context of pain, which is difficult to treat and where the standard treatments of opioids can have a lot of risks and dangers. So if cannabis permits patients to reduce their dose of opioids or to not use opioids at all, it could be a major contributor to pain treatment.

MG: Who do you worry most about? Because we know that medical cannabis is being used by veterans, is being used by cancer patients. It's being used to treat children as well. So if you take a look at all of that without the evidence on dose and unsafety, who are you most concerned about?

JM: My biggest fear has probably come about because I'm a psychologist by training. And I think that I see some of the highest rates of use amongst people who are using medical cannabis for psychiatric conditions. And when we look at recreational cannabis users, people who use cannabis to self medicate anxiety or depression or PTSD generally have more problems with cannabis and are at greater risk for developing cannabis use disorder. And unfortunately, a lot of psychoactive drugs, like alcohol, for example, helps reduce anxiety or reduce depressive symptoms or alleviate PTSD symptoms in the short run. But I think that my fear is that people who are vulnerable with mental health conditions will see this as a possible miracle cure. And it may be that, unfortunately, the evidence ultimately won't support that. And actually a recent clinical trial on PTSD and three different kinds of smoked cannabis just revealed no positive results.

MG: James, let me bring one more guest into the conversation. Rebecca Zak is on the line from Dundas, Ontario. She tried medical cannabis to treat her insomnia. Rebecca, good morning to you.

REBECCA ZAK: Good morning, Matt.

MG: Why did you want to use medical marijuana to help you sleep?

RZ: Well, any time I had ever tried marijuana recreationally, it just put me to sleep. And then when I experienced insomnia for the first time in my life, I thought, oh, well, I know something that puts me to sleep. So I went to the dispensary first and they told me that they were not allowed to give me any advice if I was using it for a health condition. So then I went to the doctor and she prescribed me cannabis oil. But there wasn't a whole lot of advice around that, to be honest. For dosing, for example, she said, you need to go slow and you need to work up incrementally. So every day you're trying 0.1 Milligrams more and you're waiting to see what kind of effect it has on you.

MG: So you're laying in bed and then you take this because you can't sleep. What happens?

RZ: You wait and you wait. And then I was having different symptoms. For example, I was lying there, just full body buzz in the middle of the night and I didn't know, is this what I'm supposed to be looking for? Is this working? So there was a lot of confusion for me.

MG: Do you think it worked?

RZ: Ultimately, no, I don't think it worked because lots of times, even if I did fall asleep, I would wake up with a horrible cottonmouth and I would stumble to the washroom to get a drink of water. And I would be so dizzy that it was hard to keep my balance. So I reported all of this back to the doctor and she said, oh, that's, you've actually had too much. So I actually was prescribed this other much stronger product and again, had some really uncomfortable side effects. But it also didn't put me to sleep like I wanted it to.

MG: So given that, would it be worthwhile to do more clinical research on medical cannabis?

RZ: Absolutely. If we had a better idea of what it takes, then I could have saved time and money and discomfort. And if the data shows that it doesn't really work for insomnia, well, then I just wouldn't have tried it at all. But I was really my own guinea pig.

MG: How is your insomnia now?

RZ: Slightly better. Actually, the funny thing is that the best thing I found that works is reading in the bathtub. [laughter]

MG: I'm glad that that is working for you and I appreciate speaking with you, Rebecca. Thank you very much.

RZ: Thanks, Matt.

MG: That is Rebecca Zak. She is in Dundas, Ontario. James McKillop, director of the Michael G. DeGroote Centre for Medical Cannabis Research at McMaster University in Hamilton, still listening in. Does that sound familiar, James?

JM: It sounds very familiar, Matt. I think that she put it very aptly when she described herself as being her own guinea pig and that there's not a lot of guidance from either physicians or so-called cannabis professionals because there isn't good evidence to base that on. I think her story is really valuable also because we are inundated with so many positive anecdotes, so many miracle cure stories. And what is much less newsworthy is the reality that lots of people try it and don't find benefit. All we hear about are very positive reactions, and that kind of shapes the lore around cannabis, the mythology, and that's why we need the evidence.

MG: What are the negative consequences? I mean, again, one of the reasons why perhaps that lore persists is because there is the assumption that compared to other substances, this one is relatively harmless.

JM: The negative consequences also fall on a spectrum. And Rebecca highlighted a couple of the more benign ones. What I worry about is people using medical cannabis typically are using it daily. And what we do know is that regular use does affect cognitive performance, especially in terms of things like memory, short term memory, attention and motor performance, like reaction time. And that's really important when it comes to driving or other safety sensitive aspects of work. And of course, there's also the risk that people could develop addiction to cannabis and cannabis use disorder is not all that common, but it is a real thing. Another myth is that it doesn't exist and we unfortunately have a history of aggressive pain treatment with opioids leading to very high rates, indeed, epidemic rates of opioid use disorder. And I think that one of the real risks is that, unfortunately, medical cannabis could lead to the development of cannabis use disorder also. So those are the two most troubling areas, from my perspective,

MG: Just about out of time. Let me ask you about what specifically you're looking for. Health Canada says that it's working on a response to your letter that the clinical trial regulations are in line with international standards and are in Health Canada's words, "aimed at protecting the safety of clinical trial participants and the integrity of the data generated". They're looking at flexibility in this process. What do you want from Health Canada?

JM: I think flexibility would be ideal because I understand that there are differences in terms of international standards relative to the regulations around medical cannabis. But Canada has been a leader in this area before and finding a way to work within international standards but still promote clinical trials at home is really the answer we're looking for. Clinical trials are the raw materials of how good medical practise happens. It's why physicians are uncomfortable with medical cannabis now because good physicians based their care on good science. So we really hope that Health Canada will work with the scientific community to create regulations that allow us to do the trials that are much needed to advance this area of care.

MG: In the meantime, I mean, in some ways the horse is out of the barn. There are a million plus Canadians who are using this. This is big business as well. So what should patients be thinking about if they are considering using medical cannabis?

JM: Well, I think that's a great question also because what should a patient do? Trials take time and they're costly and the answer won't come back in six months. So I do think that working closely with a physician who has expertise in this area and is open to ongoing clinical management is really important. I think going it alone is a riskier path. And even though cannabis is legal, that doesn't mean you should go that route. So I would encourage people to work closely with a health care provider and be their own, not just guinea pig, but sceptic and make sure that they're pursuing all the other avenues of traditional health care, along with medical cannabis, to make sure that they're not at risk of harms or delaying access to things that will really help.

MG: James, good to speak with you about this. Thank you very much.

JM: Thank you, Matt.

MG: James McKillop is the director of the Michael G. DeGroote Centre for Medicinal Cannabis Research at McMaster University in Hamilton, Ontario. Your thoughts on this. Welcome, as always. Do the stories of Rebecca and Allie sound familiar? You can email us Thecurrent@cbc.ca. Your CBC News is next. And then a new approach to ageing. We will tell you about naturally occurring retirement communities and the benefits of listening to seniors as you design the homes that they will live in. My name is Matt Galloway. The Current is back with that story in six minutes.

[Music: Theme]

How seniors find support in naturally occurring retirement communities

Guests: Catherine Donnelly, Christine McMillan, Catherine Bigonesse

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

[Music: Theme]

MG: Still to come:

[Sound Clip: Cicada sounds]

MG: Sort of the sounds of summer, a cicada on a hot, sticky night but can you imagine swarms of them? Billions and billions all in one place soon parts of the United States will experience that firsthand as the insects emerge after a 17 year slumber. But first, a new take on retirement living.

[Music: Theme]

MG: This pandemic has revealed many cracks and how we care for seniors in this country today, we're going to hear about a different approach to our current system. We start in Toronto with Humber River Hospital's community vaccine outreach program. Ruben Rodriguez and his team have been targeting a specific group of seniors.

RUBEN RODRIGUEZ: Today is part of our engagements with the naturally occurring retirement centres we have in our region that is part of the Humber area. We have about 45 of these buildings, where 30 percent of the population are people older than 65. To walk from here to the hospital will be quite a bit of a hike for someone, especially a senior with mobility issues, for someone to be able to go on public transit and a senior, they probably will have to do three or four connections to be able to make it to the clinic. One of the comments that we often hear is, oh, thank God, I don't have to go anywhere. I'm so happy that you are here. And one of the most impactful experiences for us was when we did a building on 35 Sharhan Avenue. And the individual was not only a senior, but it was also someone from an ethnic group. So her first language was not English and she had language barriers. And her grandson was with her there and he's about 10 years old and he was translating to help his grandma. And we were chatting with him and he seemed quite emotional. And he said grandma was sick on the [inaudible] one. And we were very worried about her life. And now knowing that she's receiving the bus in and she having this protection is such a relief he couldn't really, he couldn't actually finish that sentence, it was very emotional for him. And it's those moments that validate the importance of this work to go door to door. Many of these individuals with language barriers, mobility barrier, ability to navigate the assistant booking online. It is a problem for many people. And when you come to them and it's really valuable for them, but it's also valuable for us to see that we bring in this sense of hope to the community, especially with this wonderful population.

MG: Ruben Rodriguez is director of Humber Rivers Reactivation Care Centres, Long Term Care and Kongregate Care Support. And he's been helping seniors living in naturally occurring retirement communities get covid vaccines. It is that term naturally occurring retirement communities that we are talking about today. Catherine Donnelly is an associate professor and director of the Health Services and Policy Research Institute at Queen's University in Kingston, Ontario. And Catherine Bigonnesse is a postdoctoral fellow at the Research Centre on Ageing at the University of Moncton. Good morning to you both.

BOTH: Good morning, Matt.

MG: Catherine Donnelly. Just briefly, what are naturally occurring retirement communities?

CD: So I'm going to call them NORCs just to make it easier. And it's a funny term. I know I always say it and people smile. And so NORCs are really just a geographical area and a way to describe a place where there's a high proportion of older adults. And so in itself, it doesn't mean anything. It's just a descriptor. Some NORCs are what we call NORCs with supported service programs, and it would be a geographical area or NORC where they actually bring in and leverage community services and support. So NORCs on their own or just areas where people live.

MG: I think one of the most interesting parts of that title is the naturally occurring bit of this. How do they develop?

CD: That's a great question. So if you think about where you live and where you grew up, NORCs could just simply be a neighbourhood where at one point there was lots of children running around and over time no one moved and eventually the neighbourhood just grew old together. Or it could be something like there's an apartment that might be close to amenities that older adults find appealing for many reasons. It's close to a shopping centre, for instance. And so older adults just naturally move into an apartment building. And so that, again, would be considered a naturally occurring retirement community. So they're really unplanned neighbourhoods or communities. They could be a neighbourhood of houses or they might be what we call vertical NORCs, apartment buildings.

MG: You helped map them out in Toronto. How many of them are there in that city?

CD: Yes. Well, that was a good colleague of mine, [inaudible], and he's been working with the COVID task force there. And so I wasn't part of that work specifically. But we've done our own work mapping NORCs all across Ontario, actually. And what's fascinating, we just use Stats Canada data. So they have something called dissemination areas, and you can actually look them up if you went to MLS and look for a house, for instance, and you can see that if you go on and look for houses, you can see neighbourhood statistics. And they're just areas of 400 to 700 people, just little small pockets. And again, what we looked at all across Ontario and looked at the percentage of dissemination areas. And so in 2006, nine percent of the dissemination areas were considered NORCs. And we called those if there is forty percent of people living there 55 and older, and by 2016 in Ontario, 20 percent of dissemination areas, we would consider NORCs, which is quite remarkable. So these are only getting more frequent in Ontario and a really a great way to think about how we might reorganise and reconceptualized how we provide services and supports to older adults.

MG: Well, just I guess briefly on that, what sort of services and supports do they have for the seniors who are living in those communities?

CD: Well, it's a great question. So, because they're naturally occurring most of the time, people don't even know they're living in a NORC actually. And so at this point, we haven't capitalized on NORCs at all in Ontario. You know, I've been working with a program called Oasis Senior Supportive Living, and we'll probably talk about that a little bit more.

MG: We will.

CD: But it started in Kingston and that is a group that came together who were living in a NORC and decided they wanted to bring services to them. So for the most part in Canada, we do not capitalize on NORCs at all. In other parts in the United States, New York specifically, they've done quite a good job of taking NORCs and reorganising services and supports to bring those to these NORC areas they've identified.

MG: Catherine Bigonnesse, this is not just in Ontario. You've been looking at the NORCs in Vancouver and White Rock, British Columbia. What did you find there?

CATHRINE BIGONNESSE: Actually, very similar finding that Dr. Donnelly just shared is really a question about where people naturally will be there and they realise that the area is good, especially in B.C. the weather is quite an attraction for seniors, but usually everything is walkable, they can access services by foot. They have good public transportation and health clinics are there, like quite close by. And some challenges. Even though they yes, they have access to amenities, additional services is not available for them. So they have to self organise somehow to be able to age in place a little bit longer. So and again, it's not mapped really well outside Ontario. Same here in New Brunswick, at this time it's the thing we have not either looked at.

MG: Tell me about the community that you're working with in New Brunswick and how that might be different from the ones that you saw in B.C. or that Catherine was describing in Ontario?

CB: Yeah, it's a complete rural area where it's a small village. When we talk about dissemination area for them, it's one third of the city or where they live. So but the proportion of seniors in [inaudible] here in southeastern New Brunswick is very high, is about 50 percent of 55 and older. And that is the stats from 2016. I'm expecting the number to go higher with the new census. And the major challenge they have is like there is no services or anything close by. Everything is car driven. They are dependent on helping each other. The neighbours, which is quite present, in the small rural area. But it's a challenging place to age in place. And we have been trying to offer services through a one-stop shop, but it's quite an adventure to try to just have this functional and working in a rural area.

MG: So in some ways, the NORCs would work better in more urban settings where those services are more densely kind of collected.

CB: Yes, you definitely have like the economy of scale there, although I don't think we should ignore NORCs in rural area because they expressed the same challenge. And there are also housing challenges that are different. But it would be much easier to start with the city and then, as we usually do, try after to work in the rural areas. Yeah.

MG: Catherine Donnelly mentioned the Oasis Senior Support Living Program in Kingston, Ontario. I want to bring in the founder of that program. Christine McMillan has been working on naturally occurring retirement communities for years. She actually founded that Oasis Centre in Kingston more than a decade ago. Christine McMillan, good morning to you.

CRISTINE MCMILLAN: Good morning.

MG: Christine, tell me how the first Oasis in Kingston was started.

CM: I was president of the local council on aging and we did a lot of work on elder abuse. And the question came up is how safe are seniors in high rises or in apartment buildings that are living alone? And do they know about elder abuse and how to deal with it? But when we met with the seniors in those buildings, what we heard was they felt very safe in the building, but the overwhelming loneliness just haunted me. And then when we asked, how do they manage meals? And I heard things like, well, you know, when you eat alone all the time, you get tired. So you just don't bother, so you have tea and toast, or you have a bowl of cereal for supper. Many of them were in their 80s and they were having trouble walking and they had two fears. One was that they would have to go into long term care, and the other one was that they would die alone in their apartment and no one would find them for days. It haunted all of us. But you know, there didn't seem to be any answer to that. They couldn't afford a retirement home. And one night I thought, you know, there's no big deal about a retirement home. I mean, they have meals and I have programs and they live together and they get to know each other. And I thought, I wonder if you could do that in an apartment building. The next thing we did. The [inaudible] identified a building where there were 11 seniors on the waiting list for a long term care. And we met with them and we didn't say we know what you need because I said to them as a senior, that really turns me off when young people think they know what I need and don't listen to what I have to say. So we listened to them, and they talked about having no place to get out of their apartment. And those with mobility or sensory issues were really locked into that one space. They dreaded going into long term care, they couldn't afford a retirement home, they were not eating properly. They were not, they didn't see people, they didn't even know their neighbours across the hall. So we said, what would happen if we developed a program like that with your help, where you took the lead and we figured out how to do it? And I remember one woman said, I don't believe this, but I'll tell you, if you could do it, I will change my life.

MG: So describe I mean, in an Oasis building, what are the services that are there that may not be there?

CM: It's a building that's owned by Homestead. It's a four... five story building. There are 60 units in it. There is a party room that was very large and that's become the heart of the program.

MG: And the lounge would be where people could go and meet for a coffee or tea or something like that.

CM: Yeah, well, what it is, it's a very comfortable room. We were able to beg, borrow and steal furnishings, including a nice electric fireplace. We have a PSW who is the program coordinator. And she's been there since day one, and she's a real house mother if she thinks things are getting a little testy in the conversation, she'll say not in this room, out in the hall. And everybody laughs. It was the happiest place I ever lived. I moved in when my husband had Alzheimer's. And I'll tell you, it was such a happy place. There are meals three times a week that are served in the conference room. Volunteers serve the meals and it was not uncommon once the meals over the group would be sitting at a table and other people would come and join them and they would sit there for maybe an hour talking before what they did. They went away, but. The reason for the happiness is the seniors control the program.

MG: I was going to say you said that earlier on. How important is it that they were the ones who determined the services that they needed?

CM: It's absolutely important that seniors have a say in what is provided to them. You know, just recently I was just assessed for... would you like this term placement in long term care. And when she was through, she said, well, you are certainly eligible for long term care, but I would really recommend that you stay on your own. And I said, OK, but I'm going to need help with laundry. With maybe, you know, putting groceries away now, that you have to wipe everything down. And she said, Oh, I'm really sorry, we don't do any of those things anymore. If you needed help having a bath, I could provide the help.

MG: But the other things they wouldn't be able to help you with?

CM: No, but that they would put me into long term care at $187 dollars a day. It just makes no sense.

MG: What has changed during the pandemic? What has that meant in terms of the services that you would normally get?

CM: Well, we haven't been able to open up the seniors lounge. And by the way, what we're talking about that apartment owners love this program. And the reason they love it is that as they age in place, some people have severe health problems. Other people, there are a few. But there will be people that will develop dementia. And when they're living alone, the staff didn't really know how to handle that. Now they have an extra pair of hands as a professional onsite. They can go and say, I'm a little concerned about Mrs. So-and-so. She's coming down to get her mail in her nightdress and the PSW on site can say, I'll look after it for you and she'll go up and visit with the person, make whatever the necessary calls are. The other thing is the seniors in the building look after one another.

MG: Yeah. What do you think? Just before I let you go, I mean, we're coming out of hopefully the pandemic and we're coming out thinking differently about how we care for seniors. What do you think we can learn about how better to care for seniors?

CM: I just wish the government had that attitude. And the recent report had nothing to do with alternatives to long term care. They just are going to be building more of them or how you were able to keep people better at home. And home care over the years has changed from a home making service to a service, really, that's only for people getting out of hospitals and need bandages changed or need dressings changed or need, you know, their medication given to them or help with bathing, it has nothing to do with looking after seniors anymore. But I'm not going to give up. I mean, the program is expanding. Seniors are demanding something that's different. And I think this is one of the good alternatives to what we have right now.

MG: Christine, you're a force of nature and it's really great to speak with you about the work that you're doing. Thank you very much.

CM: Well, I really appreciate it.

MG: Bye bye.

CM: Bye bye.

MG: Christine McMillan is the founder of the Oasis Senior Support Living Program. She's now living in Toronto, where she helped start another Oasis program. She's 91 years old. Catherine Donnelly, that whole idea of ageing in place is something that we talk a lot about. And as I mentioned, this pandemic is forcing us, I think, to rethink long term care and how we approach ageing seniors. What is the opportunity here with NORCs?

CD: Well, it's tremendous. And, you know, I've had the great privilege, along with my colleague Vince DePaul and many other people here I represent, to expand Oasis based on Cristine's vision to eight other communities across Ontario. And so Oasis really represents a new way of looking at how we can consider leveraging these NORCs, which are all around us. We live in them maybe and we don't know it. And so it's thinking about how we can bring services to older adults to where they're already living. But most importantly, as Christine alluded to, it's, you know, how do we empower seniors to articulate what they want and so they can come together? You know, oftentimes people are living in apartments and don't know each other. And so, again, it's thinking about how NORCs can build social supports within their buildings. And it's very much based on partnerships. And landlords have been crucial to this, you know, thinking about even how we in vertical NORCs that are existing that people don't know about, you know, how can older adults get together, meet with their landlord and help to bring the space that they've got to other other older adults and bring those community supports to themselves.

MG: Cathrine Bigonnesse, why haven't we taken advantage of the opportunities that these communities are offering so that we could scale these up and help the seniors age in place where they want to live?

CB: I think it's taking a lot of coordination between different agencies that usually never talk to each other. So you have... the landlord are very important key in this whole puzzle because they are the one or the gatekeeper. They won't allow necessarily everybody to get in there and offer services. There is also the non-profit who usually also provides services in the area, but they're not necessarily aware or allowed to go in buildings. And there's a health care provider that don't think about necessary geography. They think about individual patient in a separate way. So to put all those people together around the same table and of course make the effort is a real challenge. It's absolutely possible. But it's just we have not tapped into that potential, yet.

MG: You used the word geography. And you were talking earlier about urban versus rural communities. Is this possible to be scaled up within rural communities as well?

CB: I think it is the challenge we face is everything will be a little bit more costly and it will also take a group of seniors that is really, really willing to try to implement that. And we face barriers that are a little bit different than in urban areas. So access to having a home care worker coming to your place, working in a rural area, they did travel like half of their day, just being in the car, getting to the client versus you enter in one building and you can see multiple people in a very short, short time. So that needs to be included in the way we think about those programs and how they can be sustainable in the long term.

MG: Catherine Donnally, how do you get governments to buy into these programs as a viable alternative to the long-term care models that so many people are looking at with critical eyes coming out of this pandemic?

CD: Yeah, that's a great question Matt, you know, I think I'm going to have to say with my researcher hat, it's data and stories. And so it's mobilising older adults who are living in NORCs, for instance, Oasis, that they see the value in this. And we've had incredible success. Even as we started these Oasis, people were connecting with their counsellors where their buildings were. They were connecting with their MPPs, for instance. So I think mobilizing the voice of older adults is one factor. But the second factor is we need to learn more about them. So, again, your questions are all good and we can't answer them definitively yet because we're still learning about it. And so we have research funds and we're already seeing that we have evidence to show the impact on both physical outcomes, social outcomes. But we're also seeing early data showing a reduction in health utilisation. So the more we can collect this data to show the value not just to personal health outcomes, but also to the system. And it's truly looking at saving dollars, but also making sure people are having positive experiences. So I think leveraging both those, we've just received a large grant from the Canadian Institute of Health Research. And so we have a four year research program that is going to be looking and collecting data over time to look at this long term impact of NORCs across Ontario. So we're excited that, we're hoping that gives a stronger voice to governments. But we also, again, leveraging all of the work with partners. And so those partners themselves can also be strong advocates to governments. But, you know, people are entrenched in their belief that institutions are the answers. But I would have to say communities are the solution.

MG: Well, you would think that that belief would be shaken by what we've just gone through.

CD: You would? You'd hope so. And I hope it's a new way forward, a new way to conceptualise how we can support older adults.

MG: This is fascinating to hear about. I think a lot of people are going to be wondering whether these communities are around them. As you said, people may not even know that they live in and around those communities, but also thinking about how to think differently about caring for our elders. Catherine Bigonnesse, thank you very much.

CB: Thank you, it was a pleasure to be here.

MG: Great to have you and Catherine Donnelly, thank you very much.

CD: Thank you. It's a privilege.

MG: Catherine Bigonnesse is a postdoctoral fellow with the Research Centre on Ageing at the University of Moncton. Catherine Donnelly, an associate professor and director of the Health Services Program policy research institute at Queen's University in Kingston, Ontario. Your thoughts on this? Again, this is a larger conversation that we are having as a nation about caring for our elders. You can reach us thecurrent@cbc.ca. Well, coming up after your regional update:

VOICE: Because they're committing these senseless acts of violence, in such a brazen way, in such a public area, it puts all of us at risk.

MG: We're heading to British Columbia, where gang violence is ramping up in the lower mainland. Midday shootouts are causing police to sound the alarm around public safety. I'm Matt Galloway. We're back in 90 seconds with that story. Stay with us.

[Music: Theme]

Journalist Kim Bolan on gang-related violence in B.C.; and trillions of cicadas emerging for first time in 17 years

Guest: Kim Bolan, Paula Shrewsbury

MG: Hi, I'm Matt Galloway, you're listening to The Current, the body of a man who was shot lays on the sidewalk right in front of the international terminal at the Vancouver International Airport. A passer-by takes a video showing the bullet casings laying on the ground nearby. This all happened in the middle of the afternoon on Mother's Day. Police say the shooting of 28 year old Karman Grewal on Sunday was part of a growing surge of gang related violence in very public places by people who don't care who's around when it happens.

DWAYNE MCDONALD: They've clearly shown there is no regard to where that location may be. There's no regard necessarily for security cameras or members of the public or even police. As we've seen recently, these individuals, make no mistake about it, are vying for control of the drug trade, a very lucrative illicit drug trade. And in their mind, there's money to be made. And in that line of business and given their histories, all kinds of conflict can occur.

MG: That's RCMP Assistant Commissioner Dwayne McDonald speaking at a news conference yesterday, Kim Bolan, and has been covering crime and gang violence on the Lower Mainland for decades as a reporter for the Vancouver Sun.

MG: Kim, good morning.

KIM BOLAN: Good morning.

MG: In all of your work, I mean, daylight shooting in front of an international airport. Have you ever seen anything quite like this?

KB: No, it really was unprecedented. And, you know, we don't usually say there are good things about this horrible pandemic, but honestly, there were a lot fewer people at that airport because of the pandemic. And that is a good thing. You know, we're really fearing that we're going to see more innocent people get hurt in this very public and brazen gang violence. In fact, on Saturday night, the day before the shooting, there was another one in Burnaby, part of the Lower Mainland, and a bystander was struck, fortunately not injured too seriously, and he made his own way to hospital. Well, another young man was shot dead.

MG: Just briefly, what do we know about the man who was shot outside of the airport, Karman Grewal, and the gang that he is said to have been part of the United Nations gang?

KB: The United Nations gang is a mid-level gang in B.C., but they do have international connections and they've been very successful in the drug trade here for more than 15 years now. They were formed in the Fraser Valley kind of as a rival to the Hells Angels originally. And in fact, they were mocking the Hells Angels, you know, general policy not to have non-white people in the gang by calling themselves the United Nations and embrace embracing all kinds of immigrants and people of different nationalities. So there was inclusivity in this gang at the beginning. They have had a number of high profile people arrested and killed. They've been part of a gang conflict on the lower mainland here dating back to probably 2007 and very famously were hunting another gang called the Red Scorpions and specifically the Bacon Brothers, three brothers within the Red Scorpion Gang. But they're still involved in this conflict more than a decade later. Now they have rivalries from, still the red scorpions, but also a newer gang called the Brothers Keepers here in Metro Vancouver. Karman Grewal, 28 years old, had already been involved for at least a decade. We know that several years ago, Surrey RCMP issued a public warning for people to stay away from Mr. Grewal and his associates, because at that point in time, they were being targeted in shootings and there was concern that if you were near them, you might get hit. So it's not a total surprise. He gained a bigger reputation within the U.N. over the last few years. People within sort of the underworld are telling me that they expected he would be targeted.

MG: The assistant commissioner for the RCMP, Dwayne McDonald, said that in many ways this is about controlling the drug trade. There's been a surge in gang violence, as you've been reporting recently. What is this all about? Is that what this is really focussed on? Is controlling the drug trade in this moment?

KB: Well, certainly that's why these criminal organisations exist in the first place. But I think it's a bit more complicated than that in that sometimes these guys have very personal disputes that date back more than a decade and they still want to settle scores. You know, maybe someone dated someone's girlfriend, maybe someone used to be and aligned with one group and then switched sides. So then they, you know, that's a very serious grievance that they will try to settle going forward no matter how long it takes. But definitely the drug trade is a big part of it. And, you know, we think that drug use has increased during this pandemic. I think there's some problem getting as much product, perhaps, as people used to be able to access in the criminal underworld due to the border closures. And so it's very tense out there. And these guys do not care about where they go, whether it's a mall or a busy public park, an international airport to take out a rival.

MG: When you say product, I mean, is there a connection with the opioid crisis that has been kind of roaring away in the shadow in some ways of this pandemic that we've been living through?

KB: Well, for sure. I mean, we have what are known as dial a dope lines all over the region, all over the province. Right. They operate very much like a pizza delivery service where you phone a number, you say what you want and people deliver it. And this is a model that was developed here in the early 2000s and is now used in many other parts of Canada as well. But, you know, the opiate crisis, particularly in the Downtown Eastside of Vancouver, there are drug lines there. And these criminal organisations at a higher level are controlling what is on the streets in the Downtown Eastside. And the young man that was gunned down Saturday night before Mr. Grewal, he was linked specifically to the Downtown Eastside drug trade, which is, you know, a lower level, the street level, if you will, but still has connections to mid-level gangs and in fact, higher echelon organised crime that has access to the bulk product.

MG: There are questions as to why young people in particular would be drawn into this lifestyle. Last week, CBC Vancouver spoke with Manpreet Serai, family educator for the In It Together Anti Gang program, about what is actually drawing people into gangs? Take a listen.

MANPREET SERAI: Each year our youth have had their own story of why they got involved. Well, there was a sense of belonging, identity control, others seeking protection because that they have been victims of violence, also seeking connection because their parents are away working sometimes days, sometimes weeks at a time. They have connections through their cousins and other generational gang members who are already involved in the gang lifestyle.

MG: Kim Bolan, and what do you see through your reporting as the reasons why young people would be attracted to gangs right now?

KB: Well, I think, number one, it is money or it's the belief that they will get a lot of money if they stay involved in this lifestyle. Unfortunately, many of them don't live long enough to make the money they think they're going to make. But in the meantime, you know, it's also reputation. They are able to flash around cash. A lot of them lease high rise penthouses or very fancy apartments. Again, using cash. They drive fancy vehicles. Most of them are also leased. So they're not making any real money to sustain them in the future, but they can sort of have this flashy lifestyle in the meantime. You know, I hear that they feel a sense of, you know, connection loyalty from their brothers in the gang, if you will. But really, we have seen so many of these organisations splinter and then their worst enemies often become their former friends. You know, we don't know how the shooters knew Mr. Grewal was at the airport, for example. You know, was there someone close to him that let his rivals know? So it's not really a lifestyle where people have your back. Though, that is why many of them enter it and they think they'll have these, you know, pals for life.

There are a couple of ways that people are calling for this to be dealt with. One is through the anti gang programmes that the B.C. government and other organisations are funding. Are those anti gang programmes working?

KB: You know, it's like anything. Can you tell how many people have been prevented from getting involved because of the existence of a program? It is very hard. I'm sure they are helping some people and there are some excellent programmes out there. They're also giving us more of an analysis of who's getting involved and why they're attracted to the lifestyle. And that's important going forward. But there still isn't really, as far as I know, any comprehensive province wide curriculum, for example, in the school system that would start at a very young age and show every kid that they're potentially at risk if they, you know, head down this path. A lot of them are volunteer programmes and they may be going to schools a few times a year. They're good. I do think they steer some kids away from this lifestyle, but I don't think it's enough. I think that, you know, many of these guys... you see brothers all in one family, you know, one gets involved, maybe goes to prison, maybe dies. It's not stopping the other two from getting involved. In fact, one of the sort of more high profile people who was gunned down April 17th, Harb Dhaliwal with the Brothers Keepers gang, people around him were pledging revenge on social media instantly. And after the airport shooting, which was a rival of the Brothers Keepers who died, there were people in the Brother's Keepers posting on Instagram. We will kill 100 people using slightly different language in retaliation for Harb's murder. So they were suggesting that this airport shooting was a direct retaliation for this murder outside of a busy Vancouver restaurant on the harbour back on April 17th.

MG: And so in the wake of that being brazen, we just have about a minute or so left. But there's also calls for police to crack down harder on this. And you were tweeting, saying that some police have been telling you that they're frustrated. Why?

KB: Well, I think front line officers are... they know who's involved. And, you know, there's a big gap between knowing who's involved and being able to get charge approval, which is, charges in this province are laid by crown counsel. So sometimes you'll see a major investigation looking at one of these gangs or their drug connections and the investigation and there are search warrants executed. And then two to three years later, there's still no charges laid. So I think people get frustrated who are directly involved, police officers and analysts, because of that big lag time. And, you know, there's just no message being sent to these people involved in the gun violence that there are consequences and that the consequences are immediate.

MG: You expect to see further violence?

KB: I hate to say yes, but it certainly looks like this is going to continue.

MG: Kim, it's great to talk to you about this. Thank you very much.

KB: Thanks for having me on.

MG: Kim Bolan is a crime reporter with the Vancouver Sun. Just last week, she was recognised with a lifetime achievement award by the World Press Freedom Canada Organisation.

[Music: Upbeat music]

MG: You're listening to The Current on CBC Radio One. My name is Matt Galloway. Yesterday we talked about a pandemic poetry project. It's called the Global Vaccine Poem. It's inviting people to write poems about getting the vaccine. And without fail, you sent us mail. I'm just beginning, Karin. Karin Marley, senior producer of The Current, here to go through some of your poetic submissions. Karin, good morning.

KARIN MARLEY: Good morning. Let's start with Pat MacLane-Batstone of Sheet Harbour, Nova Scotia. When the sky turns green and the earth spins gold, when the elephant climbs the tree and the fires of sun are cold, then look sharp. A man can change his destiny.

MG: This is from Bonita Moore of New Brunswick. Oh, covid. You continue to break my heart. In 2020, your virulence cancelled a wedding. You pushed your bullying way into 2021. We cannot travel to relish and delight in the birth of our first grandchild. I will not be there for his mother and father to cook and clean and support. No soft creeping to check on my grandson, to watch him nestled in his cradle, protected from the world. We await you, dear vaccine. The world's defender, scientific champions, technological brilliance, sanctioned and accepted to penetrate arms, travelling through our hopeful bodies, ready to fight battles, vaccinated to make us stronger, encouraging us to work together, allowing us to travel to loved ones, to hug and hold hands that have been forsaken for too long.

KM: Here's one from Adex, who's in Montreal now, but is originally from St. Lucia. Can you hear me? As I stand on the shores of the Caribbean under a state of emergency since March, unaware of the horrors to come, can you hear me as we suffer under your rule, under your thumb of laws, rules and protocols seemingly never ending and cruel. Can you hear me as I leave these shores for another jurisdiction? Oh, Canada, let Quebec be my home. I droll, but it's too soon as even here you rule. Can you hear me as I lose my father to covid-19 and no underlying health conditions. How cruel I am unable to travel for those laws, rules and protocols. I say goodbye via Zoom. Can you hear me as I stand at the Olympic Stadium in line for my prick, in line for my humanity. In line to play my part to end your rule. Can you hear me as I have hope to end your laws, rules and protocols that you have brought to us. Can you hear me as I see science ending your rule, can you hear me as I call you to end your rule and your rule?

MG: This from Gunes Ege. Who is a doctor and writes. O covid-19 thou be not proud, lurking amongst us a big dark cloud tearing peace and life asunder gleefully our norms to plunder our saviour vaccine parts the cloud. The joyful chorus is clear and loud as we are lifted to new heights from languid days and sleepless nights to embrace once more those near and dear and breathe and sigh with no more fear.

KM: And finally, here's one from Mary Ellen Chown of Oakville, Ontario. Dear vaccine, for too long I've been a goldfish circling a small bowl, a goose hissing at danger near my brood, or a spider fretting my carefully spun webs rent in this storm at midnight. I'm a mosquito playing vibrato on the E string, a loon wailing for those I cannot touch a doe in strange woods, twitchy. Vaccine please bring me back to my anthropoid self. A woman who wakes without dread to a day rife with possibility.

MG: That's how I feel some days. A goldfish circling a small bowl. Thank you, Karin.

KM: You're welcome.

MG: Karin Marley, senior producer on The Current. We received many, many more of your poems and we hope to read them on The Current in the days to come. You can write to us about anything you hear on this program. The email address is thecurrent@cbc.ca. This is The Current. My name is Matt Galloway.

SIR DAVID ATTENBOROUGH: After 17 years, underground, creatures are staring. The nymphs of the periodical Cicada have been biding their time. Now they march like zombies towards the nearest tree and start to climb.

MG: Sir David Attenborough bringing the drama there. Those zombies that he's talking about are cicadas, cicadas in the UK, periodical brood cicadas, to be precise. Trillions of these insects are about to emerge after a long slumber in the soil of the northeastern United States. They are known as Brood 10. One alone can sound like this.

[Sound Clip: high pitched sound].

MG: Bring them all together and the sound is almost deafening. Paula Shrewsbury is professor in the Department of Entomology at the University of Maryland.

MG: Paula, good morning.

PAULA SHREWSBURY: Good morning, Matt. How are you?

MG: I'm well, thank you very much. I heard an entomologist yesterday described this as cicada palooza. How much excitement is there in the insect world about this event?

PS: There is so much excitement, we are looking forward to the cicada palooza for sure in College Park where our campus is the cicadas have started to emerge and everybody's so excited and out at night walking the streets, looking for the cicadas, just enjoying the biology and the ecology as it happens right in our backyard.

MG: So I have some questions about all of this. One is, why have these cicadas been underground for 17 years?

PS: They've been underground for 17 years as amateurs and they've been developing and they feed on xylem sap, which are in the roots of plants, and xylem is known to be a nutrient poor resource. And we think that maybe because they feed on that poor resource, it takes them longer to develop. And plus they, by living for so long or staying underground for so long, they can outlive their predators. So when they do come up, their predators don't remember that they were there. So the predators can't track them. So it's all about survival.

MG: And then when they come up, I mean, how do they decide that now is the right time to emerge to.

PS: Good question. And we don't really know how they tracked the 17 years. We think maybe they tracked seasonal cycles in the trees that they're feeding on and they can track the changes and they're able to count to 17 years or we think that they may have some type of biological or molecular clock in their little brain. And like we have biological clocks. I wake up at five thirty every morning without an alarm. I think maybe potentially cicadas can do that, but they're at a 17 year clock.

MG: That's amazing.

PS: It's very amazing.

MG: And so when the clock goes off and they come out, I mean, we heard, you know, the BBC Earth description of it with the zombies. I mean, what does it look like when these insects emerge?

PS: Oh, it's amazing, it's amazing you can be standing there in your yard and you will see billions of cicadas coming up out of the ground and it's been estimated because they make holes right now, they're in the soil, burrowing holes, getting ready to emerge. And when the soil temperatures reach 64 degrees, that's the cue that they need, that it's time to emerge. And then we'll have this mass synchronous emergence where they merge by the billions. And it's been estimated by the number of holes that we can have up to 1.5 Billion per acre. And you're standing there and they all started merging and they start around dusk and they start climbing the trees and any other vertical structures because they want to go up in the trees. And right away, they shed their skins and moult and come out as adults. But if you're standing still, they'll crawl up you because you're a vertical structure. And as an entomologist, that's really exciting.

MG: Sorry, it's exciting to have the cicadas climb up you?

PS: Oh, yeah. It's just kind of a cool, eerie but exciting feeling. So I'm sure most people don't feel like it.

MG: What does it sound like?

PS: Well, the only ones that make the sound are the adult males and the males make this sound quite loud and the louder they are, the more females they can attract. And they've measured that the loudness of it, and they estimate anywhere between 80 and 110 decibels. So that's about the equivalent of a lawnmower or a jet aeroplane flying overhead. And actually, we've had jet aeroplanes going overhead in the cicada, coursing in the trees gets louder like they're competing with the aeroplanes or with lawnmowers going in people's yards. So it's pretty interesting in that way.

MG: And that's the call for mating. And so I guess once they're out, that's kind of the purpose of life in some ways is to try and find a mate?

PS: Yes. That's exactly it. The purpose of life, of, I guess everything is to mate and carry on your genes to the future generations. And insects tend to do that more obviously than humans do. And their main purpose is to attract a mate. They mate with the females and the females will go off and lay eggs in the twigs of trees.

MG: Having spent 17 years underground and then emerging, how long do they live once they are on the surface?

PS: That's a good question. And it's pretty interesting because 17 years is immature, is down there in relative isolation, kind of a covid like existence. They come up and individual cicadas, once they're up and on the tree, will live anywhere from two to four weeks. But because they emerge over a two or so week period, we will have cicada adults active up in the trees about six or eight weeks.

MG: And you mentioned the females laying the eggs and that the eggs then would drop back down and start this whole cycle again.

PS: If the female has a little... her ovipositor has a little saw-like structure on the end. So she makes these slits in the pencil sized twigs of trees, insert her eggs, and then after about eight to 10 weeks, those eggs will mature, they will hatch. And the first stage in matures are about the size of a rice grain and they'll drop from the branches. So it could be from a small tree that's like five feet above the ground or could be from a large tree that's 50 feet above the ground. And they'll drop down and these little rice sized immatures will burrow their way down into the soil and start feeding on roots and start the next 17 years underground.

MG: What to you, just finally, is most fascinating about everything that you have just described? All of it is wild. But I mean, to you, as somebody who studies this, what's most fascinating about this?

PS: I think the most fascinating is the long life cycle, and there aren't many other insects that have long life cycles like this. And then the other part is, there are cicadas on every continent in the world, but only in the eastern United States are there 13 and 17 year life cycle cicadas. So that's pretty unique in itself. So living in Maryland and having the opportunity to experience this is great.

MG: Do you know when the cicadas will arrive?

PS: They are starting to arrive already. The Brood 10 cicadas will come out in 15 of the eastern United States and so far they've come out in Georgia, North Carolina, Tennessee, Virginia and Maryland. And I just found my first cicada in my yard this morning. So that was very exciting. And like I said, we've had them on campus emerging, but we call these the early risers. So there's always some that emerge now before the mass synchronicity emergence because, you know, there are microclimates and the temperatures are patchy. But the ones that are emerging now that we've seen, they don't make it through the night or the next day because the predators are there and they eat them all up. So we see lots of wings and half eaten bodies on the ground. But once the mass synchronous emergence happens where you have billions and trillions emerging within a very short time period, there are so many cicadas, every predator can eat their bellies full and there will still be enough cicadas left to carry on the population. And we call this, it's their defensive strategy. It's called predator satiation and it's all about the numbers.

MG: What an incredible thing to see in front of your very eyes, Paula. Enjoy the emergence of the cicadas. Thank you very much.

PS: Thanks, Matt. Try to get down here and enjoy it, too, if you can.

MG: It's the kind of thing I mean, without this pandemic and the ability to cross the border, you can imagine that people would actually want to come and see this thing unfold.

PS: Oh, yes, totally. And we've had people from California call and want to know what date they should plan their trips to come out here so that they can experience the cicadas.

MG: Amazing. Paula, thank you very much.

PS: All right. Thanks, Matt. Take care.

MG: And you, Paula Shrewsbury, professor in the Department of Entomology at the University of Maryland. That is The Current for Tuesday. Coming up next on CBC Radio One, it's Q. We thought we would leave you today with a more soothing take on the sound of billions of cicadas humming. This is Feist, a song called Cicadas and Gulls. I'm Matt Galloway. Thanks for listening to The Current. We'll talk to you tomorrow.

[Sound Clip: Cicadas and Gulls by Feist]

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