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The Current Transcript for October 20, 2021

Host: Matt Galloway

STORIES FROM THIS EPISODE

Prologue

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Wait until it happens to you and tell me you don't want a house like this. You need houses like this. You talk about people on the street sleeping on the street. We'll get off your arse and give them a room.

MATT GALLOWAY: In a country where home prices are skyrocketing and rent is climbing drastically. Rooming houses are often the cheapest housing out there. Renting a room and sharing a kitchen and a bathroom can be a lifeline for those struggling to make ends meet. They're also politically toxic in many communities. In 30 minutes, yes, in my backyard, the role that advocates say rooming houses could play in addressing Canada's housing crisis. Also this morning, Jonas Bendixen is an award winning photojournalist who has travelled the world telling stories through his camera. His latest collection is unlike anything he's ever done, though.

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Can one average, geeky photographer like myself go into his basement and generate fake characters, a fake storyline, a fake documentary. I decided I want to try to do that.

MG: Truth, fakery and whether you can really believe what you see in an era of fake news. That's coming up in an hour. But as world leaders get set to meet and discuss the climate crisis, we start with a new old idea for making buildings more sustainable. Good morning. I'm Matt Galloway and this is The Current.

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Could building big with timber be better for the environment?

Guests: Michael Green, John Talberth

MG: Next month, tens of thousands of politicians, diplomats, activists and scientists will gather in Glasgow for the COP26 climate conference. That meeting is being billed as humanity's last best hope to prevent the worst effects of climate change. On this programme, we have promised to bring you stories about the science. What's at stake and introduce you to the people who are working on solutions. Architects are some of those people, since building materials like concrete and steel are a major source of CO2 emissions and just steps from the Toronto waterfront. There is an attempt to find a sustainable alternative.

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We're just beginning we're just beginning what is close to a three year journey to to build this building, so exciting for us. And so as you come through these areas of more metal and glass buildings. You will come up against the armour and start to see from this perspective. Timber is very large ones rising up right in this corner here. So my name is Carol Phillips, I'm a partner at Moriyama & Teshima Architects, and we have been working for close to four years now, together with a collaborating team on the Arbour for George Brown College. The Arbour is a 10 storey exposed mass timber net, zero carbon emissions, new teaching facility for George Brown College here on the waterfront. So mass timber really is the putting together of smaller members of timber, either Dowling them together, laminating them with special glues, putting them under pressure until they accumulate enough mass to become larger scale structural members. So in the past, you might imagine people used to cut down old growth trees and use those and their structural and natural structural integrity of a tree. What we're doing now is we're using smaller members and leaving the old growth alone. So much of the construction industry is extraction based. It takes geological millennia to form stone and rock trees can be grown back. And if we're managing our forests in a sustainable way, we can harvest trees responsibly and keep replacing and replenishing them. The arbour is going to be made out of something you recognise. It is built out of the trees that and the timber that we all associate with the great forests of Canada. And I think that when you walk into the arbour, you will immediately be struck by by something familiar and also feel very much like you're in a way in a forest at the edge of the water, which this was.

MG: this Carol Phillips of Moriyama & Tashima architects. Projects like the Arbour are something Michael Green has been advocating for for years. He's an architect in Vancouver. He uses mass timber in many of his projects, including one underway right now in California for Google. Michael, good morning.

MICHAEL GREEN: Good morning.

MG: Carol, gave us kind of the little thumbnail sketch there, but just briefly, what is the difference between mass timber and wood? What are we talking about here?

MICHAEL GREEN: So mass timber is is, as I said, sort of gluing together small pieces of wood to make huge panels of wood. So these are panels that can be, you know, 12 feet wide and 60 feet long and various thicknesses, but up to 12 inches thick of of laminated wood. So imagine jumbo jumbo plywood, it's a good way to describe it would put that together with beams is how we build them.

MG: And what excites you so much about about building with mass timber?

MICHAEL GREEN: Well, there's a whole host of reasons for the top reason for me is that it's it's currently the best tool we have to address climate impact and in the building materials for a large building. And what I mean by that is, as mentioned, steel and concrete have these huge carbon footprints. They're good materials. We just need to use a lot less of them until they become more, you know, more green as they may someday become. And for now, wood is a much more green alternative. Although not a perfect solution, it's a much better solution.

MG: One of the things that you're involved in is building tall structures from wood. What is it about mass timber that allows you to do that?

MICHAEL GREEN: So what's important if you think about it as many, if not, you know, the vast majority of Canadians live in wooden homes, they're made with what we call dimensional lumber two by fours, two by sixes you might see and at the local hardware store. When we start building bigger buildings, not suburban scale buildings, but very tall, very large buildings, the materials have to be much more robust. They have to be more resilient to fire. They have to be more resilient to earthquakes or high winds. And we need to use these much stronger materials. And so mass timber sort of unlocks the capacity to build big wood buildings safely in more dense urban environments. And part of our climate goal is to move people, you know, keep people living close together in more dense communities so that we're not travelling long distances and increase decreasing our carbon footprint in that way.

MG: And this material is safe to build those tall buildings with. I mean, again, part of that, I think, is getting people to think differently about it. They assume that if you're building, you know, 20 30 storeys up that you need steel, you need concrete and you're suggesting that mass timber can can work in that environment.

MICHAEL GREEN: Yeah. So we have projects right now underway at 35 stories tall and wood. We've been designing them for a long time. We haven't built one yet, but they're they'll come soon. And we've actually done analysis to see that you could have built the Empire State Building, which is 102 stories tall, entirely in wood. So it's a public perception point of view. You know, it's sort of we're just not used to the idea. But what is incredibly strong and part of the reason is that it's considerably lighter than steel and concrete, so straight way that actually, in many respects, it's stronger than steel.

MG: Is it a strange question to ask about fire and fire resistance?

MICHAEL GREEN: Yes, it's a great question. Totally reasonable. The good way to think about it is these products are very thick, very large, and as a result, it's a little bit like if the audience sort of imagines taking a big log and I hand you a letter and say, like that log on fire, you probably know enough about building a campfire that you know you can't do it. You have to start with training pieces and work your way up until eventually, you can put the big log on. These mass timber products are a little bit like that big log. They just have such a huge mass to them. They're very difficult to catch on fire. And if they do catch on fire, they burn very slowly and very, very predictably, which allows us to manage fire much the same way as we might in a concrete or steel building.

MG: What do you see is the opportunity for industry here? I mean, George Brown, the Arber. There's going to be a tall wood research hub. There is a plant that is in St. Thomas, Ontario, that's manufacturing mass timber products. So what is the opportunity here, do you think?

MICHAEL GREEN: So I live in British Columbia and obviously our forests and our forestry industry has been pushing this idea for a while because it's a huge value add for our communities to make these products and not simply sell logs off offshore. That's true, coast to coast in Canada, we're a timber nation. It's one of the four corners as you enter into parliament that forestry is one of the four cornerstones of our history. And and so there's a huge opportunity for us to use this resource if we use it wisely. And that's a big if. And there's a lot that goes with that statement. But if we use it responsibly, we use it wisely. It's an opportunity for us to grow our cities, grow our buildings instead of using huge carbon resources in order to work to make steel and concrete buildings.

MG: I guess we're all just fine on that point. You mentioned the forest industry. I mean, there are people who are wondering, you know, whether the industry is pushing something like this and whether this is a good idea for the climate to chop down forests for new construction, given what forests offer in terms of being carbon sinks and the the role that they play in helping to mitigate climate change.

MICHAEL GREEN: Yes, and I think it's a really important and really complex issue, because in many parts of the world, keeping the forest in the forest is much more important. And that's true in parts of Canada as well. And the forest is under threat because of climate change, making this even more complicated issue. But our forests can be maintained sustainably. We do have a regrowth programme that is regenerative enough that we can do this safely in volume. But whether it will always be able to do that safely and volume depends very much on what happens with the rest of climate change. So, the formula is basically that trees are soaking up oxygen, storing carbon, locking that carbon when we put it into these products, into the building. The two things we do to counteract climate change are effectively reduce our carbon by not using heavy materials like steel and concrete and then store carbon and wood does both those two things. And so if we do it wisely with good forestry, we can we can make it a sustainable solution.

MG: I'm speaking with Vancouver architect Michael Green. Stay with us, Michael. I want to bring another voice into our conversation. John Talberth is president and senior economist of the Centre for Sustainable Economy. We reached him this morning in Port Townsend, Oregon. John, good morning to you.

JOHN TALBERTH: Good morning. Good morning, Mike.

MG: How are you doing? Let me just get your reaction quickly to what you've heard from from Michael Green. What are the concerns that you might have about mass timber as a sustainable solution in building the buildings that we need to house people in our cities and communities beyond the cities?

JOHN TALBERTH: Well, with respect to claims about climate benefits, I disagree with all of Michael's statements. The idea that we can cut down our forests and turn them into two by fours and build our way to a stable climate is absurd, and it's just another one of these false narratives of big timber corporations are using to get us to buy more of their product and continue to subsidise their record profits. Just like Big Oil, Big Tobacco, Big Pharma, the natural gas industry. You know, the list goes on. These false narratives created by big timber to sell more of its product are leading us in a fundamentally wrong direction from the standpoint of climate stability and, frankly, human well-being, because humanity really needs hockey for us, for our survival and not the damaged and degraded lands supplying mass timber and cross laminated timber markets right now. And so there's two real key points to to to remember in this argument. The first is about carbon intensity, or tons of greenhouse gas pollution per ton of product delivered to the construction gate. By the time a tonne of steel arrives, on average, it's about 1.85 to two tons of carbon dioxide has been added to the atmosphere as a result of the production process for cement. It's about a tonne right. But for the logging and wood products sector, the values appear to be much, much higher. And there's a lot of ongoing studies on this right now, but they're in the range of seven to 18 tonnes of CO2 released per ton of lumber delivered to the construction site, at least for the states we've looked at. And this accounts for the deforestation related effects of logging, which is primarily done through clear cutting. For these for these products, at least in the U.S., the Dr. William Pneumo of Tufts says that logging emits more carbon than the residential and commercial sectors combined each year. So that's one point in the claims about cutting emissions with wood. Buildings don't seem to hold water at all. And that's only half the story. The other half is how these industrial tree plantations that feed markets for silt and timber are making the land more vulnerable to climate change. The plantations that are being used to create these markets are more susceptible to wildfires, flooding, insects, disease, wind damage, landslides, harmful algae blooms than the natural forests they replaced. And so these stressors are already in the rise due to climate change. Timber plantations make the effects so much worse.

MG: What are we meant to do? Because we have a growing population, there's a lot of building that's going to need to be done. We know that steel and concrete are huge emitters, the production of steel and concrete, huge emitters of CO2. So is it really better to build a steel and concrete? What's the way forward then?

JOHN TALBERTH: Well, as I said, steel and concrete, the carbon intensity seemed to be lower than conventionally produced timber.

MG: But that seems to be a low bar. I mean, they're still producing a lot of CO2 from those sources.

JOHN TALBERTH: But so here's what I tend to get calls from architects every day wanting to do the right thing, who are finding it hard to swallow all the propaganda about seal team mass timber. Here's what I tell them. I tell them if you want to build a stylish building with wood, minimise its carbon footprint by first looking for reclaimed lumber. Second, by considering bamboo and alternative building materials that are produced on farmland, not forest land. Third, by minimising the size of the structure, we always build way too many structures and structures are usually oversized and can't even be fully rented out. And then fourth, by ensuring that all the wood that is used comes from sustainably managed forests managed with climate smart or climate sensitive techniques that simultaneously achieve four key objectives reducing emissions, increasing sequestration, increasing storage on the land and carbon storage, and improving the land's ability to withstand climate change. Alternative logging techniques like variable density, thinning and long rotations are the best way to do that in very few of any mass timber buildings are built with these techniques right now.

MG: Michael Green John isn't the only environmentalists will say that it's more important from a climate point of view to let these forests grow, and he's pretty pointed language saying that, you know, this is propaganda from the forestry industry to say otherwise. What do you make of that?

MICHAEL GREEN: Well, yeah, I disagree with a fair amount of what was just said, and it shows, I'm sorry to say, a lack of understanding of our actual human need globally about the way we build buildings. Bamboo, for instance, is not structurally a material that can actually satisfy the demand of three billion people that need a new home because it doesn't build large buildings. And we unfortunately do need to build large buildings to meet that human need. The carbon story, I also think, that's one interpretation of it. But there's an enormous amount of studies, not from independent studies, including the IPCC on climate change or as well as support from folks like the Sierra Club and and others in the environmental movement. The World Wildlife Federation, who support the science that says that wood solutions and building actually are a part of the formula. It's one of the recommendations that will be part of the Glasgow COP26 conversation from one of the solutions and buildings that is recommended actually by science. So I'm not sure that that's a universally held position about the carbon story. I do think it's an important issue to study. I think it's important to hear from contrarian views. I value that, but I don't necessarily agree with what was just said as a full picture of the story of what we need to do. I am an architect or not, of course scientists. I'm not an advocate for forestry. At the moment, that steel and concrete are better for the environment than wood. I would be happy to use those materials in preference. I want to use as an architect the materials to help us satisfy this very desperate human need to reduce our global carbon emissions. But currently, there's no question that the ability to store in wood is a renewable resource as compared to fossil fuel based steel and concrete means that we have to stay with renewables now. We also need to do a whole bunch of other things around the forest, which is not the forest and areas which are causing massive climate change, for instance in the Amazon or in Africa. Those are areas where these solutions do not work because the forest is fragile. Deforestation is a huge component of climate impact, and we don't want to use these same solutions everywhere in the world.

MG: We just have a few minutes left. I mean, what does this tell you when you take a look at how complicated this is? What does this tell you about the scale of the challenge that we face in trying to figure out how we're going to build the buildings that we need to build?

MICHAEL GREEN: Right, so I think we are in an and and situation, unfortunately, we are doing our best. All of us in every industry, not just building industry, building industries, almost 39 percent of global emissions. So it's a really critical industry to figure out. But what we need to be looking at is what is the best alternative, not necessarily the perfect alternative. We need to keep working towards the perfect, perfect alternative to throw away better alternatives simply because they're not perfect. Unfortunately, we've run out of time. We've got eight years to have global emissions eight more years. This is the plan that will be discussed at COP26 and by 2050, we ought to be carbon neutral to get there. We're going to have to employ these solutions and we have to do them responsibly with really, really responsible forestry, which is again, not something you can do everywhere, but it is something we can do here in town.

MG: John Talberth just before we run out of time in the last minute or so that we have. What does this say to you about again, the challenge that we face and some of those hard decisions that are going to be faced at COP26 in a month's time?

JOHN TALBERTH: Yeah, I think it's important to do sustainable forestry everywhere, not in select locations, as Michael suggests, and we can do it everywhere. And in fact, doing sustainable forestry like long rotations mean that we could actually have more wood per acre that come off when we actually start growing big trees instead of burning a bunch of small trees and woodland together. So I think there are solutions like long rotations and alternative to clear cutting are out there that could satisfy all our our building needs. And you know, we're not going to we're not going to get there as long as we have advocates for mass timber and cross laminated timber out there claiming that these are climate solutions because they're not. It's another false narrative from big timber, just like big timber is out there telling us we need to cut down forests to reduce wildfire risk. No, the scientists say it's actually increasing wildfire risk. The big timber is out there saying, we need to cut down trees and burn them for energy. The science are saying no, that's not a good option, either. So we really need to take pressure off our forests and look for alternative building materials like concrete that does absorb carbon dioxide. These help create made out of hemp. Believe it or not, bamboo can actually be put together in the structurally with high structural integrity beams to make taller buildings. So these alternatives are out there that what we what we need is to have advocates like Michael stop focussing on seal team mass timber realised that, you know, we're we're creating mass extinction through creating these mass timber plantations across the landscape to feed these wood here.

MG: We'll leave it there. This is fascinating and I think more to come. Certainly, Michael and John, thank you very much.

JOHN TALBERTH: Thank you for having us.

MG: Michael Green, an architect in Vancouver. John Talbot, the founder of the Centre for Sustainable Economy. Coming up after your news, more on housing. We're going to look at rooming houses across this country that's on the current on CBC Radio One.

Threats facing rooming houses and those who rely on them

Guests: Andy Yan, Elizabeth McIsaac, Tom Ermidas

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

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MG: Still to come on a September evening in the south of France, some of the world's greatest photographers attended a prestigious photojournalism festival, and they were shown pictures taken in the town of Veles, Macedonia. To the dismay of the man who took those photos, not a single person realised that they were fake. I'll speak with him in 30 minutes, but first, when a room becomes a home.

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MG: From Vancouver to Toronto to Halifax, people in this country have been feeling the housing crunch. Rents have skyrocketed. Prices to buy have bordered on the absurd in some cities. One of the few low income housing options left in some big cities are rooming houses. Tenants share a kitchen, washrooms and living spaces. Their rooms are private. But these days, even rooming houses are getting pricey and scarce. Have a listen to Greg Martel, who works at the Souls Harbour Soup Kitchen in Halifax.

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VOICE 1: How are you?

VOICE 2: Not bad. How are you doing?

VOICE 1: So good to see you, Man.

GREG MARTEL: People that I know, they don't know where it is that they're going to be in six months from now because rents keep going up. It seems to be that they have been forgotten about.

VOICE 1: Meals? Whatever I can give. Love with love.

VOICE 2: Oh, and both your mother, did you want me to give you some for her as well.

VOICE 1: Yes, please. Thank you, sir.

GREG MARTEL: Yeah, I have lived in rooming houses and at the times that I've lived in rooming houses of 550 a month was like basically everything included, like my laundry. But the only thing is is that they're guests that are coming to me and one or two guests are paying up where of $950 to $1000 a room here in the Halifax atrium area, for a room. Some of the places around here are like cockroach infested. We need somebody to help. And again, the places, some of the places where people live, they're afraid to call the tenancy board because if a place is condemned, then that literally puts them with no place to go.

VOICE 1: See you later! Stay safe.

MG: In Toronto, there are only legal in certain parts of the city, mostly in the downtown. Toronto City Council has put off a vote to legalise rooming houses across the GTA. Many exist. They're just not licenced. We'll dig into the tensions over legalising rooming houses across this country in a bit. But first, I am in Parkdale, a Toronto neighbourhood that has seen a lot of dramatic change in the last few decades. It used to be that rent here was cheap. Place is full of newcomers, artists and low income people looking for a place to call home. Tom Ermidas is a longtime Parkdale resident. He lives in a licenced rooming house run by an organisation called Quota, and they support adults with mental health challenges. Tenants usually pay somewhere between five hundred and seven hundred dollars a month for their rooms and meeting up with Tom on the porch of his home. Tom? Matt Galloway. How are you?

TOM ERMIDAS: I have two mikes like that. Yeah.

MG: So Tom, why don't you describe where we are right now?

TOM ERMIDAS: We are busy at my new address, which is a great place, and I lived here 15 21 Queen Street West a long time ago. And my living conditions are a million times better. I can't- I can't say, you know anything bad about it. It's grey here.

MG: Can you describe what it's like inside? We can't go inside but describe what those living conditions are like inside this building?

TOM ERMIDAS: Well, it's basically seven or eight guys that live here. We have staff on call. We have security. We have our own cooking like we can cook ourselves. We have our own rooms. We have showers in them, so we're self maintained.

MG: What is your room like?

TOM ERMIDAS: It's big enough for one person compared to where I've lived before, it's a million times better.

MG: What do you like about living here, here?

TOM ERMIDAS: The the the staff are always there for you. You know, if you need help, you're there. The people that live in the building, we get along. Some of us have our issues, but you know, we work it out. You know, if they had more places like this to help people, it would be a lot better.

MG: If you weren't in a house with the other options, be in terms of somewhere to live.

TOM ERMIDAS: I'd be dead.

MG: Why do you say that?

TOM ERMIDAS: That's being honest. I'd be dead. Well, for one, I wouldn't know where I am. And for two, I'd panic, and for three, I just cut my throat. That'd be the end of it.

MG: So this is a life saving kind of place for you.

TOM ERMIDAS: To me, it's more than a life saving, you know, I mean, like, I'm in an area where I know people know me around here and I've been here basically all my life, you know? So it's like a godsend. For a lot of people, like a lot of people look at people that have issues with their mind or whatever, and they they look at them and look down on them. You've got to remember one thing, you could be that person. Don't look at them and look at them with disgust. Look at them as another human being with a problem, and they're trying to get help. A lot of times people don't do that.

MG: You mentioned that this place is better than places that you lived in before. I mean, describe what the rooming houses were like that you had been in before.

TOM ERMIDAS: 1521 was a room shared washroom. You had drugs going in and in and out all the time. Here you don't have that problem because we were really maintained on that way. So there's no show for any sort of narcotic other than prescription.

MG: You mentioned you had a shared washroom. I mean, what was that room like in

TOM ERMIDAS: that the other place, 1521? I'd like to see it my way, but..

MG: What's your way of saying?

TOM ERMIDAS: It was disgusting, a shithole? And I mean that literally it was run as a hotel illegally. You had four four, eight, 12, 16... 16 to 20 rooms on that floor on one floor. And it was like everybody was battling, you know, like fighting and the drugs that went in and out of there were like water.

MG: Why would people, I mean, given how rough it is there, why would people stay there, do you think?

TOM ERMIDAS: why would people stay there? Because the rent was cheap. A lot of places ask you for first and last. You didn't pay first and last.

MG: People couldn't afford to pay first and last,

TOM ERMIDAS: That's right. That's the biggest reason. You know, when you can't afford to pay first and last and you get the option, OK, it may be a crappy place, but you've got to have your head put somewhere.

MG: Do you worry? I mean, this is a big, big building. And I mean, this city is really expensive now, and you take a look even across the road, they're doing renovations there. There's a lot of money in this neighbourhood and people are renovating and turning houses like this that are split up into one big family house. Do you worry about that, that a building like this could be valuable in somebody else's eyes?

TOM ERMIDAS: It is valuable in a lot of people's eyes. The houses around here are not cheap.

MG: One of the other things is just that there are people in some neighbourhoods who don't want houses like this near them. What do you what do you say to those people?

TOM ERMIDAS: Wait until it happens to you and tell me you don't want a house like this in your neighbourhood where you get help. You need houses like this. Give them something to give them to lift their spirits. Sean, there's somebody out there cares, but a lot of people don't. A lot of people don't care. That's the whole problem with the society.

MG: Sounds like he landed in a good spot.

TOM ERMIDAS: Yeah. Very good. I'm very happy to be here. If I didn't get this, I would probably be dead by now. That's being very, very honest.

MG: I'm glad you're here, and I'm glad to have the chance to talk to you. I'll let you back to your coffee.

TOM ERMIDAS: It's always hot water.

MG: It's cold by now.

TOM ERMIDAS: Thank you very much. I appreciate you guys coming down.

MG: Tom Ermidas is a long time resident of the Parkdale neighbourhood in Toronto, that rooming house the Tom lives in is licenced. Many others in Canada are operating illegally and those can be dangerous places to live, even though they are vital homes for many people. Elizabeth McIsaac is president of Maitri Charitable Foundation in Toronto that focuses on human rights and poverty. Andy Yan is an urban planner and director of the City Programme at Simon Fraser University in Vancouver. Good morning to you, both.

ANDY YAN: Good morning.

ELIZABETH MCISAAC: Hi, Matt.

MG: Elizabeth. What were you thinking as you heard from Tom?

ELIZABETH MCISAAC: Oh, I mean, he told such a compelling story and and I was taken by. I think what he really focussed on was our ability to see the dignity in each person. When when he talked about this just being a lifeline, a place that he can live, that that allows him to to to live and thrive. But I think the way that he spoke to, you know, people seeing you are not stigmatising you because of where you live or because of the health issues you might have. I thought that really cut to the core of how are we thinking about how we do land use planning and ensuring that there's houses and homes available for everyone?

MG: And ask you more about that in a moment. Andy, we should clear up some technology because in many parts of this country, shared housing is often referred to as a rooming house in Vancouver. They're called rows single room occupancy. How important are SROs to Vancouver?

ANDY YAN: Well, with the case of arseholes in Vancouver, they're really the last step of private market rental housing for their residents before homelessness. But it's important to understand that as that last step, it's actually a very uneven step in certain cases. There are an example to watch Dickensian levels of poverty in a modern Canadian city. And yet, at the same time, there's the other part of that spectrum where they really have when they're struggled and they're still running that they still that they provide a sense of community and connexion for their residents.

MG: And again, these would be options that would serve people not served by other forms of housing in the city.

ANDY YAN: Very much so that it is the last example of really private rental market housing that is available for those that are in desperate need of housing.

MG: Why Elizabeth is there a division in Toronto over where rooming houses are legalised and where they are not?

ELIZABETH MCISAAC: Well, I think it's it's good to take a step back and be clear that that what what what Tom was describing was a non-profit run legal rooming house. So there's support it there, supports that are in place. It's what we called supportive housing, which really allows people to live independently and have that. What we're looking at in Toronto is a much broader sort of more generic sense of what are multi-tenant houses. And so it includes the kinds of things that Tom described, but it also includes houses, perhaps in Scarborough, in the suburbs, in the inner suburbs that have up to four rooms available. And it's not just people with health issues. It might be students, it might be newcomers, other people on low incomes. It might be someone working on minimum wage because we know that that doesn't go far enough to cover 4500 or $1500 a month. It might be someone who is seeking social assistance or the a disability pension. So. So there's a wide range of people that this form of housing may serve, and it looks different in different places. They're not always going to be 12 to 25 people very often, and this is where we get a little bit of, you know, unevenness across the city. It looks different and neighbourhoods are sort of bringing or are experiencing them differently.

MG: There was an anticipation that Toronto City Council would allow rooming houses to be licenced and regulated. That did not happen. How did you react when city councillors and the mayor, John Tory, decided to hold off on this decision?

ELIZABETH MCISAAC: So that was deep disappointment. This is an issue that's been on the table for the city of Toronto for almost 23 years since we amalgamated. And so for the rest of Canada back in 1998, all the various cities became one large city of Toronto. We were amalgamated by the province. But when that happened, we had a different. We had a patchwork of regulations around rooming houses so that they are not allowed in parts of the city and they are allowed and differently licenced in other parts. And so there is a really compelling reason that we have to make this the same harmonised this across the city. And in fact, you know, in recent years, the Ontario Human Rights Commission has said it's actually a human rights issue in terms of anti-discrimination. It has to be equally available across the city. And and so this has been coming forward to council for a number of years. This is not the first time, and it's not the first time this year it came to council in June. The staff have done incredible work, I would say, and we've worked directly with them. We've. Work hand in hand with a number of the different departments in the city to look at what rooming house policy needs to look like through a human rights lens and the diligence was done, the professionalism of the staff was there. And so it really came down to a political decision of, I believe, councillors not wanting to be seen to going to be bringing rooming houses into their constituents neighbourhoods, which is not the kind of politics we want to see happen in a city that is meant to be inclusive and building community.

MG: Gary Crawford is one of the Toronto city councillors who voted to delay this decision. He represents Scarborough Southwest, and in a statement to us, he said in part In principle, I support the policy direction to legalise multitenant housing. However, the framework, as it has been set out, does not go far enough to address the current illegal rooming house issues, including the protection of tenants. You said that this was a failure of leadership and in a statement your organisation said if you do not take your duty to protect the dignity and human rights of each and every person living in Toronto, seriously, you're in the wrong job. What is this really about, do you think, Elizabeth McIsaac?

ELIZABETH MCISAAC: I think it's about about standing up as a political leader and saying this is the right thing to do. We owe it to every member of our city to ensure that their rights as tenants are being protected by not moving this forward. This leaves hundreds of people who are currently living in rooming houses across the city. They are not licenced, they are not permitted, they're not legal per se, and those tenants are vulnerable. So as long as as the political leaders kick the can down the road, those people continue to live in a situation of housing precarity. It means that they're not able to exercise their tenants rights. It becomes an access to justice question, really. And what we need to see happen is they need to have that put on the table. Legalisation is an essential platform from which an appropriate regulatory framework can be built. And so we need to get started. The longer we delay it, people remain in situations of housing insecurity. They can be evicted at any time. They're not able to invoke many of the same channels other tenants can, and their safety is at risk. In the last 10 years, there's been 14 deaths by fire in a legal rooming houses in the city. That's not acceptable.

MG: And what kind of political will is there in Vancouver to have these sorts of places regulated?

ANDY YAN: I think that the political will has actually understood the kind of pragmatic nature of the roles that we've seen. I think the kind of cooperation certainly at the city level, but then also now at the provincial and with the help from the federal level in terms of really the transition of SROs into a level of self-contained units, that it's been a slow process. And I think that there are still tremendous amounts of challenge. But then I think that this level of licencing kind of begins the role of documenting and understanding really how some rules fit into a housing ecosystem in a city.

MG: Is part of the challenge the political unpopularity of rooming houses, particularly with single family home owners in a gentrifying city?

ANDY YAN: That's an it's an interesting question, because it's something that doesn't necessarily happen here in the city of Vancouver in terms of this type of accommodation, in terms of this type of home. But then I think at the same time, I think it touches upon the roles of property and who and who isn't included in terms of providing the type of secure housing that is a fundamental human right. I think that also an important thing to note is that it's not. It's how systems make vulnerable people. It's not that people are vulnerable, but it's the systems in this case, a housing system that make people vulnerable.

MG: Briefly, Elizabeth, what about from your perspective? You talked about dignity. Is there not in my backyard kind of stigma that's attached to these sorts of housing options?

ELIZABETH MCISAAC: I believe that there is. I believe that people are concerned about their investment, so I'm talking about homeowners who are concerned about what happens to the value of of their house if there are rooming houses down the street. I think that there is stigma attached to who lives in a multi-tenant house. Are they going to be people that are going to change the so-called character of their neighbourhood? And those are terms that we've heard from resident groups and from counsellors?

MG: What would you what would you say in the face of those concerns?

ELIZABETH MCISAAC: I would say those people are part of our community. First of all, in many cases, they're already living in those neighbourhoods. They're just living. They're not able to live above board because the house is illegal and their their landlord doesn't allow them to. Sometimes the landlords don't allow them to receive their mail at that address. They are not counting in the community. And so I mean, you can even a colleague of ours, John Stapleton, who is a social policy expert and resident of Scarborough, has pointed out that people who are living in illegal multitenant houses are not being counted by census data, so they're not being part of their not being included as part of the picture. So that's part of it as well. The character of the community, every single member of the community contributes, and the beautiful thing about cities and neighbourhoods is that they are continually evolving. They are not static things. And so the more we are able to include and include meaningfully each resident of a neighbourhood and of the community, the better it is.

MG: We spoke with one man who lived in an unlicensed rooming house in Scarborough for years before moving with his family into subsidised housing. Take a listen to Siva Arul.

SOUNDCLIP

I live in a rooming house tenant for 15 years. My wife came and I sponsor. My daughter came, three years old, so I am making a minimum wage. I couldn't afford my rent, so I live in the rooming house. So the problem is a ventilator, carbon monoxide, even fire safety regulated these unlicensed. The landlord they are saying you using water too much. And heater is wintertime less heat. My daughter gets asthma. A nightmare life. I see so many people sharing their story in the Scarborough community.

MG: Andy, his concerns include safety, things like fire, proper heat, ventilation. If you bring in licencing, does that address those safety concerns?

ANDY YAN: It can. But then of course it also then if it's not, I think developed in coalition with the community, with, I think, a set of transparent levels of accountability and really the funding to ensure that there is that type of enforcement that it can actually be a tool towards evicting low income tenants.

MG: tIt goes up because they have to pay for the licencing.

ANDY YAN: Because they have to pay for licencing or that in certain cases that they that the landlord uses this means of clearing out a building to really raise the rents. And I think that this really, I think highlights really one of the kind of things you have to be very careful on. In the city of Vancouver, there's a standards of maintenance laws which have been on the books for almost 20 and 30 years. But then at the same time, the city is very reluctant to enforce it because of really how it could result in the eviction of many of these tenants outside of these out of these assigned roles.

MG: Elizabeth, we're just about out of time. But very briefly, what do you see as the possibility in terms of rooming houses and sorrows when it comes to addressing the whole crisis of affordable housing in this country?

ELIZABETH MCISAAC: I think they're an essential part of it. They're an essential building block or affordability issues in the country. Across the country, it's all the big cities, it's the smaller cities and towns. We need a range of options we cannot keep. We cannot take our eye off the need for deeply affordable and affordable options because too many people are too close to being unhoused if those aren't available and we need to make them safe and protected.

MG: Andy, last few seconds to you. What role could these options play in the housing mix for people in this country?

ANDY YAN: I think it's critical. I think that we need a stabilisation fund from the federal and the provincial governments to ensure that these that that the good players are supported. And I think that fundamentally we also need to look at things like vacancy control to ensure that there is a level of affordability within these units and they stay affordable.

MG: And are you confident that that's going to be addressed? I mean, the crisis seems to be just getting worse.

ANDY YAN: I think that it's going to take a lot of work, not from the level, not only from the levels of government, but then from the local, from the local organisations. I think about these are all collaborative here in the city of Vancouver, as well as the Chinatown Foundation, as well as end the Downtown Eastside neighbourhood house. That all these are community based organisations, I think are doing the kind of advocacy that is so desperately needed for this type of housing.

MG: Good to speak with you both about this. Thank you very much.

ANDY YAN: Thank you.

ELIZABETH MCISAAC: Thank you.

MG: Elizabeth McIsaac, president of Maitri and an urban planner and director of the city programme at Simon Fraser University or. Welcome on this, perhaps you, like many of us, lived in a rooming house, shared accommodation now or perhaps earlier on in your life. Maybe you have those concerns as well about them in your community. You can reach us thecurrent@cbc.ca. Well, coming up after your regional update.

SOUNDCLIP

I thought all of that would make people go. You know, there's something fishy going on in this work. The problem is that didn't happen, right? Then I realised, Wow, people aren't going to catch this.

MG: Something fishy, indeed. Photographer Jonas Bendixen wanted nothing more than for the public to realise that his pictures were fake. In 90 seconds, we'll tell you what happened when not a single person did I'm Matt Galloway you're listening to The Current on CBC Radio One. Stay with us.

Photojournalist Jonas Bendiksen on truth, fake images, and The Book of Veles; and monoclonal antibodies as a tool to fight COVID-19Seg 3

Guests: Jonas Bendiksen, Dr. Zain Chagla

MG: Hello, I'm Matt Galloway and you're listening to The Current. Jonas Bendiksen is a photojournalist who has travelled the world, and his latest book is about the small riverside town of Veles in North Macedonia. The town became famous back in 2016 during the US presidential election as the epicentre of the fake news industry, a place where industrious teenagers pumped out made up online articles. All of them in favour of then candidate Donald Trump. And when Jonas Bendiksen decided to create a book with photographic portraits of the town of Vellis, he decided to run with the theme of fake news, and it ended up being a bit of a lesson for the rest of his profession, the public and others about whether you should believe everything you see on the internet. Jonas Bendikson joins me now from Oslo, Norway. Jonas, good morning.

JONAS BENDIKSEN: Good morning.

MG: Thank you for being here. What was it that got you interested in going to document what was happening in this town in Macedonia?

JONAS BENDIKSEN: I mean, I think for me, it started in the first years of the Trump era. I was sitting there kind of going, What happened to information? What happened to truth, to facts? You know, we're in this landscape now of alternative facts and everything you didn't agree with people calling fake news. So I was a bit confused reading about this when I came across the story of Veles and what happened there and these kind of youngsters in this faraway town that created all these fake news websites. Not as a political act. I mean, they were just trying to make some money. So, I saw that I saw it as a fascinating image of sort of information, hacking and sort of globalisation. At the same time, I was looking at sort of how misinformation was developing in new ways. You know, we have these sort of deep fake videos and these kind of synthetic technologies come and and I saw it as something unique was happening here.

MG: Tell me about the book that you created. This is a book of photos of the town and the people who work and who live in the town.

JONAS BENDIKSEN: Yeah. So the Book of Veles is a photo book. When you open it, you will see- I mean, it's fairly straightforward photographic reportage where I meet this community of fake news producers look into the, you know, sort of crummy offices where they're working and street scenes around this town. The book also has some historical levels. I visit an old story about a discovery called the Book of Veles, which was this sort of apocryphal historical text discovered in 1919, which has to do with a God, a pre-Christian God called the Veles from that part of the world. So I mix as a mythological layer into this story out of this information hackers.

MG: And these are beautiful photos. And I mean, it shows life in this town and what people perhaps are up to in their daily lives. But that's not everything that's going on here. This is not like your previous work as a globetrotting photographer for one of the great agencies in our world. What had you actually done with this book?

JONAS BENDIKSEN: Yes, I know in no way is the back seat similar to anything I've done, because as I was looking into these synthetic imaging technologies, the deep fakes and and this kind of thing. I realised that, wow, it's really hard to tell the difference between a deep fake and a normal image.

MG: And the deep fakes are like, those are those fake videos that are done where it looks like somebody is saying something. And it turns out that it's not that person saying that thing at all.

JONAS BENDIKSEN: Yeah. And we're basically looking at images that aren't based on cameras. We're looking at images that are generated straight from the computer chip, sometimes using artificial intelligence, sometimes using 3-D modelling like computer game technology, what computer game and the film industry will use to create animated characters. So, I basically asked myself, Well, how good is this technology and how easy is it to use? And can you on average, a geeky photographer like myself go into his basement and basically straight from the computer chip, generate fake characters, a fake storyline, a fake documentary that has no basis? In fact, just, you know, the spring side of computer technology. So I decided I want to try to do that because I I got the sense that if I could actually do this, it would say something frightening about the information landscape that we're headed into. So I basically went to photograph, photographed a bunch of backgrounds and then inserted 3D avatars as my protagonists into my images. So the people you see in the pictures, while the story of What Happened in Veles is a true one. All the characters in my photographic documentary are basically a computer game character.

MG: OK, so explain how this worked. I mean, as simply as you can, you shoot, you set backgrounds and then you create the characters in the computer and use A.I. to kind of create the various characters that we would see throughout these photos in the book.

JONAS BENDIKSEN: So basically, I would photograph any location. I thought it was interesting and interesting. Also is an interesting story that I would the way I would do the opposite of what I normally would do as a documentary photographer. I would wait until there were no people in the picture, and then I would get an image of the empty scene when I got back home. I would sort of convert that image into a 3D landscape, and I would take these characters and I would morph them into different personalities. I would float hair and makeup on them and post them, and you can even motion capture these guys. Funnily enough, I spent lots more money on clothes for these digital avatars than I've spent on my own wardrobe in the last 10 years, I think. So I created a whole cast of characters and put them into my images. They're also objects, animals, other things that fit into it, so basically every picture in the project has something fishy going on.

MG: Did you think that people would figure out right away? Oh, come on. This is not- this isn't real. Or did did you when you were done that work, did you assume that what you had created would be enough to to confuse people to to pull the wool over their eyes?

JONAS BENDIKSEN: Well, I mean, that's the funny thing, because the whole intention was for people to find this out. I mean, I expect that people to start asking some questions within a couple of weeks of the book coming out, and I was sharing this material on my social media channels and the product is full of breadcrumbs that's supposed to sort of show people that there's something weird going on.

MG: Breadcrumbs like what?

JONAS BENDIKSEN: Like in the text itself, which, by the way, the text in the book is generated by our artificial intelligence. I didn't write the word of it myself about. The machine somehow came up with some phrases that that that says, basically, this is a construction. Other things, I mean, I kind of went overboard and sort of the cliches of what a story like this from an eastern European town supposed to look like and it bears walking all over town, you know. I mean, I kind of went a little bit crazy. So I thought all of that would make people go, you know, there's something fishy going on in this work. What is it? And I wanted to sort of play into that discussion. The problem is that didn't happen, right? So all I got after it was published was a bunch of thumbs up and people liking it on Instagram and nobody asked them questions. And when I really realised that, wow, we. We are kind of in some sort of trouble here is when I started getting messages from people who had read this text in the book, which again, this written entirely by artificial intelligence saying, You know, what an interesting text. What's great reporting? Thank you for being out there in the field, you know, writing about these important issues. So, then I realise, wow, people aren't going to catch this. And then I have to start making some plans for how I was going to bring this project down, basically. And how did you do that?

MG: I mean, part of this involves this festival.

JONAS BENDIKSEN: Yeah, so so I did a few different things. I created a few fake social media profiles, especially one by the name of Chloe Mysskin. She wants to be my nemesis. At one point, she would go on the attack against me on social media. The other thing I wanted to stress test you know how far this can actually go? Can this pass through even professional institutional filters of people who look at pictures every day? So I submitted the work to about this the world's biggest photojournalism festival in in France, which took place in September. They immediately accepted it. So interesting work, you know, are interested in the screening. So I said yes without saying what this actually was. And that became this test. Whether you know, this can pass through editors, could this end up in magazines? If I had wanted it to go worldwide, could do this fake documentary actually be accepted as a real reportage by seasoned editors. And I think the answer is yes, because it passed into the festival. They're supposed to select the best photojournalism of the year. It was shown there on huge screen settings. They're like 70 or 100 metre wide screens to an audience of photo editors and photographers and industry people. And then I was going to give it 24 hours after that to see if anyone came up with any questions, which they didn't. And then I realised, OK, now it's time to stop this game, you know? I mean, I was starting to feel terrible about myself and all this deceit and all these lies, and I was living a double life. So that's when I unleashed these fake social media profiles to to go attack me on Facebook and Twitter.

MG: How did it feel to finally confess that that this is what you had done?

JONAS BENDIKSEN: Well, I think like many criminals, you know, they're extremely happy to have the truth come out and that people see you for who you are. So I was kind of like that because, you know, I'm not the person who particularly enjoys going around and scamming people. But I think it nevertheless was an important demonstration, an important experiment for us to live for telling stories in the journalism and photography communities that, you know, I think in the next two years, we will have a fairly serious problem here of synthetic information, both synthetic images, synthetic text. All this technology is maybe not quite mature as of today, but the technology is going very fast. Artificial intelligence is going, developing fast. And, you know, I think in the future we will have. Issues, because we already are thinking now that we have a problem of sorting fake news from real news and information from misinformation. But give it a few years, we will have this whole synthetic layer on top of it where you will have misinformation not even produced by people, by but by machines and in quite great quantities. And I think it will get really complicated.

MG: One of the things in reading about this that. Somebody in the world of photography, a photo editor at The Washington Post mentioned, was part of this is about how easy it is to fool people. But the other part of it is will we care what's real and what's not? Do you think that people, if they look at a beautiful image or they hear something that sounds close enough, will they employ the critical thinking to to investigate whether it's real or not?

JONAS BENDIKSEN: Well, these are the big questions. I also think what you're seeing is that people are everyone is sort of sinking into their own realities, their own set of facts, their own credible sources. And it doesn't matter if serious institution or New York Times or whoever debunks that or that conspiracy theory, well, you have your own. Credible source over here who stands by it, and I think that's a frightening thing because in a democracy and in a society, we need to be able to establish some, some basic basic realities that we share somehow. And I think this is a question, what do we do with with this level of misinformation that we're going to be wandering around? And this technological solutions and mechanisms we can apply, you know, we can employ machine learning against the problem, etc. But I think this is something that has to be in, an important subject in schooling. Like how how can we make our young, the next generation, better at navigating this very difficult mix of information, how to find credible information and in this mess? I think these will be things we really have to concentrate hard on in the years to come.

MG: You said at the very beginning. You describe this whole idea is terrifying. And I just wonder, having gone through this, how this changes, how you see your own work.

JONAS BENDIKSEN: Yeah, I mean, I went through with this big cos I found it frightening every step of the way, what I saw. I mean, listen, everything I know about this. These techniques, I learnt from spending some hours on YouTube tutorials. It's not like rocket science, it's not difficult to do. So that terrified me that it was so easy for me to do this with no prior experience. I think what changes in my own practise is that, you know, I had to basically go around reconstructing from scratch sort of cliche versions of my own images. I had to study how I see things, how I make images, what do I want to be these pictures? I had to sort of look at those ingredients from the outside. And then I wonder, will I ever be able to go back to doing exactly what I did before? No, probably not. Not in the same way, visually speaking. But I think what has always driven me in my work is it's really the idea of using photography and visual storytelling to go out there, as I explore the difficult questions out there, you know, the questions I have about the war, the things I get curious about and find a way to do that, that I will probably continue doing that in some form or another, but I'm not sure if it will look exactly like the classical reportage that you saw in the Book of Veles.

MG: Do you look at things differently now?

JONAS BENDIKSEN: Yeah, I think and I think I certainly will look at. Photography and even, you know, text and articles around me with more critical eyes than I did before, because I see now how easy it is to reproduce fake versions of this.

MG: It's a brilliant project. I'm really glad to talk to you about it. Thank you very much.

JONAS BENDIKSEN: Thank you.

MG: Jonas Bendiksen is a photojournalist who is based in Oslo, Norway.

[Music]

MG: You're listening to the current on CBC Radio One. My name's Matt Galloway. We know that vaccines are the most effective way to keep people safe from COVID 19. But once someone is already sick, there are drugs that have been approved to give them a better chance at fighting. Call it off. One of those treatments is called monoclonal antibodies. Former US President Donald Trump is a famous recipient of those when he was in hospital with COVID last year, and now one hospital in Hamilton, Ontario, has launched a pilot project to treat some patients using those antibodies. Dr. Zain Chagla is leading the project. He's an infectious disease physician at St. Joseph's Health Care and an associate professor at McMaster University in Hamilton, Dr. Good morning.

DR. ZAIN CHAGLA: Hi, good morning.

MG: Can you explain what this treatment actually is? What are we talking about here?

DR. ZAIN CHAGLA: Absolutely. One of the fundamental aspects of us fighting infections is us developing antibodies. And so when we're infected with COVID 19 and survive, we develop antibodies which help clear the virus when we're immunised. What are the big parts of that is that we make antibodies such that when we see COVID 19, they work immediately and prevent us from getting infected or getting sick. The last step of this, though, is if people don't make antibodies by the time they see COVID 19, we can give them synthetic antibodies essentially to jumpstart that process so that they can clear the virus faster like their body would normally do. And there's a precedent for this. We give antibodies, for example, for people to prevent complications even if they get bitten by an animal that that's at high risk. So this is kind of expanding on that therapy into the COVID 19 space. And, you know, these drugs are now available on the market for us to use.

MG: And you do it through an IV. Is that how?

DR. ZAIN CHAGLA: Yes, right now, through intravenous infusion. There is actually [unintelligible] doing this through subcutaneous infusion or an intramuscular infusion like, you know, an immunisation. So, you know, we're stuck with IVs for now, but that's probably not the long term future with these drugs.

MG: Do we know when we're talking about COVID, whether there is a specific patient profile that seems to respond best to this kind of treatment?

DR. ZAIN CHAGLA: Yeah, it's ones that don't have antibodies. So you know, the number of antibodies you generate from having natural COVID or the number of antibodies that you generate from having a vaccine are really high, much higher than we can infused with these, these types of monoclonal antibodies. So those people largely don't benefit from this therapy. So people that are unvaccinated who are very high risk of complications, those over the age of 50, those under the age of 50 with medical conditions like heart disease, liver disease, kidney disease, obesity, diabetes or immunosuppressed, or those who are vaccinated but have high levels of immune suppression such that they're essentially unvaccinated. And you know, it could help those who are under 50 and unvaccinated. But again, because this is a therapy that limited in terms of the resources we can give, we're targeting at people at the highest risk of hospitalisation rather than the people that would likely have a reasonable outcome for the most part, statistically.

MG: I guess that was the other part of that is, I mean, the timing of this. Is it for people who are already incredibly sick? Is it people who are slightly ill and kind of moving through you trying to figure it out? I guess when in someone's progression, these are actually going to work?

DR. ZAIN CHAGLA: Yeah. So we talk about these about seven days after symptom onset. And the reason is is we kind of have to get in early before the virus starts wreaking its damage. That inflammation gets out of control and give the body a chance to actually get that jump start to clear the virus out. So we need people to get tested early in order to be eligible for these therapies rather than, you know, after day seven, where a lot of the disease is not necessarily the virus, it's just the immune system and the inflammation from it that are causing people to end up in hospital.

MG: Can I save somebody's life?

DR. ZAIN CHAGLA: Yeah, absolutely. So the big study done in the United States saw 70 percent reduction in hospitalisation, which obviously means a 70 percent reduction in things like ICU stays and a marked reduction in death. There was no one in the study that died after getting the monoclonal antibodies as compared to a few people that died getting the placebo.

MG: Why, then, aren't we using them more in this country when you take a look south of the border? This treatment has been used much more readily.

DR. ZAIN CHAGLA: Yeah, I mean, in the US, there's there's treatment centres all over that give this. I mean, number one, obviously, the health care system has been incredibly stretched in Canada. You know, getting the health care human resources to get things up and active are difficult. You know, number two is there's going to be different implementation strategies no matter where we are. You know, the Hamilton pilot is going to generate some data around what to do for maybe urban centres in the province. But these are going to be as applicable to somewhere like, you know, Chatham, Kent or another small city, and there may need to be different strategies. And number three, it's a different paradigm, right? The paradigm has been get tested. Isolate, if you get sick, end up in hospital. It is hard to start breaking that paradigm and saying, actually, there's a step in between here where if we intervene for a lot of people, yes, we have to reconfigure our health care systems to deal with it. But there is a big reward here. Hospital beds are a commodity. They're incredibly difficult to come by, especially going in the winter. Preservation is going to be incredibly important and it's a lot of work, but a huge amount of downstream reward if they're implemented correctly.

MG: When you say a commodity, I mean, is there a cost issue to this as well?

DR. ZAIN CHAGLA: You know, I mean, there are operating costs of a clinic of paying nursing a pharmacy cost. The drug has been procured by the federal government. So for now, it's not costing hospitals anything yet, but eventually it will likely have to be bought by by health care facilities. But again, you know, the average infusion likely runs with people's time maybe 500 to 1000 dollars a day to run a clinic. You know, a single hospitalisation prevented is $23000. If that person goes to ICU, it's over $50000.

MG: Do you have patients who are knocking on your door saying, I know that this is available south of the border, get it here?

DR. ZAIN CHAGLA: Yeah, absolutely. You know, when these came to the market in the United States in kind of late October or November of last year, you know, we had patients calling saying, you know, My family member tested positive. They're high risk. And we kind of just scratched our heads and said, No. We did buy a little bit of the drug earlier in the year at a separate drug called bamlanivimab, which is now off the market. But again, no one had an implementation plan and health care was stretched to the limit at that point before going through lockdowns. And so this is kind of put on the back burner, even though again, the data was starting to suggest that it did save people from ending up in hospital. So we're happy to do this now. It's all out on the market. It's guideline approved by the World Health Organisation, its guideline approved by the Ontario Science Table. People know this drug exists and again, we have to give them a fair shot of accessing it.

MG: Let me go back to where I started, which is that we know that the vaccines are the best way to keep people safe. We also know that there are much less effective or completely ineffective treatments that have been sort of co-opted by people who might be vaccine hesitant or anti-vaccination. They might say, Well, you know, treat me with ivermectin and we won't get that sick. I wouldn't need to get the shot. Despite the fact that there isn't any evidence that that actually works in Health Canada has said that people should not use, you know, ivermectin to to prevent getting COVID. How do you how do you thread that needle when that dynamic is at play right now?

DR. ZAIN CHAGLA: Yeah, I mean, look, there is a counterculture, obviously, as you mentioned about drugs that are not evidence based for the treatment of COVID 19. You know, that is a small minority of some of the patients out there that are vaccinated. But there are still patients that are unvaccinated who, you know, have medical concerns that unwanted individual advice that were missed by our campaigns. And so, you know, no. one, I think we have a duty to use what we can for patients. And again, we do this in other forms of infectious disease. You know, we have lots of preventative therapies for HIV, but it doesn't mean we stop caring about HIV patients if they contract the disease. And you know that similar paradigm has to just be put into place here, right? We have tools there, evidence based. We have access to them regardless of the patient population. You know, we need to treat patients first and foremost, and that's what health care providers do.

MG: This is a pilot project. How will you judge whether it's a success?

DR. ZAIN CHAGLA: Yeah. So we'll look at a number of factors. Number one, is just trying to identify patients, make sure they're eligible, make sure they're being, you know, put in in time. See what their experience is with the feasibility of the clinic is in terms of scaling up or or dealing with surges and the number two looking at the efficacy. So does this translate out to real life? Many of these studies were done pre delta. Many of these studies were done free vaccine. And so kind of you know that subtlety of trying to find patients make sure they fit the profile is very different than before, where it was literally just everyone who who met the criteria were eligible. Many other pilots are being generated across the country as we speak to help with the feasibility and again troubleshooting of that initial setup.

MG: But as a tricky winter approaches, you see this as potentially another tool in dealing with COVID.

DR. ZAIN CHAGLA: Look, hospital beds were hard to come by in the wintertime pre-COVID. I can't imagine that COVID is going to make anything better, and so any reduction in health care utilisation going into the harvest season of the year is going to pay dividends down the line. And again, if people can get their surgeries of ice, use can be kept open and not at critical capacity if people can stay in their hometown for care. You know, that's a win for everyone in terms of mitigating the damaging effects of this disease.

MG: Doctor, good to speak with you. Thank you very much.

DR. ZAIN CHAGLA: No problem.

MG: Dr. Zain Chagla is an infectious disease physician at St. Joseph's Health Care and an associate professor at McMaster University in Hamilton. And that is The Current for this Wednesday. Coming up next on CBC Radio One, its q. For science fiction fans. The movie event. Of the year will be happening on Friday after a very long pandemic delayed Denis Villeneuve's adaptation of the novel Dune will be out in theatres. This is a very difficult book to adapt if you remember the David Lynch version of the film from 1984. You know what I mean. Bit of a mess. Disney Villeneuve himself will drop by Q to tell Tom Power about how and why he made this film. That's coming up in just a few moments on CBC Radio One. My name is Matt Galloway. Thanks for listening to The Current. We'll see you tomorrow.

Wednesday October 20, 2021 Full Transcript

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