Thread by @karenpaulscbc

7 Manitoba churches challenging province's #COVID19 pandemic powers in court starting today. More ⁦@CBCWorldReport⁩ cbc.ca/news/canada/ma…

Chief Justice Glenn Joyal has opened court, saying exceptional steps have been taken to ensure access by media and members of the public. He says this is an important case re: public profile and issues adjudicated.

Joyal says there's every reason to ensure this hearing and the issues are dealt with and addressed in transparent way. Participating: 10 counsel, 10 applicants, two of whom will testify this morning, 4 government reps online, 7 media online, 3 media in court.

Joyal says media is playing their role as proxies for citizens of MB. He says there has been controversy about public access but there are 57 members of the general public online - in excess of what public courtrooms can house.

Joyal says he will be "disappointed and irritated" if anyone suggests members of public are not welcome to this hearing because they are. He reminds everyone that court proceedings are not to be recorded or disseminated.

MB government's lawyer Denis Guenette is asking Church of God Restoration pastor Tobias Tissen about protests he has attended, which violated public health orders re: physical distancing, mask use, gathering numbers.

Tissen and his lawyers object to Q about whether he observes 14-day self-isolation when he returns from protests out-of-province. Lawyers say it could incriminate him in criminal proceedings. Judge and government lawyers say it won't.

Judge is allowing question because he says quarantine issue is relevant. Q is re-asked. Tissen says he doesn't observe 14-day isolation.

Government lawyer is showing social media ad for a protest at the law court this afternoon, which includes Tissen as a speaker. Tissen agrees he will be at that event.

MB gov lawyer asking if his church enforces indoor gathering, physical distancing limits. Tissen says he has no authority under God to limit people from coming to church to hear the word of God.

Government lawyer is playing a 15-min video of a Church of God Restoration service Jan 31 that was posted on social media, showing singing and preaching. No masks or physical distancing.

On the video, Tissen was interviewed by someone who attended the service, saying if big box stores can be open, church should be too.

In court, Tissen says showing this video has dragged his people and children into the case, adding to the "trauma, stress and harassment." Gov't lawyer says on Jan 31, churches were supposed to be closed. "Required by men, allowed by God," Tissen replied.

Tissen lawyer asks if he stops congregants from observing public health orders. Tissen says he doesn't stop anyone if they want to wear a mask. Tissen testimony is now finished.

Court is taking a lunch break until 1 pm CT.

As we wait for court to begin again, a rally is taking place outside the courthouse. The outdoor gathering limit in MB right now is 10 people.

Two of the rally speakers are from Alberta and BC. No word if they observed Manitoba's mandatory 14-day isolation requirement.

This is the next witness to be cross-examined by lawyers for the Manitoba government.

MB lawyer Heather Leonoff points out Bhattacharya is an MD but isn't licenced to work and has never practiced as a medical doctor. She's going through his CV since 2015, suggesting his papers are mostly about the cost of healthcare. He says his primary focus is patient outcomes.

Meanwhile, there are about 150 people at the rally outside court now. 10 is the limit under current public health orders.

Manitoba pastor who openly defies pandemic restrictions tells court he has no authority to enforce rules, story by @ianfroese. cbc.ca/news/canada/ma…

Court is taking a short break. MB lawyer Leonoff will go through Bhattacharya's reports, attached to affidavits dated Jan. 5 and Mar. 31. We do not have the affidavits or reports, which are paper copies in the judge's possession.

Court is back in session. I'm watching it from home via video conference. MB lawyer Leonoff says she is not challenging Bhattacharya's expert credentials - but will challenge re: the weight it should be given

Bhattacharya says more people have died of flu in the US than COVID, it’s more dangerous than the flu.
Leonoff is putting up Manitoba Health info showing hospitalizations, ICU admissions and deaths in the province.

Leonoff is challenging if he’s familiar with how MB tests for flu and COVID. He says surveillance is similar and numbers would be similar if we tested for flu like we do for COVID. Bhattacharya says age is the biggest risk factor but agrees no age group is exempt.

Bhattacharya agrees COVID more disproportionately impacts the poor, those with chronic health conditions, living in crowded conditions. He’s read about health risks and outcomes for Indigenous people in Manitoba but can’t offer a professional opinion.

It's hard to know what Leonoff is trying to get at because I haven't seen Bhattacharya's expert report. They're discussing when COVID should be listed as causing/contributed to death.

Leonoff has @WHO guidelines up. Bhattacharya says those guidelines change how doctors are being asked to think about cause of death. He says it will lead to an over-estimate of the number of deaths related to COVID.

Bhattacharya agrees a major thesis of his expert report is that COVID transmission is rare in people who are not showing symptoms and that governments could have less-intrusive restrictions that include symptom-checking requirements. eg require churches to screen people

Leonoff is still going through scientific studies to look at the rates of asymptomatic/presymptomatic transmission of COVID. Bhattacharya agrees it happens, but he says it's rare.

Bhattacharya says it's impossible to decide definitively on this topic because new information could come up but right now - he says symptomatic patients spread COVID more than asymptomatic/presymptomatic.

Court is adjourned for the day. MB government lawyer Heather Leonoff will continue cross-examination of applicants' expert witness Jay Bhattacharya tomorrow at 9:30 a.m. CT.

This court case and the constitutional arguments are taking place in this context: COVID-19 cases doubled from March to April as Manitoba's third wave continues to rise cbc.ca/news/canada/ma…

.@MBGov says enforcement officers were present and closely monitoring the rally, incl collecting video evidence to support tickets for non-compliance w/public health orders. Info collected will be used for ongoing investigations. @wpgpolice members were also on site.

Court begins with day 2 cross-examination by MB gov't lawyer Heather Leonoff of Stanford U Medicine prof Jay Bhattacharya, expert witness for the applicants. He's spoken against US lockdown measures and criticized chief medical adviser Dr. Anthony Fauci's support of restrictions

The case is scheduled for two weeks. I will not be covering gavel-to-gavel but will dip into the virtual hearing for some of the witnesses, which will include MB chief public health officer Dr. Brent Roussin and @KindrachukJason

Leonoff says she has more than 50 pieces of literature to show Bhattacharya, all published articles that show a disagreement to Bhattacharya's opinions in his affidavits/expert reports. Reminder, this is the overview of the case: cbc.ca/news/canada/ma…

In its weekly enforcement data, just released, @MBGov says 4 tickets were issued so far after yesterday's rally at the law courts. 2 tickets were given after rally in Winkler May 1. 20 after rally at Forks Apr 25. Province says additional charges are expected.

Leonoff is asking Bhattacharya about the value of lockdowns. He agrees they can reduce the peak # of infections but said they really only delay it into the future. She asks if it makes sense to delay infections until a vaccine is available. He says "that's one strategy."

Bhattacharya says he's spent his whole career building modelling programs but they need lots of good data to be useful. So far, he says there's not enough basic info, eg COVID infection fatality rates and transmission probabilities, and that modelling to now has been "poor."

Bhattacharya says Sweden didn’t lock down/force business closures and had same results as countries that did lock down. Leonoff says comparing countries has to be done with caution bc of different biological, social factors. He agrees but says it's important to learn from others

Lots of discussion about scientific study/papers in court this morning. The details are under debate but the policy decisions made based on them have real-life significance. Here is one example: cbc.ca/news/canada/ot…

Here is another example of how #COVID19 science and policy is affecting our everyday lives and why the constitutional arguments being made in the Manitoba court case are important: cbc.ca/news/canada/ma…

Leonoff asked Bhattacharya whether bending the curve and spreading out infections could help w/timing of hospitalizations, use of ICUs, stress on healthcare workers? He said yes, in theory, but we also have to compare against the harms, eg delays in cancer treatment.

Court is taking a short break.

Court is back. MB gov't lawyer Heather Leonoff asked applicant expert witness Jay Bhattacharya about the mental health impacts of the pandemic. They're debating the cause of stress/anxiety - #COVID19 or the government measures meant to prevent it.

Bhattacharya says lockdown is an "extraordinary measure" that has caused "enormous mental stress" on the population. He says the normal reaction is increased anxiety, alcohol, drug use. Leonoff cites a @CAMHnews report that Canada was already in midst of a mental health crisis.

Court break until 2 p.m. CT. MB gov't lawyer Heather Leonoff will take all day to finish cross-examination of Jay Bhattacharya. Tomorrow, witnesses expected: MB chief nursing officer responsible for hosp operations @LanetteSiragusa and emerging viruses researcher @KindrachukJason

A reminder of the context this constitutional court challenge of #COVID19MB pandemic restrictions is taking place in: Manitoba reports 291 cases, 1 death due to coronavirus variant
cbc.ca/news/canada/ma… #cbcmb

In court, gov't lawyer Heather Leonoff is still cross-examining Jay Bhattacharya. He co-wrote a controversial statement which says those at low risk of #COVID19 death should live normally; only those at high risk should face public health restrictions medpagetoday.com/infectiousdise…

More on enforcement at rallies in Manitoba, including the one at the law courts building yesterday. Manitoba doles out $78K in tickets for pandemic health order violations in final week of April cbc.ca/news/canada/ma… #COVID19MB

Some analysis of the statement Jay Bhattacharya co-wrote by experts including @CaulfieldTim and @AshTuite: cbc.ca/radio/thecurre… Bhattacharya is an expert witness for the 7 churches challenging @MBGov in court over its pandemic public health orders.

My colleague @ianfroese story from the court hearing so far today: cbc.ca/news/canada/ma…

Bhattacharya says he’s been an expert witness in 3 cases that reached US Supreme Court and a recurring issue is whether churches are being suppressed for doing similar activities to other groups, eg permitting gatherings of one type and saying no to religious activities.

Bhattacharya says if public health measures are done well, governments will get cooperation from religious communities. In places where they haven't been done well, it's led to court cases like this one in Manitoba.

Gov't lawyer Heather Leonoff is giving examples of how MB and Canada already do "focused protection" for different sectors of society. eg personal care homes, Indigenous communities, workplaces

Leonoff is asking Bhattacharya how PCR tests work. He suggests they're only useful in identifying whether fragments of the SARS-CoV-2 virus exist, not if someone is infectious. Leonoff says it's used around the world as a proxy to identify positive cases.

MB gov't lawyer Heather Leonoff has finished her cross-examination of Jay Bhattacharya. Now his counsel from @JCCFCanada will have a chance to follow up. Judge has asked her to be quick, as it's already been a long day.

Allison Pejovic of @JCCFCanada asked a couple of questions about Jay Bhattacharya's qualifications and his opinion about locking down a region until a vaccine is available.

Chief Justice Glenn Joyal said it was not necessary for Bhattacharya to answer because Joyal understands his expertise and opinion and he has all the information necessary to grapple with that issue. Court is adjourned until 10 a.m. CT tomorrow.

Watching Day 3 of the court case involving 7 rural Manitoba churches vs MB gov't again today. Chief Justice Glenn Joyal has just issued a strong warning to members of the public who have been harassing, disrespecting court staff about accessing the virtual courtroom.

Joyal says there have been a lot of requests for individuals accessing the virtual hearings. He says it's an important case with some public profile, citizens have a right to follow it and media is acting as a proxy.

Joyal says access to the public virtually is in excess of numbers permitted in the courtroom. Those numbers have to be capped because of issues with bandwidth, eg audio and lips not matching. Requests to access have to be made in advance.

Joyal says people in clerk’s office are being treated disrespectfully by people acting in rude, provocative, accusatory way and he will not tolerate that when the efforts to create access are not only reasonable but extraordinary.

The hearing is starting with chief nursing officer Lanette Siragusa on the stand on behalf of the province, being cross-examined by lawyer Jared Brown of @JCCFCanada for the applicants. Here's some background on her, written last year: cbc.ca/news/canada/ma… #cbcmb

Siragusa says she’s not responsible for making public health orders but she helps communicate it and also coordinates the health system response, eg making sure there's capacity for hospital beds, staff, equipment.

Brown asks about cancelling elective surgery and a backlog of 16,000 cases based on previous year. Siragusa says public health orders didn’t dictate the cancellation of surgeries, those decisions were made by clinical/medical experts based on what was happening in hospitals.

Siragusa is also being challenged about the number of ICU beds available. In an affidavit, she said 72 but @JCCFCanada lawyers showed info about 78, then 86 beds. Siragusa says the larger number reflects all ICU beds in MB, her number is only for general, non-cardiac ICU beds

Brown continues to ask Siragusa about the differences in ICU beds between her affidavit and the documents he’s supplied showing there were 173 ICU beds available in mid-December. Siragusa says that's what they were planning for but staffing was a challenge w/ illness and training

Brown shows part of affidavit of a witness coming tomorrow, of increases in cases of substance abuse, mental health, intentional injuries, etc. He calls the increase "eye-popping" but says healthcare system managed and "did not break."

Siragusa agrees but with possible repercussions for patients waiting for hip replacements or cataract surgery. Agrees the 16,000 wait list may have grown. Siragusa cross-examination is finished. Court is back at 1:30 p.m. CT for cross-examination of scientist @KindrachukJason.

Here's my colleague @ianfroese's online story from this morning's testimony by @LanetteSiragusa: cbc.ca/news/canada/ma… #COVID19MB

Here's another case being heard in an Alberta court. Some of the same constitutional arguments apply: cbc.ca/news/canada/ed…

.@JCCFCanada lawyer Jared Brown is now cross-examining @KindrachukJason, a microbiologist and expert witness for the province. Asking Qs about whether herd immunity is possible through exposure/infection and without vaccination. Shows documents from @WHO, others suggesting it is

Kindrachuk says there are Q's about how long immunity lasts through exposure/natural infection. Says vaccination will provide more sustained immunity. Agrees not everyone can get vaccinated, access is a barrier. Says we're still learning about this virus.

Brown is looking at studies of church "super-spreader" events. Suggests proper mask use, physical distancing reduces transmission, even during singing. Kindrachuk agrees, but says that was before variants of concern, also differences between droplets and aerosol transmission.

Brown asks about a paper co-written by Kindrachuk that says governments have been "forced" to implement measures. Kindrachuk says they were forced to act quickly or face deaths seen elsewhere. "I don’t believe government had other options to curtail COVID19 transmission spread."

Brown says the paper discusses other measures incl stimulus payments, paid sick/quarantine leave, childcare for healthcare workers, suggests that is political opinion. Kindrachuk says basic rights for human beings are not political concepts in Canada.

Brown asks Kindrachuk if he's in favor of government restricting gatherings/interactions? Kindrachuk says it depends on context (indoors vs outdoors, rate of community spread etc) but in a period of uncontrolled transmission, yes.

Cross-examination of @KindrachukJason is complete. Court will be back tomorrow at 10 a.m. One of the witnesses will be Carla Loeppky, Director of Epidemiology and Surveillance, Manitoba Public Health Branch.

The churches in this court case are a small minority. The majority are following #COVID19MB public health orders. On @CBCWorldReport Thursday, two Christian ministers say the restrictions are a way to follow one of Jesus' commands: to love your neighbor as yourself. #cbcmb

Court is back in session. Allison Pejovic of @JCCFCanada is cross-examining Carla Loeppky, Director of Epidemiology and Surveillance, MB Health Public Health Branch. Her team gathers COVID data and does the modeling that decision-makers use to create policy.

Loeppky believes good contact tracing is important for a good public health response. Admits there are shortcomings, eg someone not being honest and sharing all contacts. Says MB contact tracing was "stretched but not overwhelmed" in Nov 2020 but adjustments were made quickly.

Loeppky says contact tracing is challenging if there is widespread community transmission but her team looks for patterns, clusters and trends, relying on many pieces of data. Even with perfections, they can understand what's happening in the population.

Pejovic asked Loeppky - do you agree someone might have to isolate needlessly if they were exposed to someone whose infection was resolved months ago? Judge asked her to remove "needlessly" from Q because it turns into question like - have you stopped beating your wife?

Pejovic re-phrases, asking if some family/contacts might have to isolate when they're not actually exposed to an infectious person. Loeppky is confident chances of that are "incredibly low." Says lab info and contact tracing would flag if it's not a new case or a reinfection.

Chief Justice Glenn Joyal has just asked lawyer for the churches, Allison Pejovic, to "stop giving evidence" as the preamble of her question and to make her arguments later.

Pejovic asks if Loeppky agrees it's not good public health practice to give new cases of COVID19 without saying how many are infectious? Loeppky says MB provides same info as others around the world. “What we’ve chosen to present is fair, appropriate and very comprehensive.”

Pejovic asks about #COVID19 death numbers. Loeppky says if someone dies during their active period, they are considered a COVID death. But RHAs review each death within 24 hours to ensure it meets the case definition of a COVID death.

Pejovic challenged Loeppky on value of modeling, says they used low bed capacity numbers to justify claims the healthcare system would be overwhelmed in November. Loeppky says modellers were watching bed numbers carefully as province used those projections to increase capacity.

Loeppky says they watched how the model was simulating real-life. There was “extremely close alignment" between what it was predicting and what was happening, "something we took very seriously.” "Breaching the hospital system is your last line of defence.”

Loeppky's cross-examination is finished. Court is taking a break until 2 p.m. CT.

Speaking of #COVID19MB modelling: cbc.ca/news/canada/ma…

Meanwhile, Manitoba has 363 new cases of #COVID19, the highest single-day total since Dec 11, the highest in this 3rd wave. There are 4 more deaths. Winnipeg test positivity rate is 10.4%.

In court this afternoon, @jccf lawyer Jared Brown is cross-examining Dr. James Blanchard, Cda Research Chair in Epidemiology + Global Public Health at U of Manitoba, former provincial epidemiologist. Brown questioned his expertise, suggested it's not respiratory illness.

Blanchard says he isn't advising or assisting with the Manitoba government's COVID plan but says he's an advisor for India and Pakistan's response. That global health work is funded by @WHO, governments and @gatesfoundation.

Blanchard is refuting ideas in an affidavit submitted for the applicants by Dr. Joel Kettner, former MB chief public health officer. Kettner's affidavit argued local decisions should be made based on local conditions. Kettner is expected to be cross-examined next Monday.

Blanchard objects to decisions made based only on what we see in Manitoba rather than what we know the virus is capable of doing based on what we've seen globally. "Responding to something is different than trying to prevent something that hasn’t happened yet."

Kettner hasn't testfied yet and we haven't seen his affidavit but the applicant's lawyer is asking Blanchard to respond to it. Blanchard says Kettner's support of "focused protection" and developing herd immunity through natural infection, not vaccination is a "reckless policy."

More on the Manitoba context to this constitutional challenge of the province's #COVID19 pandemic response: cbc.ca/news/canada/ma…

This concern has also come up several times during cross-examination of different witnesses, in the context of lockdown harms and hospital capacity: cbc.ca/news/canada/ma…

Brown asks if it's possible to protect known vulnerable cohorts by allowing people at minimal risk of death to live normally, building up herd immunity through natural infection. Blanchard says it's impractical and maybe impossible. He doesn’t know of any successful examples.

Brown asks if all indoor gatherings should be treated equally in public health orders. He says it's a judgement to say big box stores/economic activities are more valuable than faith-based settings.

Blanchard says there should be clear, transparent, reasonable balance between the impact on the epidemic and the harm to society. eg more impact to closing grocery stores than other settings. This cross-examination is finished now.

Court Friday will focus on testimony of Manitoba's chief public health officer, Dr. Brent Roussin. It will be key because @JCCFCanada's legal action challenges his public health orders and asks the court to "end the violation of Manitobans' Charter freedoms." #cbcmb #COVID19MB

Court reconvenes at 9:30 a.m. CT tomorrow. Also happening Friday morning, the province will brief Manitobans on hospital preparations as the third wave of #COVID19MB gets more severe. @LanetteSiragusa testified in this hearing yesterday. Tomorrow will be a busy day!

Story by @ianfroese on the morning's testimony: Manitoba hospitals were 'extremely at capacity,' epidemiologist testifies at pandemic restrictions hearing cbc.ca/news/canada/ma…

Breaking news by @bkives that is very relevant to the constitutional challenge happening in court. We'll learn more about this tomorrow in a morning news conference. cbc.ca/news/canada/ma… #COVID19MB

Pandemic restrictions don't infringe on right to faith, say some Manitoba religious leaders

cbc.ca/news/canada/ma…

A busy day in Manitoba. As the province is expected to announce #COVID19 cases are rising to the point the healthcare system may soon be overwhelmed, the chief medical health officer will be in court, defending public health orders meant to decrease transmission of the virus.

I will cover as much of @roussin_brent's cross-examination as possible but will also be keeping an ear on three news conferences by Premier @BrianPallister, @LanetteSiragusa and the deputy chief public health officer. All for @CBCWorldatSix tonight.

Court has begun with Jared Brown of @JCCFCanada asking Dr. Brent Roussin about managing the #COVID19 response. Roussin says he meets w/prov chief public health officers across Cda. Their goal has been to minimize morbidity and mortality while minimizing social disruption.

Brown asks Roussin about PCR tests and how accurate/valuable they are. Roussin says based on positive test results in the second wave, they could predict accurately how many hospitalizations and ICU admissions to expect w/in 10 days. Clinical reality lined up with positive tests

Brown asks if positive PCR test showing viral fragments = positive case? Roussin says yes at surveillance level but at clinical level, +ve cases are referred for case investigation. Says MB does few asymptomatic tests so most people are symptomatic and/or had high-risk contact

Brown asks if we know more about the harms caused by public health orders now than in early 2020? Roussin says possible consequences are considered at special/technical advisory committees, public health level and a whole government approach.

Roussin says government/public health experts understand there are unintended consequences of any actions. In the midst of the pandemic, they don’t have a full picture of the effects of all public health measures, which vary across the country.

Roussin says there would be societal disruption if there's widespread #COVID19 illness, eg healthcare/critical infrastructure/first responder workers off work. Says there would be severe economic impacts if they allow the pathogen to spread unchecked.

Brown asks about postponement of elective surgeries/procedures in March 2020. Roussin says it wasn't a public health order, it was a response of the acute care system to manage the impact of #COVID19 on the system. Brown notes Roussin would be advising that response.

Brown has returned to asking questions about PCR tests, in particular two studies done by Jared Bullard, a witness coming to court on Monday. Chief Justice Joyal asks Brown why he's asking Roussin about it. Brown says he wants to know how aware Roussin is of this recent research.

Brown summarizes/interprets the research: some samples found positive in PCR test didn’t grow SARS-COv2 in culture = those samples were not infectious. Roussin repeats PCR tests have been accurate at population level; 7% of positive cases show up in hospital 10 days later.