What's going on, infinite family? Welcome back to another video. It's your girl Janice. If you guys are new to the channel, make sure you hit that subscribe button and join the family. Guys, right now Isaiah is upstairs playing the game. He is occupied, so I am so excited to tell you guys what I have on my sleeve today. So I am going to be pranking Isaiah by making him think that I have a nice, sexy outfit ready for him. But in all reality, I'm gonna surprise him with this. Guys, it's a Thanksgiving turkey costume. I'm going to be giving him so many hints. I'm gonna blindfold him. And I'm going to basically tell him that I have something so cute, something that he's not going to resist. And we are going to see his reaction when he finds out what I'm actually wearing. So if you guys are ready for today's video, don't forget to smash that like button. Comment down below, Team Janice, and let's get this prank started. Awesome, I'm ready to get this prank started. So I'm basically going to blindfold Isaiah. I'm gonna make him sit right here. And to make sure that he doesn't see me, I'm going to go ahead and grab this blanket right here. And I'm going to hold it over myself so that way if he does try to peek, he is not going to be seeing me at all. I'm gonna make him close his eyes. And yeah, let's go ahead and get this prank started. Babe! I see surprise. Yes, but when you come downstairs, you have to have your eyes closed. Okay, come. When you come downstairs with your eyes closed, this isn't the best idea. Okay. If I fall, it's 100% your fault. Well, when you get downstairs, let me know. Okay, I'm downstairs. Okay, so you can open your eyes, but don't look around. Okay. I'm covering myself so you can't see. I see that, what are you doing? Nothing, I want to surprise you. You see that blindfold on the chair? Yes. Sit down and put it on. Okay, I like where this is going. Mm-hmm. It's about to get real spicy, I'll tell you that one. Okay, I like exactly where this is going. Mm-hmm. All right. I think this has been a good boyfriend lately. Very good boyfriend and I want to just please you today. Hell yes, I think I deserve it. Yeah, you do. All right, I'm blindfolded on. I'm ready. Wait, wait, let's see. All right. What's going on here? So, I decided, I'll let you know when. What, you're wearing something? Yes, I just said I'm wearing something sexy that I want to surprise you with. Okay, right, so. I'm gonna give you a few hints and if you guessed right, you can take it off sooner than later. Oh, okay, okay, I like this game. All right, what are we doing? So, let me set a vision for you real quick. Okay, wait, can I like feel you touch you or anything like that? Maybe if you're behaving. Oh, okay, all right, what you got for me? All right, so the first hint is, I have feathers on. Ooh, okay, okay, all right, this is all right. I'm picturing you in like a white lingerie set with white feathers like sticking out of like here and there. Oh, close, close, how'd you know? Okay, am I right? Is it like white lingerie? Actually, it's red. Red lingerie? Mm-hmm. Ooh, okay, that's even hotter. All right, what's my other hint? Your other hint? Yeah. Is that it's really skin tight and velvety.  Mm-hmm. Okay, can I feel, can I touch?  Ooh, baby, that's soft. Mm-hmm. Okay, all right, so, but I don't know, what else am I supposed to guess? Go ahead, keep touching it if you want. Oh, you don't gotta tell me twice. How does it feel? Very soft, very suede-like, very much like velvet. And it's red? Mm-hmm. Oh, that's hot.  Babe, chill. I'm ready for you to gobble me up on it. Chill. I'm just ready, I'm ready to go upstairs to the bed. All right, so what are we playing this game for? I'm ready. Because, it's exciting. Okay, but no one likes a T, so let's just get straight to it.  Yeah, I mean, like, I still, I don't know why we're playing the game. Whoa, whoa. Just give you a little peck. Hey, yo, all right, I'll give you a peck. Yeah, I know you would. Okay, what else am I supposed to guess here? I don't know. What's the whole point of this going on? I just wanna surprise you. Okay, well, can I take the blindfold off? Nope, I'm gonna keep teasing you and teasing you, until you can't take it anymore. Okay, but what am I supposed to be guessing now? I don't know, you tell me. Babe, I don't know, you're wearing a bodysuit, you said it's ready, and it has feathers. Okay, so what else am I supposed to guess? I don't know, what else do you wanna visualize? I mean, I'm just trying to actually see you at this point, and yeah. No, you can't see me yet. Why not? Because. Let me, Warren, are you facing me right now, yeah, right? Okay, turn around. Whoa, whoa, whoa, whoa. All right, babe, no more games, I think I'm ready to get stuff. No, wait, what? You heard me right, I'm ready to get stuffed, baby. Babe, you can. Bruh. Yo. All right, let's just take the blindfold off. Wait, no, back to the stuffing, bro, hold on, you're ready for a kid? Babe, come on, let's just go upstairs, I'm just ready to get to it, that's it, I'm over it. Take the blindfold off, let's do it. I made a typo, hold on. Bruh, what the fuck, come on, what are you doing?  Bruh, did you see your flaps? Bruh, get out of here, why? You want another peck? No, I don't want the peck anymore, Bruh, get out of here, I'm ready to be stuffed. I think you just ruined things giving for me. I'm never gonna eat turkey again. Turkey again, this is what you meant by red and the feathers and the stuff. You see my going? They get offers using that and thank you. I was right there, but then he left, so.  You love me, look at my wings. My feathers is up now, I'm ready to go. I am disgusted.  It is time for today's post notification shout out. Today's post notification shout out goes out to Asina Douglas, thank you so much for your love and support. I'm Zan and I love you. If you guys want a post notification shout out, all you guys gotta do is like, comment, share, subscribe. Turn on those post notification bells. I'm gonna show you my costume. Say it in a fight whenever we post a new video. And with all that being said, we will catch you in the next banger. Hey, don't touch my beak.


What's up everybody? Jason here for Jaspies. We just did some Fanatics Live Bricks today and this is a little quick recap of what we did in 2023 Top Chrome Jumbo eight box case break picketing number 34 So there's all the user names and the teams in the break So quick little recap here. So obviously, you know, we kind of Sleep in top load a lot of these cards here. So kind of just skim through these ones and we'll go with the autos All right, so some negatives couple of ultanis right there. There's a hyper All right some negatives again There's a number to rara Kunya, there's another old Tony orange So a lot of a lot of old Tony is kind of out of now for sure since he is gonna win MVP most likely for the ale All right, so there you go There's a gold Now let's go to the autograph So now unfortunately guys, I believe there was a box That had no auto so we were shorted autographs, which kind of sucks, but There's a guy reserved for the Padres double of him Cori Lee. You got paparazzi Well, Brennan Prato Wilson Connecting leers around Brad Beatty was nice for the Mets waters Henry Stevan for the Cubs Sosa Hensley appell Kyle Tucker was nice though for a vet there out of 50 capel Ruiz Stefanik. There's an outman Ray wave at 150 and they gave him a random variation laying weirs Radiant rookie and then a Sammy Sosa ultraviolet all-stars So not the best case we've ever done of this but still some nice stuff pop in there for a lot of teams So thank you guys. That was just a quick recap there of the tops chrome jumbo break guys. Thank you


This study identified a new antibody fragment called VNART1, which recognizes all three forms of transforming growth factor beta, TGF. It was found to be highly specific and selective for TGF, with an affinity of 9.61 times 10 to the power of negative 8M. Additionally, it was shown to bind to key amino acids within the TGF structure, suggesting that this antibody fragment could potentially be used to treat diseases associated with excessive TGF activity. This article was authored by Mernabasioge Flores, Ana Laura Marquez Aguirre, Salvador Duenas, and others.


with us this morning, Mrs. Sylvia Sorkin. Who I understand will be competing in a big contest this evening. I hope you can all get out the sunrise for that event. I wish a special assembly, but I hope you weren't too disappointed. I've been looking forward to this chance to speak to you because I've got a very important mission that I want the countries want, the same thing. A safer and better future for themselves and their children. And the growth in nuclear arsenals about injustice and persecution of fellow human beings and about threats to peace around the world. It was because I shared that concern that I went to Geneva to begin a dialogue for peace with Mr. Gorbachev. We talked about many things. The need to cut the number of offensive nuclear weapons on each side. The wars of independence being waged by freed men of good will should be rejoicing. That our deliverance from the awful threat of nuclear weapons may be on the horizon. And I suggested to him that I saw the hand on this issue. We were realistic going into these meetings with the Soviets. The United States and the Soviet Union are as different as two names Gorbachev is the leader of the Soviet Union and no leader has held out the promise of change. He has said that he wants a better relation. Let's begin at the very least to draw back the barriers that separate our peoples from whatever that exists between us. The Soviet Union is not a democracy. The hopes and aspirations of the Soviet people and of the people of America that I will see to it that information on these people-to-people exchanges is widely disseminated. We want all of you through us to reach agreements for deep reductions in nuclear arsenals with strict compliance. To help support an end to regional conflicts and to see to it that human rights are respected. Together we can build a future that will be safer and more secure for you and your children. Yeah, if suddenly there was a threat to this world and some other species from another planet outside of the universe, we'd forget all of the local differences that we have between our countries and we would find out once and for all that we really are all human beings here on this earth together. I don't suppose we can wait for some alien race to come down and threaten us, but I think that between us we can bring about that realization. Thank you all, God bless you. Thank Ronald Reagan on his visit to the Faustin High School for pretending Maryland's December 4th, 1981. With this in mind, I would like to present to you our mascot, a Faustin Cougar, as a token of our respect for you and our appreciation for your visit. The class of students here at Faustin High School have several questions prepared for you today on your speech this morning on the news. How come I'm nervous? You could all be seated. Well, it's good to see you and I'll try my best with the questions that you have and have you decided who's first or... Mr. President, my name is Bill Breher. And this is going to talk to yourself our very strong dependence on your respective political systems. It was apparent that the two of you formed a friendship, but there was also a sense of mistrust between you. Do you really believe we can achieve world peace with the Soviets? Yes, I have to believe that we can and I'm optimistic and hopeful of it. In spite of the differences between our systems, I think one thing on our side is the Soviet people have, are virtually obsessed with the desire for peace because of the suffering they underwent in World War II. The Soviets lost 20 million people in that war. And that was not just military. That was the civilians that died as the attacks went into their cities like a Stalingrad and all. So there is a great desire for peace there. At the same time, there is a mistrust and we have to at least recognize that I got the impression that they really, many of them do believe that we have hostile intentions toward them. And I tried to disabuse them of that thought by pointing out that when World War II ended, ours was the only country that our industry hadn't been bombed to rubble in the war. Our military was virtually intact. We had 12 and a half million people, men and women in uniform, and we were the only ones with the nuclear weapon. We were the only ones who had the bomb. At that point, we could have literally dictated to the world if we'd chosen to do so, and we didn't. We set out to help the other nations in the war, including our enemies. And I pointed this out to him that we had some evidence on our side that we didn't have hostile intentions. And I can only hope that it registered. This is one of the things that I think could come out of these meetings that we're having, because now that they too have been victims of terrorism, I think that they've got a very definite reason for wanting to... We do cooperate with all the other nations in the world, or most of them. We've managed to establish a contact, exchange information, and so forth on terrorism. And I hope the same thing can happen with them. And then I'll go that way. My name's Troy Baseton, and I've been wondering what checks you're putting in place to stop a $2 billion failure like the Sargent York program from happening again? Well, it is in the case of putting things in place, you don't want those things to happen, and yet you must realize that in that field, as in so many others, you're going to research, and your research indicates the potential of some weapon system, and you go forward, and now and then you're going to find that defensive abilities have been developing all the time too, and suddenly you find that something that looked good when you first planned it and ordered it has now been overtaken by a superior defense. And I don't know any answer to that. Just try our best and see that those kind of things don't occur. A verifiable agreement of nuclear disarmament can ever be accomplished? A verifiable agreement. Agreement? Yes, but it's going to take confidence and trust on both sides. And this was one of the first things that I talked to General Secretary Gorbachev about, that for us to start talking, reducing arms or doing this or that, we would first have to by deed, not just word, prove that we were losing our distrust of each other. Because as long as we distrust to the point that there are restrictions on whether you can go in and verify what the other fellow is doing, then you're going to have to be suspicious and believe that those restrictions are based on a desire to not keep the agreement. And this was the basis of one of our talks and made it plain again that it's more than just words. There have to be deeds, both sides, to show that we mean we want to get along. And this was why I offered to them with our Strategic Defense Initiative. I told him that their scientists could come into our laboratories if ours could come into theirs, where this research was going on so that they could see exactly what it was we were trying to develop. Steel imports are still coming into the country above the quotas that were set. What stuff are going to be taken to enforce these quotas? We have the quotas and here and there there are violations and sometimes there are countries that get into the steel business that haven't been there before. Our whole system is based on equity and trade between the countries. And we just have to pursue that and wherever we find a violation we then bring that case forward and nail the other country where that violation is occurring. I think I should maybe turn this way for a minute. I'm going to be fair at all, shouldn't I? What is the most important accomplishment of the summit being outside of the cultural exchange? I think the most important thing was the very fact that we decided to continue having the meetings. We had thought when we left that the Soviets might be so resisting to future meetings that this alone could make the summit a success if we could get an agreement and we got it on the first day there and with no problem at all. He was almost eager for that and I think that but also our agreement for ever since 1946 our country has been proposing controls of weapons and in more recent years the controls of nuclear weapons and we've had negotiators, Vienna in Stockholm and in Geneva on this subject. For the first time really now the Soviets have actually suggested a figure to which if we can work out the conditions they would be willing to reduce their numbers. Up till now we've been the only ones that have had a number and said let's do a wavevex number of weapons and there's never been in the negotiation of them coming back and saying we're willing to reduce this number so you could then haggle about it. Now we've both come to the agreement that the idea would be right now to start with 50% of the nuclear weapons and so I think this was an accomplishment also. Mr. President, my name is Steve Dahlko. I was wondering why was Boston High School choosing out thousands of schools across the country to be honored by your visit? Well, you're a pretty outstanding high school and you're also here within range of the capital. I'd like to do this in more areas of the United States but we just thought that this was a pretty good place to start telling your generation about our dreams of people exchanges and with the hope that we have that it will be your generation that will start these exchanges where we can get better acquainted. Mr. Steve Dahlko, I'm wondering what position was held by the Russians about the human rights issue? I have to be a little careful here on that because I talked privately with General Secretary Gorbachev about that. They feel very strongly that they could appear to be yielding to an outside influence if they change their laws and so forth that we think are so repressive. So I felt that that was something that we should talk about in private and I can tell you that he has our full view and understanding of how we feel about the differences between our two nations in that respect but it isn't something that I think you go public with because of this resistance of anyone in leadership position in a government about seeming to give in to an outside government but I can assure you they know how we feel and they know what we think would be a good move. Mr. President, my name is Kimberly I. Do you believe that in the future an economic exchange will be established between the United States and the Soviet Union? An economic exchange. Well, there are certain areas of trade now as you know between us and this too would come along with this better understanding. Right now with the conditions the way they are and the arms race that has been going on and their evident desire to be number one militarily we have had to have restrictions on trading with them things that might help them in their arms race and those are the restrictions the only ones that I know basically on the trade between us but we, there is trade particularly in our agricultural field and we want to keep those doors as open as we can. Mr. President, I'm advocate and in issue of arms production do you believe that there will ever be any significant agreement settled between the U.S. and the Soviet Union because of the unwillingness of either sides to take either way out of each other's major stockpiles? I think, no I think as I said before that we made a pretty good start here on this matter of the nuclear weapons I think that both sides recognize that as long as we keep building these mountains of armaments higher in an effort to stay even with each other and here I have to say on our behalf we are the ones who are trying to catch up they are the ones who went out ahead and have placed their military emphasis on offensive weapons where we have thought of them as a deterrent to war and why we are seeking a defensive shield right now that would render nuclear missiles if not obsolete at least more harmless as a threat but I believe that for the first time they recognized with some of their problems that the arms races helped create those problems for them they have brought so much on military buildup that they have had to deny their people many of the things that you and I think are just every day in our ability to go down to the store and buy them well they don't have such privileges and we hope that with that as a help that maybe we can begin a reduction back in 1980 when I was running for this job there had been a number of arms agreements but all of them were limitations on how fast and how much we would increase and I got pretty outspoken about that those weren't the kind of agreements we needed that we needed an agreement that started reducing them and so for the first time that's what we're proposing and what's going on in Geneva way in the back there My name is Jennifer Harrison How do you and Mr. Gorbachev propose to organize a risk reduction center to prevent accidental nuclear war? Now wait a minute, I had a little problem there How do you and Mr. Gorbachev propose to organize a risk reduction center to prevent accidental nuclear war? How do we propose to... You've got to forgive me, I have a little problem To organize a risk reduction center? Oh, well this is a thing that we're trying to put together here in a proposed and they seem very willing to go along with this and this is to have, again, meeting places where our own military can meet with each other so that there wouldn't be danger of one or the other of us thinking that a hostile action had been taken This is more information on maneuvers war games, practice war games and so forth and we would have these centers where we could immediately communicate with each other at a military level and know what's going on So we're going to go forward with those and it's kind of a new experiment so I can't tell you exactly how they'll work out As we said, the Soviet... was a one world communist state So this has caused us to view with alarm as I say, their outright offensive build up of offensive weapons Now I think this would be one of the things and the type of deeds that we would talk about if they do not still follow that Marxian principle if they are not aimed at expansionism and conquering or taking over the whole world then they can help prove that they are joining in arms reductions to show that they have no hostile intent But this is one of the reasons for the basic suspicion between us Mr. President, I have a question concerning a different issue Due to the success of the crew of the Atlantis with experiments in the area on space construction what are your plans concerning Skylab or Space Station? We believe that the newest frontier in the world is space and we believe that the shuttle experiments so far have shown us so many literally miracles that can be performed in the weightlessness of outer space that instead of these just shuttle flights going up with experiment that we should see if we cannot put together out there a place where then the shuttles could carry workers and workers in space could develop let's take in the field of medicines alone we have an incurable ailment diabetes we have found in the experiments in the shuttle out there that a cell which in order to have a cure for diabetes must be able to be divided and split we can't do here on earth as we could do it up there in the weightlessness of space so there are other medicines and things of that kind that from the experiments already conducted we believe we need a place now not just experiment but to actually manufacture and so this kind of a Space Station I don't particularly like that name Space Station I know some people are toying with things like call it a universal space camp Station again has a kind of a hard possibly military sound to it and that isn't what it's for First I'd like to thank you for mentioning the contributor's competition at Rising Sun today I'm a cheerleader my question to you Mr. President is simply how do you feel none of the effects of any decision you make concerning the strategic defense initiative or more generally the nuclear arms race literally affect the lives of billions of people all around the world Well it's something anyone in this position has to live with it isn't easy and I have come to understand very much why Abraham Lincoln once said that if he well he said that he had been driven to his knees many times because there was no place else to go and he said if he didn't believe that he could call on someone who was stronger and wiser than all others he couldn't meet the responsibilities of his position for a single day and all you can do is try to the best of your ability with all the input and knowledge you get then hope that the decisions you make are based on what is morally right and that's all you can do and as I say I have come to understand very much what Mr. Lincoln meant he's supposed to be around the White House you know now and then Mr. Reagan, my name is Todd Pegg and I'd like to know what will the United States position be when the SALTO agreement expires late in December we haven't made a decision on that yet we have compiled a report right now that shows the Soviet Union has committed 23 violations of the SALTO agreement and we have to decide whether we can have complete agreement on both sides that we're going to abide by it even though it has never been ratified or we're going to have to conduct ourselves on the basis of what they are doing also there's no way that we could be so one-sided as to be destroying missiles and things of that kind to stay within a limit that they are violating this is one of the things when I talk about an arms buildup and where the race started when SALT-1 was agreed upon from the time of SALT-1 the Soviet Union has added 6,000 warheads nuclear warheads and since SALT-2 3,850 of those have been added and this is what I mean about agreements that were aimed at trying to limit the increase instead of flatly saying let's get rid of some of these things so we have a decision yet to make on that and it's going to in part depend on our negotiations with them about the present violations of that agreement and I'd better come back over here and I was wondering do you feel that a nation other than the United States or the Soviet Union could possibly start a nuclear war? that another nation other than the Soviet Union of the United States could start a nuclear war well we know that there are a few other nations some allies of ours that have some nuclear weapons we suspect that here and there there have been efforts whether they've succeeded yet in creating a missile or not we don't know but other countries and some of them other countries that are in the third world and where there is a lot of hostility and instability wars can start by accident if you take World War I it's been called by everyone who ever knew in history the war that no one wanted but it started when a terrorist a radical through a bomb at a leader of a European country assassinated the leader of the European country and out of that came World War I which finally included even the United States wars can start accidentally wars can spread across borders regional wars such as the one in Nicaragua and this is why this was one of our subjects also for negotiation we want to help in any way we can to persuade the Soviet Union to withdraw its troops they've had their fighting for six years bring them home and then let the people of Afghanistan within their country settle peacefully what kind of a government they want the present government of Afghanistan was installed there by the Soviet Union so that's why they're in defending that government I feel the first impressions are very important a little louder there I feel the first impressions are very important what were your first impressions of the premier general secretary Gorbachev my first impressions of him very intelligent man and while at the same time I recognize that he heart and soul believed in his in the system but he's grown up in he's young enough that this is all he's ever known he grew up even earlier than you in this in this system he has faith in it believes in it but at the same time having dealt with other leaders the Soviet Union who can kind of pound the table and get quite excited about things no our discussions I must say would be like we're having him he listened well and I listened to him and we were affable in this and it was a case of disagreeing on particular issues but no hostility no enmity and I had to believe that he believed some of the propaganda that's been going on for 70 years about us that he's never been to the United States and that his impression of us he was ready to believe for example that our strategic defense initiative that we're trying to find a defense against nuclear weapons that really out of that research we might develop something that would be a weapon in space for attacking them and I countered that by telling him that if our research yielded a defensive weapon we would sit down with them and with our allies with all the world and share it and say look why don't we all have this and then none of us have to have nuclear missiles and I hope that that had some impact on him but no I think that I have no illusions about him suddenly turning soft about their system and he totally believes in that that's the system that the people should have and I said to him look you have your system we don't like it and you don't like ours but we can each have our own systems and still get along together I hope you like teaching maybe one day I can try out your job well thank you very much having a meeting Helen later today back at the chapel and I'll be in front of you


So we're gonna talk a little bit about transient visual loss. Let's just start by defining what it is. So it's a sudden loss of visual function. It could be partial or complete in one or both eyes. However, it lasts less than 24 hours, so that's the key right there. Most common cause of monocular transient vision loss is retinal schema due to carotid artery disease, and the most common cause of binocular transient visual loss is migraine. Just remember that. And as you always hear, you know, Dr. DeGruy and Warner always belabor this point about obtaining a good history. This is the key to making the diagnosis. This is not like, you know, it's not just in their ophthalmology, but it's also in UVI it is, and one of the more complicated sub-specialties. But the history is very, very important. It's alive and well in ophthalmology. So a little bit about the some key points when you're taking the history. Monocular versus binocular visual loss, it helps to localize the lesion. Typically, if it's a monocular issue, you always think about a lesion that's that's pre-chiasmal, and if it's binocular, think about chiasma or retrochiasma. You should also be aware that, you know, when patients experience a transient monomous hemianopia, they a lot of times describe it as monocular vision loss. However, it's usually in the eye where it has the or is experiencing temporal deficit. Okay, so keep that in mind. Age is also important to believe if they're younger than 50 years old, think a lot of, you know, think horses, not zebras, so migraine, vasospasm. However, in pregnant women, you should always consider the diagnosis of eclampsia. It's typically occurs, you know, right around the times, the time of delivery, and it's due to a more serious pathogenic cause, something known as vasogenic edema, edema of the occipital cortex. So remember that. Older than 50 years old, think about cerebrovascular disease or giant cell artery, right? It's typically if they're even, you know, older than like 60. All right, so duration of vision loss is actually very important as well. So if it's lasting seconds and it's associated with changes in posture, think about optic disc drusen or papillodema. If it's monocular lasting several minutes, but no more than 15, think about ipsolatal internal carotid artery stenosis. If it's binocular lasting 20, 30 minutes with scintillating scatomas, you would, everybody in this room would think about migraines. However, retinal artery spasm, this is something I wasn't really familiar with, but this can present, I mean, this kind of, it kind of throws, you know, a curveball in your diagnosis or your differential because it can last from seconds to an hour as well. So this is something to consider. Here's a good chart, thinking about, you know, your differential, depending on how long the vision loss lasts. And I can send you guys this slide afterwards. It can help you when you're seeing patients with vision loss, but it typically happens for, you know, a couple of seconds. Think about tear film abnormalities, papillodema, optic nerve hitches, and what we spoke about, some congenital anomalies of the disc. Think about a large PVD, especially when it moves with the eye movement, as well as gaze evoked hemorrhosis. Does anybody know what that is? Chris, you'll talk about it. Perfect. Perfect. Okay. And then minutes. I don't want to steal any thunder from Eileen or Julia, but a lot of the vascular pathic causes, you should think about that hypercoagulable conditions, cardiac abnormalities, utophth phenomenon. I don't know if either of you are going to be covering you. I'll be covering that. Okay, great. Pattern of visual loss and recovery is also important. Monocular descending curtain, tunnel-like constriction, sudden loss of vision. Think about retinal emboli, altitudinal aspect of visual loss. Think about carotid artery disease, vasospasm, or Naion. It's classically, you can see it. As well as vision loss precipitated by exercise. Think about vasospasm and demyelinating disease. And Julia said that she's going to elaborate a little bit more about Udhoff's phenomenon, but this is typically seen in patients with a demyelinating disease where they get transient visual blurring with activity or elevation of their body temperature. A little bit more. You should always think about the posterior circulation, particularly ischemia occurring there when they have complete simultaneous bilateral visual loss or hamonomes, hemianopia. And this is something I didn't know of. There was that binocular visual disturbance that's described with a geometric quality, typically this hexagonal chicken wire pattern. Think about occipital lobe dysfunction. Some associated symptoms and additional signs, positive visual phenomenon associated with headache as the classic migraine. If you have persistent headache with intra-cranial noises like a pulsatile tinnitus, you always think about increased intra-cranial pressure. GCA, everybody probably had this beaten into their heads about scalp tenderness, jaw colotication, headache, weight loss, fever, a lot of the other constitutional symptoms. You also get loss of consciousness associated with dizziness, diplopia, dysarthria, a lot of the bulbar symptoms. Think about global perfusion problems, typically affecting the brainstem or the cortex. And the skin and joint changes, renaughts phenomenon. Think about collagen vascular diseases as well. Some pertinent points that you want to pick up from the past medical history. Ask about vascular pathogryst factors, hypertension, diabetes, hyperlipidine and carotid stenosis, hypercoagulable risk factors, their migraine history, their smoking history, if there's increased risk for clots, recent surgery, their medication history, typically more importantly, their oral contraceptive pills or hormone replacement therapy, which makes them more coagulopathic, IV drug use, recent trauma, any congenital heart defects or acquired heart defects as well as demyelinating diseases. Examination, as many of you have already gone through the neurophemology rotation, you always want to do a full exam most of the time. Most of the time, you guys are probably going to see the patients in the ED, so just check everything. So from their visual acuity, their fields, extracurricular movements, Dr. Bird's going to talk a little bit more about the gaze about the amaurosis and the significance of that, but that's also important as well. Any abnormalities and movements, it's important as well. Color vision, pupils, DFE, and the photo stress recovery test. Can anybody tell me, Chris, can you tell me what the photo stress recovery test is? So you basically hold the lights for a certain amount of time and see how quickly vision recovers should be like 10 to 15 seconds. 45 seconds. Yeah. What's the cutoff for? So what does it help you distinguish? So whether it's like retina pathology or macular pathology versus optic nerve. Yeah. And the cutoff, do you know if it's a macular or retina problem? 90 seconds. Typically 90. If it's more than 90 seconds, you think more of a retina pathology. So examination, here's a good chart. Think about differential depending on your examination findings. So if you have a normal ocular or neurothalamic exam, migraine, intravascular embolus, that's already cleared, retinal arterial vasospasm or retinal optic nerve hyperprofusion due to systemic hypertension. The thing that I did not know about with retinal vasospasm is that if there's an acute episode and you actually look at the fundus, you can see retinal arterial constriction. Is that true, Dr. Degree? Have you ever seen that? Perfect. Great. So we won't have to talk about that good. No, no, no.  So I didn't want to steal anybody's thunder. And then yeah, so I'm not going to go into these, these other findings because Julie is going to talk about that. And these are just some common nonvascular ocular causes of vision loss of tear film abnormalities, corneal disease, recurrent hyphemes, something I also thought about was like uveidities as well, something you should think about. Angle closure glaucoma, vitreous debris, macular disease, and a lot of the optic nerve problems that we already kind of covered at this point. So just quick quiz. And then I just want to say something about because this will be the only time you cover the ocular causes. Yesterday in clinic, we had a woman who had numerous complaints and numerous types of ocular visual loss. But but hurdles have come and went in monocular and binocular. The tear film don't, don't just call it tear film because it's really very heavy. All right, everybody done. Next one. Ready with that one. Everybody done? Got those. Alright, so question number one. What is it? You call it out? Anybody? Yeah. Number two. Well, I have to say it's a big comment.  I said, could you she goes, Well, it's blurred. I said, but could you see print? You know, through this work. And yes, she could. It was, you know, I have to say it's it's so common. And I've seen people get worked up for my carotid. And utop phenomenon. Someone tell me what that is. Absolutely perfect. Last but not least. Call him out. Good tunnel vision. Good. And last


It is now time for oral questions. I recognize the leader of Her Majesty's loyal opposition. Thank you so much, Speaker. Speaker, my first question this morning is to the Premier. On Friday, the Government's long-term care commission confirmed what frontline staff and families of residents have been crying out for months. And I'm going to quote from that report. Long-term care homes were forgotten in the initial provincial plans to control the spread of COVID-19 until residents started dying. Now, just last week, the Ford Government's Minister of Long-term Care was still insisting that the Government had acted immediately and done all it could. No one on that side of the house, not the Minister, not the Premier, is prepared to take any responsibility for the disasters that have unfolded in long-term care. So will the Premier finally do the right thing and ask his Minister of Long-term Care to resign? Mr. Speaker, please take your seat. Minister of Long-term Care to reply. Thank you, Speaker. I reject your premise in your statement. I have been a doctor, physician, family physician for decades. I came to politics because of issues surrounding long-term care that I knew both professionally and personally. And I want to thank the commissioners for their report, this early report, to help us with guidance and to create transparency for the public. This is a very important commission that is nonpartisan. It is independent. It is transparent, and it is publicly facing. And I appreciate it hearing from all of the groups that want to be heard in this. Our government has worked relentlessly with a commitment like no other government in the history of this province for long-term care. A response? Thank you, Speaker. The supplementary question. Speaker, I think it's pretty disgraceful that the Minister is pretending that there is nothing in this report that is problematic. The report says clearly that government didn't plan to protect seniors in long-term care when COVID-19 was hitting our province. And that's a shameful thing to have happened. And somebody needs to take responsibility for it. The report only confirms what residents have been saying and what family members have been saying for months. In fact, for years, on Friday, CBC's marketplace revealed that there is routine abuse and violations that occur in most homes across the province. And there are virtually no consequences, no consequences when those homes break the law repeatedly. Now, sadly, this situation of a neglect and of abuse has become the norm in long-term care, completely unacceptable. If this happened anywhere else, what happened in long-term care with COVID anywhere else, the Minister responsible would be offering her resignation. Why has the Premier failed to do the right thing and asked for that Minister's resignation? Minister of long-term care. Thank you, Speaker. And thank you for the question. We look at the neglect for decades by the previous government and supported by the opposition right here today. When you had the opportunity to deal with the deep, deep issues, the systemic issues in long-term care, you did not take them. Our government is the government that is committed to repairing, rebuilding and advancing long-term care. And I am the Minister who cares so deeply about long-term care that I have come after many years of serving the public, caring every day about patients and families, and doing my very best to serve them. And now I'm here serving Ontarians, and I will continue to be relentless working with other ministries, working across governments. And I would hope that you would be part of the solution in such an unprecedented situation. I will be relentless. Thank you. I'll remind all members to make their comments through the chair. Start the clock. Final supplementary. Speaker, what the Minister hasn't figured out is this is not about... Order. Member for Northumberland, Peterborough South. Come to order. I'll give you extra time. It's about what's happened in long-term care, and if there was that much neglect, she should have known and should have protected long-term care homes from COVID-19, should have protected those residents. She shamefully admits that she knew the system was a mess, and yet they forgot to plan, forgot to plan for protecting seniors in long-term care. Families, residents, frontline staff in long-term care homes were not surprised by the commissioner's report. These are the same issues that they continue to plead with the government, and they were pleading with the government for months and even years to try to fix. The Friday's commission report really did feel compelled to tell the minister to actually take her study that she commissioned and received back in July off the shelf and start implementing it. Stop studying the study for goodness sake. Get some things done. No one's accountable. Nobody is... nothing is changing at all for people. So the premier now has to actually do the right thing, and if she will not resign, if she will not do the right thing and resign, the premier of Ontario needs to fire his minister of long-term care. Stop the clock again. Stop the clock. Minister of Labor must come to order. Start the clock. Minister of long-term care to respond. Thank you, Speaker, and thank you for the question, and I would suggest to the member opposite, please don't make it about me. I want it to be about Ontarians, if you continue in the proper... of why we are here. It is about serving Ontarians. It is about repairing, rebuilding, and advancing long-term care. And the actions that we've taken speak for themselves starting very early. The Ministry of Health, the lead on the preparedness plan, making sure that all across the sector there was integration. A group of experts, not only in public health, public health Ontario, but on Ontario health. All the expertise, whether it's in testing, virology, many, many experts in forming this plan. And so I agree with you. This is about Ontarians. It's about serving the people. And it is not about me. The unprecedented issue that we've seen with COVID across the world, looking at asymptomatic spread, something that the world has never seen before. So now our government is... Thank you very much. The next question, once again, the Leader of the Opposition. Thanks so much, Speaker. My next question is also for the Premier. Yesterday, Ontario achieved a troubling new milestone as total daily case counts of COVID-19 soared to a record high. It's clear now that the failure of the four governments planned to deal with the upcoming second wave, which we're now in, and make the necessary investments in things like testing capacity, smaller class sizes, staffing and long-term care, is having a devastating effect. Weeks ago, the Premier claimed Ontario was flattening the curve and hitting a plateau. And now, he has to answer the question, is he prepared, finally, to admit that his government's plan for the second wave has fallen tragically, tragically short? Deputy Premier and Minister of Health. We took steps very early on to prepare for the fall. The fall preparedness plan, keeping Ontario and safe with six key pillars. And we've also put $2.8 billion into this plan across the board, making sure that we can respond to surges within our hospitals and public health facilities. Making sure we have the strongest flu campaign in Ontario's history. Making sure that we have the health human resources that we need to make sure that we can have the people that we need working in our long-term care sector and in our hospitals. We've been preparing for this. We've already taken steps in four key areas with modified stage two. We're looking to see for the results. There's a problem in the sense that there was Thanksgiving festivities that happened about the same time as we cut back and modified stage two in four areas. So we still have to wait to see the effects of those provisions. But we are seeing the numbers starting to go down in certain areas. The total numbers are still troubling, but we are starting to see some of the numbers go down. A supplementary question. Speaker, all summer long, the Premier simply ignored experts that were pleading for the government to protect kids in classrooms, seniors in long-term care, and to upgrade our chronically under-resourced lab system. Instead, he's offered direction that is so inconsistent and so unclear that even his own MPPs are publicly calling for clarity. This weekend, two government MPPs wrote the Premier warning that people may start ignoring public health advice. And the member for Niagara West, as we all saw, literally posed for a photo where he violated public health guidelines with over 40 of his friends and family. So why is the Premier's own team challenging and outright ignoring his directions? Government House Leader to reply. Thank you very much, Mr. Speaker. Of course, nothing could be further from the truth. The member opposite will know that the members for Milton and Burlington were responding to a challenge that is happening in Halton, Mr. Speaker, where the elected officials there currently disagree with their chief medical officer of health on how this, on how Stage 2, if and when Stage 2 should come into effect in Halton, Mr. Speaker. Of course, we would expect that our members would attempt to intervene when there is those types of disagreements. They did the right thing. I suspect, and I would hope that members opposite would do the exact same thing when their municipalities find themselves in the same situation. Can I ask the Government House Leader to withdraw the... withdraw. The final supplementary. Thank you, Mr. Speaker. People have been let down. That's the truth. People have been let down by this government's refusal to prepare properly for the second wave. They've been stuck in long lines, they've seen jobs disappear and businesses close, they've lost loved ones in long-term care. The Premier's focused on saving money. He was focused on saving money when he should have been focused on saving lives. And now his own MPPs are questioning him or outright ignoring health advice. Is he now prepared then? Is the Premier now prepared to admit that his government's planning for the second wave of COVID-19 was tragically a disaster? Government House Leader. Again, Mr. Speaker, as I just said, the members for Burlington and Milton, I know that the member for Oakville and Oakville North Burlington also have some concerns with respect to the fact that in Halton there is a disagreement between elected officials and the Halton Chief Medical Officer of Health with entering Stage 2. As a result, the members sought clarity from the Ontario Chief Medical Officer of Health as I would hope that all members would do in instances where there is a clear difference of opinion. Mr. Speaker, with respect to COVID-19 measures, look, this government, we're very proud of all of the work that we have done. We will continue to fight COVID-19 with all of the resources available to us and by doing something extremely different than what the Leader of the Opposition would suggest. By working together with our friends in the municipal... Response? ...and across party lines, Mr. Speaker. Thank you. The next question, the member for Tomiskaming Cocker. Thank you. My question is to the Premier. With COVID cases peaking, it's vitally important that we all follow the rules. The Premier and his daily press conferences implores us. You know, social distance, wear masks. Don't let your kids come home for Thanksgiving. And Ontarians across the province followed. Followed his advice. But now we see a picture from one of the Premier's own team with 40 people unmasked. So could you please tell Ontarians why his own team doesn't follow his advice? Mr. Chairman, I'll sleep. Again, thank you, Mr. Speaker, for that question. I'll be clear. The member in question has apologized for the lack of judgment in that instance. I've spoken with him as has the Premier. We accept his apology. And of course, we encourage all members to do everything that they can to help us, help Ontarians to flatten the curve and defeat COVID-19. And the supplementary question. Once again to the Premier. Apology is great, but we need to set an example. You need to set an example. What's even more concerning is that the member from Niagara didn't seem to think that that was a problem. Like, are you really taking this seriously yourselves? Really. So it's a case of do as I say, but not as I do. And it's not going unnoticed. Anthony Dale, CEO of the Ontario Hospital Association said the member should resign from his parliamentary assistant role. That would set an example. Is the Premier willing to ask for his resignation? Mr. Speaker, what the member did was wrong. He apologized to the Premier and myself. We both spoke to him, but when it comes to following the rules and what we do as I say, and not as I do, this is an opposition party that on day one, when we return to this place after negotiating a cohort agreement, on day one, that agreement, Mr. Speaker. So when it comes to listening to all that we can, when it comes to listening and doing this is an opposition, Mr. Speaker, that within 10 hours of an agreement being reached to keep this legislature order, to keep the business of the people being enacted decided to ignore that, break the cohort, Mr. Speaker, and flood this chamber, Mr. Speaker. So I would suggest to the member opposite to take a good long look at the mirror. The Leader of the Opposition come to order. The Member for Windsor West come to order. The Member for Hamilton West and Caster Dundas come to order. The next question, the Member for Oakville. Mr. Speaker. My question is to the Associate Minister of Energy. Mr. Speaker, the COVID pandemic has changed my constituents' lives dramatically by forcing them to work and spend much more time at home. I know we froze the time of use electricity rates and introduced a COVID-19 recovery rate of 12.8 cents per kilowatt hour to help them through a very difficult time. But what happens next? Could the Minister please tell us to let Ontario's choose what's best for their family when it comes to electricity pricing? The Associate Minister of Energy. Thank you very much, Mr. Speaker, and thank you for the member from Oakville for his great work and a great question on behalf of his constituents. Because of our decisive action this past summer, insurance benefited from stability and lower electricity bills. We knew that when homes became offices and classrooms that the laundry machine and the air conditioner would need to run more. Insurance have had no choice but to use more electricity. That's why it was critical for us to provide stability and predictability. Starting in November 1st electricity customers in this province will be able to choose a plan that best suits their household and lifestyle with the option of choosing either time of use electricity rates or tiered pricing which will provide a set rate for electricity up to a certain level of consumption. Mr. Speaker, insurance deserve to choose what works best for them and their families and our government will always look for ways to make life more affordable for the people we're giving the privilege to serve. Thank you, Speaker. And a supplementary question. Thank you to the Minister for that answer and I know that many of my constituents will appreciate the option to be able to choose an electricity plan that works best for them. Mr. Speaker, COVID-19 has changed the way people work right across this province. Some may be spending more time working at their home and other essential workers are spending much more time than ever at their workplaces. Mr. Minister, please tell this House how the Customer Choice Initiative considers all Ontarians no matter what their work situation. The Associate Minister. Thank you again Mr. Speaker and through you, the member from Oakville makes an important point. Ontarians consume electricity in different ways and they all deserve the opportunity to save on their electricity costs. Whether you work from home 9 to 5 or do shift work or work multiple part-time jobs customers use electricity differently. If customers use more electricity during weekends like evenings and weekends time of use may be better rate plan for them. But if customers use more electricity during weekday hours, tiered pricing can help them save. That's why we're offering both Mr. Speaker Choice. Mr. Speaker, for all that Ontarians need to do to make that advantage of this program is contact their local distribution system center and they will be switched to the price structure of their choice. We're proud to offer stability and affordability Mr. Speaker when it comes to electricity for the people of Ontario. Thank you. The next question is from London Fanshawe. Thank you Speaker and my question is to the Premier. This week the government's long-term care commission echoed a long standing call from new Democrats frontline workers residents in long-term care to establish a minimum of standard of four hours per day of hands-on care per resident in every long-term care home in this province. This week the time to care act which would establish the standard in law is up for debate for the fourth time. There should be nothing left to debate. This is a long overdue and simple measure that will protect seniors and improve their quality of life. Will the Premier support it? Mr. Lantern care to reply. Thank you Speaker and once again I want to thank the commissioners for their early response. This is something that we had been looking to to the commission for early guidance if possible and so we are very appreciative of that and certainly we've recognized the long-standing staffing issue in long-term care the crisis that was leading into our government's situation when we took in 2019 in the summer as a new ministry understanding what really had not been done by the previous government. So clearly we take the safety and well-being of residents and staff in long-term care as a main priority. There is no doubt about the importance of their safety and the well-being and the care the high quality care that our residents need and their complexity understanding our residents are more complex than ever before. So we understand the imperative to addressing the staffing issue the issues that are long-standing in long-term care and we will continue to work towards improving care for our residents. Thank you. The tragic reality is Harris eliminated the minimum standards of care for over two decades ago government after government has promised action and failed to deliver. The Liberals promise to re-establish the minimum standards in 2003. Before the last election every conservative in this legislative voted to support this bill. The government's own staffing review and now their commission have called for this to be enacted urgently. The government has established a minimum of four standards of four hours of day hands-on care per resident in this province. Thank you very much Mr. Speaker. I appreciate the members question with respect to private members business. We'll be debating that if I'm not mistaken on Wednesday when the House will give consideration of her bill. The next question the member for Cambridge. Thank you very much Mr. Speaker for the weekend former employer of the Premier's Chief of Staff the Toronto Sun Tabloid in an active state propaganda mischaracterized a letter signed by two government members as pushback against the Premier when in fact it was written to the Chief Medical Officer of Health and not the Premier. It was another example of this government passing the buck. Six weeks ago during question period I stood here and I asked the government for objective criteria and a framework. Why did the government refuse transparent objective criteria prior to shutting down businesses in four regions across Ontario? Mr. Health. We have been very transparent with the information that we've published with respect to why some of these areas were put into modified stage two. It depends on a number of factors including the number of cases of course the ability of our public health system to be able to deal with that in terms of contact tracing testing isolating and so on in hospitals to be able to manage that access capacity if we have an overrun of patients with COVID-19 and of course we consult with the Medical Officers of Health in all of those areas. It's not just one person that makes this decision it's Dr. Williams it's the Public Health Measures Table but it's also the Medical Officers of Health in those particular areas in the areas that are now in the modified stage two the local Medical Officers of Health in those areas that are now in the modified stage two. It's not just one person that makes this decision it's necessary. The supplementary question. Thank you very much Mr. Speaker. You know this government continues to pass the buck in one breath they say they rely on medical experts and want the public to give them a pass on their botched use of emergency powers because they aren't doctors. In another breath they threaten swift action and that they might bring and this government are they making the decisions or not because if they're not making the decisions and don't want any of the criticism perhaps they should let the Chief Medical Officer who they like to blame serve as First Minister and Minister of Health so I repeat is this government making the decisions or not? Minister of Health Well in every case all of our decisions have been made based on scientific evidence and clinical evidence I'm not sure if you remember through you who she would like us to rely on to make these decisions we have to make decisions based on the scientific evidence based on the recommendations of the medical officer of health on the people on the health command table on the people on the health measures table by number of doctors physicians who have volunteered their time to serve by the medical officers of health and all of the units this isn't a single decision it's made by the political advisors by all of us as politicians based on the recommendations of the medical officer of health and all of the other people that are giving us recommendations that's what we should be making the decisions on that's what the people of Ontario expect us to be relying upon Thank you the next question the member for Whitby Thank you My question is to the Minister of Children and Women's Issues Speaker we sit in this house many times and even more outside of it Ontario's child welfare system is broken it's an outdated system with only minimal changes through its over 125 year history while there have been some improvements small changes aren't enough apprehensions Speaker seems to be the first choice rather than accessing the family issue and providing the right support it's also clear the child welfare system is just protecting children in the home unfortunately Speaker the previous Government helped by the NDP let the system suffer Speaker can the Minister of Children and Women's Issues please confirm with the house that she won't keep the status quo but actually help children in need to respond the Associate Minister of Women's and Children's Issues Thank you to the member for Whitby for that question no child no family member should fear speaking to a children's aid society or asking for help children and youth should not be removed from their cultures, religion, faith or communities and Speaker poverty is not a reason to remove a child from a loving home the culture in Ontario's child welfare system needs to change and that's exactly what we are doing we are moving from apprehension to prevention on intervening early and providing supports to keep children and youth with their families and communities as best as we can when they do need to be removed we are prioritizing family based care over group homes and giving children and youth a stronger voice in the decisions about their care Speaker we know that children and youth who maintain connections to mothers, fathers family, community, faith or culture have better outcomes and that's what we are going to do thank you back to the minister and thank you minister for that response minister makes an important point that children and youth who maintain connections to their mothers fathers, faith cultural communities have better outcomes Speaker the impacts child welfare has on individuals reaches far beyond the home and in his current state those in contact with the system have worse life outcomes changes need to happen Speaker and kids need a modern system that puts them and their families at the center Speaker can the minister commit to modernizing the child welfare system so that children and youth who have been left behind by the Liberals on the NDP will now have a chance at success the associate minister thank you the member for raising this important question the member is correct that child welfare is about so much more than just protection it is about community it is about family supports it is about education and building a strong foundation for success and I can say yes I can commit to changing a system for the children and youth and families in Ontario who need it that's why I am working with my colleagues to create a better integrated system so that a woman fleeing violence doesn't have to worry about being separated from her kids so that children who might have to be removed from their home are getting supports in school and don't fall behind so that Indigenous children can remain in their communities and receive culturally appropriate care and stay with families Speaker redesigning the child welfare system won't happen overnight but we can commit to the long-term work that is needed to achieve success and positive outcomes for children, youth and families future generations are depending on us thank you very much the next question the member for Kitchener Thank you Mr. Speaker my question is for the Premier Mr. Speaker Ontarians are not pleased to see that this Premier is rewarding Charles McVeedy for his friendship and his political support instead of focusing on helping Ontarians to get through this pandemic the Premier is distracted by his current arts and science degrees at his college today the National Council of Canadian Muslims called on the Premier to distance himself from this man and his bigotry and to reassess whether this Government will proceed with schedule 2 of this legislation and so I ask will the Premier listen to NCCM and all other Ontarians outraged by this decision to support Charles McVeedy's hateful views The Parliamentary Assistant Mr. Speaker and I thank the member opposite for the question Mr. Speaker just to be clear independent review of degree granting has existed for decades under governments of all stripes factually this institution has had the ability to grant degrees up to the PhD level under the previous Government and since the 90s Mr. Speaker the reason we have a high quality of education in the province of Ontario is because parties of all stripes have supported the independent process and review of secondary quality assessment board thank you Mr. Speaker supplementary thank you Mr. Speaker and back to the Premier the Premier should not be doing political favours for his close friends and die hard supporters people like Charles McVeedy I've written to the Ontario Human Rights Commission and I've asked the chief commissioner to look into whether this bill is a violation of Ontario's Human Rights Code or Canada's Charter of Rights given the long standing track record of Charles McVeedy using this college as a platform for discrimination and harm against protected groups and the concerns raised by NCCM among so many others will the government do the right thing and pull this bill while the chief commissioner looks into the matter again the Parliamentary system replied thank you Mr. Speaker again just to be clear enabling legislation for degree granting has existed under governments of all stripes and Mr. Speaker it is reliant on the independent process of the post-secondary education quality assessment board we look forward for the review Mr. Speaker thank you next question the member for Scarborough Guildwood thank you Speaker my question is for the Premier Speaker in March this government announced their COVID-19 action plan which was largely comprised of tax deferrals for businesses instead of the real help that they needed like commercial rent relief just a few weeks ago the Treasury Board President told us that he is planning to collect an astonishing 100% of those tax deferrals despite being businesses being closed with no cash flow and we are now in a second wave shutdown to slow the spread of COVID-19 it is clear that the March action plan failed it is clear that there was no plan for the second wave the Premier was taking a summer victory tour while Ontarians were waiting for back-to-school plans and lining up for hours to get a COVID test Speaker will the Premier's budget include a real second wave plan not just deferred supports will the Premier make investments commensurate with the health crisis that we now face and how will the Prime Minister thank you the parliamentary assistant to reply Thank you very much Mr. Speaker and to the member opposite what the Premier was doing was touring this province engaging with the small businesses throughout this province Mr. Speaker these are moment pop shops and behind every single one of those closed doors Mr. Speaker is a family trying to provide for their loved ones during a very difficult time and I reject the member's statement Mr. Speaker that's been tax cuts employer health tax cuts to the tune of 300 million dollars 175 million dollars to keep hydro rates low 300 million dollars just announced for the regions that are affected by the revised stage to Mr. Speaker and that's going to go help with their fixed cost whether that's hydro whether that's those taxes that we spoke about Mr. Speaker or even with property taxes and so while the member opposite considers that consulting with those hard working response as a waste of time we disagree here on the government and the supplementary question Mr. Speaker you know as the PA lists these figures and they claim that you're committing for support the FAO points out that this government is sitting on 9.3 billion dollars in reserves and unallocated funds which could be invested in programs and supports for Ontarians to keep them safe in fact you've fallen short on long-term care participation on small business and in fact when you look at cutting off the emergency benefits that the most vulnerable Ontarians rely on in OW and ODSP income supports Speaker since March as the PA knows the Standing Committee on Finance and Economic Affairs held hundreds of hours of hearings across industries sectors hearing testimonies and witnesses from restaurants to spas to tourism operators tech hubs in fact we have this book of ideas that have been presented why are we still waiting for supports for the much needed supports that have been called for what are you waiting for parliamentary system to reply Thank you very much Mr. Speaker certainly a lot to digest in that question but I want to share with that member a lesson that my parents taught me at a convenience store in Rexdale and that is when times are good you put away for a rainy day and that's what this government did in its first two years of its mandate and that's why we're able to provide that direct relief Mr. Speaker the member opposite mentions the FAO report and I want to remind the member that the FAO's first quarter report is a snapshot in time and it would be irresponsible of a prudent government to spend its entire year's budget in that very short period of time and it would be announced 300 million dollars for the revised stage two those supports are going to continue in a coordinated effort with our federal partners in Ottawa Mr. Speaker to fill the gaps of this joint program that is released and that's why we will have this for the support measures announced in that budget and I look forward to continue to assist the great hard working business of this province through the budget Stop the clock Mr. Labour will come to order the member for Scarborough Guildwood will come to order the next question the member for Perry Solomon Thank you Mr. Speaker my question is for the Minister of Energy Northern Development and Mines and Minister of Indigenous Affairs Mr. Speaker we know that this has been a challenging period for many of us but small business and particularly northern small businesses have been hit hard by the COVID-19 pandemic through the Speaker to the Minister what is our government doing to support Northern Ontario small businesses The Parliamentary Assistant Thank you Mr. Speaker and through you I'd like to thank the member for Perry Solomon Skoka for his question As we continue to respond to the COVID-19 outbreak and kickstart the economy in Ontario we know that investing in businesses in Northern Ontario will be critical for our long-term success that's why we introduced the Northern Ontario Recovery Program to support hard working businesses in Northern Ontario that have been impacted by COVID-19 In fact Mr. Speaker the CEO from Sault Ste. Marie Chamber of Commerce said they're very pleased to support the Northern Ontario Recovery Program Through many consultations with the governments of Canada and Ontario was evident that many small businesses were unintendedly falling through the cracks of support programs for a variety of reasons The Northern Ontario Recovery Program will help address that issue by supporting the many businesses that are investing in ensuring a safe environment for their employees and customers so we can have a safe, today and healthy tomorrow And the supplementary question Thank you for that response it's clear that our government is listening to the people of Northern Ontario and stepping up to support them Can the Parliamentary Assistant share more details of the Northern Ontario Recovery Program and the type of projects that it aims to support Again the Parliamentary Assistant Thank you Mr. Speaker and again thank you for that question The program is being administered through the Northern Ontario Heritage Fund Corporation and will provide targeted funding so businesses can install the necessary upgrades and adapt to the challenges that they have with COVID-19 Applications will be open until December 31st 2020 and companies can apply for assistance for things like building renovations or adding on new construction to support physical distancing and measures Installing employee and customer safety installations like plexiglass shields sneeze guards Equipment purchases including PPE and marketing for new business initiatives and restructuring of business operations so that they can thrive during this COVID-19 challenge This has been a challenging period for many of us but I know that with this investment the resilience of Northern Ontario from this crisis stronger and better than ever The next question is from Winslow West My question is to the Premier On Friday the Conservative Government's own long-term care commission recommended that given the physical care and psychosocial support that caregivers provide long-term care residents must be provided consistent safe access to family members and loved ones I couldn't agree more since the first wave of the pandemic families, experts and the official opposition NDP all sounded the alarm about the mental, physical and emotional suffering among isolated residents It motivated me to table the More Than a Visitor Act which this government supported but has not moved forward Will the government follow their own commission's recommendations and pass the More Than a Visitor Act to allow for safe, consistent, meaningful caregiver access Mr. Long-term Care Thank you Speaker and that is exactly what we've done with the essential caregivers the dedicated, the designated essential caregivers each resident is able to designate two care providers that will be allowed into the home if there's an outbreak in the home one caregiver will be allowed in they will be trained in the appropriate necessary equipment that they are required to use and the the putting on and taking off of this equipment we recognize the absolute necessity to support the mental well-being of our residents in long-term care and this has been a difficult decision early on to limit but that was done through the chief medical officer of health to limit visitors into the home but each resident I want to reinforce this point can designate two people who will be allowed into the home and one person, one caregiver in the case of an outbreak so even in the situation of an outbreak these people will be allowed into the home Thank you This government has a responsibility not only to keep people safe from COVID but from the harm of isolation as well they're failing miserably on both fronts and it's important that the minister listen to this so she knows the reality of what's going on as opposed to what she wants to think this weekend and wrote to me she said that she has been fully shut out of her mom's retirement home even with no outbreak Joan also sent me an email concerned about her husband who lives in long-term care she said quote I don't want another six months of not seeing him due to spread the situation needs to be improved now speaker I have hundreds of other emails exactly the same as this will the premier fast-track the more than a visitor act and provide the staffing levels PPE and training to actually facilitate and force safe access for caregivers long-term care as I said Mr. Speaker and to the member opposite this is a situation that already has been addressed we will continue to take additional measures if you want to provide the names and the home the homes of which you speak then I would be happy to take that back to the ministry to fully understand order I would be happy to address that thank you the next question member for Ottawa thank you Mr. Speaker and my question is for the Minister of Education this government has repeatedly mentioned the importance of providing mental health services in Ontario especially in the middle of this crisis to that effect we need to be aware of the incredible pressure that education workers of all categories are going through whether it's teachers, bus drivers principals, administrators staff in schools and in school boards I was told that right now education workers of all kinds are feeling the exhaustion as if it was the end of November with no relief in sight before the holiday season which is a whole two months away and on behalf of all these exhausted workers what support is the Minister offering for education workers that are working in this extremely challenging environments the Associate Minister of Mental Health and Addiction thank you Mr. Speaker and thank you for that question as you know the roadmap to wellness was established back in the early part of March and as a result of COVID we had to look at finding resources that would help the children in the schools but also help the instructors and we invested in virtual care we invested initially $12 million in additional $14.75 and we created help lines both for students kids help phone we established lines for the frontline workers and first responders and we created a network of supports in a difficult time when face-to-face services were provided in addition to that we also ensured that in school there were additional resources invested and the additional resources brought in additional mental health care workers to assist the teachers in the work that needed to be done with the children thank you supplementary question thank you and again to the Minister of Education on the same question education workers are working tirelessly in normal hours to be responsive to public health requirements in addition to their workloads there is added work and stress from having to react to public health notice of an outbreak within very short time frames and I'm sure you're very well aware of what they need to do another example for the secondary schools with the hybrid model is the fact that school calendar has not been adjusted to provide teacher with any preparation time to prepare for the second quadmaster so a consequence of this is also the cancellation of the exam which gives no gap in between the first quadmaster and the second so they have to jump into the second subject with no time to prepare these workers at a risk of burnout and they need some breathing room will the Minister work with all parties involved to give education workers and students some breathing room to protect their mental health and supports to parents and teachers and make sure that it is included in the budget Thank you Minister of Education I want to build on the message for the Minister of Mental Health and Addictions as the member opposite will know and I appreciate the question realizing full well the stress that the pandemic has imposed on our staff and these are people who work very hard who have families themselves and I think who really are trying to do their best to make sure that it is in the right way and that is the basis for why in June when we announced the grant for student needs we invested an additional $15 million in mental health supports but since then we have announced 30 million more to support mental health for children and likewise for staff boards have the latitude to utilize those funds to support staffing and to support the mental health resilience of our frontline workers it is also why in September we funded the grant for health and safety for COVID for permanent teachers as well as occasional supply teachers as well as for mental health we appreciate how the impact of COVID has had on our frontline people and all Ontarians and will continue to be there for them for students and for all families in Ontario Member for Hamilton West and Ambassador Dundas My question this morning is for the Premier Today the Hamilton Spectator reported that Hamilton Health Sciences and St. Joseph's Health Care are in 24 staff in the middle of a pandemic hospitals in my community are in dire need of nurses, lab technicians psychologists, PSWs the list goes on and on Mr. Speaker the workers on the frontline of this pandemic need support so my question, what is this government going to do to provide the relief to these hospitals that are so understaffed Mr. Health I thank the member very much for the question and this is one of the key strategies in our fall preparedness plan keeping Ontarians safe is having the health human resources that we need in order to deal with COVID-19 we have already put money into the nursing guarantee program for new nursing graduates we've also given a temporary increase in page of March 2021 for personal support workers and have also increased their salaries for the people that are working there and bringing people back to provide them with benefits as well so we're very cognizant of the issues we're in regular contact with the hospitals as well as with the hospital association and we will make sure that the necessary staff will be there to serve the patients in your community the supplementary Mr. Speaker I find this answer disturbing because these hospitals are understaffed right now I mean they need help now and if that wasn't disturbing in its own right we've also learned that as of October 15th 113 staff have tested positive for COVID-19 and I would just like to add the majority of these are women Michelle LaRue the VP of Hamilton Resources at Hamilton Health Science had this to say the pandemic is taking a toll on our staff and physicians both at home and at work despite this they continue to show up every day and simply go above and beyond to care for our community so my question what is this government going to do today is get the support they need to stay healthy and to continue the fight against COVID-19 well we're all very grateful for the work that our frontline healthcare workers have done since the beginning of this pandemic they have come to work each and every day that's physicians, nurses, PSW staff everyone has come forward and we are very grateful to them for doing that but we know that they need to be able to have the resources to stay safe themselves and keep their families safe because at the end of the day they go home and they're concerned about passing on COVID-19 to their families so we have provided them with the personal protective equipment that they need we've increased the supplies dramatically we've come forward and worked with Ontario companies who've come forward to produce some of the PPE on us as a sideline to their regular businesses they've been preparing the gowns the masks they've been preparing the face shields that people have the supplies that they need we've also made changes to allow for people to be moved around within hospitals if there are some people that aren't there because unfortunately they've become ill we can move people from other parts of the hospital we didn't have this ability before this is a temporary measure thank you, thank you very much the next question, the member for growth good morning Mr. Speaker my question is for the Premier last week when I asked about the conflict at 1492 Lambak Lane the Premier referred to indigenous land defenders as bad apples he went on to suggest that he knew exactly what people in indigenous community wanted, broadband there's no doubt Speaker we need better rural broadband but if the Premier took the time to listen he would know that indigenous land defenders are talking about treaty rights and a resolution to outstanding land claims Speaker, I will acknowledge that I'm not in a position to speak for indigenous land defenders but I am in a position to ask the Premier if the government will agree to enter into land claims negotiations with the traditional Haudenosaunee Confederacy Chiefs and the Six Nations BAM Council to seek a peaceful and respectful resolution thank you for raising this important issue the issue that is happening right now in Caledonia is deeply disturbing to many of us we are now in the 98th day of basically a community that is in upheaval and I have great faith in the judicial system when they made a ruling on Thursday I have great faith in the OPP in keeping that peace but I will accept and respect your call I do believe that the federal government does have to step up and start having some true conversations about how to resolve these issues because it is incredibly disruptive to the community to the individuals who are protesting and ultimately to the public thank you the supplementary question I appreciate the solicitor general's response and I do agree the federal government does have a role to play but I believe the provincial government has a role to play as well this is not the only ongoing conflict that is happening right now multiple First Nations are suing the government over bill 197 and the fast tracking of the environmental assessment process Chief Solomon of the Mushkovic Council said and I quote sadly they are using COVID as a decoy to restart the economy at the cost of the environment the waters, the animals and our livelihood Speaker First Nations across Ontario are raising serious concerns that their treaty rights are not being respected they are rightful and constitutionally guaranteed input on decisions about their way in and resources the federal solicitor general will the government settle with First Nations around the environmental assessment process rather than dragging this through the courts the parliamentary assistant to reply thank you very much Mr Speaker and thank you very much for that question Mr. Rickford has formed a round table to add to the consultation with respect to this he's brought in a number of the chiefs from Ontario to make sure that we have a full consultation around 197 and all of that information will be fed back to the rest of the ministry thank you Mr. Speaker The next question Member for Toronto Danforth Thank you Speaker to the Premier the Ontario Energy rebate is going to be removed for common areas of many condo and apartment buildings as of April 30th next year that means that hydro bills for power used in those common areas will be revised by over 30% one condo in Toronto is calculated the impact on their residents would be $140 per unit per year why Premier are you dramatically increasing the hydro bills for almost a third of condo owners and tenants in Ontario the Associate Minister of Energy Thank you very much Mr Speaker and let's just start off by answering this by saying that that government is reversing the liberal policies that created the hydro mass we are stabilizing our electricity system and keeping electricity bills affordable through a 33.2% Ontario electricity rebate had we not done that Mr Speaker rates would have gone up an additional 30% under the watch of the Liberals and the NDP the Liberals spent 15 years adding billions of dollars to our electricity system to give us the highest energy rates ever in our history and the highest level of debt from billions of dollars to our electricity system by signing contracts for power we did not need and could not afford we are rebuilding an affordable electricity system that prioritizes the electricity customers Speaker in the meantime materials don't deserve to pay for the mistakes of the Liberals that is why our government will continue to subsidize and ensure that we keep the bills as low as possible and support families and businesses of this great province and a supplementary question Speaker the Premier promised to cut hydro rates by 12% in the last election and since then rates have gone up almost 4% and many condo and apartment dwellers will be seeing big hikes in their hydro bills next April why did the Premier break his promise and why is he gouging so many apartment and condo dwellers Associate Minister Thank you very much Mr Speaker last response we cannot fix 15 years of mismanagement by the Liberals supported fully by the NDP in opposition overnight Mr Speaker please be assured we are working on this if we continue down the Liberal path as I said earlier 30% more on those hydro bills is that what you want to support is 30% more of your first error I don't think so Ontario has paid $37 billion extra for electricity from 2006 says Auditor General Bonnie Isaac Mr Speaker we are doing what we can to ensure that we keep those bills affordable that we keep those bills for business and seniors and people across our province as low as possible and we will not forget that the Liberals and the NDP caused the mess that we are currently trying to fix and ensure again affordability reliability and a system we can be proud of Thank you Mr Speaker Thank you the next question member for Eglinton Lawrence the next question is for the Associate Minister of Transportation last week the government brought forward the Ontario Rebuilding and Recovery Act now is not the time to delay delivery of priority infrastructure projects including public transit and highway projects it is the time to accelerate the building of key infrastructure projects to create jobs and build a strong foundation for a strong economic recovery can the Minister the Associate Minister please advise us will commit to accelerating rebuilding and growth in this province the Associate Minister of Transportation DTA Thank you very much Mr Speaker and to the member thank you for the question and I cannot agree more of course safety will always be our priority particularly during this very difficult time but our government needs to play a dual role in making sure that we stimulate our economy in the months to come this legislation will make sure that we extend the tools that were previously designed to building our subway projects to extend to other transportation projects other healthcare and other long-term care projects it is incredibly important that we make sure that goods continue to move efficiently throughout the province of Ontario that people can continue to go to hospitals for the surgeries and services they need and that we continue to build capacity in our long-term care sector the supplementary Thank you Speaker and thank you to the Minister the proposed legislation would reduce barriers in the planning, design and construction of major infrastructure like highways and public transit networks and support growth of transit-oriented communities which are very important in my area can the Minister please elaborate on how the Ontario Rebuilding and Recovery Act will help the people of Ontario and we'll call on the opposition parties to support this bill Associate Minister absolutely and again thank you to the member opposite, Mr Speaker in this legislature we heard countless times from the members opposite about how important it is to invest in public infrastructure Mr Speaker in this legislature we've heard countless times about how important it is for us to provide funding and to accelerate the building of highways that are in their respective writings Mr Speaker and Mr Speaker every single day during question period the members opposite always inquire about the status of healthcare as well as long-term care capacity this bill will help us achieve this it will help us invest in our critical infrastructure so that we can make sure that Ontario prospers in post-pandemic world Mr Speaker The next question the member for Nickel Belt Thank you my question is for the Minister of Health we have seen through the first wave of the pandemic that many non-urgent surgical procedures were cancelled through the first wave of the pandemic this has led to 129,000 patients added to the already long list for surgery and procedures in our hospital we've also seen that many people are diagnosed later for cancer or other diseases which will require even more interventions from our hospital to hopefully bring them back to health my question to the Minister is I am curious as to the last stats that were shared it was at 129,000 backlogs for surgery could the Minister update us as to how many people are now waiting Mr Vell Well I thank the member very much for the question this is a serious concern it's an issue that we did address in our fault preparedness plan keeping Ontarians safe is reducing the backlog it was at about 189,000 procedures and surgeries that we were behind we have been dealing with that as part of our fault preparedness plan in creating the extra space in our hospitals to allow for both COVID patients to be treated as well as patients who need to have these surgeries because as much as it's terribly sad that we've lost patients to COVID but it's equally sad if we lose people because their cancer surgery has been delayed or their cardiac surgery has been delayed we want to make sure that we can take care of all of those patients in a timely way so that they can recover so we have dealt with that as a very serious matter we're approximately 95% of our orthopedic surgeries right now about 87% of cardiac and COVID surgeries so that's compared to where we were this time last year there's still work that we need to do but we are taking a new approach to this which I'm pleased to discuss in this supplementary answer fortunately that concludes the time we have available for question period this morning there being no further business this house stands in recess until 1pm