BGU Palliative Care Centre Memorializes Kappy Flanders

Nov. 13, 2020 

By JANICE ARNOLD

MONTREAL—“I don’t beat around the bush. I can’t use all these euphemisms. In my book, people don’t pass away, they die.”

That memorable quote from Kappy Flanders summed up her unflinching attitude toward death. People retreat into vague terms because of fear, she believed, and avoidance of reality has meant that too many endure their final days without proper care.

Kappy Flanders
Kappy Flanders

Flanders, who died in June at age 81, devoted her last three decades as a volunteer to the improvement of palliative care, urging greater access and quality and, equally, dispelling misconceptions about what it is.

She endowed an academic chair in palliative medicine at McGill University in 1994, the first of its kind in North America, and was instrumental in the creation of the grassroots Council on Palliative Care in Montreal, a public education and advocacy group. She went on national initiatives.

Flanders cringed at “medical aid in dying,” insisting on calling it euthanasia. If there was adequate end-of-life care, relieving physical and psychic pain, doctors would not have to be put in the position of terminating lives, she contended.

The motivation for her activism was watching her husband Eric suffer for 18 months with the lung cancer that would kill him in 1991 in his 50s. Medical treatment was intense, but no professional support to ease the course of his illness was known to her in Montreal.

When her mother, who lived in Israel, died of cancer a couple of years later there, Flanders was impressed by the hospice approach that allowed her to die comfortably and peacefully.

In 2000, Flanders established the Eric M. Flanders Endowment Fund in Palliative Medicine at Ben-Gurion University of the Negev (BGU) to strengthen its nascent training in palliative care.

Flanders, who grew up in a Zionist family in London, England, remembered meeting David Ben-Gurion as a child. Her husband was a founder of the Canadian Associates of BGU in 1973 and its first president.

Two decades on, BGU has fulfilled Flanders’s vision. In October, it inaugurated the Kappy and Eric Flanders National Palliative Care Resource Centre, described as the first of its kind in Israel. It brings under one roof multidisciplinary academic education, practical training and research, as well as play an advocacy role.

Dr. Pesach Shvartzman, director of the palliative unit at Soroka Medical Centre and chair of the health ministry’s committee to establish national standards in palliative care, is the centre’s director.

“We believe this centre will help make palliative care much more accessible throughout Israel, just as Kappy would have wanted,” he said.

The centre, in whose development Flanders took a keen interest up to her death, was made possible with a significant donation from the Prosserman family of Toronto. Ron Prosserman said at the virtual dedication, that it was his longtime friend, Dr. Vivian Rakoff, former head of psychiatry at the University of Toronto, who died earlier in the month, who suggested the gift.

Flanders’s three daughters, Susan, Judith and Elle, said the centre is a fitting tribute to their mother’s work from which she never flagged. 

“When she believed something should happen, she made it happen,” said Susan of her mother, who inducted into the Order of Canada in 2015.

In addition to Shvartzman, the centre’s founding members are Drs. Yoram Singer and Mark Clarfield, both originally from Canada, and Tali Samson. The centre also has an international advisory board that includes Dr. Bernard Lapointe, chief of palliative care at Montreal’s Jewish General Hospital and until recently, holder of the Flanders chair in palliative medicine at McGill.

“Kappy was a connector, bringing together volunteers, professionals, intellectuals, artists and leaders, all around the cause of quality end-of-life care,” said Lapointe, who called her a mentor.

Flanders died – not passed away – the way she wanted for herself, and everyone: at home, surrounded by her family.

COVID Vaccine Distribution by Early Next Year: Moderna Chief

Oct. 29, 2020

By JANICE ARNOLD

MONTREAL— Moderna Therapeutics’ COVID vaccine should be ready to begin widespread distribution by late winter or next spring, Dr. Tal Zaks, the company’s Chief Medical Officer, said on Oct. 7 in a videoconference hosted by the Canadian Associates of Ben-Gurion University of the Negev.

Dr. Tal Zaks

Zaks is hopeful that the vaccine will be available in early 2021 for those at high risk, such as front-line workers or the elderly.

“My sense is that by the start of the next school year, things will be back to normal,” Zaks said.

In August, the Canadian government signed a deal with Moderna for 20 million doses to be delivered in 2021. An option for an additional 36 million doses was appended to the agreement last month.

In late July, the Cambridge, Mass.-based biotechnology company became the first in the United States to begin Phase 3 clinical trials of its vaccine candidate. Currently, 30,000 adults are enrolled in the late-stage investigation, conducted in collaboration with the National Institutes of Health.

Zaks, an Israeli oncologist, earned his medical degree and a PhD at Ben-Gurion. Israel has placed orders for the Moderna vaccine, among other countries.

The company expects to produce between 500 million and a billion doses next year, he said, noting that two inoculations would be administered, with a booster shot about a month after the first one.

Zaks said this vaccine has been shown to produce even more antibodies in a person infected with the coronavirus. Some in the trial have experienced mild flu-like symptoms that last a day or two, he said, but no serious side effects have been recorded.

How long immunity will last is not known, he acknowledged, but it should be at least a few years.

New vaccines are developed each year for the seasonal flu because different strains arise, he explained. Mutations have occurred in COVID, but that will not diminish the Moderna vaccine’s effectiveness, he said.

Moderna is currently expanding its trials to ensure the vaccine’s efficacy among children, pregnant women and those who are immune-compromised.

Mark Mendelson, chief executive officer of Canadian Associates of Ben-Gurion University, said there were nearly 220 registrants for the Zoom webinar, an indication of the high level of interest in the subject – and the pride of the university’s supporters.

In response to questions, Zaks assured that no corners are being cut to rush the vaccine to market. The U.S. Food and Drug Administration is “working in lockstep” with Moderna, he said, and has been, in fact, “overly conservative by some measures.” The company published the success of its findings in the New England Journal of Medicine on Sept. 29.

He warned that demand for a vaccine will likely outstrip supply, and countries that are less rich may have trouble meeting their citizens’ needs, at least in the first year. It’s also unclear how the several billion doses he expects to be needed by the end of next year will be deployed around the world, he said.

The Moderna vaccine will cost between US $20-$37 per dose, depending on the volume of purchase, he said.

Asked what keeps him awake at night, Zaks replied, “Our ability to explain our science to a public that is highly fractured in how it gets its information, where venues are polarized. That worries me.

“We are on the cusp of one of the greatest achievements in modern medicine and we find ourselves getting the very strange response of either we are not moving fast enough or ‘I do not believe you.’”