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1 year after Canada's first coronavirus case, the COVID-19 pandemic rages on – CBC.ca

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Monday marks one year since the first case of the virus that causes COVID-19 was confirmed in Canada, in a patient who came to Toronto’s Sunnybrook Hospital after returning from Wuhan, China. 

While many of the lessons learned from the early days of the novel coronavirus are being applied in the pandemic’s second wave, concerns remain about inadequate protections in long-term care and the disproportionate impact of the virus on people of colour. 

Among both long-term care residents and the general public, more people have now died of COVID-19 in Ontario during the second wave than in the six months after the global pandemic was declared in March.

“These are all preventable deaths,” said Dr. Nitin Mohan, an assistant professor at Western University in London, Ont., and a physician epidemiologist with the public health consulting firm ETIO.  

Long-term care crisis continues 

“The fact that we’re this far along in the pandemic and we’re still seeing the outbreaks and deaths in long-term care homes, it’s almost embarrassing that this is happening,” Mohan said in an interview. 

Dr. Zain Chagla is an infectious disease specialist in Hamilton, Ont. (Craig Chivers/CBC)

Infectious diseases specialist Dr. Isaac Bogoch of Toronto’s University Health Network calls what happened in Ontario’s long-term care homes last spring tragic.  

“What’s more tragic is how it’s unfolding in the second wave, because there certainly could have been steps taken between wave one and wave two to significantly protect the most vulnerable population among us,” said Bogoch in an interview.

“What we’re seeing in the long-term care facilities just demonstrates, unfortunately, years and years of neglect,” he said. “It was awful to watch this unfold, but sadly, it was predictable.”

Uncertainties characterized early days

In the first two months of 2020, predictions varied about how Canada would be affected by the novel coronavirus first identified in China. 

Public health officials and political leaders seemed to tilt more toward calming fears about COVID-19 than sounding the alarm.

There were repeated assurances that the risk in Ontario was low, that the general public should refrain from wearing masks. Well into March, officials were saying that no evidence could be found of community spread. 

At a news conference inside the Ontario legislature on Jan. 25, 2020, officials announced Canada’s first confirmed case of the novel coronavirus that causes COVID-19. (Chris Young/The Canadian Press)

“Those uncertainties in the early part of the pandemic were real because we just didn’t know,” said Bogoch.

Although he acknowledged that public health messaging adapted over time, Bogoch said it didn’t do so as fast as they would have liked. 

The system was slow to acknowledge that the virus was not just being imported by travellers returning from a handful of distant countries, said Dr. Zain Chagla, an infectious diseases physician in Hamilton and an associate professor of medicine at McMaster University.

“I think the pivot from this being a travel disease to this being an endemic disease was done relatively late,” Chagla told CBC in an interview.

“There’s something to be said about understanding the evidence has changed and recognizing it quickly and making those changes quickly.” 

Chagla said a crucial point came in late February when community transmission was identified in the U.S. and doctors in Canada were seeing people returning from the U.S. with COVID-19. 

“There was no hope that this was not going to (spread in) Canada at that point,” he said. “I think probably that was the turning point to say, ‘OK, there is a risk here to us. We need to start invoking public health measures.’ ” 

Ontario declared its state of emergency on March 17, and the federal government halted non-essential travel across the land border with the U.S. on March 20. 

Mohan believes governments acted decisively to impose lockdown measures in the spring.

“We were dealing with something that was relatively new and unknown, getting data and making decisions in real time,” he said. 

During the first two months of the pandemic, Ontario had limited capacity to test for COVID-19. Except for people who had travelled out of the country, most of the general public couldn’t get tested unless they were sick enough to go to hospital. (Darryl Dyck/The Canadian Press)

Lack of testing hampered tracking

When experts look back to the early months of 2020, there’s a general consensus that Ontario’s hospital sector mobilized quickly to face COVID-19, readying for a potential surge of patients even as supplies of personal protective equipment were tight. 

However there’s also strong agreement that Ontario’s limited capacity to test for the coronavirus hampered the ability to track its spread. 

Until May, Ontarians couldn’t get a test for COVID-19 unless they met a strict range of criteria that excluded much of the general public.

Given the death rates in the first wave, scientists believe the actual number of infections in the spring was far higher than the officially reported case counts. 

“There were some clear limitations in our testing capacities that are a result of poor funding models of public health,” said Mohan.

“In a once in a generation pandemic, when we need to act quickly and decisively, it’s hard to do that when you’re sort of building a plane in the sky.”

The ability of the SARS-CoV-2 virus to be transmitted by people before they showed any symptoms also confounded the experts. 

Early on, officials put a big emphasis on screening people for symptoms such as fever and cough. Although that helped identify a significant proportion of cases, it sent an inaccurate message that people couldn’t spread the virus before showing symptoms.

“Had we known clearly that there was pre-symptomatic transmission, I think the way we would have handled things would have been much different,” said Chagla. 

Dr. Isaac Bogoch is an infectious disease specialist at the University Health Network in Toronto. (Craig Chivers/CBC)

He said quarantines would have been imposed on travellers sooner and the way public health officials traced cases would have changed significantly.  

Chagla, Bogoch and Mohan all say too little was done to protect people in racialized and low-income communities.

Even this deep into the pandemic, people of Black and South Asian descent are over-represented among the COVID-19 caseload

2nd wave shows signs of receding 

The one-year anniversary of the virus in Canada comes amid signs that the second wave is starting to recede, albeit with warnings that new case numbers will only continue to drop if public health restrictions stay in place. 

There are also fears that highly contagious variants of the coronavirus could either prolong the second wave or drive an even more widespread third wave before the bulk of the population gets vaccinated.  

Thousands of new infections are still being reported every day across the country, and the average daily number of deaths is not expected to decrease for weeks.

About 200,000 Canadians have contracted COVID-19 in the past month alone. The case fatality rates among different age demographics suggest that hundreds of those will die. 

“It’s hard for me to reconcile with the mistakes being made in the second wave,” said Mohan.

“We can’t get back these lives lost.”  

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STD epidemic slows as new syphilis and gonorrhea cases fall in US

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NEW YORK (AP) — The U.S. syphilis epidemic slowed dramatically last year, gonorrhea cases fell and chlamydia cases remained below prepandemic levels, according to federal data released Tuesday.

The numbers represented some good news about sexually transmitted diseases, which experienced some alarming increases in past years due to declining condom use, inadequate sex education, and reduced testing and treatment when the COVID-19 pandemic hit.

Last year, cases of the most infectious stages of syphilis fell 10% from the year before — the first substantial decline in more than two decades. Gonorrhea cases dropped 7%, marking a second straight year of decline and bringing the number below what it was in 2019.

“I’m encouraged, and it’s been a long time since I felt that way” about the nation’s epidemic of sexually transmitted infections, said the CDC’s Dr. Jonathan Mermin. “Something is working.”

More than 2.4 million cases of syphilis, gonorrhea and chlamydia were diagnosed and reported last year — 1.6 million cases of chlamydia, 600,000 of gonorrhea, and more than 209,000 of syphilis.

Syphilis is a particular concern. For centuries, it was a common but feared infection that could deform the body and end in death. New cases plummeted in the U.S. starting in the 1940s when infection-fighting antibiotics became widely available, and they trended down for a half century after that. By 2002, however, cases began rising again, with men who have sex with other men being disproportionately affected.

The new report found cases of syphilis in their early, most infectious stages dropped 13% among gay and bisexual men. It was the first such drop since the agency began reporting data for that group in the mid-2000s.

However, there was a 12% increase in the rate of cases of unknown- or later-stage syphilis — a reflection of people infected years ago.

Cases of syphilis in newborns, passed on from infected mothers, also rose. There were nearly 4,000 cases, including 279 stillbirths and infant deaths.

“This means pregnant women are not being tested often enough,” said Dr. Jeffrey Klausner, a professor of medicine at the University of Southern California.

What caused some of the STD trends to improve? Several experts say one contributor is the growing use of an antibiotic as a “morning-after pill.” Studies have shown that taking doxycycline within 72 hours of unprotected sex cuts the risk of developing syphilis, gonorrhea and chlamydia.

In June, the CDC started recommending doxycycline as a morning-after pill, specifically for gay and bisexual men and transgender women who recently had an STD diagnosis. But health departments and organizations in some cities had been giving the pills to people for a couple years.

Some experts believe that the 2022 mpox outbreak — which mainly hit gay and bisexual men — may have had a lingering effect on sexual behavior in 2023, or at least on people’s willingness to get tested when strange sores appeared.

Another factor may have been an increase in the number of health workers testing people for infections, doing contact tracing and connecting people to treatment. Congress gave $1.2 billion to expand the workforce over five years, including $600 million to states, cities and territories that get STD prevention funding from CDC.

Last year had the “most activity with that funding throughout the U.S.,” said David Harvey, executive director of the National Coalition of STD Directors.

However, Congress ended the funds early as a part of last year’s debt ceiling deal, cutting off $400 million. Some people already have lost their jobs, said a spokeswoman for Harvey’s organization.

Still, Harvey said he had reasons for optimism, including the growing use of doxycycline and a push for at-home STD test kits.

Also, there are reasons to think the next presidential administration could get behind STD prevention. In 2019, then-President Donald Trump announced a campaign to “eliminate” the U.S. HIV epidemic by 2030. (Federal health officials later clarified that the actual goal was a huge reduction in new infections — fewer than 3,000 a year.)

There were nearly 32,000 new HIV infections in 2022, the CDC estimates. But a boost in public health funding for HIV could also also help bring down other sexually transmitted infections, experts said.

“When the government puts in resources, puts in money, we see declines in STDs,” Klausner said.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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World’s largest active volcano Mauna Loa showed telltale warning signs before erupting in 2022

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WASHINGTON (AP) — Scientists can’t know precisely when a volcano is about to erupt, but they can sometimes pick up telltale signs.

That happened two years ago with the world’s largest active volcano. About two months before Mauna Loa spewed rivers of glowing orange molten lava, geologists detected small earthquakes nearby and other signs, and they warned residents on Hawaii‘s Big Island.

Now a study of the volcano’s lava confirms their timeline for when the molten rock below was on the move.

“Volcanoes are tricky because we don’t get to watch directly what’s happening inside – we have to look for other signs,” said Erik Klemetti Gonzalez, a volcano expert at Denison University, who was not involved in the study.

Upswelling ground and increased earthquake activity near the volcano resulted from magma rising from lower levels of Earth’s crust to fill chambers beneath the volcano, said Kendra Lynn, a research geologist at the Hawaiian Volcano Observatory and co-author of a new study in Nature Communications.

When pressure was high enough, the magma broke through brittle surface rock and became lava – and the eruption began in late November 2022. Later, researchers collected samples of volcanic rock for analysis.

The chemical makeup of certain crystals within the lava indicated that around 70 days before the eruption, large quantities of molten rock had moved from around 1.9 miles (3 kilometers) to 3 miles (5 kilometers) under the summit to a mile (2 kilometers) or less beneath, the study found. This matched the timeline the geologists had observed with other signs.

The last time Mauna Loa erupted was in 1984. Most of the U.S. volcanoes that scientists consider to be active are found in Hawaii, Alaska and the West Coast.

Worldwide, around 585 volcanoes are considered active.

Scientists can’t predict eruptions, but they can make a “forecast,” said Ben Andrews, who heads the global volcano program at the Smithsonian Institution and who was not involved in the study.

Andrews compared volcano forecasts to weather forecasts – informed “probabilities” that an event will occur. And better data about the past behavior of specific volcanos can help researchers finetune forecasts of future activity, experts say.

(asterisk)We can look for similar patterns in the future and expect that there’s a higher probability of conditions for an eruption happening,” said Klemetti Gonzalez.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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Waymo’s robotaxis now open to anyone who wants a driverless ride in Los Angeles

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Waymo on Tuesday opened its robotaxi service to anyone who wants a ride around Los Angeles, marking another milestone in the evolution of self-driving car technology since the company began as a secret project at Google 15 years ago.

The expansion comes eight months after Waymo began offering rides in Los Angeles to a limited group of passengers chosen from a waiting list that had ballooned to more than 300,000 people. Now, anyone with the Waymo One smartphone app will be able to request a ride around an 80-square-mile (129-square-kilometer) territory spanning the second largest U.S. city.

After Waymo received approval from California regulators to charge for rides 15 months ago, the company initially chose to launch its operations in San Francisco before offering a limited service in Los Angeles.

Before deciding to compete against conventional ride-hailing pioneers Uber and Lyft in California, Waymo unleashed its robotaxis in Phoenix in 2020 and has been steadily extending the reach of its service in that Arizona city ever since.

Driverless rides are proving to be more than just a novelty. Waymo says it now transports more than 50,000 weekly passengers in its robotaxis, a volume of business numbers that helped the company recently raise $5.6 billion from its corporate parent Alphabet and a list of other investors that included venture capital firm Andreesen Horowitz and financial management firm T. Rowe Price.

“Our service has matured quickly and our riders are embracing the many benefits of fully autonomous driving,” Waymo co-CEO Tekedra Mawakana said in a blog post.

Despite its inroads, Waymo is still believed to be losing money. Although Alphabet doesn’t disclose Waymo’s financial results, the robotaxi is a major part of an “Other Bets” division that had suffered an operating loss of $3.3 billion through the first nine months of this year, down from a setback of $4.2 billion at the same time last year.

But Waymo has come a long way since Google began working on self-driving cars in 2009 as part of project “Chauffeur.” Since its 2016 spinoff from Google, Waymo has established itself as the clear leader in a robotaxi industry that’s getting more congested.

Electric auto pioneer Tesla is aiming to launch a rival “Cybercab” service by 2026, although its CEO Elon Musk said he hopes the company can get the required regulatory clearances to operate in Texas and California by next year.

Tesla’s projected timeline for competing against Waymo has been met with skepticism because Musk has made unfulfilled promises about the company’s self-driving car technology for nearly a decade.

Meanwhile, Waymo’s robotaxis have driven more than 20 million fully autonomous miles and provided more than 2 million rides to passengers without encountering a serious accident that resulted in its operations being sidelined.

That safety record is a stark contrast to one of its early rivals, Cruise, a robotaxi service owned by General Motors. Cruise’s California license was suspended last year after one of its driverless cars in San Francisco dragged a jaywalking pedestrian who had been struck by a different car driven by a human.

Cruise is now trying to rebound by joining forces with Uber to make some of its services available next year in U.S. cities that still haven’t been announced. But Waymo also has forged a similar alliance with Uber to dispatch its robotaxi in Atlanta and Austin, Texas next year.

Another robotaxi service, Amazon’s Zoox, is hoping to begin offering driverless rides to the general public in Las Vegas at some point next year before also launching in San Francisco.

The Canadian Press. All rights reserved.

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