It’s tough — even impossible — to predict exactly how Canada will fare in the fourth wave of the COVID-19 pandemic. And looking for clues from other countries only gets you so far.
Some regions are being overwhelmed, yet again, by this virus; others are avoiding catastrophe largely thanks to high vaccine uptake and other precautions. Widely different policy decisions and levels of restrictions also mean there’s no one-size-fits-all outcome.
So what will determine Canada’s experience in the months ahead?
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Multiple experts told CBC News that there are a few key factors in how the pandemic will play out as the delta variant continues spreading.
According to Matthew Miller, an associate professor of infectious diseases and immunology at McMaster University in Hamilton, there’s also good reason to hope that Canada might fare even better than many other countries with similar public health measures, thanks to our high vaccination rate and unique approach to immunizing residents.
“Vaccinated people in Canada are going to be much better off than vaccinated people almost anywhere else because of a reliance on mRNA, mixed-vaccine schedules and extended intervals,” he said.
“Obviously, though, as infectious disease experts and public health experts have rightly pointed out, a mixture of measures is still going to be required to control the pandemic effectively — and those are going to have profound influences on how we as a population experience the fourth wave.”
WATCH | Vaccine expert weighs in on how Canada could fare in the 4th wave:
Vaccine expert weighs in on how Canada could fare in the 4th wave
22 hours ago
Matthew Miller, an associate professor at McMaster University in Hamilton, explains some of the key factors at play in how Canada could fare in the fourth wave of the COVID-19 pandemic. 1:11
1. Vaccine uptake
Despite a sluggish start, Canada quickly became one of the most heavily vaccinated countries in the world against COVID-19.
Roughly 63 per cent of the total population is now fully vaccinated, and the number is slowly ticking higher.
While millions of people across the country remain unprotected, virologist Alyson Kelvin said Canada’s relatively high rate of immunization bodes well.
“We have fairly good coverage,” said Kelvin, who works with the Vaccine and Infectious Disease Organization (VIDO) at the University of Saskatchewan in Saskatoon.
“And the stats have come out that it seems we have better coverage compared to other countries — that’s going to be our biggest source of protection, that we were able to vaccinate so many people and, again, stop that chain of transmission of the virus.”
While high vaccination rates haven’t entirely blunted COVID-19 infections in other areas of the world, they have noticeably reduced cases of serious illness compared with earlier surges of the coronavirus.
Will Canada’s fourth wave of COVID-19 sting a little or a lot? Experts say multiple factors are at play in how the country will fare as cases keep rising thanks to the more contagious delta variant. (Evan Mitsui/CBC)
In Spain, which has about a 66 per cent vaccination rate — a little higher than in Canada — the country’s latest wave of infections shot up the virus’s daily death toll, but nowhere near levels seen in earlier waves.
The heavily vaccinated U.K. also experienced a surge, then a dip before seeing another increase in cases this summer, but throughout it all, rates of hospitalization and death were far lower than earlier in the pandemic.
And in Iceland, where roughly 72 per cent of the total population is fully vaccinated, the rates of COVID-19 hospitalization remained low even as infections went up — and the country hasn’t recorded a single virus death since May.
McMaster University’s Miller said it’s crucial for Canada to get its vaccine uptake as high as possible by improving access, encouraging those who are still hesitant and even mandating vaccines in certain settings — particularly when it comes to persuading younger age groups.
“A little bit of pain with vaccine passports to do certain things that that demographic likes to do — go to clubs, eat indoors at restaurants — that’ll be enough to push those people to get vaccinated,” he said.
“That’s really where a vaccine mandate will make the biggest difference, I think, is in that younger group that are lagging a little bit behind right now.”
Already, there’s a patchwork of vaccination policies and mandates coming into force in health-care institutions, concert venues, universities and various levels of government across the country — but it’s not yet clear how much those efforts will increase uptake.
WATCH | Vaccination key to avoiding the worst from delta variant, experts say:
Vaccination key to avoiding the worst from delta variant, experts say
5 days ago
With the delta coronavirus variant making up more than 80 per cent of cases in Canada, experts say most people will encounter it. Getting a COVID-19 vaccine will prevent the worst outcomes. Correction: At 1:30 in this story, Dr. Mike Nayak is incorrectly identified as Mark Nayak. 2:44
2. Delaying, mixing different vaccines
Canada’s vaccination strategy was quite unorthodox in several ways, giving Canadians the ability to mix between different forms of vaccine technologies and space out doses.
But Miller — who is affiliated with Canada’s National Advisory Committee on Immunization but isn’t speaking on the advisory body’s behalf — said the recommendations were rooted in decades of vaccine science and could have a “profound influence on the longevity of the immune response.”
The unique road Canada took — allowing people to get second doses well beyond manufacturing guidelines, to a maximum of four months — is now likely a better bet than sticking to the speedy timelines used in clinical trials, he said.
“We know mixing and matching, we know that delayed prime-boost schedules really do give a better overall protective effect from vaccination,” Kelvin said, though she noted that more research is still needed.
Manitobans enjoy outdoor yoga with puppies at the Bronx Park Community Centre in Winnipeg in late August. More people are socializing again, with looser restrictions now in place in much of the country, even as Canada is dealing with the early days of a fourth wave of COVID-19. (Tyson Koschik/CBC)
Emerging studies, however, are starting to back up the early recommendations around mixing different vaccine technologies, with a focus on using the highly effective mRNA-based options, said Dr. Allison McGeer, a professor at the University of Toronto and an infectious disease physician at Mount Sinai Hospital in Toronto.
“From what we know about T-cell immunity and antibodies, probably the best two doses to have are AstraZeneca followed by one of the mRNA vaccines,” she said, referring to the Pfizer-BioNTech and Moderna vaccines. “So that was a really good choice for Canada, I think, to make that recommendation — and almost certainly better than two doses of AstraZeneca.”
McGeer said while Canada’s unique approach helped to get more shots in arms, she isn’t convinced it would necessarily make much of a difference in how the country fares in the fourth wave.
And Miller acknowledged that not every Canadian got their shot in the same manner, making it hard to know how the country’s strategies will play out.
“One complexity, of course, is that on the bookends of our vaccine rollout, there are exceptions, right?” he said. “So many health-care providers and long-term care residents got their vaccine in the recommended interval.”
WATCH | How convenient COVID-19 vaccine clinics help convince some to get the shot:
How convenient COVID-19 vaccine clinics help convince some to get the shot
16 days ago
As health officials work to get more people vaccinated against COVID-19, there’s hope that convenient pop-up clinics could help some decide to get the shot. 2:01
3. Public health measures and restrictions
To buy time while more Canadians get vaccinated, multiple experts point to the need for certain public health measures to keep case growth at bay — not necessarily a full lockdown but some level of restrictions.
That means maintaining the basic day-to-day precautions Canadians now know well: mask-wearing, physical distancing, avoiding large gatherings and crowded settings.
“We really need to think about our current situation and how having layers of protective measures really keeps everybody safe,” Kelvin said.
“We’re in a different landscape right now where a lot of public health measures have been lifted.”
Bringing back certain precautions will be particularly crucial as millions of unvaccinated children return to school this fall, according to Miller, who also said that’s the issue bringing the most uncertainty to the months ahead.
Both vaccines and some level of restrictions should be used in tandem to put Canada in the best position as delta-driven cases keep rising, several experts agreed.
“If we are really concerned about protecting vulnerable populations — people in long-term care facilities, those people who are immunocompromised, such as transplantation recipients — these multiple layers will help protect them,” Kelvin said.
“So it’s all of our jobs to take part in this.”
Have questions about this story? We’re answering as many as we can in the comments.
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.
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.
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.
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