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Children's hospitals under strain in Canada's 6th COVID-19 wave – CBC News

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As Canada’s sixth wave of COVID-19 continues, hospitals caring for the country’s youngest patients are facing both high patient volumes and high levels of staff off sick.

This time of year, the Children’s Hospital of Eastern Ontario (CHEO) in Ottawa normally sees up to 150 daily patients in its emergency department, but lately, it can be double that, with hours-long wait times.

Tammy DeGiovanni, CHEO’s senior vice president of clinical services and chief nurse executive, said around two-thirds of those kids are coming in with COVID symptoms. 

The hospital has also been forced to cancel some surgeries.

“The double whammy for us is that we also have many staff, medical staff and volunteers that are off as well because of COVID symptoms or COVID in the household,” DeGiovanni said.

She said that on any given day recently, roughly 10 to 15 per cent of the hospital’s workforce has been off work — with each staff member taking 10 days away to recover.

“That’s causing the additional pressure on the system right now, as opposed to in previous waves,” she said.

According to hospital figures, CHEO’s single-day record for the number of staff, medical staff, learners and volunteers restricted from entering for COVID-related reasons was 199 in early January — just as the initial Omicron wave was taking hold after the holiday season. 

The next highest day was April 11, at 191, with the facility still experiencing major daily staff shortages.

Children with COVID, other illnesses

In Saskatchewan, health-care facilities are also dealing with a surge of sick kids, alongside record overall hospitalizations — Wednesday’s provincial data showed a new all-time high of 417 people in hospital with COVID-19.

“There’s just a huge increased number of kids coming in with upper respiratory illness and related complications. Many of them, as you would suspect, have COVID,” said Dr. Alexander Wong from the Saskatchewan Health Authority. 

Esther Shi Berman, 10, receives a dose of a COVID-19 vaccine at a clinic in Toronto on Nov. 25, 2021. (Evan Mitsui/CBC)

“That’s creating a lot of pressure on the acute care side, with regards to hospitalizations, as well as ICU admissions, as well as on the emergency department.”

Data provided by BC Children’s Hospital in Vancouver shows a mix of both COVID-19 and other respiratory illnesses showing up in young patients in recent months.

In February, 76 children tested positive for COVID-19 in the hospital’s emergency department, while another 29 tested positive for other respiratory illnesses. The following month, that ratio shifted, with 37 kids having COVID-19 and 72 having other respiratory illnesses, including one case of influenza. (The hospital did not provide April data.)

Health-care workers at children’s hospitals, like their adult counterparts, are “similarly affected by disease spread in their communities,” said Dr. Srinivas Murthy, a pediatric critical care physician and infectious diseases specialist with BC Children’s Hospital.

At McMaster Children’s Hospital in Hamilton, Ont., the number of admitted pediatric COVID patients has remained low and relatively stable through the fifth and sixth waves, a hospital spokesperson said in a statement to CBC News. 

However, the volume of kids coming to the hospital’s emergency department with respiratory symptoms — some of which are related to COVID — is very high. The spokesperson said that, combined with staffing pressures, has led to the system being “very challenged.”

Visits back to pre-pandemic levels

It’s a similar situation inside one of Canada’s largest health-care centres for youth, Toronto’s Hospital for Sick Children (also known as SickKids).

The whole hospital is “under strain,” in part because of roughly 10 to 30 per cent of staff being off sick on any given day throughout the two Omicron waves, said Dr. Jason Fischer, SickKids’s division head of emergency medicine. 

Hospitalizations and ICU admissions remain high across Ontario, just as the number of patients coming to the emergency department at SickKids are expected to return to pre-pandemic levels, hospital data shows. 

There were more than 7,000 total emergency visits at the hospital in April 2019, but that tally dipped in April 2020, during the early days of the pandemic, when many health-care facilities experienced a major drop in visits. 

Dr. Jason Fischer, SickKids emergency department division head, says the whole hospital is “under strain,” in part because roughly 10 to 30 per cent of staff being off sick in any given day throughout the two Omicron waves. (SickKids/Supplied)

The total hit roughly 4,400 in April 2021 and nearly 4,000 young patients showed up in the first half of April this year — a daily average of 222 visits, roughly the same as before the pandemic. 

Despite those volumes, Fischer said it’s crucial to keep staff with COVID-19 home for a full 10 days.

“We’re seeing a lot of kids aged zero to five who are not immunized, and so we’re particularly conservative in ensuring that no one’s coming to work sick,” he said.

Low vaccination rate among kids

Across Canada, vaccination rates remain low among youth. The latest country-wide data shows just 40 per cent of kids aged five to 11 are fully vaccinated, while younger children don’t yet have access to an approved vaccine.

With millions of kids still vulnerable to infection — while hospitals are under pressure — it’s left some parents wondering about the best approach if their child does catch COVID-19.

Nicole Rajakovic, a Toronto mother of two, faced that dilemma in the last month. Her whole family wound up falling ill, with her five-year-old son the first to show symptoms back in late March. At the time, she said, he’d only had one vaccine dose, while the rest of the family was fully vaccinated. 

“He had a really serious coughing fit, which included an inability to breathe, and that was the scariest moment for us,” she recalled. “Do we call 911?”

Nicole Rajakovic, right, and her family all caught COVID-19 this year, one by one, starting with her five-year-old son. (Supplied by Nicole Rajakovic)

Rajakovic wound up caring for her son at home, and he’s since recovered from his illness. But she said it was a tough decision. 

“Where we would normally go to a doctor or urgent care, we’re not making those decisions anymore, because we know they’re short-staffed, and we know they’re exhausted.”

Fischer from SickKids agreed that health-care workers are often stuck working long hours, while families are facing long wait times for care. 

Even so, he stressed that if parents are worried about their child’s symptoms, they should still bring them to an emergency department, urgent care centre or use virtual care options.

According to the Canadian Pediatric Society, mild symptoms don’t require a hospital trip, but parents should seek medical advice if their child isn’t drinking well, has a high fever, is having trouble breathing or if their symptoms continue or worsen.

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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.

The Canadian Press. All rights reserved.

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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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