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'A fundamental shift': Nearly half of reported COVID-19 cases in Canada now from community spread – CBC.ca

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Almost half of Canada’s COVID-19 cases are caused by spread in the community from an unknown source, and experts say that signals there could be a silent epidemic happening across the country.

Of the 1,044 cases that the Public Health Agency of Canada has provided epidemiological data on as of Monday, 48 per cent are a result of infection from community transmission, while 42 per cent are tied to travel and seven per cent are linked to close contact with a traveller who tested positive.

Community transmission is the spread of an illness with no known link to travel or previously confirmed cases, which suggests a growing number of cases are likely going unreported across the country.

“It’s about 50 per cent of travellers versus those who are acquiring it in the community,” Dr. Theresa Tam, Canada’s chief public health officer, said Tuesday.

“That is a fundamental shift in our epidemiology.”

Dr. Theresa Tam, Canada’s chief public health officer, says the growing number of COVID-19 cases from community transmission signals a ‘fundamental shift in our epidemiology.’ (Justin Tang/The Canadian Press)

Jason Kindrachuk, an assistant professor of viral pathogenesis at the University of Manitoba and Canada Research Chair of emerging viruses, said that shift makes it more difficult to slow the spread of the coronavirus in Canada. 

“If a virus is now spreading in the community, what that means is that we don’t have a really good ability to be able to monitor where that virus is, who it’s going to and who that person has contacted,” he said. 

“You don’t know where the virus is at any particular moment in time, and now what you have is basically the potential for that person to pass it on to a much larger group of people.”

Kindrachuk said community transmission is particularly challenging because the virus doesn’t produce symptoms in everyone it infects.

“They’re not maybe being monitored through self-isolation or health officials don’t know that that person is infected,” he said. “So it creates a much broader concern very, very quickly for us in terms of the transmission of this virus.” 

Given the available data from the federal government only covers about half the number of confirmed or presumptive cases in Canada as of Monday, experts say it will be some time before we know the true picture of how widespread community transmission is in Canada. 

“It could be more or less than that. It’s probably more,” said Dr. Andrew Morris, a professor in the department of medicine at the University of Toronto who studies infectious diseases. 

WATCH | How social distancing can make a difference in stopping spread of COVID-19.

Social distancing measures like working from home, school closures and cancelling sporting events could lead to a drop of new infections of coronavirus. 1:54

“In Ontario, there have been challenges with testing as many people as possible. And because patients are being told when they’re unwell, but not very unwell, to just stay away and not get tested, it drops our numbers substantially.”

While Ontario’s assessment centres have been conducting roughly 3,000 swab tests per day, the province’s labs are currently producing only 2,000 to 2,100 test results each day. 

Morris said he expects levels of community transmission to rise in Canada, in part because cases in the community with mild symptoms are not being treated and are not being added to the total.

“Because borders have closed over time, we’re going to see almost no cases related to travel,” he said. “Almost all cases will be community acquired.”

Social distancing key to stopping community spread

In an effort to stop the spread, Tam and other public health officials continue to urge healthy Canadians to stay at home, wash their hands frequently and keep two metres apart from others when venturing outside.

Morris said that given what we know from other countries about how the virus spreads, Canada needs to take an “aggressive approach” when it comes to social distancing to curb community transmission. 

“The people who can take care of most of the cases are the people at home,” he said. 

“If everyone just does their best to maintain their distance from everyone else, and stop meeting anyone outside of your household, then that should do the job.”

Kindrachuk said that while there are severe cases of COVID-19, the “vast majority” of infected people experience mild or moderate respiratory symptoms and can even spread the virus before developing symptoms. 

“For every one case we identify, there are probably quite a few other cases that have not been identified and that are able to transmit virus readily in our communities,” he said.

A man sits alone as he watches the sunset in downtown Vancouver on Friday. Dr. Andrew Morris says Canada needs to take an ‘aggressive approach’ to social distancing to curb community transmission. (Ben Nelms/CBC)

 

He said the rising rate of community transmission has moved Canada into a “new phase” and that now is the time for Canadians to take social distancing seriously.

“I think we still have a chance in Canada right now to try and curb transmission as much as possible because cases are not growing exponentially across the country,” he said. 

“But we are kind of getting close to that precipice where the window is closing for us to really try and tamper down the transmission…. We all need to kind of play our part in that as much as possible.”

Dr. Srinivas Murthy, an infectious disease specialist and clinical associate professor in pediatrics at the University of British Columbia, said social distancing is particularly important for the minority of people with few symptoms who never get diagnosed.

“If you can envision a world where we all stay in the same place, six feet away from everybody else for the next 14 days, then the virus would die itself out,” Murthy said. “The outbreak would end.”

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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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