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The 2nd wave is coming. Here's what public health experts say we should expect – CBC.ca

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For many health specialists in Montreal, a second wave of COVID-19 infections isn’t a matter of if but when — and how bad it will be.

And some epidemiologists believe the second wave may already be underway. 

The good news is that many of these experts also say the severity and duration of that wave can be kept under control and that it is not a foregone conclusion that Quebec will again fare worse than the rest of the country.

Those observations are based on the answers that 170 medical doctors, epidemiologists, public health experts and medical researchers provided to CBC Montreal in an informal survey circulated earlier this month. 

Of the 170 who answered, two-thirds indicated that a second wave was “very likely.” A further 24 per cent said it was “somewhat likely.”

The concept of a second wave is contested and carries different meanings. It should be understood here at its most basic level: another sustained increase in infections.

 

Some experts believe a second wave is inevitable, based on the history of infectious diseases such as SARS, a respiratory illness caused by a virus that is genetically related to the coronavirus, which causes COVID-19. 

“It’s useful to understand that a second wave is not a discrete thing that happens or doesn’t,” said Dr. Cédric Yansouni, an infectious-disease physician at the McGill University Health Centre in Montreal. “There haven’t been any pandemics of respiratory diseases that had a single wave.

“You will always have ongoing transmission for some time. It can last for months and up to a two-year period.”

Another reason a second wave is likely is that not enough people were infected in the first wave to generate sufficient levels of immunity in the population at large. 

“Second waves are expected for airborne transmitted viral infections for several reasons, the principal being the existence of a large population of unexposed [non-immune] hosts,” said Tatiana Scorza, an immunologist at the Université du Québec à Montréal.

A study by Canada’s COVID-19 Immunity Task Force, which did not include blood samples from Quebec, estimated that less than one per cent of Canadians have had the virus. The results of a separate study of Quebec blood samples are expected next month.

What will it look like?

There have been some indications that a second wave could already be underway in Quebec. 

After peaking in late April and early May, the rolling average of new cases in the province reached its lowest point in the final days of June.

But the average has climbed steadily since the start of the month, and now stands at more than 150 new cases per day. 

“If it starts increasing and not coming down over the next two weeks, I would say we’d be into a second wave,” said Mark Goldberg, an environmental epidemiologist and professor in the department of medicine at McGill University.

The Quebec government says despite the increase in cases, the public-health situation remains under control. It points to the low number of deaths and hospitalizations. 

But Benoît Mâsse, a professor at the school of public health at Université de Montréal, cautioned that the increase in hospitalizations will likely come later.

He expects infections will increase for several more weeks. The danger, he said, is in September, when schools resume and the public begins to spend more time indoors, where the chances of infection are higher.

“We can expect a more substantial increase in infections with a rise in hospitalizations by the end of October, early November,” Mâsse said in an email exchange.

WATCH: Quebec’s health minister outlines preparations for second wave:

Health Minister Christian Dubé explains what the government is doing to prepare for a second wave of COVID-19 infections. 1:09

Other experts in Montreal are more reluctant to offer predictions. They stress that because the virus is new, there is a lack of data allowing them to anticipate infection patterns. 

Janusz Kaczorowski, a professor and research director in the department of emergency and family medicine at Université de Montréal, pointed out that many of his colleagues initially expected infections to decrease over the summer months, much like the flu, another virus thought to be transmitted by airborne droplets. 

“Look at what’s happening now in the United States … I mean the numbers are going through the roof,” Kaczorowski said. 

“It doesn’t look like COVID is necessarily following the same pattern as the annual influenza. It is a different animal.”

What should we do about it?

While experts maintain another round of infections is inevitable, they say its severity will depend on government policy and the willingness of the public to follow guidelines.

Not only do scientists know much more about COVID-19 than they did six months ago, but the public is better informed about hygiene measures and elected officials also have a wider range of policy tools at their disposal.

“I think everybody’s learned a lot,” said Dr. Brian White-Guay, a public health and family medicine specialist who teaches at Université de Montréal. 

“It’s likely that things would be handled differently in a second-wave setting.”

He suggested that health authorities, for example, now have a better understanding of which segments of the population are more vulnerable to COVID-19 and how best to protect them from the disease.

likely have a better sense of how to limit transmission in institutionalized settings, such as long-term care homes

As part of the survey CBC Montreal and Radio-Canada circulated to health experts in early July, we asked an open-ended question about what the Quebec government should do when a second wave of the virus hits.

The most popular response? Make masks mandatory. 

Though the province implemented provincewide mask requirements in indoor public spaces as of July 18, the answers to our survey suggest the government was late in catching up with the scientific consensus. 

“It should have been done much earlier in the pandemic,” said Dr. Eva Suarthana, a medical epidemiologist at Hôpital du Sacré-Coeur de Montréal.

Masks have been required in all indoor public spaces in Quebec since July 18. (Graham Hughes/The Canadian Press)

Another popular response was to stress protecting elderly Quebecers, especially those living in long-term care centres, where the vast majority of deaths occurred during the first wave.

Several experts said they were happy to see that provincial health authorities have already begun to implement tighter infection-control protocols and are training 10,000 new patient attendants for long-term care homes (CHSLDs).

But they also warned that delays in implementing these measures could come at a serious human cost.

“If we are not able to put in place proper measures to provide greater protection for [the] most vulnerable groups, there is reason to believe we would see a significant order of casualties, possibly up to the range of what we saw in the first wave,” said White-Guay.


Methodology

CBC collected 907 email addresses of health professionals from university and hospital websites. We sought out experts with research areas related to the pandemic, such as public health, epidemiology and emergency medicine. They were sent a questionnaire on July 7 and a reminder on July 10. 

Of the 180 responses, 10 were duplicates; 104 of the 907 emails sent bounced back with out-of-office replies or the email addresses were invalid.

This is the breakdown of professions that responded:

Infectious diseases, including epidemiology, immunology, virology: 41.
Emergency medicine: 23.
Public health: 20.
Family or general medicine: 17.
Epidemiology of non-infectious diseases: 6.
Biostatistics: 3.
Other medical specialization: 55.
Non-medical specialization: 5.

The questionnaire can be viewed here:

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What’s the greatest holiday gift: lips, hair, skin? Give the gift of great skin this holiday season

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Give the gift of great skin this holiday season

Skinstitut Holiday Gift Kits take the stress out of gifting

Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.

In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.

“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.

There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.

Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.

Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.

In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.

 

Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

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Here is how to prepare your online accounts for when you die

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LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?

It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.

Here’s how you can prepare your digital life for your survivors:

Apple

The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.

For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.

You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.

Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.

Google

Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.

When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.

You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.

There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.

Facebook and Instagram

Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.

When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.

The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.

You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.

TikTok

The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.

Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.

X

It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.

Passwords

Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?

Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.

But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.

___

Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.

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Pediatric group says doctors should regularly screen kids for reading difficulties

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The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.

New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.

The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.

Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.

Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.

“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.

“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”

McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.

But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.

The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.

He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.

“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.

“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.

McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”

McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.

He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.

“Early identification of reading difficulty can truly change the trajectory of a child’s life.”

This report by The Canadian Press was first published Oct. 23, 2024.

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