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Detecting the young silent spreaders of coronavirus as Canadian schools reopen

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With just weeks to go until schools reopen across Canada, one uncertainty that remains is how effectively children can spread the coronavirus that causes COVID-19 to others — even when they don’t show symptoms.

“It’s now clear the idea that children don’t often get infected and don’t transmit the virus is mistaken,” said University of Western Australia epidemiologist Zoe Hyde.

“We know that children can transmit the virus, but we don’t yet know whether they can transmit as effectively as adults.”

While Canada has had fewer than 10,000 COVID-19 cases in those under the age of 19, including only one case where a child with the COVID-19 disease has died, experts say schools are uncharted territory because they have remained closed in much of the country during the pandemic.

Hyde argued in a new preprint article in the Medical Journal of Australia, which has not yet been peer reviewed, that while evidence shows children generally have less severe illness from the virus — it’s wrong to assume they play a smaller role in spreading it.

“Children are much more likely to have mild or even asymptomatic infections than adults, and so they’ve gone under the radar,” she told CBC News.

“However, as community transmission has grown in some countries, the virus has finally started to make its way into younger age groups, and large outbreaks in schools have followed.”

An outbreak at a school in Chile found younger children and teachers were more likely to be infected, while Israel saw an explosion of coronavirus cases after it moved to reopen schools quickly despite cases in the community being low.

An article published in JAMA Pediatrics last month also found children at a hospital in Chicago carried a similar amount of virus in their upper respiratory tracts as adults.

While that doesn’t necessarily mean they can spread the infectious virus as effectively, it did find kids aged five and under with mild COVID-19 symptoms had 10 to 100 times as much of the virus in their systems as older children and adults, so they could still be “important drivers” of the virus in the general population.

Could schools cause a surge of COVID-19 cases in Canada?

Given what we know and don’t know about the way in which children can spread the coronavirus, one question remains top of mind — will reopening schools next month put students, teachers and the wider community at greater risk?

Raywat Deonandan, a global health epidemiologist and an associate professor at the University of Ottawa, said much of the research to date on how kids spread the virus is flawed because it was done while schools were already closed and cases in the community were low.

“We don’t really know to a large extent what happens in the school arena,” he said. “You cannot reliably conclude that child transmission is unlikely.”

 

Canada’s federal guidelines for returning students to school focus heavily on isolating those with symptoms but make little mention of asymptomatic transmission. (Shutterstock/Halfpoint)

 

Another caveat is that the research also focused largely on children with COVID-19 who were symptomatic, which Deonandan said leaves many questions unanswered for younger kids who are much less likely to show symptoms.

Ashleigh Tuite, an infectious diseases epidemiologist and assistant professor at the University of Toronto’s Dalla Lana School of Public Health, said that there is an increased risk of spread in schools because children’s social circles are generally wider than adults.

“If you have 30 people in a classroom and each of those children has a social circle of 10 people and you have a case introduced into that classroom setting, you’re potentially talking about having to think about disease transmission among 300 people,” she said.

“We’re dramatically increasing the size of our social networks as we have this return to school, and if you have an initial case that is introduced into that setting in a child who’s asymptomatic, it may take time until you recognize that there’s transmission happening.”

Is Canada doing enough to stop asymptomatic spread in schools?

Canada’s federal guidelines for returning students to school focus heavily on isolating those with symptoms but make little mention of asymptomatic transmission. They also concede COVID-19 in children is “not fully understood” and “evidence may change with time.”

“From the very beginning of the epidemic, we have completely dropped the ball on understanding the role of asymptomatic transmission of this infection,” said Dr. Isaac Bogoch, an infectious diseases physician at Toronto General Hospital.

“To date, seven months in, we still don’t have a very good understanding of the proportion of people that are truly asymptomatic.”

Despite that lack of understanding, Bogoch says the current back-to-school protocols in place could work to address any potential asymptomatic spread in the classroom.

“If an asymptomatic person is going to school and they have a mask on the entire time and they’re washing their hands religiously and they’re separated two metres from other people, it’s far less likely that they’re going to transmit this infection to other people,” he said.

But new modelling from the federal government warns of the potential for a “fall peak” in coronavirus cases, adding that “closed and crowded indoor settings where physical distancing is a challenge pose high risk for outbreaks.”

WATCH | Potential ‘fall peak’ in cases of coronavirus infections:

Chief public health officer Dr. Theresa Tam says her team is striving for a best-case scenario but preparing for the worst: a so-called “fall peak” of COVID-19 cases across the country. 1:06

Rapid testing would be ‘a tremendous benefit’

Besides focusing on increased ventilation, physical distancing, masks and avoiding crowded indoor spaces as essential aspects of reopening schools safely, one other key element that could help curb spread before it starts is rapid testing.

“If there was a rapid test, that would really identify people that have enough virus in their system that they’re capable of transmitting it to others,” said Bogoch.

“This would be a tremendous benefit, because you could identify people who are at risk of transmitting this infection and prevent them from going to work or from going to school and infecting others.”

But Canada does not yet have access to this type of testing technology called antigen tests, which could allow schools to test entire classrooms quickly with results in about 30 minutes.

“Right now, trying to test people on a regular basis, and children in particular and teachers is not part of the approach,” Canada’s Chief Public Health Officer Dr. Theresa Tam said in a press briefing this week.

“If you had a case in your school, we expect rapid response in terms of testing and looking at contacts, but right now the technology in Canada doesn’t support that kind of approach.”

 

Chief Public Health Officer Dr. Theresa Tam says Canada is ‘actively pursuing’ rapid testing technologies, but to date no such tests have been approved by Health Canada. (Justin Tang/The Canadian Press)

 

Surveillance testing could help catch asymptomatic cases

The U.S. Food and Drug Administration recently authorized emergency use of antigen tests in the United States this month, which are already being rolled out in schools from kindergarten to Grade 12 in states such as Arkansas.

Tam said Canada is “actively pursuing” a similar technology for use here, but no antigen tests have yet been approved by Health Canada.

In absence of that, randomly testing classrooms with our current technology through what’s known as surveillance testing could help catch asymptomatic cases in schools before they spread.

But no provincial or territorial back-to-school plans in Canada have focused on surveillance testing in the classroom in order to monitor and curb potential asymptomatic spread.

“We definitely need to be doing surveillance testing in schools,” said Hyde. “At the very least, we need to be doing this kind of testing to get the data we need to work out how safe schools are.”

Some provinces, such as British Columbia and Newfoundland and Labrador, have opted to delay the start of their school year in order to better prepare for reopening in the pandemic. But others, like Canada’s most populous province, have opted to push ahead amid the uncertainty.

 

 

Ontario’s Chief Medical Officer of Health Dr. David Williams said Thursday there was a negligible risk of sending students back to school, citing low rates of transmission in the province.

“If there was a risk, I would not be recommending the schools are being opened under the current situation,” he said during a news conference. “Therefore, at this time, I don’t see those risks.”

Some experts disagree, citing flawed research that hasn’t provided a clear picture of asymptomatic transmission in children and the fact that COVID-19 has largely gone untested in Canadian schools with a second wave expected in the coming months.

“It’s inevitable. I think we are going to see a rise in cases, and it’s probably going to come in the fall. And I don’t think that’s lost on many people that are following this closely,” Bogoch said.

“We have to ensure that there’s good early detection systems in place so that we can rapidly identify outbreaks and respond to them before they spiral out of control.”

Source: – CBC.ca

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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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