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Ontario's 2nd wave of COVID-19 forecast to peak in October – CBC.ca

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Fresh projections suggest that Ontario’s second wave of COVID-19 will peak in mid- to late October and will likely send enough patients to intensive care that hospitals will need to scale back non-emergency surgeries.

The forecasts come from the COVID-19 Modelling Collaborative, a joint effort of scientists and physicians from the University of Toronto, University Health Network and Sunnybrook Hospital. 

Based on how quickly Ontario’s infection rate has been rising in recent weeks, the model projects the province is on track to exceed 1,000 new cases per day by the middle of October, unless stricter public health measures slow the accelerating spread.

The average number of new cases reported daily in Ontario is currently running four times higher than what it was at the end of August. Premier Doug Ford’s government has since shrunk limits on the size of private gatherings, reduced opening hours for bars and ordered strip clubs to close.

On Sunday, Ontario’s Ministry of Health reported 112 patients in hospital with a confirmed case of COVID-19, nearly triple the number of two weeks ago. The research team says the impact of the second wave on Ontario’s hospitals will depend on the demographics of who gets infected in the coming weeks. 

The dotted line shows the current prediction for the start of Ontario’s second wave of COVID-19, based on work by a team of researchers from the University of Toronto, the University Health Network and Sunnybrook Hospital. The solid lines model how the case numbers will evolve if the second wave follows the patterns seen in Ontario in the spring (orange), in Michigan this summer (light grey), in the Australian state of Victoria (dark grey), or Italy in the pandemic’s first wave (black). (COVID-19 ModCollab)

“We are at this critical moment right now where we see case numbers increase and we don’t quite know yet where it’s going,” said Beate Sander, a scientist at the University Health Network and Canada Research Chair in economics of infectious diseases. 

“Right now, we have predominantly younger, healthy people (contracting COVID-19 in Ontario),” Sander said in an interview with CBC News. “But what we’ve seen in other jurisdictions is that it really spills over into other population groups.” 

The team of researchers has run four scenarios for how Ontario’s second wave could play out from here.

The best-case scenario would mimic Ontario’s first wave in March and April, when case numbers increased rapidly but were then reined in by a lockdown. 

Two moderate scenarios would resemble how a second wave hit jurisdictions comparable to Ontario: the Australian state of Victoria (home to Melbourne, a city of 5 million), and the U.S. state of Michigan. 

Long lines at testing centres, like this one pictured in Toronto on Sept. 21, 2020, mirror a spike in cases of COVID-19 provincial health officials link to people under 40 not following public health guidelines at social gatherings. (Evan Mitsui/CBC)

None of those three scenarios shows COVID-19 patients filling Ontario’s hospital wards or ICUs beyond their capacity. That happens only in the modellers’ worst-case scenario: a second wave as severe as the first wave that hit Italy when the pandemic began.

However, in all but the best-case scenario, the researchers foresee ICU demand that exceeds the capacity required for patients undergoing scheduled surgeries. 

“The really high-risk cancer surgeries, for instance, won’t be able to go ahead if the ICUs are overwhelmed with people who are showing up in the emergency department dying of COVID-19 associated pneumonia and respiratory failure,” said Dr. Kali Barrett, a critical care physician at the University Health Network and part of the modelling research team. 

The researchers stress that their modelling scenarios are simply forecasts. They use data on the proportion of people who have have ended up in hospital and ICUs while positive for the coronavirus, and project those onto Ontario’s current trend in new cases.

The shifting demographics of who’s getting infected with COVID-19 as the second wave builds makes it challenging for the researchers to forecast just how many people will need hospital treatment.

“The second wave in Spain and France started in the younger populations, but it is spreading to the elderly and the people who are more at risk of ending up in the intensive care unit or in the hospitals,” said Barrett in an interview with CBC News.

“It is just a matter of time until this virus, if it’s affecting the young populations, spreads into the elderly population,” she said. “We’re already starting to see that happening in Ontario.”

The latest figures from the province’s Ministry of Health show 227 people aged 70 or older with an active confirmed case of COVID-19. That number has increased 34 per cent in the space of a week.

Changes in the eligibility criteria for testing can also muddy the forecast. When testing is widespread and captures larger number of mild cases, the percentage who end up in hospital will be smaller than when testing is restricted to priority groups most likely to have the virus, as it was in Ontario in the spring. 

Ontario altered its “anyone can get a test” policy on Friday, so far fewer people without symptoms are now eligible for testing. 

ICU demand could lengthen surgical backlog 

Ontario has around 2,000 intensive care beds, and the province plans to add 139 in October. The province’s ICU beds are typically two-thirds occupied by patients whose cases have nothing to do with COVID-19, whether it’s a heart attack, car accident, or another critical illness. 

Since ICUs can’t actually function at 100 per cent occupancy full time, the researchers calculate that Ontario has around 475 beds available for non-emergency surgery patients and COVID patients. When scheduled surgeries are running at full pace, those patients take up all but 100 of those beds.

This graph forecasts what will happen in Ontario if the second wave resembles what happened in the Australian state of Victoria, home to the city of Melbourne. It would see some 1,200 patients in Ontario’s general hospital wards and 350 to 400 patients in intensive care (ICU) beds at the peak in late October. (COVID-19 ModCollab)

   

Their conclusion: if more than 100 people with COVID-19 need ICU care, they’d be competing for space with scheduled surgery cases. 

“Then we would have to make decisions in terms of who to treat,” said Sander. “Do we admit COVID patients or do we do (non-emergency) surgery?”

The projections suggest if Ontario’s second wave follows what happened in the Australian state of Victoria — a sharp spike in new infections that drops off quickly after a strict lockdown — some 350 to 400 people will need an ICU bed at peak demand in late October.

If the second wave in this province plays out as Michigan’s did — a rise in new infections that levels off but doesn’t slow down for a long time — the forecast is for more than 200 patients with COVID-19 in the ICUs from late October onwards. 

Figures published Sunday by the Ministry of Health show 28 ICU patients with a confirmed case of COVID-19.   

In Ontario’s first wave, the number of COVID-19 patients in ICU peaked at 264, while the number of people in hospital at one time peaked at 1,043. Non-emergency surgeries were postponed across the province.  

If the majority of Ontario’s second wave infections come among younger healthier people — as has been happening through September — hospitalization rates are expected be lower than in the spring. 

The modellers say ICU occupancy numbers will be of more critical concern than total hospitalization numbers because Ontario’s hospital system can far more easily free up general ward beds than it can make space in intensive care.   

That’s less about the available beds and ventilators, and more about the having enough doctors and nurses capable of the specialized care that ICU patients need.    

“You can’t just train people overnight to do this type of thing,” said Sander. “You can buy a lot of beds and you can buy a lot of ventilators, but you can’t get these highly qualified staff on the ground within a very short period of time.” 

Barrett agrees that human resources are the key limiting factor, and is concerned about how the second wave could hit hospital staff and their families. 

“The majority of people working in hospitals are in their 30s, 40s and 50s, so many of them have children who go to school,” she said. “If there is a massive outbreak amongst the younger population and school children, that’s a whole sector of our health workforce that won’t be able to come to work.”


Still have questions about COVID-19? These CBC News stories will help.

Is another lockdown coming in Ontario? What do we know about the Ford government’s fall plan?

CBC Queen’s Park reporter Mike Crawley obtained a draft copy of the plan

What’s the latest on where I should get tested?

It’s confusing, but here’s an explainer complete with a flow chart

What’s the most recent guidance on mask use?

Reporter Lauren Pelley took a look at what the experts are advising

What should I do about my COVID bubble?

With cases going up, even small gatherings are getting riskier

Who is getting COVID-19?

CBC News crunched the data from across Canada to get the clearest picture possible

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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.

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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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