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Canada still downplays risk of airborne spread of coronavirus despite WHO, CDC guidance – CBC.ca

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This is an excerpt from Second Opinion, a weekly roundup of health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.


Canada’s guidelines on how COVID-19 spreads still do not acknowledge the threat of infection through the air, despite other countries and international health organizations updating their stance on the issue.

As researchers around the world race to learn as much as possible about the novel coronavirus, many health agencies have concluded that it can be transmitted via aerosols — or microscopic airborne particles — yet Canada has not followed that lead so far. 

It was originally believed the novel coronavirus spread only via large droplets, which fall and settle on the ground within a distance of two metres — prompting the recommendation to social distance and stay two metres away from others. But understanding of the virus has evolved, and it’s now widely believed that it can also spread from smaller droplets that contain virus particles that can remain suspended in the air for a long time.

The World Health Organization came under fire in July after 239 scientists from 32 countries wrote an open letter calling on the United Nations agency to update its messaging on the risk of airborne transmission of the coronavirus.

The WHO amended its guidelines days after the letter and acknowledged the possibility that these smaller droplets, also known as aerosols, can lead to outbreaks of COVID-19 in places like choir practices, restaurants and fitness classes.

The U.S. Centers for Disease Control and Prevention (CDC) updated its guidelines on Monday to say COVID-19 can sometimes be spread by airborne transmission, after mistakenly posting and later removing a draft version of guidelines.

“I was happy and relieved, because now they’re acknowledging the best available science that we have,” said Linsey Marr, an expert in the transmission of viruses by aerosol at Virginia Tech.

“You’re not going to be able to bend the curve unless you pay attention to this transmission route.” 

No plans to update guidelines in Canada

Yet the Public Health Agency of Canada’s guidelines make no mention of aerosol transmission and instead say the virus spreads only through breathing in respiratory droplets, touching contaminated surfaces and common greetings like handshakes and hugs.  

Besides the WHO and the CDC, countries like Germany and Italy recognize aerosols as a risk. But PHAC told CBC News it is not updating its guidance on airborne transmission — even though it admits aerosol spread has happened. 

“Aerosol transmission of COVID-19 in ventilated and unventilated environments continues to be studied,” a statement from the federal agency stated. “There have been situations where aerosol transmission in closed settings has occurred.” 

Studies of superspreading events, such as a choir practice in Washington state, a call centre in South Korea and a restaurant in China, have supported the conclusion that some degree of transmission is occurring through the air. (Evan Mitsui/CBC)

PHAC says its guidance remains the same: limit time spent in closed spaces, crowded places and close contact situations where there are “no controls, protocols or policies in place to reduce the risk of COVID-19, like good ventilation.” PHAC also recommends maintaining physical distancing, hand-washing and mask-wearing.

But infectious diseases specialist and medical microbiologist Dr. Raymond Tellier, who is also an assistant medical professor at McGill University in Montreal, says that by acknowledging ventilation plays a role in curbing transmission of COVID-19, PHAC is admitting that aerosols are a significant route of transmission. 

That’s because ventilation does not change the risk of transmission via larger respiratory droplets or contact with contaminated surfaces. 

“If you promote avoiding a poorly ventilated indoor area, you implicitly admit that you accept aerosol transmission because the ventilation effects only aerosol transmission,” he said. 

“So if you are pushing ventilation, what are you talking about, if not aerosols?”

The agency said it is also reviewing evidence on the topic and acknowledges that aerosols can be suspended in the air and infect others nearby, but the rate at which that happens and under what conditions is “not known.”

“The resistance has been extremely strong in Canada,” says Tellier.

“We have a lot of data that builds up a very strong case for aerosol transmission to be also a part of the transmissibility of the disease.” 

Studies of superspreading events, such as a choir practice in Washington state, a call centre in South Korea and a restaurant in China, have supported the conclusion that some degree of transmission is occurring through the air. 

WATCH | Linsey Marr on evidence the virus could be airborne

A signatory of the letter urging the WHO to change its recommendations around COVID-19 airborne transmission says it would be wise to do as much as we can to slow down the virus.   6:00

Tellier said the reluctance to acknowledge aerosol transmission may be related to the need for more extensive personal protective equipment like N95 masks in hospitals and increasing ventilation and air circulation in public buildings, which can be expensive.

“I’ve heard anecdotes of school districts, where they pointed to the older CDC guidance and said, ‘Well, they don’t say anything about it so we don’t have to do anything about it,'” Marr said. “Even when people were urging them to pay attention to ventilation.” 

The importance of masks

Jose Jimenez, a professor of chemistry at the University of Colorado specializing in aerosol science, said a simpler way of looking at aerosols is by comparing it to smoke, where you are exposed to a higher concentration being exhaled the closer you are to an infected individual, which highlights the importance of wearing a tight-fitting mask. 

“If everyone in the world could just spend 10 minutes paying attention to not having gaps in their mask, that will be a huge benefit,” he said. “It’s almost amazing that the masks are effective given how poorly they’re mostly worn.” 

Dr. Mark Loeb, an infectious disease expert with the department of medicine at McMaster University in Hamilton, said that while he believes most COVID-19 transmission occurs in short distances, there are circumstances when longer range transmission can occur. 

One example he pointed to was a nursing home outbreak in Montreal where virus particles were found in the air, and a faulty ventilation system may have been a source of transmission that infected 226 residents and 148 employees. 

“So I think we have to say that in certain circumstances, it can happen,” Loeb said. “But I do think that sometimes there’s over-interpretation.” 

The Public Health Agency of Canada says its guidance remains the same: limit time spent in closed spaces, crowded places and close contact situations where there are “no controls, protocols, or policies in place to reduce the risk of COVID-19, like good ventilation.” (Evan Mitsui/CBC)

He said when experts from different schools of thought look at the same outbreak, they can come to completely different conclusions. 

Take the choir study, for example, where 61 members gathered for a two-and-a-half-hour practice in Mount Vernon, Wash., on March 10. 

They sat close to each other, sang together, shared snacks and stacked chairs when it was over. 

Two weeks later, 53 of the members in attendance had either confirmed or probable cases of COVID-19. Three of those people were hospitalized. Two died.

“Some people say, well, this is definitive proof of aerosolization. Other people will say, well, if you look at it more carefully, people are walking around touching each other in close contact,” he said. 

“Sometimes it becomes impossible to say it’s definitely one or definitely the other.” 

Regardless of how much of a role aerosol transmission plays in the spread of COVID-19, Tellier said for some reason the burden of proof is much higher.  

“There’s a very, very high threshold for scientific certainty for aerosols,” he said. “Somehow, transmission through surfaces has been accepted with a lot less evidence.”

The WHO said in July there have been “no specific reports” of COVID-19 directly from contact with contaminated surfaces, even though research consistently shows the virus can survive on them for several hours or days.

“We’re not seeing people infected from touching packages,” Loeb said.

For its part, the CDC says the virus spreads “less commonly” from touching contaminated surfaces, while PHAC maintains that is one of the ways the virus “most commonly spreads.”

“My view is that there’s a lot that’s unknown and we have to keep an open mind,” he added. “We have to look at all the data.”


To read the entire Second Opinion newsletter every Saturday morning, subscribe by clicking 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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