For a few hours on Thursday it appeared the new coronavirus (2019-nCoV) had spread to Saudi Arabia with reports that a nurse in Asir was infected.
But it was a case of mistaken virus identification, quickly corrected.
The unfortunate nurse was actually infected with a different but equally frightening coronavirus — MERS (Middle Eastern respiratory syndrome MERS-CoV) which made the leap from animals to humans in 2012, creating a brand new human disease.
It was a vivid reminder that for almost a decade there has been a threat from another highly pathogenic never-before-seen virus. MERS was only the second coronavirus ever known to leap from animals to humans and cause a deadly illness.
The first of these notorious bugs was SARS, (severe acute respiratory syndrome SARS-CoV) which swept the world in the spring of 2003 killing more than 800 people, including 44 Canadians.
2019-nCoV makes 3
With scant information about the novel virus that has just emerged in China, experts are reviewing the experience of SARS and MERS for important clues about what to expect.
“The interesting thing about this is that we’re really not sure which way it’s going,” said Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases. “We first thought, well, there really wasn’t much transmission from human to human.”
Now that it’s clear the virus can spread between people, Fauci said the next question is how easily it will spread.
“The real question right now is will it get better at going in what we call ‘sustained transmission’ from human to human. Because if it doesn’t then we have a very good chance of pretty quickly getting our arms around it and, by public health measures, essentially stopping it.”
Michael Osterholm, an infectious disease specialist at the University of Minnesota, is a veteran of the SARS and MERS outbreaks, and he’s blunt about the current situation.
“This is a bad disease. It makes people very sick and it can kill you. And so I think that is an important combination. But the ultimate case fatality rate is still yet to be determined.”
In other words, experts still don’t know how dangerous the new virus is or how it compares to SARS — with a case fatality rate around 10 per cent — or MERS with an estimated fatality rate as high as 30 per cent.
“I know how this picture is starting but I don’t know how it ends. And so I think that’s the question we’re all asking,” said Osterholm.
Part of the genetic sequence of the new coronavirus 2019-nCoV. (GenBank by Shanghai Public Health Clinical Center & School of Public Health, Fudan University)
The SARS and MERS viruses followed different paths.
SARS began in China in the fall of 2002 and spread around the world quickly. By spring of 2003 it had travelled to 37 countries including Canada, sickening more than 8,000 people.
Still, SARS lacked the ability to spread easily between humans.
“It never really developed the capability of having sustained vigorous transmission from person to person,” said Fauci. “There was clearly person-to-person transmission but it wasn’t like influenza. You had thousands of cases but not millions of cases.”
And after nine frightening months, SARS was extinguished, apparently forever.
“SARS was actually a huge public health success in that we were able to control contain and eliminate that virus,” said Dr. Catharine Paules, who co-authored a new paper with Fauci about coronavirus infections published this week in JAMA.
“But then in 2012 we had the emergence of a second animal coronavirus in the human population.”
Michael Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota, is a veteran of the SARS and the MERS outbreaks. (University of Minnesota)
MERS first appeared in Jordan in 2012 with cases showing up in 27 countries over eight years. The U.S. Centres for Disease Control states that all of the MERS cases are linked to travel or residence in countries around the Arabian Peninsula. There was a major outbreak of MERS in a South Korean hospital in 2015 where 186 people were infected and 36 died.
Sneezing camels
So far, public health agencies have been able to limit the human-to-human spread of MERS but they have not been able to eradicate the virus. That’s because MERS has become the camel version of the common cold.
“The camels will be sneezing or coughing and they sort of sneeze or cough this virus onto people; that’s how we think it’s transmitted,” said Paules.
In the case of SARS, animal-to-human transmission was eliminated when live-animal markets stopped selling small mammals including palm civets, which were found to be carrying the SARS virus.
“Once we realize that palm civets were the primary animal species transmitting is to humans, and the markets were eliminated, we literally shut off the faucet of new infections coming into humans,” said Osterholm.
So far the animal reservoir for the new virus is a mystery. Experts are extremely skeptical about early reports of an association with snakes.
“I know there was a recent publication that came out about snakes but that’s hotly being debated right now as we aren’t even sure that reptiles can get infected with coronaviruses,” said Paules.
“I think many of us thought that that was in error and not likely to be the source,” said Osterholm. “But at this point we have no data otherwise from the Chinese to know what might have been the animal reservoir.”
“If you want to put some money on it you’d get a bat involved,” said Fauci. “SARS went from the bat to the palm civet cat to the human and MERS went from the bat to the camel to human. I don’t have any idea what the animal is for this one but I would not be surprised if a bat was involved somewhere.”
Dr. Catharine Paules, an infectious disease specialist at Penn State University in Hershey, Pa., co-authored a new paper about coronaviruses. (Penn State Health Hershey)
There are also major questions about the transmissibility of the new virus. Scientists still don’t know how the virus spreads, although Fauci said environmental tests revealed traces of the virus at the market in Wuhan, China.
“They did environmental samples and it was able to be seen on some of these inanimate objects in the fish market,” he said. “Though no one has yet done the definitive experiment of seeing whether it stays alive on a doorknob or not, I wouldn’t be surprised if it did last for a limited period of time on inanimate objects.”
Fauci said it appears to take about six days for someone who has been infected to show symptoms, but it’s not clear whether the virus can be spread by someone who does not appear to be sick.
“But there are anecdotes, for example the individual from Seattle who got infected does not remember coming into contact with anyone that was sick nor does he remember coming into contact with any animals nor did he feel that he had any exposures, yet he got infected.”
‘Super-spreaders’
A grim aspect of all three diseases is the phenomenon of the super-spreader — a person who, for some reason that’s still not well understood, is able to infect a large number of people.
“That’s one of the big mysteries,” said Osterholm. “Super-spreaders have been individuals who have been severely ill and even people who’ve been moderately ill. Why they’re putting out so much virus is just not clear.”
In the case of MERS, Osterholm said one person in a South Korean emergency room was able to infect 82 people in 2015.
In the case of SARS, one super-spreader in Beijing was responsible for a chain of infections in 76 people.
It’s been reported that one man in Wuhan infected 14 hospital workers, which could be the first evidence of a super-spreader in this outbreak. But because it happened during surgery, the infection could be related to the surgical procedures.
“I think we have to still be a little bit careful, because this individual actually had had surgery and anytime you intubate somebody you know you may very well have induced a higher rate of spreading the virus,” said Osterholm.
Lessons from SARS and MERS
One of the encouraging aspects of the SARS story is that the virus was contained, said Osterholm, pointing to Canada, where most of the more than 400 infections and 44 deaths happened in and around Toronto.
“While Canada suffered miserably because of what was going on in Toronto, there weren’t even any cases in Calgary, and Winnipeg,” he said.
“So what we need to get people to understand is that we can’t say this isn’t going to come to every country in the world. It’s unlikely, but it could. But when it does, it’s going to likely be largely an institution-based outbreak like a hospital.”
“So that just helps give people a sense that we’re not all going to die from this,” he said.
Training to respond to a viral threat
At her hospital in Hershey, Pa., Paules is part of a team that trains regularly to respond to an emerging viral threat.
She said some of the strategies developed during the SARS and MERS outbreaks are already bein used, including the closing of animal markets and airport screening.
“Some of those things have been able to get up and running very quickly, probably because of the lessons learned from SARS,” said Paules.
China was able to sequence the new virus and get that critical genetic code to the world quickly. Diagnostic tests have been developed, which means cases can be identified and isolated to contain the spread.
“I think some of the things from SARS and MERS that have really helped us here is how quickly the Chinese authorities were able to globally circulate the sequence of this virus,” said Paules, who echoes Osterholm’s point that most people don’t have to worry about this virus.
“I would be concerned if I was in some of these areas in China. I would not myself probably decide to travel to any of those areas right now. But here sitting in my office in Hershey, Pennsylvania I have a low concern that this virus is going to impact me personally, although I’m concerned for the global community.”
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.
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.
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.
