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Border closures worry Americans who come to Canada to buy insulin

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When Travis Paulson drove from his home in northern Minnesota to the Canadian border last month, he thought he’d have little trouble crossing over to buy his insulin.

Paulson, a Type 1 diabetic, has made the trip many times for himself and others as the price of the lifesaving drug has skyrocketed in the United States over the last decade. A vial in Canada costs roughly $25 US, a fraction of the $350 to $400 he would be charged in his home country.

Paulson called Canada Border Services ahead of time to see if he’d still be able to come into Canada. Travel between the two countries has been restricted during the COVID-19 pandemic, but Paulson said he was told he could still make the trip if he only went to the pharmacy and came back the same day.

But when he arrived at the border near Fort Frances, Ont., he said he was told there had been a policy change that very morning — and he couldn’t come into Canada because his trip was not deemed essential.

“It’s devastating because your life depends on it. You’re literally being denied the air that you need to breathe,” said Paulson, the director of the diabetes organization Northern Minnesota Advocacy Group.

“Every few hours you need it, every day. And that you might not be able to get it, I would say it’s a little terrifying.”

 

When coming to Canada, Paulson often buys insulin for himself and for others. (Submitted by Travis Paulson)

 

Many Americans rely on going up north to buy insulin, where it is roughly a tenth of the price. Canada’s Patented Medicine Prices Review Board, a federal agency that establishes the maximum price that can be charged for patented drugs, keeps the prices affordable.

But the COVID-19 border restrictions have meant that option is no longer available.

While some pharmaceutical companies in the U.S. are offering programs for cheaper insulin during the pandemic, advocates say still not enough is being done to make it affordable.

A spokesperson for the Canada Border Services Agency said Americans may be allowed to enter the country to purchase medications, but the agency offers little clarity on who will be allowed in and when.

“Entry to Canada is decided on a case-by-case basis and based on the information made available to the border services officer at the time of entry,” spokesperson Judith Gadbois-St-Cyr said in an email.

Until at least June 21, there is a temporary restriction on all non-essential travel between Canada and the U.S. That could be further prolonged if deemed necessary, Gadbois-St-Cyr said.

 

Transport trucks approach the Canada/USA border crossing in Windsor, Ont., in March. The border closure between the two countries has been extended until at least June 21. (Rob Gurdebeke/The Canadian Press)

 

Quinn Nystrom, a long-time diabetes and affordable health-care advocate in Minnesota, said she’s received several calls since the border closures began, including one from a panicked mother.

“She said her nine-year-old son was on his last insulin pen,” Nystrom said, adding that the woman’s husband had been planning a trip to Canada in the spring to buy more.

“They were just completely distraught over it.”

 

Quinn Nystrom holds the insulin she bought on her trip to Canada in the spring of 2019. (Submitted by Quinn Nystrom)

 

Nystrom gained international attention last year for organizing and taking part in several Caravans to Canada — trips to show just how easy and affordable it is to buy insulin outside of the U.S.

A Type 1 diabetic herself, Nystrom went to her congressman, Pete Stauber, last spring, begging him to protect people with pre-existing conditions and vote to help lower the cost of insulin.

“He promised me he would do that. And after leaving his office and following up with him over the next couple of months, he unfortunately voted against those things,” she said.

“It was so unfortunate to me that I decided to file and run against him.”

On Sunday, Nystrom won the Democratic nomination in Minnesota’s 8th congressional district and will be up against Stauber on the ballot in November.

 

The small group drove five hours from Minnesota to Ontario to buy insulin at one-tenth the cost in the spring of 2019. Travis Paulson and Quinn Nystrom are on the left, and Nicole Smith-Holt and Lija Greensied are on the right. (Rachel Nystrom)

 

Access to affordable insulin can be a matter of life and death for Americans.

Nicole Smith-Holt’s son died in June 2017 at just 26 years old, less than a month after he aged off of his parents’ insurance plan. He couldn’t afford the cost at a pharmacy in Minnesota and chose instead to ration his insulin.

Smith-Holt said the border closures to Canada and Mexico put up “one more barrier” for struggling Americans, especially as many of them have lost their jobs and therefore their insurance during the pandemic.

“People are going to start rationing and people are going to suffer some very long-term health effects or possibly death,” she said.

“A Type 1 diabetic really should not be lowering their dosage or missing doses. It proved fatal for Alec and countless other people.”

But Alec Smith’s family, friends and supporters worked to make sure his death wasn’t in vain.

 

Nicole Smith-Holt with her son, Alec Smith, who died in 2017 from diabetes complications after rationing his insulin when he couldn’t afford it. (Submitted by Nicole Smith-Holt)

 

On July 1, the Alec Smith Insulin Affordability Act will come into effect in Minnesota. It will allow people who cannot afford their insulin to access a 30-day supply at their pharmacy for just $35.

The new law also streamlines the process to access insulin in the long-term and manufacturers can be fined up to $3.6 million for not participating in the program.

“It means that we’re going to have the ability to save lives,” Smith-Holt said.

“People right now, especially during this COVID-19 pandemic, are really struggling. It’s going to be a lifeline for people.”

Pharmaceutical companies making pandemic programs

Since the pandemic started, some pharmaceutical companies in the United States have created programs to help struggling diabetics.

Eli Lilly, the U.S. manufacturer of fast-acting insulin Humalog, created a program in April to help those without insurance access a month’s supply for $35.

But these programs are difficult to apply for, advocates say, and often many people don’t meet the criteria to be eligible.

It’s also just a temporary solution, Nystrom said, adding that the issue of insulin affordability won’t go away when the pandemic does.

 

Several American groups made international headlines in 2019 for the Caravan to Canada, and launched a social media campaign under the hashtag #Insulin4all. (Submitted by Lija Greenseid)

 

With few options due to border restrictions, some Americans, like Paulson, are turning to online Canadian pharmacies.

Some Canadian pharmacies will ship insulin to the U.S., but the National Association of Pharmacy Regulatory Authorities in Ottawa said it’s important to verify the legitimacy of an outlet if ordering online by checking with the province’s regulating body.

One of the most well-known pharmacies to Americans is Mark’s Marine Pharmacy in Vancouver, just 40 kilometres from the U.S. border. It ships insulin to people across the U.S., but requires a doctor’s prescription to do so — a requirement in America.

People also turn to GoFundMe, social media and “underground networks.”

 

Lija Greenseid stands at a pharmacy in Fort Frances, Ont., last spring holding insulin for her teenage daughter. Greenseid organized the Caravan to Canada on the first weekend in May 2019 to buy cheaper insulin. (Submitted by Lija Greenseid)

 

Lija Greenseid, an insulin advocate in St. Paul, Minn., and mother of a 14-year-old daughter who has Type 1 diabetes, said people in local diabetes Facebook groups will share extra insulin if they switch brands and even give up unused vials if someone has died.

“That’s another strange consequence of our health-care system,” said Greenseid, who organized a Caravan to Canada last spring.

While some insurance companies have now capped their deductibles at $25 a month, the list price for insulin in the U.S. hasn’t been cut.

‘The ultimate goal is to be like Canada’

Greenseid had always been comforted by the knowledge that Canada was a short drive away. It’s an option no longer there.

“What is reassuring is knowing that there is an insulin underground network of people who get insulin and give it to people who need it. That’s always there.” Greenseid said.

Nystrom said Americans don’t want to have to rely on outside countries to get affordable medications — and she hopes to make that possible if elected in November.

“The ultimate goal is to be like Canada, where somebody can just go to a pharmacy and pick up insulin for $30 US. That’s our goal,” she said.

“So people don’t have to rely on a pharmaceutical company deciding to be charitable.”

Source: – CBC.ca

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Edited By Harry Miller

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STD epidemic slows as new syphilis and gonorrhea cases fall in US

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NEW YORK (AP) — The U.S. syphilis epidemic slowed dramatically last year, gonorrhea cases fell and chlamydia cases remained below prepandemic levels, according to federal data released Tuesday.

The numbers represented some good news about sexually transmitted diseases, which experienced some alarming increases in past years due to declining condom use, inadequate sex education, and reduced testing and treatment when the COVID-19 pandemic hit.

Last year, cases of the most infectious stages of syphilis fell 10% from the year before — the first substantial decline in more than two decades. Gonorrhea cases dropped 7%, marking a second straight year of decline and bringing the number below what it was in 2019.

“I’m encouraged, and it’s been a long time since I felt that way” about the nation’s epidemic of sexually transmitted infections, said the CDC’s Dr. Jonathan Mermin. “Something is working.”

More than 2.4 million cases of syphilis, gonorrhea and chlamydia were diagnosed and reported last year — 1.6 million cases of chlamydia, 600,000 of gonorrhea, and more than 209,000 of syphilis.

Syphilis is a particular concern. For centuries, it was a common but feared infection that could deform the body and end in death. New cases plummeted in the U.S. starting in the 1940s when infection-fighting antibiotics became widely available, and they trended down for a half century after that. By 2002, however, cases began rising again, with men who have sex with other men being disproportionately affected.

The new report found cases of syphilis in their early, most infectious stages dropped 13% among gay and bisexual men. It was the first such drop since the agency began reporting data for that group in the mid-2000s.

However, there was a 12% increase in the rate of cases of unknown- or later-stage syphilis — a reflection of people infected years ago.

Cases of syphilis in newborns, passed on from infected mothers, also rose. There were nearly 4,000 cases, including 279 stillbirths and infant deaths.

“This means pregnant women are not being tested often enough,” said Dr. Jeffrey Klausner, a professor of medicine at the University of Southern California.

What caused some of the STD trends to improve? Several experts say one contributor is the growing use of an antibiotic as a “morning-after pill.” Studies have shown that taking doxycycline within 72 hours of unprotected sex cuts the risk of developing syphilis, gonorrhea and chlamydia.

In June, the CDC started recommending doxycycline as a morning-after pill, specifically for gay and bisexual men and transgender women who recently had an STD diagnosis. But health departments and organizations in some cities had been giving the pills to people for a couple years.

Some experts believe that the 2022 mpox outbreak — which mainly hit gay and bisexual men — may have had a lingering effect on sexual behavior in 2023, or at least on people’s willingness to get tested when strange sores appeared.

Another factor may have been an increase in the number of health workers testing people for infections, doing contact tracing and connecting people to treatment. Congress gave $1.2 billion to expand the workforce over five years, including $600 million to states, cities and territories that get STD prevention funding from CDC.

Last year had the “most activity with that funding throughout the U.S.,” said David Harvey, executive director of the National Coalition of STD Directors.

However, Congress ended the funds early as a part of last year’s debt ceiling deal, cutting off $400 million. Some people already have lost their jobs, said a spokeswoman for Harvey’s organization.

Still, Harvey said he had reasons for optimism, including the growing use of doxycycline and a push for at-home STD test kits.

Also, there are reasons to think the next presidential administration could get behind STD prevention. In 2019, then-President Donald Trump announced a campaign to “eliminate” the U.S. HIV epidemic by 2030. (Federal health officials later clarified that the actual goal was a huge reduction in new infections — fewer than 3,000 a year.)

There were nearly 32,000 new HIV infections in 2022, the CDC estimates. But a boost in public health funding for HIV could also also help bring down other sexually transmitted infections, experts said.

“When the government puts in resources, puts in money, we see declines in STDs,” Klausner said.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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World’s largest active volcano Mauna Loa showed telltale warning signs before erupting in 2022

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WASHINGTON (AP) — Scientists can’t know precisely when a volcano is about to erupt, but they can sometimes pick up telltale signs.

That happened two years ago with the world’s largest active volcano. About two months before Mauna Loa spewed rivers of glowing orange molten lava, geologists detected small earthquakes nearby and other signs, and they warned residents on Hawaii‘s Big Island.

Now a study of the volcano’s lava confirms their timeline for when the molten rock below was on the move.

“Volcanoes are tricky because we don’t get to watch directly what’s happening inside – we have to look for other signs,” said Erik Klemetti Gonzalez, a volcano expert at Denison University, who was not involved in the study.

Upswelling ground and increased earthquake activity near the volcano resulted from magma rising from lower levels of Earth’s crust to fill chambers beneath the volcano, said Kendra Lynn, a research geologist at the Hawaiian Volcano Observatory and co-author of a new study in Nature Communications.

When pressure was high enough, the magma broke through brittle surface rock and became lava – and the eruption began in late November 2022. Later, researchers collected samples of volcanic rock for analysis.

The chemical makeup of certain crystals within the lava indicated that around 70 days before the eruption, large quantities of molten rock had moved from around 1.9 miles (3 kilometers) to 3 miles (5 kilometers) under the summit to a mile (2 kilometers) or less beneath, the study found. This matched the timeline the geologists had observed with other signs.

The last time Mauna Loa erupted was in 1984. Most of the U.S. volcanoes that scientists consider to be active are found in Hawaii, Alaska and the West Coast.

Worldwide, around 585 volcanoes are considered active.

Scientists can’t predict eruptions, but they can make a “forecast,” said Ben Andrews, who heads the global volcano program at the Smithsonian Institution and who was not involved in the study.

Andrews compared volcano forecasts to weather forecasts – informed “probabilities” that an event will occur. And better data about the past behavior of specific volcanos can help researchers finetune forecasts of future activity, experts say.

(asterisk)We can look for similar patterns in the future and expect that there’s a higher probability of conditions for an eruption happening,” said Klemetti Gonzalez.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

The Canadian Press. All rights reserved.

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Waymo’s robotaxis now open to anyone who wants a driverless ride in Los Angeles

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Waymo on Tuesday opened its robotaxi service to anyone who wants a ride around Los Angeles, marking another milestone in the evolution of self-driving car technology since the company began as a secret project at Google 15 years ago.

The expansion comes eight months after Waymo began offering rides in Los Angeles to a limited group of passengers chosen from a waiting list that had ballooned to more than 300,000 people. Now, anyone with the Waymo One smartphone app will be able to request a ride around an 80-square-mile (129-square-kilometer) territory spanning the second largest U.S. city.

After Waymo received approval from California regulators to charge for rides 15 months ago, the company initially chose to launch its operations in San Francisco before offering a limited service in Los Angeles.

Before deciding to compete against conventional ride-hailing pioneers Uber and Lyft in California, Waymo unleashed its robotaxis in Phoenix in 2020 and has been steadily extending the reach of its service in that Arizona city ever since.

Driverless rides are proving to be more than just a novelty. Waymo says it now transports more than 50,000 weekly passengers in its robotaxis, a volume of business numbers that helped the company recently raise $5.6 billion from its corporate parent Alphabet and a list of other investors that included venture capital firm Andreesen Horowitz and financial management firm T. Rowe Price.

“Our service has matured quickly and our riders are embracing the many benefits of fully autonomous driving,” Waymo co-CEO Tekedra Mawakana said in a blog post.

Despite its inroads, Waymo is still believed to be losing money. Although Alphabet doesn’t disclose Waymo’s financial results, the robotaxi is a major part of an “Other Bets” division that had suffered an operating loss of $3.3 billion through the first nine months of this year, down from a setback of $4.2 billion at the same time last year.

But Waymo has come a long way since Google began working on self-driving cars in 2009 as part of project “Chauffeur.” Since its 2016 spinoff from Google, Waymo has established itself as the clear leader in a robotaxi industry that’s getting more congested.

Electric auto pioneer Tesla is aiming to launch a rival “Cybercab” service by 2026, although its CEO Elon Musk said he hopes the company can get the required regulatory clearances to operate in Texas and California by next year.

Tesla’s projected timeline for competing against Waymo has been met with skepticism because Musk has made unfulfilled promises about the company’s self-driving car technology for nearly a decade.

Meanwhile, Waymo’s robotaxis have driven more than 20 million fully autonomous miles and provided more than 2 million rides to passengers without encountering a serious accident that resulted in its operations being sidelined.

That safety record is a stark contrast to one of its early rivals, Cruise, a robotaxi service owned by General Motors. Cruise’s California license was suspended last year after one of its driverless cars in San Francisco dragged a jaywalking pedestrian who had been struck by a different car driven by a human.

Cruise is now trying to rebound by joining forces with Uber to make some of its services available next year in U.S. cities that still haven’t been announced. But Waymo also has forged a similar alliance with Uber to dispatch its robotaxi in Atlanta and Austin, Texas next year.

Another robotaxi service, Amazon’s Zoox, is hoping to begin offering driverless rides to the general public in Las Vegas at some point next year before also launching in San Francisco.

The Canadian Press. All rights reserved.

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