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Canada's public health leaders navigate choppy waters as pandemic drags on – CTV News

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MONTREAL —
The abrupt departure of Quebec’s public health director last week was further evidence of the rocky road being navigated by the country’s chief medical officers as the Omicron wave pushes the pandemic fight toward a third year.

Quebec’s Dr. Horacio Arruda, who had been public health director since 2012, cited criticism about the government’s handling of the latest wave as he abruptly resigned Monday after 22 months overseeing the province’s pandemic response.

“Recent comments about the credibility of our opinions and our scientific rigour are undoubtedly causing a certain erosion of public support,” Arruda wrote in a letter offering his resignation.

It was a far cry from March 2020, when Arruda was among the group of top provincial health officers on the job when the pandemic hit. Arruda and the others, including B.C.’s Dr. Bonnie Henry, Alberta’s Dr. Deena Hinshaw and Nova Scotia’s Dr. Robert Strang, rose to prominence almost overnight, offering reassuring voices in a time of crisis.

“In the beginning, when we didn’t know what we didn’t know, and there was a great deal of uncertainty, the chief medical officer played an incredibly useful role, as they are intended to do — to be the public face of government and explain what is going on,” said Patrick Fafard, a University of Ottawa professor of public and international affairs who has been studying the role of the country’s medical officers.

“Their status in media terms or public opinion has declined — some of that is inevitable, but it’s also because of the tensions and contradictions in the role.”

Fafard said while the medical officers play an advisory role, each province views the role differently. In an extended pandemic, when the scientific evidence is evolving quickly, they’ve had to reconcile diverging views and governments that don’t make decisions based on science alone. They are often left to explain the policies, even though the decisions ultimately lie with the politicians.

Most of those on the job in 2020 remain in place, with the exception of Arruda and Ontario’s Dr. David Williams, who had been subject to criticism before he retired last year.

In British Columbia, Henry has become known for her signature saying, “Be kind, be calm, be safe,” which has been emblazoned on posters, T-shirts, masks and even a “Dr. Henry shoe” designed in her honour. Lauded as an effective communicator for her encouraging tone during briefings, Henry has also faced criticism for steadfastly defending her stance against the widespread use of rapid tests.

In Alberta, Hinshaw, has gone from being lionized to harshly criticized. In early 2020, her visage was etched on clothing and designer prints as she became the face of a prudent provincial government implementing health restrictions to protect Albertans and their health system.

But in subsequent waves, as Premier Jason Kenney’s government delayed implementing new restrictions and the health system threatened to buckle, Hinshaw got caught up in the whipsaw between Albertans who wanted more restrictions and those who wanted fewer. The nadir came last summer in the fourth wave, when thousands of surgeries were cancelled and the Armed Forces were called in to help.

Kenney and Hinshaw conceded they helped set the stage by ending health restrictions too soon in June, despite the rise of the Delta variant. Kenney took responsibility for the mistake but also said he would have taken action if Hinshaw had recommended it.

“Sometimes politicians are not helping, because they refer to the advice they receive from their public health officials,” said Daniel Beland, a McGill University political science professor. “In the end, it’s important to understand the responsibility for these decisions lies with the elected officials, not the civil servants.”

The distinction is not always understood by the public, and amid tougher measures in Quebec, Prince Edward Island, Saskatchewan and Nova Scotia, medical officers there have seen protests in front of their homes. Some have even faced death threats.

“They are scientists, they are civil servants, they are experts, but they are surrounded by politics,” said Beland, director of the McGill Institute for the Study of Canada. “It’s a very, very tough situation when you’re really under pressure, you receive death threats, you receive insults on a regular basis. It’s tough.”

In Quebec, some commentators had felt Arruda, who kept his role as an assistant deputy minister, was too closely aligned with the government of Premier Francois Legault. The opposition parties as well as Quebec’s College of Physicians have called for the next director to be given greater independence.

Fafard said that after the pandemic, it would be wise to revisit the role across jurisdictions as part of a larger post-mortem. But it’s important not to lose sight of who is ultimately making decisions.

“The bottom line is, we have to hold our governments … accountable, not these people,” Fafard said. “Let’s keep the focus on the politicians we elect to make the choices, not unelected public servants.”

For his part, Strang said he’s heard criticism from some and been thanked by others.

“Whether the public is getting tired of hearing from me or not, I don’t know,” Strang told a briefing last week. “My commitment is to be here and help get Nova Scotia through this pandemic as safely as possible.”

This report by The Canadian Press was first published Jan. 15, 2022.

— With files from Keith Doucette in Halifax, Dean Bennett in Edmonton and Camille Bains in Vancouver.

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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.

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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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