OTTAWA —
Canada’s Chief Public Health Officer Dr. Theresa Tam is calling for “structural change” across health, social, and economic sectors in the wake of COVID-19, in a new report highlighting the successes and shortfalls in the country’s pandemic response to date.
“I do see COVID-19 as a catalyst for collaboration between health, social, and economic sectors, and I have observed at the federal level, but also from local levels, and provincial levels,” she told reporters during a press conference discussing the report.
Tam said that while there are examples of decisions taken that begin to address some of these shortcomings—such as increasing affordable housing availability and financial supports for low-income and precarious workers—these policies should be extended past the emergency phase of the pandemic.
“What I’m really, really keen to see is that this continues… The report is calling for this to be a more sustained approach,” she said. “Why can’t we have those governance structures beyond the crisis and into recovery?”
In the Public Health Agency’s annual report made public on Wednesday, Tam offers new insights and statistics related to Canada’s battle against the novel coronavirus over the last several months and the “serious threat” the virus continues to pose.
For example, in Canada:
80 per cent of COVID-19-related deaths have been residents of long-term care facilities;
19 per cent of national cases are among health-care workers; and
92 per cent of hospitalized COVID-19 patients had at least one underlying health condition.
The annual report is entitled “From Risk to Resilience: An Equity Approach to COVID-19,” and it gives an overview of COVID-19’s consequences so far, such as the disproportionate health impacts experienced by workers who provide essential services, racialized populations, people living with disabilities or mental illnesses, and women.
It also includes recommendations on how to improve the country’s pandemic preparedness, response, and recovery.
The report says the “structural change” should include improving employment conditions and conditions inside long-term care homes, increasing access to housing, as well as enhancing Canadians’ ability to access social and health services both in-person and online.
Tam said she hopes that in future pandemic planning, “it can’t just be health and public health making it known that all other departments and different sectors, and different aspects of societies need to be part of the response. We need to sort of build it in explicitly so that, you know, future pandemics and health crises have those other supports come into play immediately.”
As Tam argues, Canadians’ health depends on their social and economic well-being and the severity of COVID-19 illness may be influenced by their access to these kinds of supports.
“No one is protected until everyone is protected,” says Tam in the report.
Tam’s overall recommendations are distilled into three calls:
Sustaining governance at all levels for “structural change” in health, social, and economic sectors. The report notes that the health of people in Canada was not equal before COVID-19, but that the pandemic has exposed and exacerbated existing shortcomings. Tam suggests that more data needs to be collected and used to inform policy decisions to eliminate inequities and mitigate some potential long-term pandemic impacts;
Harnessing “the power of social cohesion” to control and minimize the virus’ spread. She suggests this can be done by leaders sharing evidence and information to provide Canadians with confidence in taking public health precautions such as mask-wearing; and
Strengthening public health capacity. Tam says that more work is needed to ensure Canada’s public health system is able to handle case surges while having the capacity to deal with non-COVID-19 health issues, including re-evaluating “what sustained investments and the future of public health would look like.”
GLOBAL COMPARISONS
The report also goes over the timeline from the first confirmed case in Canada and when community transmission began, to the various rolling restrictions and travel advisories imposed.
From a global perspective, according to the report, Canada ranked 79th out of 210 countries with respect to total cases per million inhabitants, and 26th for total deaths per million, as of Aug. 22. The outbreaks in Canadian long-term care homes are cited as a driving factor in why Canada is so high on the list of countries when it comes to deaths.
“Pandemic preparedness did not extend into these settings leaving residents vulnerable to the introduction, spread and impact of a novel virus,” the report states.
Further, analysis of international travel-related cases between January and March found that 35 per cent of cases entered Canada from the United States, 10 per cent from the U.K. and France, and 1.4 per cent from China. Once travel restrictions were imposed, 91 per cent of reported cases by August originated in Canada.
COMMUNICATION STRUGGLES
The report notes that in the absence of an effective treatment or vaccine, individual and collective public health measures need to be taken to control the pandemic. However, “accurate, timely and clear communication” has been a challenge.
Tam notes that there have been “a number” of issues on this front, such as Canadians being exposed to a vast amount and varying quality of information and the confusion spawning from the frequently-moving goal posts when it comes to public health advice due to the evolving science.
“Information needs to be tailored and locally contextualized, while at the same time balanced with consistent key messaging being shared across the country,” the report states.
Tam is advising that as long as the virus is uncontrolled, public health officials and governments need to be transparent and provide regular updates on COVID-19 and up-to-date guidance.
It’s a part of Tam’s mandate to provide Health Minister Patty Hajdu with a report on the state of public health in Canada annually, which then is tabled in Parliament.
The report is based on Canadian data available from January to the end of August, and notes that because the virus and evidence around it continues to rapidly evolve, “the report was written with the knowledge that the story of this pandemic is continuing to change every day.”
TIMELINE OF KEY MILESTONES
December 31, 2019: PHAC was notified of a pneumonia-like illness of unknown cause originating in Wuhan, China.
January 22, 2020: Canada implements novel coronavirus screening requirements for travellers returning from China. Residents are asked additional screening questions to determine if they have visited the city of Wuhan, China.
January 25, 2020: First presumptive confirmed case of 2019-nCoV related to travel to Wuhan, China confirmed in Ontario.
February 20, 2020: First COVID-19 case in Canada from travel outside mainland China, from Iran, reported in British Columbia.
February 23, 2020: First recorded COVID-19 case in Canada linked to community transmission.
February 24, 2020: Alberta records first COVID-19 case in Canada linked to travel to the U.S.
March 7, 2020: First COVID-19 outbreak at a long-term care home in Vancouver, British Columbia involving 79 cases.
March 11, 2020: Canada surpasses 100 reported COVID-19 cases.
March 12-22, 2020: Physical distancing measures are implemented across the country. All provinces and territories declare a state of emergency and/or public health emergency. Non-essential businesses close or have significantly reduced capacity; gatherings are restricted; schools close; advisory issued for those who can, to work from home.
March 13, 2020: The Government of Canada recommends avoiding non-essential travel outside of Canada,
March 16, 2020: Government of Canada advises all travellers entering Canada to self-isolate for 14 days.
March 18–19, 2020: Additional international travel advisories and border restrictions are implemented: Entry to Canada by air is prohibited to all foreign nationals (except those from the United States); Canada and the United States agree to temporarily restrict non-essential travel across the Canada-US border; International flights are redirected to only 4 airports.
March 28, 2020: First reported outbreak among temporary foreign workers in an agricultural setting, involving 23 people.
April 7, 2020: Council of Chief Medical Officers of Health issue a statement supportive of wearing non-medical masks as an additional layer of protection for other people in close proximity.
April 14, 2020: Largest known COVID-19 outbreak reported at homeless shelter in Toronto, Ontario, involving 164 cases.
April 15, 2020: Lockdown in response to largest known outbreak at a correctional facility in Laval, Quebec involving 162 cases.
April 17, 2020: First reported COVID-19 outbreak in an isolated northern community in Saskatchewan, affecting 117 residents.
April 24, 2020: New Brunswick is the first province to ease physical distancing restrictions.
May 6, 2020: Alberta reports a COVID-19 outbreak at a meat processing plant, which becomes the largest outbreak at a single location in Canada (by the end of August) with 1,560 people confirmed.
June 17, 2020: First COVID-19 outbreak in a religious-cultural community declared in Saskatchewan, involving 285 people.
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.
___
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.
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.
___
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.
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.
