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Coronavirus in Wuhan, China: Why it’s hard to know how bad the virus outbreak will be – Vox.com

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5 years ago

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In the past 24 hours, the number of cases of the new coronavirus originating in Wuhan, China, nearly doubled to more than 4,400. Since the outbreak was announced on December 31, the virus has taken the lives of 107 people.

Less than four weeks into the outbreak, fear about how bad this could get is spreading faster than the virus. And with good reason.

While the vast majority of cases and deaths are occurring on mainland China, 2019-nCoV has already made its way to at least a dozen other countries, including the US, Germany, and Canada. People are buying face masks. Markets are on edge. Cities and countries are responding with mass quarantines and travel bans. The whole thing feels a lot like the 2011 pandemic film, Contagion.

So how big could the outbreak get? Is this the next pandemic — a disease that spreads globally?

Answering this requires knowing the answers to two other questions: How easily does the 2019-nCoV spread from person to person, and how deadly is the virus? At the moment, scientists only have informed guesses, which are likely to solidify in the coming weeks and months. But what we know so far is instructive.

With every disease outbreak, epidemiologists try to figure out how far — and how fast — a virus is likely to spread through a population. To do that, they use the basic reproduction number, called the “R naught,” or R0.

Most simply, the figure refers to how many other people one sick person is likely to infect on average in a group that’s susceptible to the disease (meaning they don’t already have immunity from a vaccine or fighting off the disease before).

The R0 is super important in the context of public health because it foretells how big an outbreak will be. The higher the number, the greater likelihood a lot of people will fall sick.

Measles, the most contagious virus researchers know about, can linger in the air of a room and sicken people up to two hours after an infected person who coughed or sneezed there has left. If people exposed to the virus aren’t vaccinated, measles’ R0 can be as high as 18.

Ebola is much less efficient: Its R0 is typically just 2, since most infected individuals die before they can pass the virus to someone else.

Now, here’s a big caveat: The R0 is not “something that is fixed,” said Marion Koopmans, who studies emerging infectious diseases and heads the department of virology at Erasmus Medical Center in Rotterdam, Netherlands.

Diseases behave differently in different environments, depending on factors like population density and susceptibility to a disease in a population. For example, in the case of norovirus — that nasty and highly contagious bug infamous for causing outbreaks of stomach flu on cruise ships — the R0 estimates vary depending on whether the outbreak is contained in one place (like a hospital) or spread more widely.

Some individuals are also more contagious — and have a higher R0 — than others, because of their viral load, for example, or the airflow in the building where they’re sick. (The folks who are especially contagious are known as “super-spreaders.”)

With these caveats in mind, here’s what we know about the R0 for the new coronavirus. According to a preliminary estimate from WHO, at the moment, each individual infected with 2019-nCoV has transmitted the virus to an average of 1.4 to 2.5 others. That would make 2019-nCoV less contagious than SARS, which had an R0 of 3, but more contagious than seasonal flu.

That’s just the WHO’s word. There are literally dozens of estimates about 2019-nCoV’s R0 floating around, from research groups around the world. And different research groups use different statistical models, assumptions, and data to plug into their models.

In all, I found a broad range of R0 estimates — from 1.4 to 5.47 — being put forward.

If one narrows the estimates to some of the world’s top epidemiological modeling labs — like Maia Majumder’s at Boston Children’s Hospital or Christian Althaus’s at the University of Bern or Jon Read’s at Lancaster — the range looks a lot smaller: 2 to 3.8. That would make the new coronavirus at least as contagious as seasonal flu and potentially more contagious than SARS.

“Given the recent emergence of this disease, the very limited data available, and the very different methods employed for estimation, the consistency of these estimates is remarkable,” Toronto epidemiologist David Fisman told Vox over email.

Still, it’s early days. “It’s difficult or impossible to get an accurate R0 at the beginning of an epidemic,” said Daniel Lucey, an infectious diseases physician and adjunct professor of infectious diseases at Georgetown University Medical Center. We don’t yet know exactly when or how the outbreak began, where it’s spread, or how many people are sick. Only in the coming weeks — as researchers gather more data on how the virus is moving — will they be able to refine the R0.

For now, though, there are a couple of things they can say. “Because it’s above 1, that means we know it can cause sustained transmission in humans,” said Maia Majumder, faculty at Boston Children’s Hospital’s Computational Health Informatics Program. An R0 below one means an outbreak is likely to burn out. But, “Just because the number is high [like SARS’s R0 or the upper end of the current 2019-nCoV estimate] doesn’t mean it’s going to cause a massive pandemic.”

“We do have good examples of high reproductive number diseases like SARS,” Majumder added. “It had no vaccine, no specific care approach, and we still managed to get the situation under control.” That’s because the R0 can’t account for all the interventions public health officials put in place, like infection control measures in hospitals or antivirals.

So even as the R0 evolves in the coming days, and even if it gets higher, that doesn’t necessarily mean the outbreak will grow into a pandemic.

Next to the R0, the other most important way to understand how bad an outbreak could get is the case fatality rate, or CFR. In simple terms, it’s the proportion of deaths a disease causes within a group of people who have the disease.

Here, too, there are problems with arriving at a solid estimate at the moment. To have a firm understanding of the CFR, you need to know how many people in a population have the virus, and among those, how many die. And early on in outbreaks, we don’t often know.

Visualization of 2019-nCoV with Transmission Electron Microscopy.
NEJM

That’s because the sickest are usually the ones who show up at doctor’s offices and in hospitals. But there may be hundreds or thousands of others with the virus who never show symptoms, or never bother going to see a doctor because they’re not very sick. (That’s why the CFR can often look much worse in the early days of an outbreak.)

Getting an accurate CFR would require a survey of the Chinese population, to find out who has antibodies for the virus, said Majumder, including the folks who didn’t even know they had it. That’ll give experts the denominator — the real case toll — in the CFR equation. “Until we’ve done [that] — and I’m sure it’ll happen sometime in the future — there are going to be some people that have mild infections or are asymptomatic infections that we’re not picking up.” Plus, there are many people with the infection in limbo in hospitals, who may or may not survive the pneumonia that comes with it.

So while there’s a great hunger for clarity about how bad the outbreak will become, frustratingly at this stage, researchers need time to work that out.

In the meantime, there’s a tendency for speculation to fill the vacuum. For example, there’s a lot of guesswork about the case fatality rate for the new virus. A bunch of people are taking the number of deaths this disease has caused, and dividing that by the number of cases diagnosed, Majumder said. (As of this writing, that’d be 106 divided by 4,629 — for a CFR of 2 percent, making this virus less deadly than SARS or whooping cough and more deadly than the seasonal flu.)

But again, it’ll be a while before we know the true number of cases and have a clear picture of the deaths.

Here is what we know for sure: While more than 100 people have died in this outbreak so far, and seasonal flu kills between 250,000 and 650,000 people annually. For most people, “you’re probably more likely to be catching flu than you are to be getting coronavirus,” said Devi Sridhar, chair in global public health at the University of Edinburgh.

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What’s the greatest holiday gift: lips, hair, skin? Give the gift of great skin this holiday season

Published

2 weeks ago

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October 31, 2024

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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

Published

3 weeks ago

 on

October 24, 2024

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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

Published

3 weeks ago

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October 23, 2024

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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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