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Coronvirus in Canada: How will we know we're in a second wave? – CTV News

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TORONTO —
Since the start of the pandemic, Canadian officials have continuously used the threat of a “second wave” of COVID-19 infections in order to remind people to adhere to public health guidelines.

The term second wave has been used repeatedly by politicians, economists, and medical experts alike to warn the public of the threat of a resurgence in cases if they’re not careful.

Both Prime Minister Justin Trudeau and Chief Public Health Officer Dr. Theresa Tam have repeatedly cautioned Canadians about an impending second wave with Tam suggesting there was the possibility for an “explosive” second spike in new infections.

So, what exactly constitutes a second wave? And if there is one on the way, can it be prevented? CTVNews.ca spoke to several experts to find out.

WHAT IS A SECOND WAVE?

Epidemiologists have been using the metaphor of waves on the sea to describe the rise and fall in the number of cases, or the “curve” of an outbreak, for years.

During the Spanish Flu of 1918, officials documented three distinct waves of illness beginning in March of that year. The second wave of that pandemic, which was far deadlier than the first, hit in the fall of 1918 before it subsided for almost a year and resurged again in the fall and winter of 1919.

Since then, the metaphor has been used on multiple occasions in reference to other influenza outbreaks throughout the 20th century, including more recently during the 2009 H1N1 pandemic.

Steven Hoffman, a professor of global health, law, and political science at York University in Toronto and director of the Global Strategy Lab, said a “wave” is an imprecise term that is used colloquially to highlight the overall shape of an epidemic curve in terms of the number of new cases per day.

“There’s nothing so precise about it. It’s more just a helpful communication tool,” he told CTVNews.ca during a telephone interview on Wednesday.

Infectious disease specialist Dr. Isaac Bogoch agreed there is no exact threshold of new daily cases that needs to be reached to be able to determine if a second wave is occurring.

If they are plotted on a graph, for example, Bogoch said the number of new daily infections would be seen rising before peaking and then decreasing again when there are no or few cases for a sustained period of time. The second wave would begin when the cases begin to rise again for continued period.

“It’s as simple as that,” he said during a telephone interview from Toronto on Wednesday. “You’re not going to have an exact definition.”

HOW DO WE KNOW THE FIRST WAVE IS OVER?

Part of the confusion around the usage of the term second wave is determining when the first wave actually ends and a new wave begins. While some countries including Canada, South Korea and Australia saw a fairly obvious increase in new infections that eventually peaked before decreasing again, that’s not always how an outbreak develops.

In the United States, for example, there hasn’t been a dramatic drop in new cases that marks a clear end to the first wave. Since the outbreak began, the country has seen more of a bumpy curve with periodic spikes and no sustained period with few or no cases. Since mid-June, the U.S. has had some of its highest number of recorded cases leading some to believe they’re experiencing a second wave.

However, American health officials including the country’s top infectious disease specialist Dr. Anthony Fauci have been reluctant to label it as such, because the curve of news cases never flattened. 

“You’re sort of seeing the first wave rolling into the second wave, a much bigger one right now,” Hoffman said. “I mean, did they ever get through the first wave? Not really.”

Bogoch said he doesn’t think the semantics really matter because, whether it’s a continuation of the first wave or a second wave, an increase in cases should elicit the same response.

“Is this a second wave or a blip? Or a spike in our first wave? Like, who cares? Really,” he said. “There might be some academic epidemiologists that don’t agree with me on that, but that’s OK. From a practical standpoint, it doesn’t matter.”

Bogoch said countries should focus on whether they have a population susceptible to the virus and if they have good policies in place to prevent further spread.

WILL THERE BE A SECOND WAVE?

No matter the label, Hoffman says a second wave of infections will likely hit Canada.

“We’re almost certainly going to get it because there’s such infectious potential out there, there’s so much of this virus that is present around the world,” he said.

Save for a few recent spikes in some parts of the country, Bogoch said Canada is currently seeing low transmission overall, which he said indicates the first wave is coming to an end in this country.

As for the prospect of a second wave on its way, Bogoch said he agrees it will very likely arrive in Canada in the fall. He said a number of factors may contribute to a resurgence in cases at that time, including schools and workplaces reopening, and cooler temperatures keeping people indoors more.

“We’ve really learned a lot about how this virus is transmitted and where it’s most likely to be transmitted,” he said. “So any settings where people are in an indoor environment in close proximity for prolonged periods of time, we know that that’s a perfect setup for this virus to be transmitted.”

Hoffman added that it’s really anyone’s guess when the second wave will come, however. He said it will be dependent on public health guidance and people’s adherence to those policies in the coming weeks.

“There’s nothing stopping a second way from happening much earlier if we’re not careful,” he said.

CAN A SECOND WAVE BE PREVENTED?

While both Hoffman and Bogoch are confident a second wave will likely hit Canada, they both said the severity of that surge can be mitigated with the proper response.

Bogoch cited South Korea as an example of a country that had a dramatic spike in cases early on, but they were able to largely suppress it through the extensive use of testing, isolating, and contact tracing.

When cases numbers began to creep back up again in June, South Korea halted further relaxation measures and relied on a program of aggressive tracking, tracing, and testing for the virus to bring the numbers down again in what the government described as the country’s second wave.

Bogoch said that type of speedy reaction will be needed to tamp down on localized outbreaks if Canada wants to prevent a wave of new infections.

“It’s like a game of Whac-A-Mole,” he said. “Infections are going to pop up and we’re going to have to smack them down and the key thing is we have to rapidly identify them and quell those outbreaks as quickly as possible before they morph into larger outbreaks.”

Hoffman said, without the development of a vaccine or treatment for COVID-19 or a scenario where everyone contracts the virus and there is herd immunity, Canadians will have to continue to physically distance from each other, wear masks, and practice good hygiene to avoid devastating second, third, or even fourth waves of infection.

“We need to be ready for when that second wave likely comes and ideally be able to react and stop it so fast that it hardly look like a wave at all,” Hoffman said. 

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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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