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COVID-19 rules were relaxed. Cases soared. How do we get them down again? – CBC.ca

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Canada is experiencing numbers of COVID-19 cases not seen since the height of the pandemic in the spring. In some provinces, they are even higher. 

Ontario registered 700 new cases of coronavirus on Monday, the most on a single day since the outbreak began in late January.  

Quebec recorded more than 800 new daily cases twice this week, including 896 on Sunday, its highest daily increase since May. 

And both Alberta and B.C. are also seeing high daily numbers with case counts in the hundreds. 

The premiers of the country’s two biggest provinces blame people that they say are socializing too much and too closely, foregoing social distancing and their bubbles. 

The question is: what will it take to get people back on board?

Mixed messaging

There is evidence that people have relaxed when it comes to observing some public health guidelines. Some analysts blame fatigue with the rules — or the feeling that certain individuals believe they aren’t at risk of becoming sick. 

But behavioural and medical experts suggest it’s more complicated than that, attributing people’s change in behaviours since the height of the lockdown on confusing and inconsistent messaging from political or health officials — and a loosening of rules that came too early. 

“If they’re saying you can have larger gatherings, isn’t that saying there’s less of a risk?” said Susan Michie, a professor of health psychology and director of the Centre for Behaviour Change at UCL in London, England. “And if it’s less of a risk, then people will relax.”

“When we have restaurants and bars open, we telegraph to people that it is okay to be in a large gathering with no masks on as long as you’re in a restaurant,” infectious disease epidemiologist Colin Furness told CBC News. “And therefore why not in your living room? The mixed messaging is a real problem.” 

WATCH | Furness says rules need to be clear and consistent:

Infectious disease epidemiologist Colin Furness says restrictions need to be tougher, messaging clearer and specific areas targetted in order to control surging COVID-19 cases in Canada. 6:02

People want to follow rules

Michie said political officials’ approach to rule-breakers is key. Most important, she said: don’t play the blame game and threaten fines.

“If [certain people] are not adhering, understand why they’re not. What are the problems? Try and solve those problems. Enforcement should only be a very last resort.”

She said it’s usually a small minority who are not following the rules; and it’s often not because they don’t want to. 

“The data shows that often people do … intend to. But it’s either a problem of again being confused about what they are, or are not, meant to be doing or it’s a case of opportunity.” 

She advises governments to consult with representatives of the groups who are most often not adhering to the rules and work from the bottom up.

(CBC News)

Approach is key

“Target especially the groups that are most challenged in terms of adhering to restrictions and work with them to co-create strategies. Listen to them… understand … what are the real barriers?”

For example, she said, some people may not self-isolate because they have to go to work to put food on the table or because they may lose their job. They may need to care for someone outside their home. Or they may want to maintain a two metre distance from others while getting outdoors, but live in a crowded city where park space fills up fast.

Officials have to be aware there are real challenges, she said. “Don’t just say we’re all in this together. Show us we are.” 

Simon Bacon agrees the approach officials take is key. The professor of behavioural medicine at Concordia University is co-leading an ongoing study into Canadians’ adherence to pandemic measures, including handwashing, distancing and avoiding gatherings. 

He said the vast majority of Canadians are adhering to the rules. 

When they were first introduced in the spring, about 90 per cent of Canadians were following them “most of the time,” he said. The messaging from health and political officials was clear. 

The practice of handwashing and social distancing slipped to about 80 per cent through June and July. But in that same time frame, avoiding gatherings dropped to 53 per cent in June, as some restrictions were loosened, he said. 

Adherence to the main measures has since come back up, but Bacon said that is likely due to the end of summer, with reduced opportunities to “hang out,” rather than a concerted effort to stop gathering.

Young people gather at the Break Water Park, near Gord Edgar Downie Pier, without any physical distancing in Kingston, Ont., Sunday, Aug. 30, 2020. (Lars Hagberg/The Canadian Press)

Reinforcement of a positive

“A lot of the messaging that has come out of most governments is, ‘you need to do these behaviours so that … you keep people safe. You don’t kill granny,'” he said. 

“What’s more motivating for people is not that, but seeing people do well,” he said, observing that most Canadians are quite altruistic and concerned about the impact the virus is having on others. “So it’s not the absence of a negative. It’s the reinforcement of a positive.”

Kim Lavoie, co-lead on the iCare project and Canada Research Chair in behavioural medicine at the University of Quebec at Montreal, also advocates a positive approach to messaging.

“You’ve got to thank everybody for their sacrifices and how difficult it’s been. You need to acknowledge sort of all the good that people are doing,” she said.

That means reinforcement of good behaviour, less calling out the bad and fewer threats of consequences, she added. “You need to make sure … the people who are adhering keep adhering. We don’t want to lose them.”

Basic human behaviour

She said it comes down to understanding basic human behaviour — that people aren’t just going to do what they’re told. 

“The government needs to have a plan,” she said. “Share the plan and delineate very clearly what’s going to happen if we stick to the plan versus not,” while explaining how it will be made possible and how the population will be supported. 

Above all, say both Lavoie and Bacon, be consistent. 

Ontario Premier Doug Ford, right, sits with Quebec Premier Francois Legault as they drink beer ahead of the Ontario-Quebec Summit, in Toronto, Tuesday, Sept. 8, 2020. (Chris Young/The Canadian Press)

“Here in Quebec … if you go into a store, you’ve got to wear a face mask. If you’re on a bus or on a train, you’ve got to wear a face mask. But if you’re a kid in a class of 30 other kids, it doesn’t matter,” said Bacon.

Quebec has not mandated mask-wearing in class. Students in grade 5 and up must wear them while moving in common areas, such as hallways, but once a student is inside the classroom, the mask rule does not apply. 

Bacon said such inconsistencies create disconnects and give people the opportunity to ignore the guidelines.

“You give people the opportunity to go, wow, you know what? Wearing a mask doesn’t align with my personal desires. And you’ve just told me that perhaps they’re not that important because a large segment of society doesn’t need to use them, Bacon said. “Guess what? I’m going to align with that.”

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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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