With a deluge of news about cancelled events together with conflicting information about what to do — or not do — the worldwide COVID-19 pandemic is causing confusion, uncertainty and worry among many Canadians.
Health workers themselves are trying to navigate a virus they’ve never seen before and deal with constantly evolving information too, said Dr. Allison McGeer, a microbiologist and infectious disease expert at Sinai Health in Toronto, and a researcher funded by the federal government to study how the coronavirus that causes COVID-19 spreads.
“The problem is that we’re in this really unstable phase of the pandemic where new cases are appearing, public health officials are uncertain about what the right interventions are to try to slow this down and spread this out so that we can manage health care,” McGeer told Dr. Brian Goldman, host of CBC health podcast The Dose.
“Things are changing so quickly [that] … the right decision today and the right decision tomorrow might be two different things.”
Microbiologist and infectious disease specialist Dr. Allison McGeer is pleading with Canadians to be vigilant about the ‘boring stuff’ — such as handwashing, staying home when they’re sick and coughing into their elbows. (Evan Mitsui/CBC)
At this moment, though, here are the answers McGeer and other health experts have for some of the top questions on people’s minds:
It’s March Break next week. Should Canadians travel?
Canadians should certainly avoid going to countries where there is a lot of coronavirus activity, McGeer said. Check Health Canada’s travel notices website.
As of Thursday, China, Iran, Italy, South Korea and Japan were listed as either places not to go at all or requiring special precautions. There were also lower levels of caution listed for several other countries, including France, Spain, Germany and Singapore.
What about travel within Canada?
“We still don’t have much community transmission in Canada,” McGeer said, so the risk of getting COVID-19 is still relatively low. She doesn’t think people need to worry too much about travelling within Canada right now — but that may change as the case numbers rise.
What about travel to the U.S.?
Travel to the U.S. is currently “unpredictable,” McGeer said.
“They still aren’t doing much testing, so it is hard to tell what is going on,” she said.
Health Canada has not issued any advisories against travel to the U.S.
But in British Columbia, provincial medical officer Dr. Bonnie Henry took a tougher stance on Thursday evening, “strongly advising” people not to travel anywhere outside Canada — including the U.S.
Any B.C. resident who does travel outside Canada should stay home from work or school for 14 days upon their return, she said.
The current risk of an individual becoming infected in the U.S. is probably less than one per cent, McGeer said.
But at a time when health authorities are trying to slow the rise of coronavirus in Canada, people bringing back any new infections during a peak travel period is always a worry.
If 50,000 people travel for March Break to the U.S. and 0.5 per cent of them become infected, that would add up to 250 new cases in Canada, McGeer said.
Dr. Allison McGeer, one of Canada’s top infectious disease specialists, joins host Dr. Brian Goldman to give you the most up-to-date information on the new coronavirus, a reality check on travel bans and quarantines and what you can do to protect yourself and the most vulnerable people around you. 30:54
Because the COVID-19 situation is changing daily, people also need to think beyond the actual risk of infection — because no matter where you travel, there’s still always a chance you could be told to go into quarantine as a precaution, whether by another country’s government or by your employer upon your return, McGeer said.
“You have to think to yourself: If I got there and got quarantined, how bad would that be? If I came back and somebody said, ‘We don’t want you at work for 14 days,’ how bad would that be? And then make your decision on travel based on that.”
What does the scientific evidence say about travel bans and quarantines?
The evidence says that travel bans and quarantines won’t stop the disease, but they can delay it, McGeer said.
The harsh quarantine in China, where the new coronavirus was first detected and became an epidemic, bought much of the rest of the world, including Canada, about three weeks to a month to prepare for the virus’s arrival, she said.
“That month is very valuable,” she said, but it also came at a “tremendous cost to the people in quarantine in China.”
That’s why decisions about whether to enact quarantines and travel bans are difficult to make.
“How much economic loss — and health losses because [of] the economic loss — are you willing to tolerate in order to delay or slow down the spread of this virus?”
What should you do if you have fever, cough or shortness of breath?
Fever, cough and shortness of breath can be symptoms of COVID-19 — but they’re also symptoms of seasonal flu and other respiratory illnesses that are common at this time of year.
Call your local public health unit if:
You have even mild symptoms and you have travelled anywhere
You have been exposed to someone known to be infected
“Generally, it is individuals who have travelled or are a known contact of a case, with respiratory symptoms that are new, who are recommended to be tested,” Dr. Vinita Dubey, Toronto’s associate medical officer of health, said in an email to CBC News.
If you have symptoms and are concerned for any other reason that you may have COVID-19, you can call public health, but you could also call your provincial or territorial telehealth service, or call your doctor to talk about your risk.
If you have travelled or been exposed to someone with COVID-19 and need immediate medical attention — for example, if you’re having difficulty breathing — go to your doctor or the Emergency Department, but call them or Public Health in advance so they can prepare and put infection control precautions in place.
On Thursday, the government of Ontario — the province that currently has the highest number of COVID-19 cases — announced it is opening dedicated assessment centres at some hospitals in the Greater Toronto Area and Ottawa to do coronavirus testing, and will add more across the province in the coming weeks.
That’s expected to take the load off emergency departments that have seen a jump in people coming in for COVID-19 testing — and also help separate possibly infected people from other patients.
You should self-isolate while waiting for test results. If you do test positive for COVID-19, you’ll need to be quarantined for 14 days.
It’s important remember that the majority of people who get COVID-19 will only have mild to moderate symptoms, health experts say. For others, especially people who are elderly or have compromised immune systems, COVID-19 is life-threatening.
That’s why it’s critical that anyone with a cough, fever, shortness of breath — or anyone feeling unwell — stay home and not go to work until they are feeling better, McGeer said, and avoid taking any chances of spreading COVID-19.
Spreading out infections that require hospitalization is also vital to ensuring patients requiring intensive care — whether they have COVID-19 or something else — are able to get it.
“This outbreak is going to be very hard on our health care system,” she said. “It’s intensive care unit beds and ventilators that are the real challenge for Canada because we don’t run with a lot of spares of either.”
The impact on long-term care homes is also a big area of concern, she said, because that’s where an outbreak could be “catastrophic”
As of Thursday, Canada’s only COVID-19 death to date was an elderly man who lived in a British Columbia long-term care home.
B.C. provincial health officer Dr. Bonnie Henry has asked people to practice so-called social distancing to help slow the spread of COVID-19, emphasizing that it’s ‘not forever.’ (Maggie MacPherson/CBC)
On Wednesday, B.C.’s Henry said there have also been positive outcomes where seniors who became infected have recovered.
But she also emphasized the need to ramp up protection for people living in long-term care facilities — including measures such as restricting visitors and screening workers in the facility to make sure they’re not ill.
Should you wear a mask to protect yourself?
If you’re not sick, the answer is no, McGeer said. There’s no evidence that wearing a mask will protect you from becoming infected.
But if you are sick, there is some evidence that wearing a mask will help reduce the amount of virus around you, potentially offering a measure of protection to others, she said.
What should you do if you are infected and live with someone?
Influenza studies have shown that people living together can reduce transmission if they stay at least two metres away from each other and wash their hands carefully, and if the sick person wears a mask, McGeer said.
But if it’s a really small space with a shared bathroom, the non-infected person should consider moving out for a while if they can, McGeer said. It could take up to three weeks for the infected person’s test results to come back clear.
How long is someone with COVID-19 contagious?
That’s an area under study, McGeer said. It will likely be another month before experts are able to answer that question with confidence.
Can a person transmit coronavirus if they don’t have symptoms?
Globally, “we have some descriptions of circumstances in which people who were asymptomatic appear to have passed on the virus,” McGeer said.
But it’s not yet clear whether that’s important, she said, because there’s a key question researchers are working to answer: How many people actually have infections without symptoms? If it’s an extremely low percentage of the total number of people who have COVID-19, then it may not be worth worrying too much about.
“The fact that an asymptomatic person has passed on the virus is not the critical issue. The critical issue is whether asymptomatic people fairly routinely pass on the virus,” McGeer said.
Can the virus live on surfaces outside the body?
This is one of the areas McGeer is researching.
Unlike bacteria, viruses don’t continue to grow outside the body. But they do survive.
They usually survive on a surface longer if they’re surrounded by a bodily fluid, such as saliva, McGeer said.
But to infect you, the virus has to get from the surface inside your body — which means touching it and then putting your hand to your eyes, nose or mouth.
Contact with infected people, rather than objects, is likely more of a risk, McGeer said.
“It’s really about the people you touch, probably not the things you touch,” she said.
How much that will help slow the spread of the virus is unclear at this point, McGeer said.
“We haven’t had COVID-19 before,” she said.
So these efforts are “by necessity based on uncertainty, because this is a new virus.”
“It’s this balancing act,” McGeer said. People are trying to make responsible decisions to do whatever they can that might help, while weighing the downsides of what they have to give up.
“I think the answer is we’re going to know afterwards,” she said. “I don’t think we have enough information to be really confident about which measures are most important and how effective they are.”
COVID-19 could become a new reality — like influenza — experts say.
But it’s likely to come in rounds, McGeer said, and this first one will likely be at least four months.
Infectious disease specialists are hoping COVID-19 will behave like other respiratory illnesses and decline during the summer — so it’s possible we may get a reprieve, but no one knows for sure.
“We do not know how this is going to play out,” McGeer said.
What’s the bottom-line advice on COVID-19 in Canada right now?
“You need to recognize that disruptions are coming,” McGeer said.
Over the next weeks and months, it’s critical to take prevention measures that people tend to “roll their eyes” at, she said.
B.C.’s Henry and many other public health experts have recommended Canadians start practicing “social distancing” — increasing the physical distance between people at gatherings, and considering not going to places that are crowded.
That especially applies if people are feeling even mildly unwell, she said.
“Stay away from others, even if you have the sniffles right now,” Henry said. “This is not forever. This is for the coming weeks. The coming weeks where we know we have to do everything we can to prevent transmission of infection in our communities, to protect those people who are more likely to have severe illness, and particularly our seniors and elders.”
It’s also the “boring stuff,” that’s important, McGeer said, including washing your hands, staying home when you’re sick and coughing into your elbow.
It’s important to remember that this isn’t just about whether you get sick but also protecting those who are vulnerable around you, she said.
“Just for the next three months, don’t roll your eyes,” McGeer said. “[Just] do it.”
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.
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.
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.
