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How Canada could avoid a 2nd wave of COVID-19 – CBC.ca

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The first wave of COVID-19 is subsiding in Canada, with daily case numbers and hospitalizations falling to rates not seen since the beginning of the pandemic.

Predictions on when a second wave of COVID-19 could hit have ranged from the fall and winter months of this year, when flu season traditionally starts, to early next year, similar to the way the pandemic began.

But experts say the likelihood of a second wave isn’t set in stone, and Canada could instead see several smaller waves in the coming months or avoid a second wave altogether — especially if we keep our guard up.

“There’s actually nothing preordained about a second wave,” said Steven Hoffman, director of the Global Strategy Lab and a global health law professor at York University in Toronto who studies pandemics. 

“We might have a second wave, we might have a third, fourth and fifth wave — we might not have a second wave at all.”

Dr. Isaac Bogoch, an infectious disease physician and scientist with Toronto General Hospital, said instead of one cohesive second wave, we’ll likely face smaller outbreaks in the coming months that will need to be clamped down on quickly.

“It’s going to be a game of whack-a-mole,” he said. 

“We’re basically going to be trying to rapidly identify small outbreaks as soon as possible, quelling those small outbreaks and preventing them from snowballing into larger outbreaks and a larger epidemic.”

Workers spray disinfectant in front of a nightclub in Seoul, South Korea, on May 12 following an outbreak of COVID-19. (Yonhap/Reuters)

Israel saw hundreds of new infections after reopening schools, South Korea faced a spike in cases at a nightclub district in Seoul while an outbreak at a meatpacking plant in Germany led to renewed lockdown measures. 

Meanwhile, countries like Singapore, Hong Kong and Taiwan quickly flattened the curve of their first wave and have so far avoided a second wave of infections altogether while keeping strict physical-distancing measures in place.

China moved quickly to quell a new coronavirus outbreak in Beijing this month, raising its emergency level, suspending reopenings and cancelling more than 60 per cent of flights in and out of the capital after reporting at least 256 new cases since early June.

Bogoch said if Canada takes a similar approach to controlling new outbreaks, we can avoid more drastic measures like shutting down nonessential businesses and reimposing lockdown measures across the country for the long term.

“If we jump on it quickly and we have the capacity to do the early identifications, contact tracing and isolation, we can get through this without a big second wave,” he said.

“But if we don’t, if we let our guard down, well, here it comes.” 

Canadians vulnerable to COVID-19 

The largest risk factor for another wave of infection is connected to the fact that most Canadians are susceptible to COVID-19 simply because they haven’t had it.

Canada’s Chief Public Health Officer Dr. Theresa Tam said almost 2.5 million Canadians have been tested for COVID-19, with an average of about four per cent testing positive and more than 100,000 confirmed cases. 

Front-line health-care staff conduct drive-thru COVID-19 testing at a specially built facility near Etobicoke General Hospital in Toronto on April 8. (Evan Mitsui/CBC)

“We have very small penetration of this disease in our society,” said Raywat Deonandan, a global health epidemiologist and an associate professor at the University of Ottawa.

“That means the vast majority are still susceptible, and if they are susceptible, then it doesn’t take a whole lot for something to trigger another explosive growth.”

For that reason, Deonandan said there is a mathematical probability that another wave of infection is possible, but it may be less severe based on what we’ve learned about how to control the virus in the past six months.

“We know that it loves mass indoor gatherings. That seems to be where the super spreading events tend to be: churches, karaoke bars, parties, nightclubs,” he said. 

“So given that, that’s kind of our way of controlling the second wave — if we just really monitor large indoor activities or prevent them entirely.” 

York University’s Hoffman said while physical distancing and lockdown measures have drastically lowered the number of new cases and hospitalizations in Canada, they continue to rise globally — putting us at further risk.

WATCH | Governments in Latin America urged to invest in public health:

Isolating COVID-19 cases and quarantining contacts is necessary in the Americas in order to prevent further lockdowns, says the World Health Organization. 2:52 

“It’s just very likely that so long as this virus is circulating around the world, it will at some point come back to Canada,” Hoffman said. “Even if we eliminated it from our country.”

Knowledge of the virus may help fend off future waves

Our understanding of the novel coronavirus and how COVID-19 presents in the human body has increased dramatically in the past six months, and we now know more about how to react to outbreaks quickly and treat the disease itself more effectively. 

“We’ve learned that this is a very strange disease that seems to manifest differently in different populations, different age groups and that the symptomatology is not at all what we might have expected at first,” Deonandan said.

“This idea of losing your sense of smell, for example, that took everyone by surprise. We also learned about asymptomatic and presymptomatic transmission.”

He said it was wrongly assumed early in the pandemic by experts around the world that simply testing symptomatic patients early could control the spread of COVID-19, much like with an influenza outbreak. 

The World Health Organization also recently backtracked on a claim that the spread of COVID-19 from people who do not show symptoms is “very rare,” later conceding that asymptomatic individuals can transmit the virus. 

There were also early concerns about the threat of different modes of transmission, either through surfaces or feces, and Deonandan said that caused confusion about how to prevent infection at a critical time.

“It seems now that almost all of it is being driven by droplets and aerosol, mostly droplets,” he said. 

“So we can direct our efforts toward controlling droplet transmission, and that would help us mitigate a second wave.”

That’s why physical distancing, proper hand hygiene and wearing masks when appropriate are essential tools in fighting the spread of COVID-19.

A woman in a mask walks past a sign in downtown Toronto on May 22. Experts say we now know more about how to react to COVID-19 outbreaks quickly and treat the disease itself more effectively. (Evan Mitsui/CBC)

Jason Kindrachuk, an assistant professor of viral pathogenesis at the University of Manitoba in Winnipeg and Canada Research Chair of emerging viruses, said we can use our increased understanding of transmission to fend off future waves. 

“We’re better prepared than we were the first round because we have a better idea of what this virus is and a little bit more about how it behaves,” he said.

“We’ve learned probably around five to 10 years worth of research in the last six months.” 

Yet while we know more now about the virus in order to prevent infection, Kindrachuk said the first wave has exposed our vulnerabilities, especially in long-term care homes, where more than 6,000 Canadians have died from COVID-19. 

“If the virus hits a resurgence in Canada again,” he said, “as long as we can try and limit the spread within those vulnerable communities, we know that the majority of the rest of the population is manageable.” 

Hoffman said he hopes we’ve learned enough about protecting long-term care home residents and ensuring employees are supported to take necessary precautions in order to prevent more outbreaks in the months ahead.

WATCH | ‘Home is the safest place’ for seniors to be:

Canadians facing old age are looking for ways to safely stay in their own homes longer, especially after the COVID-19 pandemic uncovered the system failures in long-term care facilities. 1:54

“That’s what has allowed this outbreak to continue for longer, affecting more vulnerable people, and as a result has meant that we are only able to start lifting these layers of protection at a later point after other countries have already been able to do so,” he said. 

“It’s just a total disaster and so preventable.”

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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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