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'May soon be completely out of control': COVID-19's dire possibilities could dramatically change Canada – National Post

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As if fear isn’t already in the air, if not in the grocery store lineups, then grim plans for a significant influenza pandemic in Canada are a jolt of panic infused with sobering reality of worst-case scenarios as COVID-19 continues its alarming spread.

Stockpiling body bags, choosing a central place where people bring corpses of family members and identifying hockey and curling rinks cold enough to be temporary morgue sites are among the government’s planning guidelines.

The surge capacity of crematoriums, running out of coffins and church space for holding funerals and recruiting temporary grave diggers are all outlined in the “Management of Mass Fatalities: Canadian Pandemic Influenza Preparedness,” a planning guideline prepared by the Public Health Agency of Canada in 2009.

“There are currently no plans to recommend mass burials or mass cremations. This would only be considered in the most extreme circumstances,” the guidelines reassuringly offer.

That could very easily happen here in very short order

It warns of six months’ worth of deaths compressed into six weeks.

“Most crematoriums can handle about one body every 4 hours and could probably be run over 24 hours to cope with increased demand. Cremations have fewer resource requirements than burials and, where acceptable, this may be an expedient and efficient way of managing large numbers of deceased during a pandemic.

“Refrigerated trucks can generally hold 25-30 bodies without additional shelving.”

They are hard words to read.

It is the job of disaster planners to think about the unthinkable.

The scenarios they envision are the stuff of nightmares and end-times movies but, it stands to reason, having such plans are better than the alternative of not having them, while also hoping they are never needed.

What is happening around the world and beginning across Canada makes this contagion of novel coronavirus the most worrisome health scare in generations.


Medical personnel care for patients in an emergency temporary room, set up to ease pressure on the healthcare system caused by the coronavirus pandemic, at a hospital in Brescia, Italy, on March 13, 2020.

Flavio Lo Scalzo/Reuters

Hope of containment has failed.

What was once an alarming but distant tragedy in China is now, in a slow-to-dawn suddenness most saw coming but didn’t accept, Canadian reality. Or at least the start of what is expected to become reality.

Many Canadians seem stuck in the stage of thinking the most important thing is to hoard toilet paper or else laugh at people hoarding toilet paper.

The reality, however, is sinking in.

As the virus jumps from country to country, each nation reacts in its own way. A mix of surprise and dark humour greeted the curtailment of national passions and deemed a doomsday sign: Iran cancelling public Friday prayers, an end to kissing in Italy, closing of pubs in Belgium, shuttering soccer in Spain, cancelling basketball in March in the United States, the end of Tim Hortons’ Roll-Up-The-Rim contest in Canada.

Each caused an awakening.

Perhaps the NHL suspending the hockey season was the shock that woke you up, or closing of schools; maybe it was U.S. President Donald Trump’s speech cancelling most travel from continental Europe or Prime Minister Justin Trudeau’s wife, Sophie, testing positive for COVID-19.


In the wake of the coronavirus pandemic, customers crowd a Costco store in Montreal to stock up on food and supplies, March 13, 2020.

Ryan Remiorz/The Canadian Press

Patty Hajdu, the federal health minister, said COVID-19 could infect between 30 and 70 per cent of Canada’s population. That would mean somewhere between 11. 3 million and 26.3 million people in Canada could get sick, with varying severity.

Life, for weeks, months or more — no one is really sure — will be significantly different.

What is happening in Italy offers a strong warning.

The Italian government ordered a nationwide lockdown. All shops except food stores, pharmacies and stores selling essentials were closed and all travel sharply restricted. More than 1,000 people have died with more deaths inevitable.

In the region around Milan, one of Italy’s wealthiest areas, COVID-19 is breaking the health-care system.

“It’s as if you were asking what to do if an atomic bomb explodes,” Dr. Antonio Pesenti, head of Lombardy’s intensive crisis care unit, told the Washington Post. “You declare defeat. We’ll try to salvage what is salvageable.”

Dr. Michael Warner, medical director of critical care at Toronto’s Michael Garron Hospital, said Italy’s crisis must spark an aggressive reaction in Canada.

“That could very easily happen here in very short order,” Warner said.

“The COVID-19 situation is dire and may soon be completely out of control. Health-care resources are finite, and thus we will not be able to provide care for all who become ill.

“We already run at 100 per cent capacity on most days in the intensive care units in Ontario and if we get a (surge) of patients all at once… there is no system that can handle that. It’s impossible.

“I don’t want to have to be in the position, which is something people are planning for, to have to triage resources. That’s something we haven’t really experienced in Canada but that is the reality in Italy today — decisions are made as to who gets access to critical care and who doesn’t and people who don’t are dying.

“If we can spread out the number of people who get infected over time, maybe the system can adjust,” Warner said.


A view of St. Peter’s Square, on the fourth day of an unprecedented lockdown across of all Italy imposed to slow the outbreak of coronavirus, March 13, 2020.

Alberto Lingria/Reuters

What Warner and public health agencies are urging is simple behaviour everyone should take to slow the rate of transmission.

Hand washing, covering coughs and avoiding contact with others will likely slow its spread; “social distancing can save thousands of lives,” said Warner.

The hubris of modern life made the simple ask of washing of hands as our salvation seem laughable, an ode to snowflakes or witch doctors or handwringing.

The reality is these public health measures may be crucial.

“Given that there is currently no effective vaccine or specific treatment for COVID-19, public health measures will be the only tools available to mitigate the impact of the virus,” the Public Health Agency of Canada (PHAC) said Friday.

It’s a strategy known as “flattening the curve,” based on the graphs of potential peak infection rates. Reducing the peak burden on the health-care system caused by new cases and spreading that peak out allows for better treatment for everyone who is ill.


“Flattening the curve” provides an opportunity to significantly reduce deaths from COVID-19.

Matthew McQueen/Director, Public Health Program, University of Colorado Boulder

And also buys time for a vaccine.

What might our lives look like when Canada is in the full grip of COVID-19?

The government has plans and recommendations on measures for individuals, communities and governments.

It’s a balancing of risk versus reward, personal freedoms and cultural and religious needs, along with who is most impacted by actions on a sliding scale of possible responses.

PHAC notes in its guidelines the ethical debate of “societal versus individual interests” and comes down on the side of society: “When a health risk like a pandemic affects a population, public health ethics predominates, and a higher value is placed on collective interests.”

Some possibilities are more invasive than others, such as closing public transit and schools.

“Widespread school closures as a control measure have the potential of coming at a high economic and social cost since school closures would impact the many families that have one or both parents working outside of the home,” PHAC says.

It’s as if you were asking what to do if an atomic bomb explodes. You declare defeat. We’ll try to salvage what is salvageable

Other things, like going to church, theatres, sporting events and concerts could be risky.

“Restrictions on non-essential gatherings could pose a barrier to accessing group support and personal freedoms (e.g., cancelling church services, closing community centres). It may also have cultural or religious implications (e.g. funerals, religious services, weddings).”

Businesses should consider staggered work hours to avoid crowding, allowing work from home and relaxing sick leave policies. Businesses may need to be closed all together depending on local situations, PHAC says.

Mass gatherings, such as concerts, sporting events, religious services and conference should be reconsidered or avoided.

“They can amplify the spread of infectious diseases and have the potential to cause additional strain on the health care system when held during outbreaks,” the guidelines say.

Self-serve buffets, it notes, should be off the menu.

If things get as bad as they could, such trivial concerns will be absent for a long time.

• Email: ahumphreys@postmedia.com | Twitter:


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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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