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Ontario cancer patient who must travel to U.S. for treatment trapped in near-constant quarantines – CBC.ca

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The only good thing that Dean Nixon can say about his prison is that it has a view. 

From the balcony of his small, fourth-floor apartment, the Guelph, Ont., resident can see the open countryside. Able, at least, to imagine freedom, if not experience it.

Nixon, a 46-year-old horse trainer and Stage 4 cancer patient, is living in a bureaucratic limbo, obliged to self-isolate for the coming year while in Canada due to the country’s COVID-19 quarantine restrictions.

As far as border and health officials are concerned, Nixon poses a danger because he must travel to the United States twice a month for a life-saving treatment that’s not available in Canada. And according to current regulations, he has to self-isolate in his apartment for 14 days every time he returns, resulting in a perpetual quarantine. 

“It’s extremely frustrating,” Nixon said last week, standing on his balcony with his dog, Jeanna, as he spoke to a reporter on the sidewalk, four storeys below. “The only thing I’m guilty of is trying to save my life.

“We have people regularly crossing the border for work. We have American executives coming into Canada who are allowed to circumnavigate mandatory quarantine. I’m trying to figure out how a truck driver, or a nurse, poses less of a threat to the public health than I do, when I’m part of the at-risk population.”

Nixon was first diagnosed with anal cancer in the spring of 2016, and by that fall, the disease had metastasized, spreading to his liver. His doctors in Ontario could only offer more chemotherapy, and faint hope. So Nixon searched the internet and found an experimental program for patients with human papillomavirus-related cancers being run by the U.S. National Institutes of Health (NIH) in Bethesda, Md.  

Doctors there enrolled him in a year-long trial of a new immunotherapy drug starting in early 2017. Nixon’s cancer went into remission, but returned a few months after the treatment ended. He went back on the drug for another year at the beginning of 2019, with similarly promising results. But a follow-up scan this past July discovered new tumours, and in early October he began yet another round of treatments — requiring 26 visits to the United States over the course of the coming year.

Exemption for treatment in Canada, but not for those who go abroad

Nixon is usually out of the country for less than 48 hours. He wears a mask whenever he’s in public, keeps his distance and washes his hands frequently. He stays at a Maryland Airbnb that caters to NIH patients, taking extra care to sanitize its rooms. And at the hospital’s sprawling campus, COVID-19 precautions are even stricter, with screening, mandatory masks and gloves and limited interaction with staff. Since the pandemic began in March the NIH has recorded just one coronavirus transmission at its campus.

Nixon, pictured at his apartment, finds his situation especially galling given that people who travel to Canada to receive medical treatment don’t have to self-isolate. (Evan Mitsui/CBC News)

 

But none of this has made an impression on Canadian border agents or with officials from the Public Health Agency of Canada (PHAC), who have so far refused to exempt Nixon from following the mandatory, 14-day quarantine each time he returns home. His latest crossing and self-isolation order came on Nov. 18.

He finds the situation especially galling given that people who travel to Canada to receive medical treatment don’t have to self-isolate. More than five million federal quarantine exemptions have been handed out since last March, mostly to essential workers such as truckers, nurses and technicians. But corporate titans are receiving them too, as detailed in a series of recent CBC News Investigations that have uncovered discretionary business trips by senior U.S. executives.

“There’s really no consideration for what my routine would be like, where I live, my situation….” Nixon said. “On a personal level, it means I can’t visit friends, family, can’t take my dog for a walk, can’t be out in the open air, can’t exercise…. It leaves me alone here to sit and think about my disease. Which is not a great thing.”

Unable to work and facing financial ruin

The quarantine is also interfering with his livelihood — training standardbred harness racing horses. The farm where his operation is based is just a seven-minute drive from his apartment, but he hasn’t been able to visit since the beginning of October. Instead he tries to keep abreast of how the horses are running, eating and behaving via phone calls and text messages with his hired hand. He’s already lost two clients and fears that more might follow. 

“[The horses] don’t speak. So the No. 1 tool at our disposal is to be able to monitor the animals. And if you can’t observe them, you can’t do your job,” said Nixon.

Nixon, left, poses in the winner’s circle with driver Doug Brown and part-owner Jeralene Roland, right, following a July 2019 victory by Artofficial Flavor at Kawartha Downs racetrack in Ontario. (Dean Nixon)

Over the past six weeks, Nixon has tried reaching out to his local Liberal MP, the Canadian Human Rights Commission and the Canadian Cancer Society for assistance. So far, no one has been able to help. He has also appealed to PHAC for a special exemption but has been rejected.

In an email sent earlier this week, the federal health agency told Nixon that quarantine exemptions “are purposefully limited to minimize the introduction and spread of COVID-19” and that he is unlikely to qualify for one. 

“Unfortunately, there are no exemptions for travellers returning to Canada from receiving medical treatment in the U.S.,” reads the note.

CBC News contacted the Canada Border Services Agency and PHAC about Nixon’s case, asking why the medical exemptions flow in only one direction. The CBSA said that it only enforces the rules as set out by the Public Health Agency of Canada and the federal government. PHAC has yet to provide a comment or explanation. 

No choice but to seek treatment in U.S.

Dr. Julius Strauss, who oversees Nixon’s treatment at the NIH’s Clinical Center, says he worries about how his patient will cope with the effects of a year-long lockdown. 

“I am concerned about Mr. Nixon’s mental health, about being locked down with this diagnosis and not having any ability to interact,” Strauss said.

“I understand the safety precautions, but also have concerns about his financial hardships, because he’s not able to do his normal job.” 

The immunotherapy is Nixon’s only viable choice, says the doctor. 

“It’s critical for him, this treatment,” Strauss said. “It’s not experimental for him. Because for him, we know it works.”

Nixon isn’t sure if he’s the only one facing such a cross-border dilemma. There are no other Canadians currently receiving treatment at the NIH. And no one has come forward in the patient support forums he posts to. 

Nixon’s goal is to someday set up a group to help more Canadians access foreign clinical trials. But first he must find a way to navigate the pandemic and its restrictions.

“If I don’t go to the States, I won’t get treatment and I’ll probably die. If I don’t go to work, I can’t afford to go to the States and I’ll probably die,” he said. 

His wishes are as simple as the government regulations are complex.

“I really just would like to be able to go to work, maybe take my dog for a walk, and that’s about it. I’m not asking for a lot. What they’re asking, I think, is considerably more.”

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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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