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Policy revamp might save lives in next heat dome, but so could community, say experts

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VICTORIA — She died in the arms of firefighters.

The 96-year-old woman now lingers in the memory of Chief Jim Ogloff of the Coquitlam Fire Department, a reminder of the impact of last summer’s heat dome disaster on vulnerable residents of British Columbia.

“She was elderly, clearly in a lot of distress,” Ogloff said, recalling the efforts of his officers who attended an emergency call to the woman’s townhouse in late June 2021.

“They tried to cool her down … They were unable to transport her because she was in such frail shape,” he said, and the woman died before she could be taken to hospital. She was one of more than 600 who perished in B.C. in the weeklong heat wave of historic magnitude.

The legacy of their deaths can be found in a range of policies and proposals brought in since then to mitigate such a disaster in future, including a heat-alert system and calls to re-examine building codes. But the deaths of so many residents, vulnerable and alone like the woman who Ogloff’s officers tried to save, also points to the crucial role played by social bonds.

“It takes a community, let me put it that way,” said Prof. Kim McGrail, a population data expert at the University of B.C.’s school of population and public health, who served on the BC Coroners Service death review panel that released a report and recommendations this month about the deadly outcomes of the heat dome.

Strategies need to involve both the machinery of government and the compassion of neighbours looking out for each other to succeed, officials and health and community experts agree.

“Pragmatism, I think, is one of the most important things we should lean on here,” said Dr. Jatinder Baidwan, chief medical health officer at the BC Coroners Service, at a news conference releasing the death review panel’s report.

Temperatures surpassed 40 C across much of the province around the last week of June 2021, when a high-pressure system trapped a blanket of hot air over the province.

Most of the 619 victims identified by the death review were elderly or vulnerable people living alone in buildings without air conditioning, it said. Ninety-eight per cent died indoors and most lived in socially or materially deprived conditions.

Human Rights Watch, an international advocacy group that investigates abuses worldwide, said in an October 2021 report that inadequate government support compounded risks for people with disabilities and older people, and the province’s lack of a heat-action plan contributed to unnecessary suffering and possible deaths.

In response to the disaster, the B.C. government announced a two-stage heat response system this month, including a public awareness and preparedness program and emergency heat alerts to be broadcast to mobile devices.

The alerts will be sent through the national Alert Ready system, which is already used to issue Amber Alerts and tsunami, wildfire and flood warnings, said B.C. Public Safety Minister Mike Farnworth.

The death review panel had three major recommendations: a co-ordinated heat alert response system and emergency protocols; a plan to identify, locate and support people most at risk of dying during a heat emergency; and the implementation of long-term heat prevention and mitigation strategies.

These include reviewing rebate plans for cooling devices in homes and changing building codes to require cooling designs.

On Monday, the B.C. government also unveiled a $513-million Climate Preparedness and Adaptation Strategy to prepare and protect people and communities from wildfires and floods.

Baidwan said last year’s heat wave was not taken seriously enough, by officials or individuals. “We’re all guilty of that,” he said.

Ogloff, who was also a member of the death review panel, said B.C. was “moving in the right direction” by recognizing the impact of the heat wave.

Fourteen people died in Coquitlam due to the emergency, Ogloff said.

He recalled an emergency response system that was stretched to near breaking point, with the fire department receiving more than double the emergency calls it usually does on weekends in June.

“When the resources are pulled in an extreme way that is unprecedented, you start to see some of the fissures appear and you can see how that overwhelms the system,” said Ogloff.

The emotional toll on emergency workers was traumatic, he said.

“It puts an incredible toll on the first responder community because they know there are people out there who are in desperate need of help. But there is only so much to go around,” he said.

“I think it just highlights the importance of the first-responder community, the police, fire, ambulance and how important it is that they all work together because the pieces are so interconnected,” Ogloff said.

He said he believed the new emergency response system will make the province better prepared to face the next heat dome, with harmonized messages about what to do and the dangers of heat emergencies reaching as many people as possible, Ogloff said.

Prof. McGrail said it would not be until the next hot-weather emergency that the effectiveness of the new preparedness plans could be evaluated.

“It’s hard to know how much worse it could have been but the fact the coroners service identified more than 600 people who died as a direct result of the heat dome was sufficient evidence that we were caught off guard,” she said.

McGrail said the death review panel’s report indicated “there’s a lot of will and intent to make sure there is a clear plan for a response and a way to co-ordinate that.”

The report said 67 per cent of the people who died were 70 years and older and 90 per cent of the people were aged over 60.

McGrail said any preparedness plan must focus on where these people live, ensure they are aware of the dangers they face and advise friends, neighbours and loved ones to make contact, McGrail said.

“We just need to make sure we are checking in on them … I wouldn’t want to underplay our ability to rally the community to help each other,” she said.

McGrail pointed to the importance of data analysis identify areas at greatest risk.

Rowan Burdge, provincial director of the B.C. Poverty Reduction Coalition, said the province needed to ensure access to cooling centres.

She said some people couldn’t leave their buildings for cooling centres during the heat dome due to mobility issues and some refused to venture outdoors because of the COVID-19 pandemic.

She said free transit during heat emergencies would help people get to cooling centres or making sure people have a cool place to go where they live.

“Places like shelters, (single-room hotels), all of these places should have an air-conditioned space in the building where people are able to access, and that wasn’t the case during the last heat wave.”

The death panel report calls on the government to review issuing cooling devices to at-risk people by Dec. 1.

Burdge, who has Type 1 diabetes, said she could have used air conditioning herself during the heat dome. But it was the support of friends that helped her get through it.

She said her insulin, which she receives through a pump, weakened as it became hotter, her blood sugar level spiked and she could not cool down.

“I’m a renter and live in an apartment building that doesn’t have air conditioning and I actually didn’t realize how sick I was getting for a couple days of being in the apartment,” Burdge said. “It must have been in the 40s because it was just brutal.”

“My brain functioning, and brain fog was on a level I hadn’t experienced at that point.”

Because of her chronic illness and the pandemic, Burdge was trying to stay away from crowds and public spaces.

Eventually, friends got her into a cool bath and took her to places with air conditioning, she said.

More must be done to be ready for the next emergency, Burdge said.

“I really, firmly believe strongly in my heart we’re not doing enough, and I do think if there was a heat wave tomorrow or next week we wouldn’t actually be prepared or set up to take care of people properly,” she said.

This report by The Canadian Press was first published June 26 2020.

 

Dirk Meissner, The Canadian Press

 

 

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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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