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The race to trace the spread of COVID-19 in Canada using disease trackers

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TORONTO — Increasingly frustrated health officials say they are prepared to take more aggressive measures to track and contain people with COVID-19 as the number of sick and dead continues to soar.

And that could involve employing some of the digital and mobile strategies seen in countries including Singapore and South Korea where suppression has been more successful, they suggest with caveats.

All of this is under review by various public health bodies, but a York University expert in infectious disease modelling warns that delayed action risks allowing the virus to continue its rapid spread, and force even more intense physical distancing measures.

That may be the painful lesson Canada needs to learn, said Jianhong Wu, an experienced modeller who has led multiple national projects on SARS, pandemic influenza, and immunization evaluation.

“Every country has had to go through this first before they learned how serious it is,” said Wu, a distinguished research professor whose work includes analysis of epidemic data in Wuhan, China, where the virus was first detected late last year.

The argument for more stringent contact tracing was laid bare in a directive from Ontario’s chief medical officer of health this week. Dr. David Williams instructed the province’s public health units to use their authority to isolate COVID-19 cases and anyone with whom those infected people came into close contact.

Williams reiterated that in a press conference, noting the social contacts of those infected must also be traced and contained if we’re ever to bring the virus to heel.

“Even if we were able to flatten the curve, the real grunt work of public health really then kicks into gear even more,” explained Williams, referring to the famous line graph that depicts the steep rise in cases that would result without interventions.

“(With) all these cases you’re going to have to do a lot more contacting, more phone calling, more investigating.”

Williams said his office is looking at how to add more staff, volunteers and the use of technology towards this effort.

That work will have to persist through the spring and summer in order to make sure infections don’t spark “flare-ups.”

“We’re looking at quickly how to ramp that up — not only for today, but tomorrow and in the future, because this is going to be very important in the days and weeks going ahead,” said Williams.

It’s “very much intensive” work, he added, and that’s where technology can help. Whether that includes the use of mobile tracking tools to keep tabs on the infected is an open question, and one he’s not ready to rule out.

“We have many proposals coming in, and nothing is being rejected outright,” said Williams.

Canada’s biggest hurdle to tech-assisted tracking is public and political aversion to measures that threaten individual privacy, said Wu, but he argued public safety concerns should trump those worries here.

For now, Ontario Health Minister Christine Elliott has suggested the emphasis continues to be on people power. She said Thursday that she hoped medical students can help carry that load.

Such a strategy is already in use in Alberta, where approximately 300 University of Calgary medical students have bolstered that province’s ability to contact the infected and make sure they and their contacts self-isolate.

Dr. Richelle Schindler, a resident physician at the U of C who specializes in public health and preventative medicine, said by email that nursing students may be added to the monumental task, in which trackers chase individuals by phone but can send paramedics to check on those they can’t reach.

Albertans who violate isolation orders face a $1,000 fine, but courts have been given increased powers to administer fines of up to $100,000 for a first offence and up to $500,000 for subsequent, more serious violations.

Student trackers must have clinical experience but also get two days of training before hitting the phones. They also get program credit for their time.

While the importance of contact tracing has received less attention than testing in Canada, Wu insisted it is a crucial step to suppressing an epidemic.

He noted that test results provide a snapshot of infections that are days, and even weeks, old. But contact tracing can indicate where the virus is as it jumps from person-to-person.

“The public should know that if you want to go back to normal you have to know who is exposed,” said Wu, pointing to regions in Asia where the use of mobile data is credited with allowing schools and busy markets to remain open.

Contact tracing generally involves notifying the infected and their close contacts, but really effective tracing would also notify contacts of those close contacts, said Wu.

That’s because by the time you’ve identified people who have the virus, their close contacts may already be infected and spreading it to others.

“Then you can say that the community is safe — we know who is impacted, or exposed, who is infected, and therefore you can go back to resuming some social activities,” Wu said.

Toronto Public Health’s associate medical officer of health said Thursday his unit is in the midst of “scaling up” tracing efforts by developing a web-based system that would allow more front-line staff to join the effort from home.

The Coronavirus Rapid Entry Case and Contact Management System would allow trackers to input essential case information that can be shared with the province.

Dr. Michael Finkelstein said Toronto currently has more than 100 staff following up with those who are infected and their contacts, and acknowledged that it becomes increasingly difficult to keep pace as cases grow.

But for now, mobile tracking of citizens is not part of Toronto’s strategy.

“TPH is aware that some jurisdictions have used this technology and is investigating its use,” said Finkelstein by email.

Wu described a synergistic relationship between three pillars of disease suppression: testing, tracing and social distancing. Where one falters, the others must compensate, he explained.

Even if contact tracing becomes less effective as community spread grows, people still need to know the level of infections and degree of exposure.

“It’s never too late so you can never give up,” said Wu.

“But I think we are at a stage that we really have to kick in the technologies and you really have to have the participation from the public.”

This report by The Canadian Press was first published April 2, 2020.

— With files from Allison Jones

Cassandra Szklarski, The Canadian Press

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What’s the greatest holiday gift: lips, hair, skin? Give the gift of great skin this holiday season

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Give the gift of great skin this holiday season

Skinstitut Holiday Gift Kits take the stress out of gifting

Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.

In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.

“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.

There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.

Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.

Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.

In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.

 

Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

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Here is how to prepare your online accounts for when you die

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LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?

It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.

Here’s how you can prepare your digital life for your survivors:

Apple

The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.

For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.

You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.

Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.

Google

Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.

When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.

You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.

There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.

Facebook and Instagram

Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.

When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.

The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.

You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.

TikTok

The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.

Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.

X

It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.

Passwords

Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?

Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.

But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.

___

Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.

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Pediatric group says doctors should regularly screen kids for reading difficulties

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The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.

New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.

The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.

Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.

Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.

“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.

“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”

McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.

But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.

The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.

He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.

“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.

“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.

McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”

McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.

He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.

“Early identification of reading difficulty can truly change the trajectory of a child’s life.”

This report by The Canadian Press was first published Oct. 23, 2024.

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