This is an excerpt from Second Opinion, a weekly roundup of health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.
Throughout the pandemic, Canada’s top public health officials have faced scrutiny, praise and backlash for the choices they’ve made since that first case was announced on Jan. 25.
As Canada braces for a second wave that threatens to overwhelm hospitals and push Canadians back into lockdown, CBC News spoke to key officials across the country about what gives them hope — and concern — in the coming months.
Dr. Bonnie Henry, British Columbia’s provincial health officer, says her biggest concerns moving forward are the reintroduction of visitors into long-term care homes, travellers from other provinces and the reopening of the U.S. border. (Darryl Dyck/The Canadian Press)
“We got hit hard and early,” she told CBC News in two recent interviews.
Henry acted quickly to clamp down on outbreaks across B.C. before they spun out of control, taking the province from one of the most at risk early in the pandemic to one of the fastest to reopen safely.
“The timing that we had, the recognition of a couple of big super-spreading events in a conference that was held here and then in our long-term care homes early on — those were the things that we responded to,” she said.
Henry said outbreaks in households in B.C., meat processing plants in Alberta and the accommodations of undocumented workers in Ontario showed how different the experience has been with COVID-19 across the country.
“It’s really hard to compare. There’s a lot of differences around timing, around access to tests, around population density and recognition of certain outbreaks early enough,” she said. “These are the things that we’ve all been learning across the country.”
In the coming months, Henry said, she is most hopeful about the reopening of schools in B.C. and aims to have elementary school students back in the classroom full-time in September.
British Columbia avoided the worst-case scenario during the COVID-19 pandemic largely because of its well co-ordinated messaging, sound decisions and a little bit of luck. 6:45
“We’re also contingency planning,” she cautioned. “If we get a major outbreak and lots of cases in the community and things start to get hairy, then we have plans to step back to partial in-class or if needed to full online teaching.”
Henry said her biggest concerns moving forward are the reintroduction of visitors into long-term care homes and travellers from other provinces and the reopening of the U.S. border — particularly since B.C.’s first cases were tied to outbreaks in Washington state.
Henry said she hopes to maintain a “sweet spot” going forward where B.C. can see an increase in activities, travel and socialization in a safe way to prevent “rapidly explosive growth” as new cases arise.
“We are going to see more cases, and we know that,” she said. “We need to make sure that if we do get some spread, which we have seen and will continue to see, that we’re able to prevent wide transmission to large groups of people.”
Henry said her approach in the coming months won’t necessarily be to fully shut down parts of the province in response to outbreaks but instead work to limit spread while remaining open.
“This is going to be for the next coming months, but it’s not forever, and we will get back to being together again in the way that we want to be together again — but not right now.”
Alberta’s Chief Medical Officer of Health Dr. Deena Hinshaw says she’s less worried about travel between provinces and is instead more concerned about individuals’ actions. (Jason Franson/The Canadian Press)
Dr. Deena Hinshaw
Alberta’s chief medical officer of health has faced major challenges during the pandemic after large outbreaks at meatpacking plants across the province led to a spike in cases early on.
As of Wednesday, the province had 1,251 active cases of COVID-19 — the highest total seen in more than two months.
“In some ways, we’re a victim of our own success. We have controlled the spread in Alberta relatively well, which means that a lot of people haven’t directly experienced the impact of having a loved one with COVID who’s become very ill,” Hinshaw said in a recent interview.
“I am concerned that people are perhaps relying too much on their own personal observations in their daily lives and feeling that this is something to not be too concerned about.”
WATCH | Dr. Deena Hinshaw warns of pandemic exhaustion:
Four months into the COVID-19 pandemic, Dr. Deena Hinshaw says officials are worried about COVID exhaustion leading to an increase in cases, the majority of which are Albertans under the age of 40. 2:19
Hinshaw said she’s less worried about travel between provinces, despite reports of exposure to the coronavirus at house parties in B.C. involving Alberta residents, and is instead more concerned about individuals’ actions.
“The challenge is about people really being tired of restrictions and wanting to move on,” she said. “Part of what we’re seeing is somewhat linked to relaunch having perhaps given people a message that COVID is over — even though we haven’t said that.”
Hinshaw said that while the danger of increased transmission from reopening further is top of mind, the alternative is that people will go underground to congregate in much riskier settings.
“It’s really about convincing all of our population that they need to be taking these measures seriously,” she said.
“We need to shift how we interact with each other to make sure that we don’t get huge amounts of transmission and potentially overwhelm our health-care system.”
Dr. Vera Etches, Ottawa’s medical officer of health, says the city will need to remain ‘vigilant’ about outbreaks as Ontario continues to move into Stage 3 of reopening. (Sean Kilpatrick/The Canadian Press)
Dr. Vera Etches
Ottawa’s top doctor raised the alarm early about the possibility of COVID-19 infections going undetected in the community and the need to act quickly.
Etches doesn’t pull punches, but she still remains hopeful about the future.
“We have been able to progressively go back to more activities, and yet our case counts are stable or declining, our hospitalizations are declining, our deaths are declining,” she said.
“So it really is the actions of individuals that has added up to breaking chains of transmission.”
WATCH | COVID-19 threat could be present in Ottawa for several years:
Vera Etches, Ottawa’s chief medical officer of health, says community transmission could continue into 2021 and 2022, with the virus rebounding periodically in either smaller or larger waves. 2:21
Ottawa has had just over 2,300 cases of COVID-19 and 263 deaths. Despite a recent spike in new daily cases, the city reported just 14 on Thursday.
Etches is confident Ottawa will be able to continue to maintain that level of control moving forward but is concerned about what she’s seeing south of the border.
“It is the United States that is one of the most telling stories for us about the ever-present risk of a resurgence. People talk about a fall wave, but it could start in the summer,” she said.
“We’re opening up bars, I think it’s fair to say that is one of the settings we know has had outbreaks in other places and so that is a risk.”
Etches said the city will need to remain “vigilant” about outbreaks as the province continues to move into Stage 3 of reopening.
“In the early days, before people started physically distancing, we saw case numbers double every three days and that could happen again,” she said.
“I hope that people can take a look and see that the virus is still here. I think the language about a second wave as if it’s gone, and it might come back, has undermined the reality that the virus is here and it will grow if we let down our guard.”
Dr. Eileen de Villa, Toronto’s medical officer of health, says COVID-19 cases in the U.S. and even Canadian cities like Montreal linked to the reopening of bars are important lessons for Toronto. (Christopher Katsarov/The Canadian Press)
Dr. Eileen de Villa
Toronto’s medical officer of health has guided Canada’s largest city through the pandemic with cautious optimism, despite moving slower than other parts of the country.
But de Villa said the city has used that extra time to understand more about the spread of COVID-19 in order to stop it and prepare for reopening.
“We’re fortunate in the sense that there are a number of other jurisdictions, cities and countries that are a little ahead of us in terms of their outbreaks, and so we have this opportunity to learn from their experiences,” she said. “If we want to keep our progress moving forward here in the City of Toronto, we need to be mindful of these experiences.”
De Villa said surges in COVID-19 cases in the U.S. and even Canadian cities like Montreal linked to the reopening of bars are important lessons for Toronto, because people are in close contact and consuming alcohol and can be “less careful” about following public health guidelines.
But she admits she faces a “balancing act” with giving people a place to socialize safely while avoiding congregating indoors at places like house parties.
“We are social creatures as human beings, and there is an importance to having social connection through means other than just online,” she said. “There is a desire, and it’s a very human desire, for in-person connection. The question is, how do we help people achieve that much-needed connection, but to do so safely?”
WATCH | Toronto’s top doctor says physical distancing still needed:
Patios, salons, and indoor malls are now allowed to open in Toronto. The moves come as Toronto and neighbouring Peel Region enter phase two of reopening. But Toronto’s Medical Officer of Health Dr. Eileen de Villa says public health measures must still be followed. 11:40
De Villa said many of the U.S. states that have seen spikes in cases tied to bars and restaurants had not put in place strict physical distancing or masking measures before reopening and while case counts were still high.
Toronto has seen more than 15,000 cases of COVID-19 since the pandemic began, with over 1,100 deaths. That number has declined significantly in recent weeks, with just 24 cases reported on Thursday.
“If the level of COVID-19 activity in the community is low when you start to reopen and still do that reopening in a gradual and cautious fashion, it can be done safely,” de Villa said. “I do think it means that you need to be vigilant.”
Looking forward, the reality that Toronto could see a spike in COVID-19 cases isn’t lost on her, but she’s hopeful citizens will keep up their resolve as the city looks to reopening further.
“I think people are appreciating, as challenging as the circumstances are, that it does take all of us, and each one of us has to do our part and that we are only as strong as the weakest link in the chain,” she said.
“I do have a lot of faith in the people of Toronto. That doesn’t mean perfection, right? As a mother of three, I can tell you that I don’t look for perfection, I don’t think we can expect perfection from anybody,” she said.
“But I do try to look for the strengths that we see in our community and do what we can to build on those.”
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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.
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.
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.
