Keeping society functioning and supporting devastated sectors of the economy while limiting the spread of the coronavirus is key to navigating the pandemic until a safe and effective vaccine is here.
But experts acknowledge there is growing resistance to some of the restrictions that highlights a need to manage the public mood as the pandemic rages on.
You arguably could not find a more politically charged term right now than “lockdown,” since everyone has a different, personal idea of what it is.
“This term has become equated with so many bad things that no one really understands what it means,” said Michael Osterholm, director of the Centre for Infectious Disease Research and Policy at the University of Minnesota.
“It’s everyone’s worst fear about what somebody else is doing to them regarding the pandemic.”
Osterholm, a veteran of SARS and MERS who warned the world for 15 years that a pandemic was coming, thinks the term lockdown should be abolished altogether.
Instead, Osterholm said we need to look at it as targeted public health measures necessary to reducing the spread of COVID-19 and getting back to normal as quickly as possible, while at the same time supporting those who have suffered financially.
The key to successfully riding out the pandemic lies in finding balance between working with the population to help keep the number of cases low without substantially changing life as we know it.
“The challenge is, the end isn’t coming soon,” he said. “But it’s coming, and what we need to do is try to have as few cases as possible between now and the time a vaccine arrives.”
‘Pandemic fatigue’ can turn to ‘pandemic anger’
Managing the public’s frustration presents a challenge for public health officials in the second wave.
During a journalism conference at Carleton University in Ottawa on Thursday, Canada’s Chief Public Health Officer Dr. Theresa Tam said that public health messaging can seem inconsistent because of the evolving science in the pandemic.
“We are living in a more challenging period right now,” she said, in which authorities have “to convince people who are fatigued to stick to sustainable habits or public health practices.”
Ontario and Quebec have already moved to close bars, restaurants and gyms in their hardest-hit regions amid rising cases, while Alberta and British Columbia weigh the need to tighten restrictions amid record-high rises in cases.
Osterholm said resistance to public health restrictions not only stems from the concept of “pandemic fatigue,” but also from something he calls “pandemic anger.”
“It’s people who don’t believe that the pandemic is real,” he said. “They think it’s a hoax.”
Raywat Deonandan, a global health epidemiologist and associate professor at the University of Ottawa, said the resistance also stems from “raw selfishness.”
Protesters clash with police officers during an anti-lockdown protest in London, England, on Sept. 26. (Hollie Adams/Getty Images)
“There’s an inability to think about community responsibility,” he said, explaining that people think they won’t personally be seriously affected by the virus because it has a comparatively higher survivability rate in younger age groups.
“But if you scale this up to a population, then that’s tens of thousands of deaths – and they don’t care.”
Perception of risk has a cost
The latest World Economic Outlook from the International Monetary Fund found that while lockdowns controlled the spread of the coronavirus, they also contributed to a global economic recession that disproportionately affected vulnerable populations.
But the IMF report also found the damage to the economy was largely driven by people “voluntarily refraining” from social interactions out of a fear of contracting the virus.
Osterholm said the perception of risk — and not strict public health restrictions — is what holds people back from doing things like travelling by plane or entering a retail store.
“Nobody is telling you you can’t go to the grocery store rather than ordering online — it’s just people don’t feel safe and secure,” he said.
“Well, how do you make that happen? You make it happen by making cases occur at a much, much lower rate than they’re occurring now. It’s not going to be just by telling the virus we’re done.”
Lockdowns should be last resort
Dr. Amesh Adalja, an infectious disease physician and a senior scholar at the Johns Hopkins Center for Health Security in Baltimore, Md., isn’t in favour of lockdowns as a first line of defence in the pandemic.
“If you’re going to take public health interventions, they have to be very targeted towards specific activities that are actually leading to spread,” he said. “You only use a lockdown when you have fouled up your response so bad that that’s all you have left to do.”
A group of international experts push back against the Great Barrington Declaration and its pursuit of COVID-19 herd immunity, calling it “a dangerous fallacy unsupported by scientific evidence.” 2:05
But ignoring lockdowns isn’t an effective strategy, either.
The Great Barrington Declaration, a controversial proposal from a group of scientists (backed by a U.S. think-tank) to lift restrictions, made headlines last week for its calls to protect “the vulnerable” from COVID-19 with strict measures while allowing those “at minimal risk of death” to return to normal life and build up herd immunity to the virus.
But it failed to present a logical counterargument for controlling the virus or concrete ways to protect the vulnerable (including the elderly and the poor), not to mention those who care for them.
Referring to the declaration, Deonandan said, “If there wasn’t a vaccine coming, if nothing changes and this has to be how we live in perpetuity, then OK, maybe we have to discuss some other options. But none of that is true.”
Canada has had more than 200,000 cases and is approaching 10,000 deaths, but modelling predicts the situation would be much worse if public health guidelines like physical distancing, mask-wearing and proper hand hygiene weren’t followed.
Osterholm said those pushing the the Barrington Declaration completely misunderstood the concept behind public health restrictions and the reasons behind enacting them in the first place.
“If you’re going to keep thinking about this as a lockdown, then we’re going to find a lot of resistance to this,” he said. “But on the other hand, if you don’t suppress transmission, we’re also going to see a lot of deaths.”
A question of public tolerance
Lockdowns are one of many tools a country can use in the face of an infectious disease outbreak, but their effectiveness is dependent on the public’s willingness to tolerate them.
China imposed some of the most severe public health restrictions in modern history upon the discovery of the coronavirus at the beginning of this year, something democratic nations would be unlikely to imitate.
But China is already seeing the rewards of its draconian efforts to control the spread. It’s the only major economy expected to grow this year, with retail spending surpassing pre-pandemic levels for the first time and factory output rising on the backs of demand for exports of masks and other medical supplies to countries like Canada.
Other regions like New Zealand, Singapore, Taiwan and Hong Kong acted swiftly by closing borders, imposing strict public health measures and opting for shorter, more strategic lockdowns, which have allowed them to carefully reopen society.
South Korea, meanwhile, didn’t lock down at all and instead focused on testing, tracing and isolating cases to control the spread of the virus successfully.
“The lesson here is you choose one path and you stick with it,” Deonandan said. “What is not acceptable is vacillating between different strategies.”
Lockdowns are one of many tools a country can use in the face of an infectious disease, but their effectiveness is dependent on the public’s willingness to tolerate them. (Tolga Akmen/AFP via Getty Images)
Australia imposed targeted lockdown measures in the face of outbreaks, which University of Western Australia epidemiologist Dr. Zoë Hyde said has been “enormously successful” in eliminating the virus in much of the country.
“While lockdowns absolutely have harms associated with them, the harms are much less than those of an unmitigated epidemic,” she said. “Governments can also minimize the harms of lockdowns by making them short and sharp, and by financially supporting workers and businesses.”
Lockdowns ‘a sign of failure’
Hyde said the eastern Australian state of Victoria was a precautionary tale for the debate over lockdowns, because of mistakes made in a hotel quarantine system that allowed the virus to spread again.
“If governments have not tried hard enough to suppress the virus, then a lockdown is inevitable, whether people want one or not,” Hyde said.
“Lockdowns are a sign of failure. They’re a sign that governments have not been doing enough.”
Victoria was recording around 700 new cases per day in July, but a second lockdown coupled with a mask mandate have brought case numbers down to only a handful a day at most.
“Measures to combat the virus have to be tailored. They can’t be more than the economy can bear,” Hyde said, “but equally we must remember that the best way to protect the economy is to suppress the virus.”
“Ultimately it’s the virus doing the damage to the economy, not the measures designed to suppress it. No matter what we wish, the economy won’t go back to normal if a dangerous virus is circulating.”
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.
