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Figuring out where you’re most at risk of catching COVID-19 is more challenging than ever in Canada’s Omicron-fuelled sixth wave, and tried-and-tested strategies for avoiding infection are proving less effective in everyday life.
The rapidly spreading BA.2 subvariant has been evading all of our layers of protection — from vaccines to masks — and fuelling a surge of COVID-19 levels across Canada during a time of few restrictions.
But while attempting to avoid COVID-19 risk entirely isn’t realistic, abandoning strategies that have worked to lessen the impact of the virus isn’t either — making this phase of the pandemic incredibly difficult to navigate.
“We have not experienced what it’s like to live with this virus while we are doing this little to stop it,” said Dr. Jeremy Faust, an emergency room physician at Brigham and Women’s Hospital and a Harvard Medical School instructor who recently wrote about navigating risk.
“Never until now have we been in a situation in which we have the least amount of protection against infection and these variants that are just flabbergastingly contagious.”
Hard to judge, hard to avoid
Faust says because everyone has a different risk threshold in day-to-day life, trying to navigate the pandemic based on your presumed best interest is a “dead end” because many people are unlikely to have judged the situation correctly.
“We might be completely correct one day and be safe and be completely incorrect the next day and be either personally at risk or putting someone else at risk,” he said. “And it’s this variability that makes your head spin if you stop to think about it.”
Dr. Lynora Saxinger, an infectious diseases physician and associate professor at the University of Alberta in Edmonton, said part of the problem with Omicron is that it punches through all our layered protections “much more effectively than anything has before.”
“All of those layers still reduce your risk, it’s just that the assault on the layers is a lot more aggressive right now,” she said. “It’s like there’s a lot more shots on goal.”
“The risk of infection has gone up markedly over the past three months,” said Erin Bromage, an associate biology professor at the University of Massachusetts Dartmouth who researches infectious diseases.
“And it’s getting harder for those who have avoided infection up until now to continue avoiding infection.”
With mask mandates lifted in many places, some are going without, creating a situation with fewer protections against what doctors call a ‘flabbergastingly contagious’ virus. (Evan Mitsui/CBC)
Playing field ‘rapidly shifting’
Canada’s Chief Public Health Officer Dr. Theresa Tam said this week that average daily case counts, test positivity rates and wastewater signals are all signalling growing transmission across the country that requires the “layering of precautions” to drive infection rates down.
“There is still a lot we can do to dampen down the current trajectory,” she said during a press conference Wednesday.
“We know that using personal protective measures like masking helps reduce transmission. Likewise getting a booster dose doesn’t just protect you against severe illness, it also provides a level of protection against infection.”
But the effectiveness of masking in preventing the transmission of Omicron and its highly contagious subvariants isn’t perfect, and the protection against infection from boosters appears to be waning at a rapid rate.
Linsey Marr, a researcher on the airborne transmission of infectious diseases and a professor at Virginia Tech says that while masks have the same filtration level for any virus — our chance of infection could be higher with these more transmissible variants.
“One thing that might be different with the variants is that people could be shedding more virus into the air…. You’re exposed to more virus, so your chances of infection are higher,” she said. “Another thing that might be different is that the infectious dose could be lower.”
Marr said there seems to be a “significant change” with masks against Omicron and its subvariants, meaning a cloth mask that may have been somewhat protective before is no longer sufficient and that higher-quality masks may be necessary.
“The masks could help blunt it a little bit, but they weren’t going to stop this wave or prevent this wave from happening,” said Dr. Isaac Bogoch, an infectious diseases physician and member of Ontario’s COVID-19 vaccine task force.
“I’m very much in favour of indoor masking, I’m very much aligned with ‘the mask mandate should not have been lifted,’ but it would not have stopped or prevented this wave.”
WATCH | Canadians urged to get booster shots to blunt 6th wave:
Canadians urged to get COVID-19 booster shots to blunt 6th wave
4 days ago
Duration 2:00
All signs indicate Canada is going through a sixth pandemic wave, Dr. Theresa Tam confirms. Her message to Canadians: wear a mask and get boosted if eligible. 2:00
Additional booster doses of the vaccine are also beneficial in preventing severe disease across the population, but a large new Israeli study in the New England Journal of Medicine showed fourth-dose protection against infection waned after just four weeks.
The observational study focused solely on adults aged 60 and older and found protection against severe illness didn’t wane in the six weeks after a fourth dose, but the data was too limited to determine whether a second booster provided better long-term protection.
“I’m not surprised that fourth doses aren’t generating very durable protection against infection,” said Dr. David Naylor, who led the federal inquiry into Canada’s 2003 SARS epidemic and now co-chairs the federal government’s COVID-19 Immunity Task Force.
“Two shots were much more effective against Delta. What’s clearly changed is that two or even three shots won’t preclude getting any of the substrains of Omicron.”
Naylor said fourth doses make sense for elderly Canadians, the immunocompromised and those with comorbidities, adding that we should be cautious with Israeli data because of the different spacing of doses there and their sole reliance on the Pfizer vaccine.
“We also have lots more people now with hybrid immunity — one, two or three shots, plus an infection in the last few months that may be increasing their level of protection,” he said.
“It’s a rapidly shifting playing field.”
A well-fitting mask still filters the newer strains of coronavirus in the same way, experts say. But the effectiveness of masks has gone down, perhaps because the highly contagious strains means exposure to more virus particles. (Evan Mitsui/CBC)
Worth delaying infection if possible
So while avoiding COVID-19 infection may not be feasible for most people, delaying it until you’re as protected as possible has benefits — and there are still ways you can lessen risk.
“To try and avoid infection, people still need to avoid indoor spaces that are crowded or that create close contact,” said Bromage, who wrote a viral blog post in May 2020 shared by millions explaining the places people are most at risk of COVID-19 infection.
“When in those situations, people need to wear higher quality masks than they used previously — preferably N95 or equivalent — and limit the time in those spaces. Duration matters.”
Increased immunity, broader availability of COVID treatments and two years’ worth of knowledge among members of the medical community are also helping to ensure that when people do get sick, they’re getting the best possible care.
It’s still a crisis, but the situation in Canada and abroad is steadily improving, stressed Bogoch.
“I’ve spoken with people in their 80s, who are triple vaccinated, who got COVID… but who are going to recover from this infection without having to come to a hospital. That’s amazing,” he said.
“Before the vaccines were available, many of these people would have gotten very sick, landed themselves in hospital, needed an intensive care unit and many would have died.”
In Italy, one of the countries hard hit by COVID-19 early on in the pandemic — with one of the highest global death tolls — new research suggests vaccination efforts roughly halved the number of deaths.
Vaccines prevented some 150,000 fatalities last year, the country’s National Health Institute (ISS) estimated on Wednesday, as well as more than 500,000 hospitalizations and over 55,000 admissions to intensive care.
Experts are suggesting people continue to use precautions like masks and vaccines, because it’s still worth delaying COVID infection if possible. (Evan Mitsui/CBC)
Focus on being ‘maximally vaccinated’
Even though it’s tough to avoid catching COVID, it’s worth buying time if you can while the scientific community develops and approves drugs and treatments that could cut that risk even further, said Dr. Abraar Karan, an infectious diseases fellow at Stanford University in Stanford, Calif.
“The fact that they now have more knowledge in terms of how to treat COVID means that when they do have these big surges, there are tools that they can use to reduce the infection fatality rate,” he said.
“The most important thing is really focusing on, ‘What can I do to reduce my risk of severe infection should I get infected?’ And there you say, ‘OK, am I maximally vaccinated? And am I someone who should get tested early in case I’m eligible for a treatment?'” Saxinger said.
“And if you do get infected, rather than beating yourself up, make sure that you’re accessing all the available things that would be helpful.”
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.
