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Asking ‘Where do you think you got COVID?’ helps contact tracers zero in on superspreader events

The painstaking detective work of contact tracing usually starts with an infected person and works forward, asking who has that person seen since they became potentially contagious with COVID-19.

But that mainstay of public health has a less high-profile cousin that’s become instrumental in spotting superspreader events quickly — working in reverse.

“Instead of asking who did that person potentially give the virus to, you’re asking where did that person get the virus?” said Dr. Trevor Arnason, associate medical officer of health with Ottawa Public Health.

“It makes you become better at finding people who have COVID-19 who you might not have known about.”

COVID-19 tends to spread explosively in situations where the virus can infect a bunch of people all at once, public health experts say, which is where what’s known as backward tracing comes in handy.

Ottawa Public Health cottoned on to the benefits of backward tracing when emerging evidence from Japan showed how focusing on where a person got COVID-19 and going back to that location helped to find many more who were infected.

“We started more systematically asking everybody, ‘Where do you think you got it? Or who do you think you got this from? And then we started working back from those places. You start to notice these patterns, which we’ve put together in infographics that we’ve shared with the public,” Arnason said.

Infographics tracing how many were affected from one indoor wedding allowed the public to see how seemingly disparate locations tied together, resulting in 22 people from eight households being affected in two weeks.

“Backward contact tracing is used to find the superspreading events. That’s the main goal.”

Ashleigh Tuite, an infectious diseases epidemiologist in Toronto, said most people who are infected don’t pass it to others. 

WATCH | Day in the life of COVID-19 contact tracers [May 2020]: 

The National’s Adrienne Arsenault spends a day with contact tracers in London, Ont., who help figure out where someone caught COVID-19 and determine who else may be at risk. 3:43

But the instances where an individual goes on to transmit to many others likely reflect how coronavirus transmission clusters at a particular location or environment.

An indoor gym where those working out are unmasked, breathing heavily in what may not be the best ventilated conditions is one example.

“It’s clear that telling people to wear masks when they move around a gym, but not when they’re exercising, which I think has been the protocol in a lot of places, wasn’t enough,” Tuite said. 

Suppressing variants

Backward contact tracing is a lot of work for public-health staff facing down outbreaks, said Tuite, but also potentially high yield.

It can be particularly helpful at the early stages an epidemic — which is long-gone for normal coronavirus, but the introduction of more-transmissible variants of concern is like a do-over, said Tuite, an assistant professor at the University of Toronto’s Dalla Lana School of Public Health.

“It’s an effective way of suppressing the growth of the variants of concern amongst this larger epidemic that’s happening,” she said.

“Overall, we have declining case counts and so if we can control sparks that are happening with the variants of concern, there is the potential to really keep it under control and at least keep case counts declining.”

This May 13, 2020, photo taken with a fisheye lens shows a list of the confirmed COVID-19 cases in Salt Lake County. The white board remains in the office as a reminder of how quickly the coronavirus spread. (Rick Bowmer/Associated Press)

Declining case counts mean hospital and health-care capacity can accommodate more surgeries and preventative care and allow the economy underpinning society to recover, too.

For now, Tuite said case counts will only decline if people restrict their interactions.

For Dr. Susy Hota, an infectious diseases specialist at Toronto’s University Health Network, keeping the variants of concern at bay is another goal of vaccinating as many people as quickly as possible.

“If we continue to allow transmission to occur, [the variants] will take over a larger and larger proportion of the market, so to speak,” said Hota, an associate professor of medicine at the University of Toronto.

Stopping spread fast

Regardless of variants, forward contact tracing to identify high-risk contacts and possible cases as aggressively as possible so they know to isolate quickly will always be a key public health tool.

For instance, a Manitoba spokesperson said they routinely collect information on where a COVID-positive case may have been exposed. But the focus is on forward contact tracing to stop spread as quickly as possible.

WATCH | Workplace physical distancing innovation:

A Calgary tech company’s device is in big demand as manufacturing companies look for ways to keep employees physically distanced while maintaining productivity. 3:09

Hota cautioned there are even more recall challenges with backward contact tracing than forward, using herself as an example.

“Do you think you were more than two metres away when you talked to that person? I think so. But I didn’t have a yardstick with me. And how long do you think you were talking? Oh, I’m terrible at that. I’ll tell you, like, five minutes. I have no idea.”

The recall problem gets amplified because to do backward contact tracing effectively means going back the full 14-day incubation period of the coronavirus. Hota does see a role for backward contact tracing in trying to pin down if there’s a single source of multiple cases, say at a meat-packing plant.

“The truth often doesn’t emerge until the epidemic is over,” Hota said.

(Tim Kindrachuk/CBC)

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PlayStation 5 Scalpers Think They’re Being Demonized Unfairly

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The people making bank selling PlayStation 5’s, Xbox Series X, various types of footwear, and both Nvidia and AMD GPUs believe they’ve been misunderstood. If you think about it, scalpers are really just providing a service. They’re not parasites, they’re just economically savvy.

Forbes recently spoke to some of these charming go-getters to get their opinions on the recent console shortages.

“There seems to be A LOT of bad press on this incredibly valuable industry and I do not feel that it is justified, all we are acting as is a middleman for limited-quantity items.” said one individual named Jordan, who co-founded a group known as the Lab. The Lab is what’s known as a “cook group,” a private organization that advises paying users on how to bypass site security systems and order multiple consoles at once.

A bot in action. Image by Janhoi McGregor, Forbes

According to Jordan, buying 25 PlayStation 5’s and reselling them for £700 (base retail price: £450) is no different than a retailer buying milk from a wholesaler at a low price before reselling it at a higher price. Another scalper, Regan, defended The Lab’s actions on the grounds that it donated most of its earnings to an unspecified local food bank.

The “scalpers are really just another form of reseller” argument would hold up better if the business relationship was voluntary. Much of the Forbes article is concerned with the various ways scalpers bypass website security and subvert ordering systems. It’s hard to imagine Walmart trumpeting the availability of Fruit of the Loom underwear while the manufacturer briefed the press on its efforts to prevent sales.

Retailers continue to insist that they’ve closed these loopholes and that they are taking every precaution possible against bots. Somehow, bot authors also keep talking up their successes, and products keep showing up on black markets. Based on what we know about the bot market structure, most of these products use a subscription model, implying that customer churn is fairly high — most people, presumably, subscribe to the service for only as long as they need to score a desired product.

The people using bots to bypass website security systems and order products before they’re even supposed to go on-sale aren’t just scalping. These people are abusing point-of-sale systems to artificially restrict supply and inflate the value of their own inventory. Third-party analysis has suggested scalpers are accounting for 10-15 percent of Xbox and PS5 sales. That’s enough to meaningfully constrict supply when manufacturers are already having a difficult time keeping systems on shelves. In some cases, there are knock-on effects to these shenanigans. PC component prices have been all over the map, making it cheaper, in a lot of cases, to buy a machine rather than build one. Scoring 10-20 Nvidia GPUs may earn the buyer a nice chunk of change on the black market, but the only value they’re providing is to themselves.

For the rest of us, this is an unwelcome, unwanted change. People should not have to subscribe to bots to have a chance at scoring products at MSRP, and we wouldn’t count on a sympathetic response any time soon.

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Why our immune system might be better at fighting COVID-19 than we think

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.

There’s a lot of confusion — and speculation — about immunity to COVID-19 at the moment. 

You may have seen the headlines this week implying that antibodies the immune system creates to fight off the coronavirus decline rapidly after infection, jeopardizing the hope for long-term immunity from the virus. 

But the issue is both more complicated than it may seem and more hopeful. 

The preprint study, which has not undergone peer review, found the number of people with detectable antibodies in their blood in England fell from six per cent of the population at the end of June to just 4.4 per cent by mid-September.

The researchers concluded there was “decreasing population immunity” and “increasing risk of reinfection” and that the community study of 365,000 patients clearly showed detectable antibodies were in decline.

But while the study and its discouraging conclusion made headlines around the world, experts say there’s a lot more to consider before we can definitively say coronavirus antibodies don’t last long enough to protect us. 

Drop in antibodies after infection is expected

One key factor to keep in mind is that it’s not uncommon for immunity to drop after an infection, said Alyson Kelvin, an assistant professor at Dalhousie University and virologist at the Canadian Center for Vaccinology evaluating Canadian vaccines with the VIDO-InterVac lab in Saskatoon.

“Simply showing that antibodies decline after an infection does not simply mean we are no longer protected,” she said. “Our immune system is more complicated than that — which is a good thing.” 

A drop in detectable antibodies is actually expected after an infection and that high levels of antibodies remaining after an illness has passed could actually be a bad thing, Kelvin said.

“Typically, we would associate high levels of an activated immune response when there is no threat with more of an autoimmune disease,” she said. 

“So we do want to see somewhat of a decline to know that our bodies are in check after we’ve cleared the virus.”

The other important factor is that the immune system can actually remember how to make new antibodies when needed to fight off future infections, by storing types of protective white blood cells in the body called B cells. 

Kelvin said just because there aren’t detectable antibodies in the blood doesn’t mean we don’t have reservoirs of these immune memory cells stored in other parts of our body like in our bone marrow.

“That’s usually where your memory B cells would kind of hide out, waiting for another exposure,” Kelvin said. “Because you’re not going to have these circulating antibodies when you’re not being exposed, you kind of need to put them away for when you need them.” 

Conflicting studies cause confusion

Another study, published this week in the journal Science and peer reviewed, may have added to the confusion over immunity to the coronavirus. 

It looked at antibody responses in the plasma samples of more than 30,000 COVID-19 patients in New York City’s Mount Sinai Health System between March and October. 

It came to a much different conclusion than the preprint study: that more than 90 per cent of patients produced moderate to high levels of antibodies that were both powerful enough to neutralize the virus and lasted for many months after infection. 

WATCH | COVID-19 antibodies may disappear quickly, study finds:

A new study out of the U.K. has found COVID-19 antibodies can disappear quickly from people who’ve had the virus, which experts say makes herd immunity unlikely without a vaccine. 3:33

One difference in the two studies is that the preprint looked at patients ranging from asymptomatic to severe, while the published study focused on hospitalized patients who were primarily symptomatic. 

“There seems to be some type of split where milder cases after infection don’t have this notable increase in antibody responses for long periods of time,” Kelvin said. “That might be more evident in people who have more severe infection.” 

Researchers in the New York study concluded that the antibodies they found were likely produced by “long-lived plasma cells in the bone marrow,” something that backs up the idea that dormant immune memory B cells could be hiding there.

“This study suggests that the majority of those people infected with SARS-CoV-2 [the coronavirus that causes COVID-19] will produce protective antibodies, which will likely protect from reinfection,” Kelvin said. 

“This would support the notion that we will be able to produce a vaccine that is safe and leads to a protective immune response.” 

How our immune system responds to the coronavirus 

After an exposure to a virus from either an infection or a vaccination, the body goes through what’s called an “expansion phase” where these memory immune cells produce antibodies in response to it — something Kelvin likens to climbing a mountain. 

Once the body believes it has cleared the infection and reached the top of the mountain,  those antibodies then start to decline during what is known as the “contraction phase,” the start of the descent down the mountain.  

As you get to the bottom of the mountain, the body moves into a “memory phase,” where the most effective antibodies get stored until the next exposure — like the experience you might have to better climb the mountain next time.

At that point, B cells are not thought to be detectable in the bloodstream, instead going into immune reservoirs in the body such as bone marrow, which means they could be missed by researchers only focusing on antibodies in the blood.

“We don’t yet know what level of these antibodies is actually needed to prevent infection,” said Dr. Lynora Saxinger, an infectious disease specialist and associate professor of microbiology and immunology at the University of Alberta. 

“But there are lots of examples of low antibody levels getting boosted up quickly when you are re-exposed to an infectious agent due to B cell memory pumping out antibodies on re-exposure.” 

Virologist Alyson Kelvin says just because there aren’t detectable antibodies in the blood doesn’t mean we don’t have reservoirs of these immune memory cells stored in other parts of our body. (Ben Nelms/CBC)

Another tool our body uses to help fight infection are T cells, a different type of white blood cell stored in the body that can also attack the virus the next time they encounter it but are a separate arm of the immune system

A recent paper published in the journal Cell found that a balance of both T cells and B cells produced in the body could lead to a better outcome after infection from the coronavirus, and Kelvin said understanding more about T cell immunity could be helpful for vaccine development. 

One positive note is that memory B cells, which have the capacity to protect against future infections, have already been detected in both symptomatic and asymptomatic COVID-19 patients, as pointed out in another study published in the journal Nature this week. 

Kelvin said COVID-19 patients who develop severe disease or die after being infected with the virus may have a lower ability to generate antibodies because it is possibly targeting and destroying those B cells

“These results would support the idea that ‘herd immunity’ through natural infection will not lead to long-lasting immunity,” she said. “Which will instead keep our vulnerable populations at risk of death.”  

Other coronaviruses, such as SARS and MERS, can also provide hints as to how long the dormant antibodies might stick around waiting to protect us from infection down the road. 

“In both SARS and MERS, for years after antibodies were no longer detectable, immune memory cells geared for specific responses to both viruses could still be found in recovered patients,” said Dr. David Naylor, co-chair of the federal government’s Immunity Task Force.

“Bottom line: It seems really likely based on millions of people infected, the duration of the epidemic and the still very small percentage of reinfections that there is pretty durable immunity to SARS-CoV-2 after an initial infection.” 

Vaccines safest way of achieving immunity

It’s important to keep in mind that research showing declining antibodies over time does not necessarily mean there is somehow less of a chance that we’ll be able to develop safe and effective vaccines in the coming months. 

“There’s still lots to learn about durability of immunity,” Naylor said.

No one expects any of the vaccine candidates to grant “indefinite immunity,” and they may work more like an annual flu shot, he said.

“The immediate issue is whether vaccines will achieve and maintain enough overall immunity to keep spread under control so we can get on with our lives.” 

Research showing declining antibodies over time does not necessarily mean there is somehow less of a chance that we’ll be able to develop safe and effective vaccines in the coming months. (Joe Raedle/Getty Images)

Regardless, Kelvin says that immunity gained from vaccines is safer than achieving it through rampant infections, a concept also known as herd immunity. 

“More work is needed to understand how long immunity lasts,” she said, adding that while a vaccine might not offer long-lasting protection either, it doesn’t come with the same risk of death faced by patients with COVID-19.

“So having a safe and effective vaccine would be the best way of controlling outbreaks.”

To read the entire Second Opinion newsletter every Saturday morning, subscribe by clicking here.

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Why the experts think Belarus isn’t going to be Putin’s next Ukraine

If there is a glimmer of a silver lining for Canada, the U.K. and its allies as they watch the brutal crackdown on anti-government protesters in Belarus, it’s this: Russia probably doesn’t want another Ukraine — and it certainly can’t afford one.

The imposition of sanctions by both countries Tuesday against Belarusian President Alexander Lukashenko, his son and six other Belarusian government officials in the wake of a disputed presidential election was the outcome of a delicate diplomatic dance that took weeks — even though some European nations chose to remain wallflowers.

Former Canadian diplomat Colin Robertson said the Magnitsky-style sanctions would have had more punch if they’d been part of a wider multinational effort.

“In the case of Belarus, we have gone after the kingpins and we hit them where it hurts — their pocketbooks and ability to travel,” he said. “It would have been better if it were a G7 rather than just Canada and the U.K., but I guess it’s a reflection of EU solidarity.”

Some experts, meanwhile, say they think there’s a better-than-even chance that — although they’re not aimed at Russia — the economic penalties will prompt dialogue and lead to de-escalation.

“The Russians don’t want another Ukraine,” said Andrew Rasiulis, a former senior Canadian defence official now with the Canadian Global Affairs Institute. “They don’t want another problem on their border.”

Police detain a demonstrator during an opposition rally to protest the official presidential election results in Minsk, Belarus, Sunday, Sept. 27, 2020. (Associated Press)

While surface comparisons can be made between the situation in Belarus now and the six-year-old war in Ukraine, the geopolitical and economic landscapes are different, said Rasiulis, who once ran the Directorate of Nuclear and Arms Control Policy at the Department of National Defence.

Unlike the Ukrainians who took part in the anti-government, post-election protests in Kyiv that preceded the Russian invasion and annexation of the Ukrainian territory of Crimea in 2014, those demonstrating in Minsk are not demanding closer association with the West or using much anti-Russian rhetoric. Belarusians are, primarily, rising up to demand good government.

And Moscow is in a weaker economic position now than it was in 2014 — in part because of the punishing sanctions imposed after its seizure of Crimea and armed intervention in eastern Ukraine.

Russian President Vladimir Putin, right, and Belarusian President Alexander Lukashenko on Dec. 20, 2019 in St. Petersburg, Russia. (Mikhail Klimentyev, Sputnik, Kremlin Pool Photo via AP)

For Belarus, getting hit by international sanctions following a presidential election is almost a regular thing.

In 2006, in reply to a heavy-handed response to protests, the U.S. and European Union levelled sanctions on dozens of Belarusian individuals and state-run companies. The EU eased up in 2016 when Lukashenko released political prisoners, but Washington has maintained an array of restrictions on Belarusian officials, including the president himself.

Penalizing the powerful

Robertson said the West has learned the hard way that targeted punishments, such as those imposed on Tuesday, will be more effective in the long run.

Experts at the U.S.-based RAND Corporation and elsewhere have warned repeatedly over the past decade that targeting key Belarusian state-owned enterprises (such as chemical and petrochemical industries) and restricting the flow of capital would cause higher economic damage to the country as a whole and hurt many ordinary citizens.

The chances of political concessions appear to be higher when you hit the business elite and the cronies, says one recent study by the think-tank.

That report, which looked at Russia’s influence in Eastern Europe and ways to contain it, said efforts to promote a more liberal Belarus were unlikely to succeed and could provoke a strong response from Moscow.

Convincing the Kremlin

William Courtney and Michael Haltzel, two noted U.S. experts on Eastern Europe, argued in a RAND Corporation blog post last month that western countries should support mediation and calls for a new presidential election with credible international monitoring.

Russia, they said, is the key — and Moscow could be enticed to go along.

“A more democratic, Eastern Slavic state on Russia’s border might be difficult for the Kremlin to accept, but the European Union and the United States could make clear that any improvement in relations with Moscow would depend on it not intervening coercively in Belarus,” wrote Courtney, a former ambassador, and Haltzel, a former policy adviser to U.S. Senator (now Democratic presidential nominee) Joe Biden.

Canada, Latvia and other western nations have called for mediation, said Rasiulis — who is convinced Moscow is more interested in keeping Belarus in its orbit than in Lukashenko’s political survival.

The Institute for the Study of War, another prominent U.S. think-tank, has warned that some of the Russian army units which took part in a recent joint military exercise may not have returned home from Belarus last week as planned.

Rasiulis said that while it’s clear Russian is keeping the option of force on table, he has a hard time believing Moscow would launch a violent crackdown because of how it would alienate the people of Belarus.

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Why COVID-19 may attack the body differently than we think

This is an excerpt from Second Opinion, a weekly roundup of eclectic and under-the-radar health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.

Understanding how COVID-19 attacks the human body is essential to developing an effective treatment or vaccine to stop the global pandemic — but there’s still so much we don’t know about how it can kill us.

As researchers around the world race to understand the illness, they are compiling and sharing their early observations of patients hit by a virus that has sickened more than two million people. The findings are preliminary, but they can help point researchers in the right directions.

They have seen that in severe cases, COVID-19 invades our respiratory cells and triggers an immune system response that targets those infected cells, destroys lung tissue and ultimately clogs our airways, cutting off our oxygen supply. 

That’s when organ failure can also occur, causing severe damage to the kidneys, liver and heart, similar to other conditions like sepsis. 

But they will look to determine whether the virus is targeting and shutting down organs in a new way or just behaving like other infections that cause such common complications.

Why COVID-19 can be so deadly

One key thing to understand about the deadliness of the coronavirus is how it infects the body and how our body responds to fight it. 

Cytokines are small molecules released by the immune system that travel throughout the body to co-ordinate an immune response against an infection or injury — even with something as common as a mild fever. 

But if the immune system overproduces them in response to the infection, they can cause “cytokine storms” that can rampage through the bloodstream and severely damage the body. 

Dr. Douglas Fraser, an ICU doctor at London Health Sciences Centre and a researcher at Western University in London, Ont., has been studying that exaggerated immune response by collecting blood from critically ill COVID-19 patients in an effort to find new ways to treat the disease. 

“The immune response to this particular disease is very different than what we’ve seen in other infected patients that end up in the ICU,” he said. “It’s a unique response and it’s going to require unique therapies.” 

Fraser said his research shows there are different types of cytokines released in the body at unusual times and levels in response to COVID-19 compared with those that are typically found in critically ill patients from more common diseases. 

“What we’re seeing seems to be occurring in all of the very sick patients: those who are requiring the ICU admissions, those who are requiring assistance with their breathing and those that are ultimately dying,” he said.

Kidneys tied to severe complications

Kidney damage was an “important complication” in a preliminary publication of a recent observational study of 287 COVID-19 patients in China, which found almost one in five had some stage of sudden or “acute” kidney injury, putting them at “substantially higher” risk of death.

While it’s not yet known what rate of Canadian COVID-19 patients have acute kidney damage, the majority occurs in severely ill patients, said Dr. Jeffrey Perl, a nephrologist at St Michael’s Hospital in Toronto and an assistant medical professor at the University of Toronto. 

“As people’s blood pressure gets very low from a very massive, overwhelming inflammatory immune response, the kidneys are starved of blood,” he said, adding that it can often lead to the need for a dialysis machine to clean the patient’s blood.

To give an idea of how serious a complication it can be, Perl said the mortality rate for patients who had developed acute kidney injury from SARS in 2003 was 92 per cent, compared to just eight per cent in those who didn’t. 

Toronto General Hospital employee Maria Tanta, left, a recovery room nurse, has her temperature checked by nurse Callie Dunne during the SARS epidemic on April 2, 2003. (J.P. Moczulski/Canadian Press)

Chronic kidney patients are also at higher risk of death with COVID-19 compared to those without pre-existing conditions who are otherwise well, he added. 

“We’re very worried about those patients getting a COVID-19 infection,” he said. “Similar to the elderly population that we’re very concerned about, I would consider these patients another high-risk group.” 

Heart may be ‘directly’ targeted by virus

One essential organ that may be at direct risk from the virus is the heart.

A cohort study published in JAMA last month found almost 20 per cent of 416 hospitalized COVID-19 patients in China had heart damage during hospitalization, putting them at a higher risk for death. 

Recent research from the American College of Cardiology found arrhythmia, or irregular heartbeat, in 16 per cent of patients and acute cardiac injury in 7.2 per cent.

“There’s the possibility and the likelihood that some of the virus might actually get taken directly up into the heart muscle cells and cause that heart injury,” said Dr. Patrick Lawler, a cardiologist and clinician scientist at the Peter Munk Cardiac Centre in Toronto. 

“We hear anecdotes from other people that have had a little bit more experience, unfortunately, with this that really are consistent with the heart suddenly starting to become weak.” 

An observational study of 187 patients hospitalized with COVID-19 published in the New England Journal of Medicine last month found high levels of troponin, which can indicate problems with the heart, in 28 per cent of hospitalized COVID-19 patients in Wuhan, China, which concluded they were at risk of “much higher mortality.” 

A medical worker checks on a patient’s condition at Jinyintan Hospital in Wuhan in central China’s Hubei province on Feb. 16. Emerging research shows the heart may be at direct risk from the virus. One study in China found almost 20 per cent of 416 patients had cardiac issues. (Chinatopix/The Associated Press)

Lawler said the outcomes for COVID-19 patients with cardiac issues are “dramatically worse,” and even though the virus enters through the respiratory system, it can take root in other areas of the body. 

“The heart is really a critical, critical part of what determines whether or not patients are going to recover from this or not,” he said.

Can it help us find a cure?

Lawler is currently looking at the use of blood thinners as a possible treatment for COVID-19 patients, which may prevent the virus from binding to ACE2 receptors — enzymes found in cells throughout the human body that can act as an entryway for coronaviruses. 

He said research suggests blood clots may play a role in organ failure in critically ill patients, so different doses of anticoagulants may prevent that from happening. 

Fraser is also using his research on the “cytokine storm” immune response to COVID-19 to find “targets” to further efforts toward an effective treatment. 

He said there could be multiple components to why different people are susceptible to the virus that range from genetics, to pre-existing conditions to age.

“Once we have an understanding of what’s going on, we can develop therapies, we can develop vaccines,” he said. 

“Then we can get back to a normal life.”

To read the entire Second Opinion newsletter every Saturday morning, subscribe by clicking here.

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‘I don’t think it’s going well’: Turks see little upside to country’s military involvement in Syria

A large billboard that towers above one of the freeways sluicing across the vast and majestic city of Istanbul carries the name of Turkey’s latest military operation in Syria and asks the Turkish people a single question:

“Who would not sacrifice their life for this paradise of a country?” 

That’s a line from Turkey’s national anthem and a not-so-subtle pull on patriotic heartstrings for a country still reeling from the loss of so many soldiers to fighting next door in Syria.

Few Turks would miss the deliberate link between an anthem originally dedicated to “Turkey’s heroic army” and an active military operation today that is causing increased domestic anxiety.

“That’s how it’s being marketed,” said political analyst Soli Ozel, talking about Operation Spring Shield, which was launched on March 1 after at least 36 Turkish soldiers were killed in an airstrike at the end of February that has been attributed to Russian planes backing Syrian forces.

“Who buys? I certainly wouldn’t buy that.”

Those deaths bring the number of Turkish soldiers killed in fighting since January to about 60. For a nation whose identity is intrinsically tied to the military through its founding father, Mustafa Kemal Ataturk, these losses are a psychological blow.

“It is our pride,” said 22-year-old student Hussein Bildek when asked about the military. “We are a soldier nation. I can’t [explain] that in English, but it’s in our blood. I believe that.”

‘You see the situation here’

Turkey has spent the past three months building up thousands of troops in Syria’s Idlib province, in a bid to halt the Syrian army’s brutal advance on the last rebel enclave in a civil war now entering its 10th year.

That advance has driven an estimated one million people from their homes and right up next to the Turkish border since December. Turkey is already hosting nearly four million Syrian refugees and fears it will be forced to take in even more.  

Hussein Bildek, a 22-year-old student, said that Turkey is ‘a soldier nation. I can’t [explain] that in English, but it’s in our blood.’ (CBC)

For Hussein Bildek, that was reason enough for Turkish President Recep Tayyip Erdogan to send more troops into Syria.

“We had to,” Bildek said. “Because we have four million refugees from Syria and you see the situation here. We have a really bad economy right now, and have to fix it somehow.”

But the operations in Idlib leading up to and including Operation Spring Shield brought Turkey into almost direct military confrontation with Russia.

Turkey has been backing Syrian rebels opposed to Bashar al Assad’s regime in Damascus while Russian support for al-Assad turned the tide of the war in his favour. Despite a subsequent ceasefire, few believe it will hold.

Events have highlighted the tightrope Erdogan is walking between East and West, and especially between his NATO partners and Russia.

“Whether you acknowledge it or not, you had a fight with Russia in Syria,” said Ozel, addressing Erdogan. “You’re calling for your [NATO] partners to send you Patriot missiles. Well, so much for the advisability of the [Russian-made] S-400 purchase and all the rest.”

Dealing with surge of refugees

It all contributes to what Ozel believes is a drop in support for Turkey’s military presence in Idlib, especially compared to an operation last fall when Turkey angered its NATO partners by taking on Syrian Kurds, who many Western nations considered allies in the battle against the Islamic State.

“The thing is, in the previous Turkish military operations [in Syria], whether in the west or in the south or in the east, there was an element of fighting the PKK,” said Ozel, referring to the Kurdistan Workers Party. “And that justifies anything.”

The separatist PKK has fought a long and bloody guerrilla war inside Turkey, and Ankara accuses Kurdish forces in northern Syria of helping them.

This funeral tent was erected in Istanbul to commemorate a Turkish soldier killed in Syria. (Stephanie Jenzer/CBC)

Turkey suspended social media for 16 hours after the late-February airstrike on its soldiers in a move critics say was aimed at quelling domestic debate over the cost of Turkey’s war in Syria, human or otherwise.

An Amnesty International report last fall described Turkey as the world’s largest jailor of journalists, many imprisoned after a failed coup against Erdogan in 2016. 

Ozel said it’s uncommon to see media coverage of families mourning the loss of Turkish soldiers killed on duty. “We don’t see the stories of those families who are shattered by the loss of their son. There was one instance I think a father said, ‘Stop the killing of our soldiers.'”

Turkey changed its conscription laws last year making it possible for those who could afford it to buy their way out of a six-month mandatory service.

Eighteen-year-old Rojin Yilmaz, a Turkish citizen of Kurdish heritage, expressed the internal conflicts many Turks seem to feel about their country’s place in the world today. 

“I don’t think it’s going well. Every day, we are watching or reading on the news that we are losing a soldier,” she said.

“It was a wrong decision to accept [the Syrian refugees] inside Turkey. Because after that, things started going bad. Something changed in our country after their arrival.”

‘We are stuck between two worlds’

Last month, Erdogan opened a new chapter of hostility with Turkey’s former foe and current NATO partner Greece by opening up his northern border with Greece and inviting refugees in the country to leave for Europe.

Eighteen-year-old Rojin Yilmaz, a Turkish citizen of Kurdish heritage, said, ‘Every day, we are watching or reading on the news that we are losing a soldier.’ (Stephanie Jenzer/CBC)

This led to unruly scenes on the border, with Turkish police ferrying migrants to crossings and Greece using aggressive means to turn them back while accusing Erdogan of weaponizing the needy.  

Ankara argued the EU had failed to deliver on parts of its 2016 agreement to stem the tide of mainly Syrian refugees through Greece in exchange for financial aid and other incentives.

The standoff led to a video conference this week between Erdogan and his French, German and British counterparts, where progress on a revision of the 2016 plan was on the table ahead of an EU summit planned for March 26.

Analysts believe one thing Ankara has in its favour is that NATO and the European Union appear to need Turkey as much as Russia does. But it does little to ease the feelings of many Turks who believe their country’s place in the world is little understood and one of perpetual isolation.  

“There is Russia. There is USA. There are other European countries, so there are a lot of players,” said Bildek, the student.  “We are stuck between two worlds. Between West and East.”

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COVID-19 outbreak: ‘Think twice’ before taking a cruise, top health official warns

Canada’s chief public health officer is warning travellers, especially the elderly and those with fragile health, to reconsider going on cruises after cases of the coronavirus were confirmed on a cruise ship which has Canadians on board. 

“Think twice about going on cruise ships,” said Dr. Theresa Tam on Friday, noting they “present environments where COVID-19 can spread easily given close contacts between passengers and crew for significant periods of time.”

Tam said that even if people on a cruise do not contract the virus they could be quarantined by destination countries for extended periods of time, increasing the risk of infection. 

State officials on Thursday quarantined the Grand Princess cruise ship off the coast of California over fears of a possible outbreak. There are 235 Canadians among the 3,500 passengers and crew on board.

According to a statement from the cruise line, fewer than 100 guests and crew members were initially identified for testing by the U.S. Centers for Disease Control and Prevention. Test kits were delivered by air to the ship Thursday.

On Friday, U.S. Vice-President Mike Pence said that so far 46 people have been tested and 21 came back positive; 19 crew and two passengers. It remains unclear if any Canadians tested positive. 

Pence said that the Grand Princess will be moved to a non-commercial port where all 3,500 people on board will be tested. 

The ship was quarantined after a traveler from its previous voyage — a Feb. 11-21 trip to Hawaii — died of COVID-19 and at least two others became infected.

Tam said there were 260 Canadians aboard that voyage and that the Public Health Agency of Canada has their names. That list, Tam said, has passed to provincial health authorities who are following up with those who have returned home. 

Tam also said that so far three of Canada’s 54 confirmed or presumptive cases of coronavirus were travelers on Grand Princess’ trip to Hawaii. 

Another cruise ship, the Diamond Princess, was quarantined by Japanese officials last month because of a coronavirus outbreak. A passenger on a third ship, the Westerdam, tested positive after the vessel docked in Cambodia.

Canadians being tested

More than 4,500 people have been tested for the virus across Canada. Tam said that all provinces and territories are fully equipped to continue testing and additional help is available from the National Microbiology Laboratory in Winnipeg. 

With more than 100,000 cases reported in more than 90 countries, and the situation continuing to change daily, Tam said all March Break travellers should regularly check the federal government’s travel advisory for their destination country because information is on destination countries is constantly changing. 

“With so many countries reporting cases of COVID-19, all travellers have to be very vigilant in closely monitoring their health for 14 days after entering Canada. At the first sign of even mild symptoms; stay home,” Tam said. 

If those symptoms develop, Tam says that people should call their local Public Health Office so they can determine if testing for the virus is required. 

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Christine Sinclair on Abby Wambach: ‘She pushed me to levels I didn’t think were possible’


After becoming international soccer’s all-time leading goal scorer, Christine Sinclair spoke about the impact Mia Hamm and Abby Wambach had on her career.

After becoming international soccer’s all-time leading goal scorer, Christine Sinclair spoke about the impact Mia Hamm and Abby Wambach had on her career. 1:10

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Lili Reinhart Has a New Love — But It’s Not What You Think!

Lili Reinhart Has a New Love — But It’s Not What You Think! | Entertainment Tonight

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Dogs may be smarter than we think — and can benefit our health in ways we don’t realize

This is an excerpt from Second Opinion, a weekly roundup of eclectic and under-the-radar health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.

You may think your dog can understand you, and in a way, you’re right.

New research suggests dogs may actually be smarter than we give them credit for and can also have profoundly positive effects on our health.

Researchers from the University of Sussex in Brighton, U.K., analyzed 42 dogs of different breeds and their reactions to specific words that were not commonly used as commands.

The study, published in the journal Biology Letters, found the dogs could differentiate between slight changes in words spoken by humans and also recognize distinct voices of speakers. (Phonetically similar words like “hid, “heard,” or “had,” for example.)

As the dogs became more familiar with the language, they only reacted when they heard a new word, which caused them to perk up and refocus their attention.

A new study suggests dogs can recognize distinct changes in words spoken by humans. Max, a border collie who was part of the study, reacts to specific words in the experiment. Credit: Holly Root-Guttridge/University of Sussex 0:41

“They could recognize a word no matter who was speaking,” said lead author and animal behaviour researcher Holly Root-Gutteridge.

“And they could also use the same cues to recognize who was speaking and could tell when you changed it on them.”

The research concludes that while dogs might not know the actual meaning of a word, they can still identify it — something that was previously thought to be a uniquely human trait.

“It changes our understanding of when human language may have started to evolve,” said Root-Gutteridge.

“It’s still held up by some people that speech is special, that humans are uniquely able to seize and produce these speech sounds, and that it puts us on this kind of special plateau that nobody else can touch — and it chips away at that.

“Dogs can’t produce all of these sounds but they can hear the difference between them.”

How smart is your dog?

It’s commonly thought that dogs are about as intelligent as the average toddler. But while that’s true in some respects, experts say they’re actually smarter than infants in certain ways — but less so in others.

“Infants come into this world with abilities that dogs will never have. And in particular, things like language are very human,” said Dr. Gregory Berns, a neuroscientist at Emory University in Atlanta.

“Dogs, although they can understand some things, are using different mechanisms than humans do.”

For the past eight years, Berns has been training dogs to undergo MRIs and then scanning their brains to understand more about how exactly they think. The research has been published in his 2017 book What It’s Like to Be a Dog.

“One thing we find when we look at their brains is they’re as different from each other as humans are,” he said. “Their brains don’t have the neural real estate to produce and process language like humans do, so what they get out of human speech seems to be a much simpler use of words.”

While dogs can recognize words that they both have and have not heard before, Berns said he has not found evidence that when they hear a word like “bone,” they can conjure up an image of it, like a human can using the visual cortex of the brain.

Though it’s commonly thought that dogs are about as smart as toddlers, experts say they process language much differently. (Full disclosure: This is the author’s dog.) (Evan Mitsui/CBC)

Another difference Berns found between the brains of humans and dogs is how they give weight to language.

“Human infants come out ready to absorb and name things. The first things they say are ‘mama’ and ‘dada’ — those are names of people,” he said.

“Dogs may be the other way around. They may actually have very little use for nouns and names, whereas they much more readily learn actions or verbs, which would probably be more important to their daily life.”

Think “walk.”

What can we learn from dogs?

Dogs may actually help us learn as well.

A recent study published in the journal Anthrozoös from researchers at Brock University and the University of British Columbia (UBC) found therapy dogs may be beneficial in helping motivate kids to read.

They examined the behaviour of 17 students in Grades 1 to 3 in Ontario’s Niagara Region while they read a passage slightly above their reading level, both with and without a dog present.

What they found was that kids were more motivated to read when a dog was in the room.

“They were more likely to read for a longer period of time and enjoy it more when the dog was present,” said Camille Rousseau, study researcher and doctoral student at UBC Okanagan’s school of education.

“Therapy dogs might provide a non-judgmental space and that would allow the children to work through the struggles associated with reading.”

A new Canadian study has found kids were more motivated to read when a dog was in the room. (Submitted by the University of British Columbia)

Rousseau said the dog can act as both a comforting presence for the child and an alternate focus of attention. The result is a more positive experience and more exposure to reading as a whole, which contributes to a growth in literacy.

But could a family dog work in helping a child read? It’s not exactly clear.

“I wouldn’t say just put a dog and a child together [with] a book and just hope for the best,” she said. “I think they do have potential, and if parents trust the dogs at home and trust that educational context, I don’t see a problem.”

Are dogs good for our health?

The short answer is yes, but we don’t exactly know why.

An extensive review of 10 studies comprised of almost 70 years worth of research found that owning a dog was linked to a lower risk of death over the long term.

The review, conducted by researchers at the University of Toronto’s Mount Sinai Hospital and published in the journal Circulation in October, examined the health information of almost four million people.

They found that dog owners had a 24 per cent lower risk of death from any cause over a followup period of 10 years on average, in comparison with people who didn’t own dogs.

And for dog owners who had cardiovascular disease, their risk of death was 65 per cent lower.

“This number is statistically significant and for sure says that somehow dogs are associated with health benefits,” said the study’s lead author and endocrinologist Dr. Caroline Kramer.

Research shows dogs can also have benefits for people with post traumatic stress disorder and depression by providing emotional support, Kramer said.

“There are also studies suggesting that the presence of a dog can lower blood pressure,” she said. “It can be really beneficial.

“So if we look at the whole puzzle, all these pre- and prior studies, plus our analysis, I would say that the evidence is really robust.”

Can we help dogs live longer?

While research shows dogs could help lengthen our lives, scientists are trying to return the favour.

The largest-ever study of aging in canines is currently underway in the U.S. and is examining the health patterns of 10,000 dogs.

Five hundred of them will also test a drug called rapamycin that could help them — and ultimately us — live longer.

University of Washington School of Medicine researcher Daniel Promislow, the principal investigator of the Dog Aging Project grant, sits with his elderly dog Frisbee at their home in Seattle. (Elaine Thompson/The Associated Press)

“What we learn will potentially be good for dogs and has great potential to translate to human health,” project co-director Daniel Promislow, of the University of Washington School of Medicine, told The Associated Press last month.

The National Institute on Aging is funding the $ 23 million US project because dogs and humans share the same environment, get the same diseases and dogs’ shorter lifespans allow for quicker research results.

But when it comes to our relationship with dogs, how they understand us and what they can teach us, we still have a lot to learn, said neuroscientist Berns.

“A lot of us are very interested in them because of what they are: they’re very special in terms of their social abilities and they’re quite unique in their ability to form social bonds,” he said.

“Because we would all obviously like to have friends and social bonds in the kind of ways that dogs seem to excel at. But we haven’t uncovered the secret yet.

“Nobody has.”

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