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How Canada can win a rare Olympic men’s soccer berth

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A big stretch for Canadian soccer kicks off this week

The men’s national program is about to take part in two major regional qualifiers. The Olympic qualifying tournament for North and Central America and the Carribean opens Thursday in Mexico, and the area’s qualifying matches for the 2022 World Cup start next Wednesday in various locations.

We’ll get into the latter in more detail next week, but for now here’s what to know about the Olympic qualifier:

It’s been a while since Canada had a men’s soccer team in the Olympics. We never have to worry about the women’s squad, which will be making its fourth consecutive appearance this summer in Tokyo and trying for its third straight podium finish. But a Canadian men’s team hasn’t qualified since 1984 and hasn’t captured a medal since 1904, when a club team from what is now Cambridge, Ont., won gold in a three-team event. Canada’s only other appearance in the Olympic men’s tournament came in 1976 in Montreal.

The tournament will decide the final two entries for Tokyo. Fourteen of the 16 spots in the Olympic men’s event are already filled. All that’s left are the two allocated to CONCACAF — the governing body for North and Central America and the Carribean. Eight teams will battle for them starting Thursday in Guadalajara and Zapopan, Mexico. They’re divided into two groups, and the top two from each advance to the cross-over semifinals (the top seed in each group plays the No. 2 team in the other). The winners of those semifinal matches, which are on March 28, get to go to the Olympics. A final will be played March 30, but it doesn’t really matter.

Canada is in the softer group — but that doesn’t make it easier to reach the Olympics. Since 1992, when the Olympics started restricting the men’s tournament to players under 23 years old, 13 of the 14 CONCACAF berths have gone to Mexico, the United States and Honduras. Only the latter is in Canada’s group, which is helpful for Canada’s chances of finishing in the top two and advancing to the semifinals. But it also means that, if Canada is able to reach the semis, it will probably have to beat either Mexico or the U.S. in a do-or-die match for a spot in the Olympics. The other two teams in Canada’s group are El Salvador and Haiti, who have a combined one Olympic appearance between them. Canada’s first match is Friday vs. El Salvador, followed by Monday vs. Haiti, then the group-stage finale Thursday, March 25 vs. Honduras.

Canada’s two best players won’t be there. The Olympic age limit could have worked in Canada’s favour because European club-team standouts Alphonso Davies (Bayern Munich) and Jonathan David (Lille) are 20 and 21, respectively. But the qualifying tournament overlaps with the first round of World Cup qualifying, and the Canadian program would rather deploy Davies and David there.

A coronavirus outbreak cost Canada some more potential players. The nine Toronto FC players listed on Canada’s provisional 50-man roster were ruled out of the Olympic qualifier after positive tests at the Major League Soccer team’s training camp. But the final 20-man roster, announced last week, still has nine MLS players — five from the Vancouver Whitecaps, four from CF Montreal — and a few that belong to European club teams. Read more about who’s playing for Canada here.

Canada’s Charles-Andreas Brym currently plays for a Belgian club. (Liza Rosales/Canada Soccer)


Another Canadian won a world-championship medal in freestyle skiing. Edouard Therriault took silver in today’s men’s big air event in Aspen. He joins Mikael Kingsbury (gold in moguls and dual moguls), Simon d’Artois and Rachael Karker (halfpipe silver for both) and Megan Oldham (slopestyle bronze) among the medallists at this year’s worlds, which were held in multiple locations and concluded today. The final snowboarding world-championship events are also today in Aspen. If you’re reading this in time, you can catch the men’s and women’s big air live until 5 p.m. ET here. Canadians Laurie Blouin, Mark McMorris and Max Parrot qualified for the finals and can join Seb Toutant (slopestyle) and Eliot Grondin (snowboard cross) as Canada’s 2021 snowboard world-championship medallists.

The empire struck back. After missing the playoffs for the first time in 12 years and posting a losing record for the first time in 20, the New England Patriots seem very determined to return to power in their second season A.T. (After Tom). Since the NFL’s free-agent negotiating window opened yesterday at noon, the Pats have already reportedly agreed to deals with two playmaking tight ends (Jonnu Smith and Hunter Henry), a good wide receiver (Nelson Agholor), one of the best pass rushers on the market (Matt Judon) and a solid defensive back (Jalen Mills). Getting defensive standouts Dont’a Hightower and Patrick Chung back from their COVID-19 opt-outs should also help, and Bill Belichick is still one of the best head coaches of all time. As long as shaky quarterback Cam Newton can be less of a disaster than he was last year — or the Pats land someone better — New England should be right back in playoff contention.

The best team in the NHL is… the Florida Panthers?! OK, “best” is in the eye of the beholder, but Florida is now No.1 in the overall standings after beating Chicago last night to leapfrog the idle Islanders and Hurricanes. Those teams have won nine and eight in a row, respectively, but the Panthers are on a hot streak of their own, winning four in a row and six of their last seven. This kind of success is not normal for Florida, which hasn’t won a playoff series since its rat-infested run to the Stanley Cup final in 1996. But this shortened season feels pretty wide-open at the moment. Six teams (the others are  defending champion Tampa Bay, Washington and Toronto) are within two points of first place overall.

Only five people have scored more NHL regular-season goals than Alex Ovechkin. He potted his 717th last night in Buffalo, matching Phil Esposito for sixth on the all-time list. The only guys ahead of Ovechkin now are Wayne Gretzky (894), Gordie Howe (801), Jaromir Jagr (766), Brett Hull (741) and Marcel Dionne (731). If Ovechkin plays in all 28 of Washington’s remaining games this season and maintains his 2021 pace of 0.46 goals per game, he’ll finish the campaign a goal or two short of Dionne. But, assuming the NHL returns to a full 82-game schedule next fall, Ovechkin will have a good shot to finish that season ahead of everyone but Gretzky and Howe.

And finally…

It’s getting really bleak in Buffalo. Last night’s 6-0 defeat to Ovechkin’s Capitals was the Sabres’ 11th loss in a row. During this stretch they’ve been shut out four times and outscored by a combined 47-17. Buffalo is now 2-13-2 since returning from its two-week outbreak timeout a month ago, dropping its record this season to 6-17-4 — worst in the league by four points. Also, franchise player Jack Eichel is out indefinitely with an upper-body issue. And, to (literally) add insult to injury, look at the Buffalo News’ latest NHL power rankings:

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Rare Copy of Super Mario Bros. 3 Sets Record With $156,000 Auction Sale

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It’s looking increasingly like next-generation game prices will max out at $ 70 for a blockbuster AAA title. That’s a lot for a game, but at least you get to play it. Someone just spent $ 156,000 on a copy of Super Mario Bros. 3 for the NES that they’ll probably never take out of the box. That makes it the most expensive video game ever sold at auction, surpassing a copy of the original Super Mario Bros. that sold for $ 114,000 a few months ago

In the world of collectible video games, tiny variations in the packaging or printing can make all the difference. A sealed copy of widely available games like Super Mario Bros. might fetch a few hundred dollars today, but some copies have rare features like different seals, alternative box art, and integrated box hangers that were phased out for wide releases. If one of these rare copies is also in good shape, you’re no longer talking about a few hundred dollars; that game is worth tens of thousands at least. 

This copy of Super Mario Bros. 3 ticks all the boxes. It’s one of only a few copies with an early box design that was tweaked early in the game’s life. The “Bros.” part of the title is off to the left on this box, overlapping partially with Mario’s hand. In later printings, that text was moved just right of center in an open area where it didn’t cover any part of Mario. You can see the “regular” box art below. 

The repositioned “Bros.” is what makes this copy of the game (left) so rare.

That change and the lack of a slight 3D effect to the font is all it takes to make this copy of the game incredibly valuable. Another game from this same printing run sold for $ 38,400 a few months ago. That’s impressive, sure, but it’s not a record. The other thing that affects the price of collectible games is the condition. The record-setting copy of SMB3 had a Wata 9.2 A+ quality rating, which means the packaging and seal were like new. The copy from earlier this year only had a 9.0 A rating, which is why it didn’t cross into six figures. 

Heritage Auctions sold the game, having previously made news selling a few other record-setting video games. It opened bidding on the rare copy of SMB3 at $ 62,500. A total of 20 bidders tried to get their hands on the game (but not literally because it lives in a protective case). In the end, an unnamed buyer snagged it for $ 156,000. At this rate, it will probably only be a few months until another video game breaks this record.

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Trump wants schools reopened. He’s getting rare support from virus experts

Donald Trump’s call to reopen schools is winning rare qualified support from a group that’s included some of the U.S. president’s harshest critics: virus experts.

Epidemiologists who have castigated the president’s pandemic handling agree with him that students should be in classrooms this fall.

Several interviewed by CBC News said the evidence favours a safe return to school, though they added caveats about how to do it and about the need to plan it carefully.

They offered that advice while stressing that the president otherwise has little credibility when speaking about COVID-19, which he has repeatedly downplayed, made untrue claims about and promoted unproven treatments for.

On this, they say, he’s got a point.

The debate is of increasingly urgent relevance to parents across the continent, as policy-makers in U.S. states and Canadian provinces weigh different approaches for reopening classrooms in several weeks.

“I’m very, very, very, very, very non-pro-Trump. But this is an issue — it should not be a political thing. It should be based on the science,” said Dr. Michael Silverman, chief of infectious diseases at the Health Sciences Centre in London, Ont.

“And the science says the kids should be going back to school,” said Silverman, who has completed a paper on the topic, now undergoing peer review.

“There is a consensus among the vast majority of us [in this field] that the schools need to open. And they need to open soon.”

The message was similar from two other epidemiologists interviewed by CBC News, as well as the American Academy of Pediatrics.

“In general, I still wouldn’t listen to the president on anything having to do with the coronavirus,” said Dr. Amesh Adalja, an infectious disease physician at the Johns Hopkins Center for Health Security in Baltimore.

“It just happens to be a coincidence that he might have said something that’s backed by epidemiological data in this case.” 

Ashleigh Tuite, an epidemiologist at the Dalla Lana School of Public Health at the University of Toronto, cautioned that areas with serious outbreaks should delay a return, but she said: “Schools should reopen in the fall. I think it’s a priority.”

Trump’s election message

Even as case totals soar across the southern U.S., Trump seems to be keen to campaign for this November’s election on the idea that life is returning to normal.

He has put schools at the centre of that narrative — this week he tweeted repeatedly and held different White House events about reopening.

“The moms want it. The dads want it. The kids want it. It’s time to do it,” Trump said at a White House event on the topic.

“We’re very much going to put pressure on governors — and everybody else — to open schools.”

In a tweet that puzzled public health experts, Trump has even pressured the U.S. Centers for Disease Control and Prevention to be more gung-ho, and he blasted the agency.

The CDC’s recommendations currently include a nine-page checklist for schools on everything from cleaning to distancing practices. 

It also offers guidelines for different regional scenarios, saying places with some virus spread should space desks two metres apart and cancel field trips, while places with more severe spread may want to consider shuttering schools again.

The CDC suggests mask-wearing when feasible and is releasing additional guidelines in a few days.

U.S. federal immunologist Dr. Anthony Fauci said this week that different parts of the country might use different approaches based on their current caseloads. 

But Fauci’s broad message was that the overall damage to children being outside the classroom is outweighing the benefits: “We should try as best as possible to get the children back to school and the schools open.” 

How to reduce risks

Adalja mentioned four things schools can do to reduce the risks of reopening schools: 

  • Have a plan for what to do if cases occur.
  • Allow at-risk school employees with pre-existing medical conditions to work in isolation.
  • Create safer spaces: Open windows and hold classes outdoors when possible; separate desks to the greatest extent possible; and try not to shuffle children between classes. (Tuite suggested using churches or universities to add extra class space.)
  • Make it voluntary: If a family wants children to study at home, let them.

Policy-makers in the U.S. and Canada are examining different approaches for reopening classrooms in several weeks. But many seem to agree that the overall damage to children being outside the classroom is outweighing the benefits. (Jonathon Hayward/The Canadian Press)

There is some disagreement among experts about what to do in the event of a regional spike in cases — a current problem in southern U.S. states.

Adalja said he favours a more aggressive reopening. 

He said he’d be very hesitant to close schools again, even in harder-hit areas. “I was never a major proponent of closing schools because I didn’t think there was strong data to support it.” 

The only reason authorities closed schools this spring, Adalja said, was fear that the virus would act like influenza — dangerous to children and easily spread by them.

But COVID-19 is the opposite, he said. 

Children’s ‘puzzling’ response to COVID-19

There’s no complete consensus yet on children’s low risk of spreading the coronavirus. But Dr. Howard Njoo, Canada’s deputy chief public health officer, said Wednesday that officials are weighing the evidence.

“From the science, what we know is that certainly young people, children, are less likely to have more severe consequences if they do get infected with the virus,” he said.

“It also appears that in terms of transmission, young children — at least in some of the studies I’ve seen — do not appear to be as efficient or effective in terms of transmitting the virus to others..”

Dr. Howard Njoo, Canada’s deputy chief public health officer, pictured on June 25, said Wednesday that officials are weighing the evidence on children’s risk of spreading the coronavirus. (Sean Kilpatrick/The Canadian Press)

Njoo said that aspect was “at the heart of the debate.” In terms of managing risk, “it is a bit of a social experiment,” he said. 

Adalja said children rarely spread, and are rarely seriously harmed by, COVID-19, based on international evidence from daycares used by the children of essential workers in the U.S.; studies in Taiwan, Finland, Denmark and elsewhere; and states that reopened schools.

Silverman said it’s equally true of Canadian provinces, some of which reopened classrooms in the spring, with flexible rules and regional exceptions.

He said Canada has had more than 8,000 adult deaths and no child deaths from COVID-19.  There is ample evidence that children don’t easily spread the virus, he said.

“We have to educate the public…. Understandably the public is very frightened [about reopening schools],” Silverman said.

“[But] the rationale for continuing to keep kids out of school is misguided. More than that, it’s harmful…. Millions of children are being kept out of school to prevent something extremely rare. We’re doing harm to millions of children.”

Researchers at Brown University in Providence, R.I., attempted to estimate the academic impact of closing U.S. schools this past spring. They published a working paper that said students would lose between 32 and 73 per cent of the likely learning gains in math and reading they would normally have achieved in the 2019-20 school year.

The hardest impact would be on poorer and at-risk students, they said.

Different opinions about what to do in places with spikes

As for places like the U.S. South, with a surge in cases, Silverman said he might take a middle-of-the-road approach. For example, he said, elementary schools might stay mostly open, while high schools could mostly shift back to online learning.

Tuite said she would take a slower approach in areas like the southern U.S. 

“I would suggest deferring [reopening],” she said. 

Graphs showing 3-day moving averages of new cases across the U.S. The redder the background, the bigger the upward trend; the greener the background, the bigger the downward trend. (Johns Hopkins University Coronavirus Resource Center)

Tuite provided a rule of thumb to help authorities decide whether to shut down: Are officials able to contact trace the individuals spreading an outbreak? 

She said that’s more useful than setting a number of cases as your benchmark for opening or closing, because raw numbers can be deceiving. 

For instance, 10 new cases found randomly in a community is greater cause for alarm than 10 cases traced to one single event, Tuite said.

“[But if tracing is] not happening, I don’t think you could safely reopen schools,” she said.

Teachers’ concerns

Teachers’ unions are expressing concern about safety.

The largest U.S. teachers’ union said the country hasn’t properly funded efforts to supply protective gear and modify classrooms. 

Other education unions in the U.S. also aren’t happy.

In Canada, Ontario’s largest teachers’ federation sent the provincial government a 37-page document with requests, including the need to respect collective agreement rules on workload and safety issues.

Ontario high school and Catholic teachers’ groups have sent similar requests and said the provincial government has not consulted meaningfully. 

Different provinces are planning different approaches this fall.

Teachers’ unions say they worry they won’t get the safety equipment they need when schools reopen. Here, students in Taiwan in March sit at desks equipped with yellow dividers. (Ann Wang/Reuters)

Quebec, Alberta and Saskatchewan say they’re preparing for a return to near-normal conditions for most age groups. B.C. and New Brunswick envision a hybrid, partial-normal return. Nova Scotia, Manitoba, Newfoundland and Labrador, and Ontario say they’re preparing for three scenarios. Ontario and P.E.I. have asked school boards to map out those different scenarios.

Tuite said policy-makers are right to prepare for different scenarios — including for the need to shut down again.

“It’s not going to be a typical school year,” Tuite said. “You’re probably going to have interruptions.”

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Julia Roberts Shares Rare Photo With Husband Daniel on 18th Wedding Anniversary

Julia Roberts Shares Rare Photo With Husband Daniel on 18th Wedding Anniversary | Entertainment Tonight

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A Rare, Ultra-Bright Star Has Disappeared Without a Trace

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Stars can do a lot of things. They can get warmer, expand, explode, and even collapse into a black hole. They can not, as a rule, simply disappear. However, that’s what appears to have happened to an ultra-bright star in the constellation Aquarius. Astronomers went looking for this well-known star in late 2019 only to find that it was missing. The team has devised several possible explanations, but this is a real head-scratcher. 

Astronomers studied this object in great detail between 2001 and 2011 because it’s no ordinary star. It is (or was?) a very rare type of ancient star called a massive luminous blue variable (LBV). And “luminous” is putting it mildly. The light output varied (as the name implies), but it was about 2.5 million times brighter than the sun on average. That’s the only reason we were able to see it — it resides in the Kinman Dwarf galaxy some 75 million light-years away. 

Last year, the team from Trinity College Dublin had hoped to use the European Southern Observatory’s Very Large Telescope to check in on this object, but it was no longer visible. Had it died? This star was getting on toward the end of its life cycle, which is why it was so interesting in the first place. Yet, a supernova from a dying star would leave evidence, and there was no sign of such an event. 

The researchers have gone back to look at older records of the LBV to come up with some possible explanations. Based on this older data, the team speculates that the star may have been experiencing a strong outburst period the last time astronomers glanced in its direction. That may have ended around 2011, causing the star to become dim enough that we can no longer pick it out from the background that far away. That suggests the LBV could flare up again at any time and become visible. 

A more exciting and speculative hypothesis is that the LBV has indeed bought the farm, but in a way we’ve never seen before. It may have somehow burned itself out and collapsed into a black hole without all the usual telltale signs. If this is true, there should be a black hole with around 100 solar masses lurking in the Kinman Dwarf galaxy. This has the potential to rewrite our understanding of the solar life cycle. 

For now, we’re stuck with speculation. The team hopes to use the ESO’s upcoming Extremely Large Telescope (ELT) to take a closer look and solve this mystery once and for all. That project is currently slated to begin in 2025.

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China scolds India after rare deadly confrontation in Himalayas

China’s foreign minister demanded Wednesday that India punish those behind deadly border clashes between their forces this week, and warned New Delhi not to underestimate Beijing’s determination to safeguard what it considers its sovereign territory.

Wang Yi’s comments came in a telephone call with his Indian counterpart, Subrahmanyam Jaishankar, two days after soldiers from the two sides engaged in fighting along their disputed border in the Himalayan mountains.

Twenty Indian troops were reportedly killed, while it was not clear whether China suffered any casualties. Wang said China demanded India conduct a thorough investigation and “harshly punish” those responsible.

“The Indian side would best not make an incorrect judgment of the situation, would best not underestimate China’s strong determination to safety its sovereign territory,” Wang said in a statement issued by the foreign ministry.

He repeated China’s claims that India was solely responsible for the conflict, saying its forces had crossed the Line of Actual Control that divides the thousands of troops from the sides deployed in the area.

Indian army trucks move along a highway leading to Ladakh on Wednesday. India’s Prime Minister Narendra Modi praised the soldiers who died in the confrontation earlier this week. (Danish Ismail/Reuters)

The statement said Jaishankar explained India’s position, but gave no details, and said New Delhi was committed to talks on reducing tensions.

Indian security forces said neither side fired any shots in the clash in the Ladakh region late Monday that was the first deadly confrontation on the disputed border between India and China since 1975. Some officials said the soldiers were carrying anti-riot gear instead of weapons.

China has not said if any of its troops were injured or killed.

India’s Prime Minister Narendra Modi said the country would be proud that the Indian soldiers died while fighting.

“Their sacrifices wouldn’t go to waste. For us, the unity and sovereignty of the country is the most important. India wants peace but when provoked, it is capable of giving a fitting reply be it any kind of situation,” he said.

India’s Defence Minister Rajnath Singh tweeted that the loss of soldiers in the Galwan Valley is “deeply disturbing and painful.”

A group of protesters gathered near the Chinese Embassy in the Indian capital condemning the killing of the soldiers and demanding a ban on Chinese goods. They carried placards with photographs of Chinese President Xi Jinping, his face crossed out, and the Chinese army.

A small group of retired Indian army personnel also marched close to the embassy with placards reading “Chinese army down down,” but they were detained by police.

Zhao, the Chinese spokesperson, repeated Chinese claims that the clashes erupted after Indian forces “provoked and attacked Chinese personnel, which lead to fears, physical confrontation between the two sides’ border troops and resulted in casualties.”

Long-standing border tensions

An official Communist Party newspaper said the clash occurred because India misjudged the Chinese army’s strength and willingness to respond. The Global Times, which often reflects nationalistic views within the party’s leadership, said China did not disclose whether it had casualties in the skirmish to avoid comparisons and prevent further escalation.

While experts said the two nations were unlikely to head into a war, they also believe easing tensions quickly will be difficult.

“This will likely be a watershed moment in India-China relations and the geopolitics of the Indo-Pacific,” said Abraham Denmark, Asia program director at The Wilson Center.

“We’ve already seen the deadliest clash on the China-India border in over 50 years, both countries are led by men who have embraced nationalism, and both countries are facing tremendous domestic and international upheaval as a result of COVID-19 and other long-standing problems.”

The main questions now are if either side can find a path to de-escalation and whether India’s allies such as the United States will help.

“It is a highly volatile and dangerous situation between two nationalistic, nuclear powers at a time when American influence has badly diminished,” Denmark said.

The editorial published in the Global Times on Wednesday said India’s reaction was largely due to encouragement from the U.S., China’s chief strategic rival which has been steadily building relations with India’s military.

“The arrogance and recklessness of the Indian side is the main reason for the consistent tensions along China-India borders,” the editorial said. China “does not and will not create conflicts, but it fears no conflicts either.”

China claims about 90,000 square kilometres of territory in India’s northeast, while India says China occupies 38,000 square kilometres of its territory in the Aksai Chin Plateau in the Himalayas, a contiguous part of the Ladakh region.

India unilaterally declared Ladakh a federal territory while separating it from disputed Kashmir in August 2019. China was among the handful of countries to strongly condemn the move, raising it at international forums, including the UN Security Council.

Thousands of soldiers on both sides have faced off for over a month along a remote stretch of the 3,380-kilometre Line of Actual Control, the border established following a war between India and China in 1962 that resulted in an uneasy truce.

Manner of death still unclear

The Indian army said three soldiers died initially. The 17 others died after being “critically injured in the line of duty and exposed to sub-zero temperatures in the high-altitude terrain,” it said in a statement Tuesday that did not disclose the nature of the soldiers’ injuries.

The troops fought each other with fists and rocks, Indian security officials said on condition of anonymity because they were not authorized to disclose the information.

After the clash, the two sides “disengaged” from the area where the the fighting happened, the Indian army statement said.

The United Nations urged both sides “to exercise maximum restraint.”

“We are concerned about reports of violence and deaths at the Line of Actual Control between India and China,” UN associate spokesperson Eri Kaneko said. “We take positive note of reports that the two countries have engaged to de-escalate the situation.”

Michael Kugelman, a South Asia specialist at the Wilson Center, said the two countries were unlikely to go to war because they cannot “afford a conflict.”

“But let’s be clear: It beggars belief to think that they can magically de-escalate after a deadly exchange with such a high number of fatalities,” he said. “This crisis isn’t ending anytime soon.”

The tense standoff started in early May, when Indian officials said that Chinese soldiers crossed the boundary in Ladakh at three different points, erecting tents and guard posts and ignoring verbal warnings to leave. That triggered shouting matches, stone-throwing and fistfights, much of it replayed on television news channels and social media.

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WHO backtracks on claim that asymptomatic spread of COVID-19 is ‘very rare’

A top official with the World Health Organization has walked back statements that the spread of COVID-19 from people who do not show symptoms is “very rare,” amid backlash from experts who have questioned the claim due to a lack of data. 

Maria van Kerkhove, an infectious disease epidemiologist and the COVID-19 technical lead for the WHO, said Monday that the available data from published research and member countries had shown asymptomatic cases were not a significant driver for the spread of the virus. 

“From the data we have, it still seems to be rare that an asymptomatic person actually transmits onward to a secondary individual,” she said at a media briefing in Geneva on Monday. “It’s very rare.”

On Tuesday, Van Kerkhove aimed to clear up “misunderstandings” about those statements in an updated briefing, stressing that she was referring to “very few studies” that tried to follow asymptomatic carriers of the virus over time to see how many additional people were infected. 

“I was responding to a question at the press conference, I wasn’t stating a policy of WHO,” she said. “I was just trying to articulate what we know.” 

Van Kerkhove said she didn’t intend to imply that asymptomatic transmission of the virus globally was “very rare,” but rather that the available data based on modelling studies and member countries had not been able to provide a clear enough picture on the amount of asymptomatic transmission.

“That’s a big, open question,” she said. “But we do know that some people who are asymptomatic, some people who don’t have symptoms, can transmit the virus on.”

WHO did ‘questionable job’ of communicating

Dr. Isaac Bogoch, an infectious disease physician at Toronto General Hospital, said there has been confusion over the evolving science on the amount of asymptomatic transmission since the start of the pandemic.

“At a fundamental level it’s extremely important to explain the science well and explain what our current knowledge is and also explain what the unknown questions are,” he said.

“I don’t think the WHO did a very good job of that yesterday and they did a questionable job of that today when they were trying to clarify their comments.” 

Bogoch said there is a key discrepancy between people who do not have symptoms, those who have not yet shown symptoms and those who only have mild symptoms, which can make studying the true amount of asymptomatic carriers of COVID-19 extremely challenging. 

“We still don’t understand the role of people who have no symptoms the entire time [they’re infected] versus people that have very, very mild symptoms that are misclassified as having no symptoms, versus people that have no symptoms for the first few days and then go on to develop them,” he said. 

“So, when we heard the WHO say that people without symptoms rarely transmit this infection, an eyebrow went up, because we certainly know that there are different types of people without symptoms and it’s a little more complicated than what they had reported.”

Some experts say it is not uncommon for infected people to show no symptoms, but data is sparse on how likely such people are to transmit the disease. (Evan Mitsui/CBC)

Timothy Caulfield, a Canada Research Chair in health law and policy at the University of Alberta who studies health misinformation, said it was notable how quickly van Kerkhove’s statement was criticized and shows how desperate people are for clear information on asymptomatic carriers of COVID-19. 

“It demonstrates how incredibly important it is to take great care in how you’re communicating science that is hyper-relevant to the public right now,” Caulfield said, adding we still don’t have a clear picture from the research community on how much asymptomatic spread is actually occurring. “The science is very uncertain and it’s evolving rapidly.”

He said van Kerkhove didn’t appear to have the intention of making a definitive statement on behalf of the WHO in her comments on Monday, and instead was speculating about her interpretation of the emerging research on the topic. 

“This is exactly the World Health Organization’s job, right? This is why they exist: to lead the world in these moments,” he said. “So when it’s less than ideal, it’s not surprising that people are critical. We need [WHO] to be a trusted voice.” 

Data on asymptomatic spread ‘flawed’

Some experts say it is not uncommon for infected people to show no symptoms.

A non-peer-reviewed study from Germany in May based on 919 people in the district of Heinsberg — which had among the highest death tolls from COVID-19 in Germany — found that about one in five of those infected were symptomless.

But data is sparse on how likely such people are to transmit the disease.

The co-head of Singapore’s coronavirus task force told Reuters on Monday there had been asymptomatic transmission cases there, between people living in close quarters.

China said last week that 300 symptomless COVID-19 carriers in the central city of Wuhan, the pandemic’s epicentre, had not been found to be infectious.

Dr. Lynora Saxinger, an infectious disease physician at the University of Alberta who has been reviewing the available literature on the topic, said studying asymptomatic transmission is extremely difficult. 

WATCH | How many asymptomatic people could there be?

Doctors answer your questions about the coronavirus, including if there’s any way of knowing how many asymptomatic people could be walking around when only symptomatic people are being tested.  4:20

Van Kerkhove was referencing modelling data that estimated anywhere between six per cent and 41 per cent of the population may be infected but not have symptoms.

Saxinger said that modelling data is “flawed” because it makes assumptions about how many people are asymptomatic and then runs a simulation on how many people could then transmit it.

“There’s a big question mark at the actual data in real-world observations with asymptomatic [carriers],” Saxinger said.

“Asymptomatic spread is a dumpster fire in terms of data.”

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Doctors investigate rare COVID-19 symptoms in bid to move from anecdotes to science

Dry cough, fever and difficulty breathing are the most common symptoms of COVID-19, but specialists are starting to learn more about less common potential symptoms such as loss of one’s sense of smell, disorientation and even seizures.

Some doctors are trying to understand how widespread these symptoms are in order to assist with diagnosing patients.

Dr. Sherry Chou, a Canadian neurologist at the University of Pittsburgh Medical School with training in critical care and strokes, said it’s important to know whether a small portion of patients with COVID-19 present with neurological symptoms rather than fever or cough.

“We need to figure that out as quickly as we can because we need to know to screen those patients for COVID-19,” Chou said.

Effective screening is an important way to slow the spread of the virus, which has killed more than 420 Canadians

Patients with neurological symptoms would also require different treatment than those with respiratory symptoms, Chou said.

What a team of specialists is looking for

To learn more, Chou is leading a team of investigators from the Neurocritical Care Society, an international organization of health-care providers based in Chicago whose goal is to improve outcomes for patients with life-threatening brain and spinal cord injuries.

The specialists caution the research is at an early, hypothesis stage and they still need to find out specifically how the pandemic virus affects the neurological system, or whether, for example, such symptoms simply result from low oxygen levels in the blood.

Deborah Copaken, an author in New York, has been sick with COVID-19 since March 18. Her main symptom is not being able to take a deep breath. She said she’s exhausted and was prescribed a nebulizer and inhaler to help with her breathing.

Then, on March 23, Copaken decided to reorganize her spice rack.

“I started taking the spices out of their old containers and putting them in new containers and I realized I had to label the containers quickly because I couldn’t smell anything,” Copaken recalled in an interview. “I couldn’t differentiate between, say, basil and herbs de Provence. All the green spices smell the same.”

Her husband and youngest son were also infected. Their symptoms were a bit different.

Copaken said her husband endured three days of intense fever and was unable to get out of bed. He also had diarrhea — another of the less common symptoms that have caught the attention of researchers.

Her 13-year-old son lost his senses of taste and smell and ate less than normal for a few days but was otherwise fine, she said.

WATCH | B.C. patient with COVID-19 describes her breathing troubles:

B.C. resident Erin Leigh, 38, is recovering from the novel coronavirus in hospital. She told CBC News she had never experienced an illness like COVID-19. 7:00

In another case, Kym Murphy of New Brunswick experienced a painful headache and fatigue.

“I was shocked that it came back positive,” Murphy said of her COVID-19 test in Saint John. “I didn’t have the fever. I didn’t have the shortness of breath. I didn’t have the coughing, but I just felt that there was something not right.”

In Italy, where there have been more than 135,000 cases, physicians set up separate units to treat patients with COVID-19 who also have neurological symptoms that resemble a type of encephalitis, which is an inflammation of the brain that is more common as a rare complication of influenza or flu in children.

Encephalitis can have many underlying causes such as viral or bacterial infections. 

Chou cautioned it is too soon to comment on what neurologists are seeing with COVID-19 because the numbers are so small.

CT scan for stroke 

Dr. Erin O’Connor is an emergency room physician at Toronto General Hospital, where she said they’re seeing some suspected COVID-19 patients who have respiratory symptoms as well as nausea and other stomach discomfort and difficulty with their senses of smell and taste.

WATCH | Ontario man describes his hospitalization and recovery:

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“It seems to be more of a loss of sense of smell without having the runny nose and the blocked nose at the same time,” O’Connor said. 

She said there are anecdotes circulating in the medical community about how stroke-like symptoms could also be an indication of COVID-19 as well.

“All of our patients who present with stroke symptoms we’re testing and we’re actually doing … CT scans on their test as well to look for signs of COVID infections,” O’Connor said.

The U.S. Centers for Disease Control and Prevention lists emergency warning signs associated with severe cases of COVID-19 that warrant immediate medical attention. They include:

The agency cautioned the list is not all inclusive and people are advised to consult a health-care provider for any other symptoms that are severe or concerning.

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‘An emerging malignancy’: Cancer linked to these breast implants no longer ‘rare’, data suggests

A cancer in women with textured breast implants is more widespread than previously believed, raising questions for patients and physicians about continuing to describe it as “rare.”

As of Dec. 20, 2019, Health Canada said it had received 106 reports describing “breast implant-associated anaplastic large cell lymphoma (BIA-ALCL),” including both confirmed and suspected cases. Of those, 52 were received since May 28, 2019.

That’s double the 26 confirmed Canadian cases the regulator said it had received before last May

“Two incident reports received after May 28, 2019 cite the outcome of death suspected to be associated with BIA-ALCL but those have yet to be confirmed,” Health Canada said in an email in response to questions from CBC News.

Health Canada describes BIA-ALCL on its website as “a serious but rare” type of non-Hodgkin’s lymphoma (a cancer that affects the immune system) that may develop many months or years after a breast implant procedure.

On May 28, 2019, the agency officially banned the sale and import of Biocell macrotextured breast implants produced by the company Allergan, due to an increased risk of BIA-ALCL associated with their use.

Karen Malkin-Lazarovitz says as soon as she heard her breast implants were associated with a type of lymphoma, she wanted them removed. (Submitted by Karen Malkin-Lazarovitz)

Karen Malkin-Lazarovitz, 45, of Montreal had a preventative double mastectomy because she has a BRCA2 mutation that increases the risk of ovarian and breast cancer. A surgeon then rebuilt her breasts using Biocell textured implants.

I think the numbers that we’re getting from Health Canada are really scary, even worldwide, because they’re changing so quickly.– Dr. Julia Khanna, plastic surgeon

“I removed my healthy breasts to not get cancer when I started hearing murmuring that these textured implants are dangerous,” Malkin-Lazarovitz said. “I knew from that moment I didn’t want them anymore.”

In May, Health Canada estimated the risk of developing BIA-ALCL is about one in 3,500. The estimate is a rough one given there’s no centralized system to track the number of confirmed cases or implanted patients.

Dr. Julia Khanna, a plastic surgeon in Oakville, Ont., first started using textured implants in her practice in 1999 and stopped using them in 2016. Since last May, Khanna’s been inundated with calls from patients looking for information.

“I think the numbers that we’re getting from Health Canada are really scary, even worldwide, because they’re changing so quickly,” Khanna said.

Dr. Peter Cordeiro, a reconstructive breast surgeon at Memorial Sloan Kettering Cancer Center in New York, estimated from his patients that the cancer was 10 times more prevalent that the official statistics.

Cordeiro reviewed the files of every textured implant patient he’d operated on since 1992.

“What’s been the experience of 3,546 patients?” Cordeira said at the 1st World Consensus Conference on BIA-ALCL in Rome last October. “Ten now have BIA-ALCL. I’ve submitted this data

Dr. Julia Khanna, a plastic surgeon in Oakville, Ont., is concerned with how the number of cases of BIA-ALCL is changing so quickly. (CBC)

At the same conference, Dr. Mark Clemens, an associate professor of plastic surgery at the University of Texas MD Anderson Cancer Center, titled his talk “Key Concepts on an Uncommon and Emerging Malignancy.”

“You notice I’m using a different word choice than you’re used to hearing about this disease. Usually rare, extremely rare,” Clemens said. “Instead, I think that we need to start referring to this as uncommon and an emerging malignancy.” Clemens disclosed that he was a consultant to Allergan up until 2015.

Cordeiro and Clemens were not available for interviews.

‘No way to diagnose cancer’

Terri McGregor, 55, of North Bay, Ont., had eight rounds of chemotherapy after she was diagnosed with BIA-ALCL in 2015 and continues to receive follow-up for a secondary cancer. A routine mammogram at age 50 had ruptured her Biocell textured implants, which surgeons had to remove along with scar tissue, called the capsule.

McGregor attended the conference and is concerned about the consequences of describing BIA-ALCL as rare.

“We have women in Canada presenting symptoms to their physician, and the physician is telling them that they don’t have cancer and … that they should get on with their lives because of the word rare,” McGregor said.

“What I will tell you is, [for] every single diagnosed woman I know there was a little bit of luck involved in that she landed at the right time and right place — and that is no way to diagnose cancer.”

Despite the growing number of cases, Health Canada and surgeons warn patients against removing textured implants unless they’ve tested positive for cancer because the removals are so risky.

Khanna said no medical organization in the world recommends removing the capsule, the natural scar tissue that forms around the implant, because it’s not a benign procedure and carries risk such as bleeding from major blood vessels.

Malkin-Lazarovitz had a terrible rash and itchiness for about a year that she believes were connected to the implants. She had the implants removed four months ago.

Health Canada said the new total could be revised downward, as it includes unconfirmed reports of lymphoma, and there could be double counting reports linked to a single patient.

Last year, a joint investigation by CBC News, Radio-Canada, the Toronto Star and the Washington-based International Consortium of Investigative Journalists found that deaths and serious injuries potentially tied to breast implants and other medical devices are underreported in many countries, including Canada.

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