Saturday, November 20, 2021

Aside from vaccination, mask-wearing seems the most effective tool for combating COVID-19, a major study suggests


Dr. Catherine Schuster-Bruce
Fri, November 19, 2021

Mask-wearing reduced COVID-19 incidence by 53%, a large study found.
CHANDAN KHANNA/AFP via Getty Images

Mask-wearing seems the best public health measure for fighting COVID-19, according to a large analysis.


Hand-washing and social distancing could also reduce the number of new COVID-19 cases, the study authors said.


The researchers bemoaned a lack of quality data on quarantine, lockdowns, and school closures.


Mask-wearing seems to be the most effective public health measure for combating the coronavirus, according to a large global analysis that found it reduced COVID-19 incidence by 53%.

Hand-washing and physical distancingcould also reduce the number of new COVID-19 cases, according to the analysis published in the British Medical Journal (BMJ) Thursday.

The scientists, from the UK, Australia, and China, analyzed more than 70 published studies from across the world that examined non-pharmaceutical public health interventions. Vaccines are proven to be highly effective at stopping people catching COVID-19 but the effects of other public health measures is less clear.

The scientists said they were unable to draw firm conclusions about the effectiveness of quarantine and isolation, universal lockdowns, and closures of borders, schools, and workplaces, because the studies were so diverse.

Paul Glasziou, director of the Institute for Evidence-Based Healthcare at Australia's Bond University, said in a BMJ editorial that "uncertainties and controversies" around the effects of public health measures and "lack of investment" — at just 4% of global COVID-19 research funding — was "puzzling" given their "central importance" in controlling the pandemic.

Glasziou said the "most striking" finding was that the study authors identified only one randomized controlled trial for mask-wearing — the type of trial considered to provide the best evidence. Meanwhile, hundreds of trials have been completed for COVID-19 drug treatments, he said.

Dr. Baptiste Leurent, assistant professor in medical statistics at London School of Hygiene and Tropical Medicine, said in a statement to the Science Media Centre that the researched published Thursday was probably the best available regarding the effects of public health measures on COVID-19 transmission.

However, the accuracy of the findings from this type of research relies on the quality of studies it analyzes.

Laurent cautioned that "nearly all" the evidence in the review was based on a type of study that shows a link between an intervention and outcome, without necessarily proving causation. "Caution is needed when trying to put a single number to their effectiveness," he said.

The authors of the study said that controlling COVID-19 "depends not only on high vaccination coverage and its effectiveness but also on ongoing adherence to effective and sustainable public health measures."

Once enough people are vaccinated, new research will be needed to discover how well public health measures work, they said.
New research offers glimpse into early human development


Research released Wednesday, Nov. 17, 2021 in the journal Nature provides a rare glimpse of an early stage of human development. This image from Oxford University shows a human embryo 16-19 days after fertilization. The embryo is undergoing a process called gastrulation, when different cell types are generated and distributed to specific places in the embryo. (University of Oxford via AP)

LAURA UNGAR
Wed, November 17, 2021

Scientists have been able to get a rare glimpse into a crucial, early stage of human development by analyzing an embryo in its third week after fertilization — a moment in time that has been difficult to study because of both practical and ethical considerations.

European researchers looked at a single embryo that was 16 to 19 days old, donated by a woman who ended her pregnancy. Until now, experts said, researchers have lacked a full understanding of this stage of development because human embryos at this stage are difficult to obtain. Most women don’t yet know they’re pregnant by this point and decades-old global guidelines have until recently prohibited growing human embryos in a lab beyond 14 days.

The study, published online Wednesday in the journal Nature, looked at “gastrulation,” which begins about 14 days after fertilization, when the embryo is still about the size of a poppy seed, and lasts a little more than a week.

It’s “a process by which you have this kind of explosion of cell diversity,” said lead investigator Shankar Srinivas, an expert in developmental biology at the University of Oxford, who worked with colleagues in the United Kingdom and Germany on the research. “It’s during gastrulation that the different cells emerge, but they also start to be positioned in different places in forming the body so that they can carry out their functions and form the correct organs.”

For decades, the so-called “14-day rule" on growing embryos in the lab has guided researchers, with some places, including the United Kingdom, writing it into law. Others, including the United States, have accepted it as a standard guiding scientists and regulators.

Earlier this year, the International Society for Stem Cell Research recommended relaxing the rule and allowing researchers to grow embryos past two weeks under limited circumstances and after a tough review process. But the rule remains law in the UK.

This research was not subject to the law because the embryo wasn't grown in a lab. But it is an example of the types of things scientists expect to learn more about if rules are relaxed. Researchers found various types of cells, including red blood cells and “primordial germ cells” that give rise to egg or sperm cells. But they didn’t see neurons, Srinivas said, meaning embryos aren’t equipped at this stage to sense their environment.

Oxford University officials said this stage of development has never been fully mapped out in humans before.

The authors said they hope their work not only sheds light on this stage of development but also helps scientists learn from nature about how to make stem cells into particular types of cells that can be used to help heal damage or disease.

Robin Lovell-Badge, a stem cell expert at London’s Francis Crick Institute who chaired the group behind the guidelines, said being able to culture human embryos beyond 14 days “would be incredibly important to understand not just how we develop normally but how things go wrong.”

It’s very common for embryos to fail during gastrulation or shortly afterwards, he said. “If things go even slightly wrong, you end up with congenital abnormalities, or the embryo miscarries.”

Dr. Daniel Sulmasy, director of the Kennedy Institute of Ethics at Georgetown University, said “those of us who are morally conservative” always thought the 14-day rule was somewhat arbitrary, “but at least it was some recognition of the humanness of the embryo.”

With the new recommendation, there will be more research on older embryos, he said. “Part of what science does is to always try to go forward and learn things that are new. And that continues to be a pressure. But the mere fact that we can do something is not sufficient to say that we ought to do it.”

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

Lungfish cocoon found to be living antimicrobial tissue

Lungfish cocoon found to be living antimicrobial tissue
Graphic drawing showing a proposed model for cocoon formation in African lungfish.
Free-swimming lungfish skin is characterized by a columnar mucosal epithelium. 
(A) Large numbers of multipotent stem cells with alkaline phosphatase activity (fig. S1)
 can be observed at the interphase between the epidermis and the dermis.
 Granulocyte deposits in the tissue reservoirs of free-swimming lungfish become mobilized
 to the skin via peripheral circulation when lungfish begin to sense lack of food and water. 
(B) Skin remodeling begins, with increasing numbers of granulocytes infiltrating the dermal
 and epidermal layers resulting in loosening of the basal membrane and inflammation. 
(C) The cocoon then starts to form by detachment and shedding of the inflamed 
epidermis. Many granulocytes are part of the cocoon, and they produce ETs in response to 
the high microbial load. Epithelial cells, goblet cells, and antimicrobial peptides (AMPs) 
are also present in the cocoon. The pool of stem cells starts to regenerate the epidermis,
 while granulocytes continue to arrive from reservoirs maintaining an inflammatory state. 
(D) In the next stages of estivation (end of the induction phase), the lungfish skin shows 
complete flattening of the epidermis and goblet cell exhaustion. The cocoon has several
 layers derived from multiple rounds of epidermal shedding and regeneration, and stem 
cell numbers are severely reduced. Granulocytes in the cocoon continue to undergo
 ETosis and are still elevated in the epidermis and dermis compared to free-swimming 
controls. It is unknown whether the cocoon continues to thicken beyond 2 weeks afte
terrestrialization. This illustration was created in BioRender. eDNA, extracellular DNA. 
Credit: DOI: 10.1126/sciadv.abj0829

A team of researchers from the University of New Mexico, the University of California and the University of Murcia has found that the cocoon created by lungfish living in dry lakebeds in Africa is made of living antimicrobial tissue. They've published the results of their study in the journal Science Advances.

Lungfish live in parts of Africa in  that tend to go dry when it does not rain for a long time. When this happens, the  create a  around themselves using mucus. The purpose of the cocoon is to protect the lungfish from drying out as it waits for wetter conditions to return. In this new effort, the researchers have found that there is more to the cocoon than previously thought.

Until now, researchers believed the cocoon was simply a shell casing of sorts, with no purpose other than to prevent moisture from escaping under the hot African sun. Now, it appears the cocoon is not only alive, but is made of antimicrobial tissue.

To learn more about the lungfish and its cocoon, the researchers began an analysis of its makeup in 2018. They found granulocyte (white blood cell) markers that migrated during the time when the lungfish was waiting for water to return. More recently, the  has taken a closer look and found that the cocoon was chock full of granulocytes. They also found that they migrated from the skin into the cocoon on a slow, continual basis—a finding that showed the cocoon was much more than just dry mucus; it was a living part of the lungfish.

Imaging showed the granulocytes create traps that immobilize bacteria. When the researchers removed such traps from several specimens, they found the lungfish became susceptible to skin infections and circulating bacteria that are known to lead to septicemia. They also found that some of the infections led to hemorrhage. The researchers suggest that the cocoon protects the lungfish from more than just heat and sun—it also protects them from infections.

Fossil expands ancient fish family tree

More information: Ryan Darby Heimroth et al, The lungfish cocoon is a living tissue with antimicrobial functions, Science Advances (2021). DOI: 10.1126/sciadv.abj0829

Journal information: Science Advances 

© 2021 Science X Network

Moonshot: Japan recruits first new astronauts in 13 years

Successful applicants will be trained as astronauts by JAXA
Successful applicants will be trained as astronauts by JAXA.

It's one small step for Japan, but one giant opportunity for would-be space cadets: the country is recruiting new astronauts for the first time in over a decade and applicants no longer have to hold a science degree.

Women are strongly encouraged to put themselves forward for the job, the Japan Aerospace Exploration Agency (JAXA) said, as all seven of the nation's current astronauts are men.

Successful applicants, who must be Japanese, will be trained and sent on missions—potentially to the Moon, the Lunar Gateway or the International Space Station.

"We want to establish a (recruiting) system that matches the current ," JAXA's Kazuyoshi Kawasaki said at a media briefing.

"Previously we limited candidates to those with a natural , but many of us agreed to make it not a requirement."

However, written exams will include university-level questions on science, technology, engineering and maths, with the applicants' English ability also tested.

JAXA said it will accept applications between December 20 and March 4—the first time it has offered positions for rookie astronauts in 13 years.

This time around, they are looking to recruit "a few"  with at least three years of workplace experience.

There is no age requirement or  and the agency has lowered its height requirement to 149.5 centimetres (4.9 feet).

One of Japan's current crew is Akihiko Hoshide, 52, who returned to Earth from the International Space Station earlier this month in a SpaceX craft.SpaceX launches 53 Starlink satellites into orbit


© 2021 AFP

Storyboards for doomed ‘Dune’ film up for auction
AFP
-November 20, 2021 6:25 PM
Surreal: Dali, Jagger and Pink Floyd were lined up for Jodorowsky’s failed 1970s adaptation of Frank Herbert’s space-opera classic. (AFP pic)

PARIS: It has entered film folklore as one of the great missed opportunities: the doomed 1970s adaptation of “Dune” that was supposed to bring together Salvador Dali, Mick Jagger and Pink Floyd.

The project famously collapsed after four years of work by cult Franco-Chilean director Alejandro Jodorowsky, but now his storyboards are going up for auction in Paris on Monday.

With a new version of “Dune” starring Timothee Chalamet packing cinemas around the world in recent weeks, interest in Jodorowsky’s version has been reignited and Christie’s is valuing the drawings at 25,000 to 35,000 euros ($28,000 to $40,000).


They are collected in one large notebook, and were made by celebrated French graphic novelist Moebius (alias Jean Giraud, who died in 2012) and Swiss illustrator Giger, who went on to design “Alien” in 1979 and died in 2014.

The tumultuous project was due to include surrealist Dali, Rolling Stones frontman Jagger, actor-director Orson Welles and silver screen legend Gloria Swanson in the cast, with Pink Floyd among the bands approached for the soundtrack.


It collapsed for lack of funding – a story retold in the 2013 documentary “Jodorowsky’s Dune”.

The brainchild of author Frank Herbert, “Dune” was first published in 1965 and became a six-volume space opera of massive influence, not least on “Star Wars”.

Following the latter’s blockbuster success, Hollywood took renewed interest in “Dune” in the early 1980s.

That led to David Lynch’s version, released in 1984 with a cast including British musician Sting and Patrick Stewart of “Star Trek: Next Generation”, which had its own troubles and became one of the decade’s biggest flops.

Jodorowsky’s storyboards have taken on mythical overtones among sci-fi fans – said to have influenced later genre hits including “Blade Runner”.

“We know of several other copies: one was offered for auction several years ago, another is in Jodorowsky’s possession… A third has been partially reproduced online,” said Christie’s.

It said around 10 to 20 copies were produced, though it was hard to be certain.



Hundreds protest in Sudan ahead of planned mass anti-coup demos




Hundreds protest in Sudan ahead of planned mass anti-coup demosSudanese security forces have cracked down on protesters, as seen in this photograph from November 13 in Khartoum, where they fired teargas 

Sat, November 20, 2021

Hundreds of Sudanese anti-coup demonstrators rallied Saturday to denounce a deadly crackdown which medics say has left 40 people dead since last month's military takeover, a day before planned mass protests.

The United States and African Union condemned the deadly crackdown on protesters and called on Sudan's leaders to refrain from the "excessive use of force".

Sudan's top general Abdel Fattah al-Burhan on October 25 declared a state of emergency, ousted the government and detained the civilian leadership.


The military takeover upended a two-year transition to civilian rule, drew international condemnation and punitive measures, and provoked large protests.

Demonstrations on Wednesday were the deadliest so far, with a toll of 16 killed after a teenager who had been shot died, medics said.

The independent Central Committee of Sudanese Doctors said the 16-year-old had been shot "by live rounds to the head and the leg".

Hundreds of protesters rallied against the military in North Khartoum, putting up barricades and setting tyres on fire, an AFP correspondent said. Other protesters took to the streets in east and south Khartoum, according to witnesses.

They chanted "no, no to military rule" and called for "civilian rule".

During the unrest in North Khartoum, a police station was set on fire, the correspondent said.

Pro-democracy activists made online calls for mass anti-coup protests with a "million-strong march" to take place on Sunday.



- 'Treachery and betrayal' -

Security forces and protesters traded blame for the torching of the police station.

Police spokesman Idris Soliman accused an unidentified "group of people" of setting it on fire.

But North Khartoum's resistance committee claimed the police was responsible.

"Police forces withdrew from the station... and after members of the police carried out acts of sabotage," it said in a statement.

"We accuse clearly and explicitly the military establishment for causing this chaos," added the committee, part of informal groups which emerged during 2018-2019 protests that ousted president Omar al-Bashir in April 2019.

Most of those killed on Wednesday were in North Khartoum, which lies across the Nile river from the capital, medics said.

On Saturday, Sudanese authorities said an investigation into the killings would be launched.

Dozens of protesters also rallied Saturday to mourn the latest deaths, demanding "retribution" and a transition to civilian rule.

Protesters also took to the streets of Khartoum's twin-city Omdurman to denounce the killings, chanting "down with the (ruling) council of treachery and betrayal".

Police officials deny using any live ammunition and insist they have used "minimum force" to disperse the protests. They have recorded only one death, among demonstrators in North Khartoum.

On Friday, police forces sporadically fired tear gas until late at night to disperse demonstrators who had rallied in North Khartoum, witnesses said.

The Sudanese Professionals Association, an umbrella of unions which were instrumental in the months-long demonstrations that led to Bashir's ouster, said security forces has also "stormed homes and mosques".

An AFP correspondent said police forces also frisked passers-by and carried out identification checks.



- 'Abuses and violations' -


The US and African Union denounced the deadly crackdown.

"We call for those responsible for human rights abuses and violations, including the excessive use of force against peaceful protesters, to be held accountable," US State Department spokesman Ned Price said.

"In advance of upcoming protests, we call on Sudanese authorities to use restraint and allow peaceful demonstrations."

The African Union, which suspended Sudan after the coup, condemned "in the strongest terms" Wednesday's violence.

AU Commission chair Moussa Faki Mahamat called on Sudan's authorities "to restore constitutional order and the democratic transition" in line with a 2019 power-sharing deal between the military and the now-deposed civilian figures.

The Committee to Protect Journalists called for the release of reporters detained while covering anti-coup protests including Ali Farsab who it said was beaten, shot, and detained by security forces on Wednesday.

"Sudanese security forces' shooting and beating of journalist Ali Farsab make a mockery of the coup government's alleged commitment to a democratic transitional phase in the country," said the CPJ's Sherif Mansour.

Sudan has a long history of military coups, enjoying only rare interludes of democratic rule since independence in 1956.

Burhan insists the military's move "was not a coup" but a step "to rectify the transition" as factional infighting and splits deepened between civilians and the military under the now-deposed government.

He has since announced a new ruling council in which he kept his position as head, along with a powerful paramilitary commander, three senior military figures, three ex-rebel leaders and one civilian.

But the other four civilian members were replaced with lesser known figures.

bur/hkb
AFP
Ethiopia hails return of looted artefacts

a "great injustice" that has been a thorn in relations with Britain.

In Summary

•Ethiopia, one of the world's oldest countries with a rich and ancient cultural and religious heritage, has said it considers the ransacking of Magdala a "great injustice" that has been a thorn in relations with Britain.

•Most of the items were plundered by the British army after it defeated Emperor Tewodros II in the Battle of Magdala in 1868 in what was then Abyssinia.


Ethiopia's Minister of Tourism Nasise Challi speaks during a handover ceremony of the collection of Ethiopian precious artefacts looted by British soldiers more than 150 years ago, at the National Museum in Addis Ababa, Ethiopia, on November 20, 2021.
Image: Amanuel Sileshi / AFP


Ethiopia on Saturday hailed the return of precious artefacts looted by British soldiers more than 150 years ago, after a long campaign for their restitution.

The collection -- recovered from Britain, Belgium and the Netherlands -- includes a ceremonial crown, an imperial shield, a set of silver-embossed horn drinking cups, a handwritten prayer book, crosses and a necklace.

Most of the items were plundered by the British army after it defeated Emperor Tewodros II in the Battle of Magdala in 1868 in what was then Abyssinia.

The treasures were unwrapped before the media at Ethiopia's national museum on Saturday, more than two months after they were formally handed over at a ceremony in London in September.

Ethiopia said it was the largest such repatriation of artefects to the country, with its ambassador to Britain, Teferi Melesse, describing it as of "huge significance".

Calls have long been mounting in Africa for Western countries to return their colonial spoils, with many prized national treasures held abroad in museums or sometimes private collections.

Earlier this month, the West African state of Benin welcomed back nearly 30 royal treasures seized during France's rule more than 130 years ago.

- 'Great injustice' -The Ethiopian government is still fighting for Britain to return other stolen artefacts including sacred wooden and stone tabots or tablets, which represent the Ark of the Covenant.

The tabots are housed in the British Museum in London -- which has a vast trove of foreign treasures -- but have never been put on public display.


Staff carry boxes containing recovered items to be on display at the National Museum as Ethiopia hailed the return of precious artefacts looted by British soldiers more than 150 years ago in Addis Ababa, Ethiopia, on November 20, 2021.
Image: Amanuel Sileshi /AFP

Ethiopia is also seeking the remains of Tewodros' son Prince Alemayehu who was taken to Britain after the emperor committed suicide following his battlefield defeat.

"A variety of artefacts which are a legacy of our culture and values were looted during the battle and taken out of the country illegally," said Tourism Minister Nasise Challi.

"Countless of our artefacts are found in various museums, research centres and in the hands of private individuals," she said at Saturday's event, appealing for their return.

Ethiopia, one of the world's oldest countries with a rich and ancient cultural and religious heritage, has said it considers the ransacking of Magdala a "great injustice" that has been a thorn in relations with Britain.

Several of the returned items were due to be auctioned but were bought by the non-profit Scheherazade Foundation with the aim of repatriation. Others were acquired from private dealers or investors.

Among them was a set of mediaeval manuscripts dating back to before the 18th century, which had been due to be auctioned in the Hague.

Ethiopia is also negotiating for the return of a bible and cross that were set for the auction block in the United States.

"These restitutions are taking place in a global context where the role of museums in portraying colonial histories and the legitimacy of displaying looted artefacts is being questioned," Ethiopia's National Heritage Restitution Committee said in a statement in September.
Portland, Ore., police declare riot in Kyle Rittenhouse protests

Nov. 20 (UPI) -- Law enforcement officials in Portland, Ore., declared a riot after dozens of people protested near the Justice Center against the verdict in the Kyle Rittenhouse trial in Wisconsin.

The demonstrators called for gun control reforms and a federal investigation into the case Friday night. The Oregonian reported about 100 people gathered near the Multnomah County Justice Center to protest the verdict, while KOIN-TV in Portland put the figure at closer to 200.

Both news outlets said protesters began breaking windows, damaging municipal buildings and throwing objects at officers, prompting the Portland Police Department and the Multnomah County Sheriff's Office to both declare a riot.

Chris Liedle, a representative with the sheriff's office, said protesters attempted to tamper with a gate at the Justice Center. The protesters threw "urine, alcoholic beverages, water bottles and batteries" at police, Liedle said.

One protester was arrested on an existing warrant and another criminally cited.

The protests came after a Wisconsin jury acquitted Rittenhouse on homicide charges for shooting three people -- two of them fatally -- during protests against the shooting of Jacob Black in Kenosha, Wis., in 2020. The city of Portland has been involved in racial justice protests, particularly over the past couple years.

"Here in Portland especially it's reasonable to expect there will be some type of reaction to the verdict" in Kenosha, Portland police Chief Chuck Lovell said Friday. "We're supportive of peaceful protests, people exercising their First Amendment rights."

WISN-TV in Milwaukee, Wis., reported that a peaceful gathering of community activists took place in Kenosha after the verdict was read.

Hannah Gittings, the girlfriend of Anthony Huber, one of the men killed by Rittenhouse, said she misses him "every single day."

"I just want the city of Kenosha to understand ... that nobody here is ever going to stop. No one here is going to stop attempting to expose the flaws in the system," she said.

Death toll rises to 4 in British Columbia flooding


An aerial photo shows damage from flooding on a highway in British Columbia, Canada. 
Photo courtesy of Ministry of Transportation and Infrastructure/EPA-EFE

Nov. 20 (UPI) -- The death toll from torrential rains, flooding and mudslides in Canada's westernmost province, British Columbia, has risen to four people.

The bodies of three men were recovered from a mudslide on Duffy Lake Road, federal police confirmed Saturday, bringing the death toll to four after a woman's body was also recovered on Monday.

One of the male bodies was recovered on Wednesday and two more were recovered on Thursday, according to a statement from Lisa Lapointe, British Columbia's chief coroner.

Lapointe added that a forensic team also tried to locate a fifth missing person Friday, who they were unable to, the Vancouver Sun reported.

"Despite incredibly challenging conditions, the dedication and teamwork demonstrated by everyone involved in the search are a testament to the professionalism of each organization, and I wish to recognize the significant efforts of our partners throughout this difficult time," Lapointe said. "I also extend my heartfelt condolences to the families who are now grieving the sudden and unexpected death of their loved one, and to the family of the missing person we have so far been unable to locate."

Other roads impacted by the landslides this week included Coquihalla, and Highway 7, where 275 people were trapped in their vehicles between two slides before a helicopter rescue.

Premier John Horgan declared a state of emergency Wednesday, explaining in a press conference that the once-in-a-500-year natural disaster has devastated entire communities, forced thousands to evacuate, and road closures and mudslides stranded others.

The extreme weather also impacted supply chains.

The state of emergency was expected to last at least two weeks to help with rebuilding.

Prime Minister Justin Trudeau said Thursday military personnel were deployed to assist in the rescue and rebuilding efforts.
Doctors calling on Canadian government to take action against abusive treatment

CTV News Edmonton
Updated Nov. 18, 2021 

Dr. Alika Lafontaine in Grande Prairie, Alta., says he's been scratched, spit on, swung at and called a bad father at work.

The abuse, he says, comes from patients or their families, and sometimes random people on the internet, whose stress could be exacerbated by a health concern or the pandemic.

"When you come through those hospital doors, I recognize that in lots of ways I'm your lifeline and gateway to better health. And because of that, I personally always had a very high threshold for these types of incidents and situations. I think my colleagues, as well," he told CTV News Edmonton in an interview on Thursday.

The Canadian Medical Association says is asking the Canadian government for protection from those they are helping.

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"We do know when protests were happening outside hospitals not too long ago, that there were objects that were thrown. People were shoved. Other incidents that would be classified as physical violence in all other settings," Lafontaine said.

Specifically, the CMA wants the Liberals to follow through on a promise to legislate protections for hospitals and hospital workers. The association believes creating a new offence in the Criminal Code would disincentivize harassment, threats and violence by the public.

"Just because you walk onto hospital grounds or in hospital doors, the expectation should be that you act the same way as you would just interacting with an average Canadian," Lafontaine told CTV News Edmonton.

The CMA has no hard data about the frequency of these types of incidents.

In a study published earlier in the year, one in four American physicians reported being attacked on social media in 2019.

A related factor is that abusive treatment isn't recorded as often as it occurs, the CMA believes. Not only is it -- as Lafontaine himself said -- considered a part of the job, there is no clear mechanism to report and address a problem without fear of retaliation.

The Grande Prairie doctor says he knows colleagues who have shut down their social media accounts or created anonymous profiles because of online harassment, and others who avoid certain topics for fear of how patients will react.

"That doesn't happen in isolation. All these things kind of collect and aggregate together until they spill over into real world incidents that actually cause great harm," Lafontaine said.

"Threats of violence -- whether real or perceived -- are just another layer that will eventually lead to providers walking away from their jobs, changing the character of the type of clinical care that they provide. These are the types of things we can't afford in the midst of all these parallel crises."

Lafontaine says the CMA has heard positive feedback from the federal justice ministry, lending hope a change will soon be included in the legislative agenda.

In a statement, the press secretary of Canada's minister of justice and attorney general reiterated the government was committed to making it illegal to both block access to a health facility and intimidate or threaten health-care workers.

"We are currently looking at all options to make that promise a reality as soon as possible," Chantalle Aubertin wrote.

"There is absolutely no place for intimidation or threats to our hardworking health care workers and anyone seeking health services, particularly at hospitals and clinics."

The CMA is also asking websites like Twitter, Facebook and LinkedIn to develop a plan to combat the harassment and threats that take place on their platforms.

"At the end of the day, protecting health providers is really about helping and protecting patients, as well," Lafontaine said.

With files from CTV News Edmonton's Amanda Anderson