Monday, August 3, 2020

Ontario moves to a Swedish style pandemic response - Shhh don't tell anyone

When Sweden opted to avoid stringent emergency measures many were shocked and surprised.  The Swede's didn't take a completely laissez faire approach, but compared to countries like Canada it sure seemed that way.  

Gatherings of more than 50 people were banned, bars and restaurants remained open but patrons had to be seated.  School for younger grades remained open, while students attending high school and up were taught on-line.  Businesses were not forced to close down, but working from home was encouraged.  Those older and/or vulnerable were encouraged to isolate themselves.  

With all of Ontario now in phase 3 and schools slated to be up and running again in another month, it sure looks like a Swedish style response to the writer of this miserable and pathetic little blog.  There are some differences, minor ones in my opinion.  Basically everywhere in Ontario now requires masks to be worn indoors while in Sweden it is strictly optional.  Students in older grades will be required to mask up, with younger students being strongly encouraged but not mandated in my home province. High schools here will be open in some cases,  depending on the region.  

The stated goal of the Swedish response was that any measures brought in would have to be sustainable over the long term.  The reality of SARS-Cov-2 is that it could very well be with us for years, perhaps permanently.  While there is encouraging news on a possible vaccine it's still a long way off, and ultimately one may never be developed.  Even if there is success a vaccine could end up providing only a limited effectiveness.  

A secondary and hoped for benefit of more relaxed measures was the possibility of herd immunity, with some arguing that was Sweden's primary goal all along.  

So now that we've moved in this direction what should we expect.  I believe it goes without saying that the number of cases is going to climb substantially.   By bringing in more stringent lockdown type measures, (closing schools, forcing businesses to shut down, banning gatherings of 5+ people) Ontario has managed to limit the degree of viral spread and has seen a lower death toll than Sweden.  Now though, with the clamps coming off so to speak, it only stands to reason that the potential for viral spread is going to increase.

Sweden is a country of about 10.2 million, smaller than Ontario's ~14.5 million.  Sweden though is much more densely populated at 25 people per square km compared to Ontario where it's just a little over 14 per sq km.  Sweden has seen 568 Covid deaths per million of population, Ontario's death toll is nearing 2,800 putting deaths per million around 193 by comparison.  

With all that being said my own thoroughly non expert opinion is that Ontario won't suffer as bad as Sweden did.  In Canada we've been living in a state of emergency for 4+ months now, people are very sensitized to the threat of covid.  Sweden by contrast, especially at the start, I think it's reasonable to assume that many Swede's likely thought it wasn't a huge deal given the more relaxed response.  

Ultimately what matters is the burden placed on the health care system.  Ontario has about 500 hospitals province wide, and at the peak in April Covid patients needing hospital treatment only numbered a little over 1,000.  Now that's down to less than 100 with just 26 in ICU and 14 of the critical care patients on a ventilator as of the most recent update.

Bottom line is we can't stay locked down forever.  Having 1+ million Ontarians out of work and on government welfare has negative health implication as well, health and wealth are not mutually exclusive.  Schools are also essential to the well being and health of Ontario's youth, to say nothing of all the other support networks for marginalized and vulnerable people.  Covid didn't erase the problems we were already dealing with, and ignoring them has made many bad situations even worse.  

Sweden in my view decided to rip the band aid off quickly, while in Canada and Ontario we opted to do it slow, extending the pain over many months.  Now we've obviously decided it's time to rip it off finally.  In my opinion better late than never.  

Wednesday, July 22, 2020

Young partiers could be said to be following expert medical advice....

Eighteen of Canada's leading medical authorites recently signed an open letter to Canada's political leadership, both at the national and provincial levels.  Among the eighteen is Dr. David Butler-Jones, Canada's first Chief Public Health Officer, someone with an actual medical degree.  

There is a letter portion and also a statement.  The letter portion contains these thoughts:

The Statement portion includes this:

It seems many young people have gotten the message about getting on with their lives.  Many are getting back to doing what countless generations have done in summers past, they're getting together and having a good time.  

This doesn't sit well with Doug Ford, which is something I find incredibly ironic given the Premier's own history when he was a young man in Etobicoke. Anyone unfamiliar with the Premier's colourful history is welcome to read about it in an excellent Globe & Mail exposé.  It should be noted that Doug Ford threatened to sue the Globe for false reporting, but never followed up on the threat.  

Someone like Doug Ford, with a history of ignorning the rules, now telling young people not to do what young people have done for ages, oh puh-lease.   And I'm not talking about dealing illegal drugs here, just about getting together and having a good time...maybe even passing the dutchie now that it's allowed.  

The sobering part of the advice being offered by leading experts in the medical field is in the words "true level of risk".  

While much has been said about trying to keep everyone from getting infected with SARS-Cov-2, the fact is well known to most that certain individuals are at far greater risk than others.  People with a host of conditions including diabetes, cardiovascular and kidney diseases, basically any conditions affecting the lung and/or heart are at much greater risk of Covid-19 being serious and potentially fatal.  There are other statiscially significant contributing factors like Vitamin D deficiency, having a blood Type of A, obesity and autoimmune disorders such as Lupus.

I hope the young people gathering are aware of the factors that can make Covid serious and potentially deadly.  And that they're staying home if they themself are at risk, and staying away from others for whom Covid is potentially lethal.  I'm not naive though, expecting there to be no mistakes would be like expecting people to wear cloth masks properly without touching the outside material....

The bottom line being that Covid-19 is not an equal opportunity disease, it is not the major health risk for younger healthy people that it is for those who are older or with compromised health, put the two together and the risk is even greater.

I've been equating our ridiculous response to one of the Toronto Island ferries sinking with 100 passengers on board, but only 10 flotation devices.  The way we're dealing with Covid now is akin to cutting each of the flotation devices into 10 separate pieces and giving each ferry passenger their little useless chunk.  Obviously the smarter course of action would be to identify those unable to swim and to give them the whole flotation device and to not give them to those who are strong swimmers.  

Of course smart and public policy are something of an oxymoron a lot of the time, and now is a prime example.  

Sunday, July 19, 2020

Ontario moving into the personal responsibility stage....finally

As of  Friday July 17th many parts of Ontario moved into Phase 3 of re-opening. Geographically it is most of the province, however with the GTA as well as the Windsor and Niagara Regions not included most of the provinces population is still in Phase 2.  

All I can say is FINALLY!!!  

In my, (not always so) humble opinion this should have happened long ago, like at the start of June.  But as is often said, better late than never.  The author of this miserable and pathetic little blog is fortunate to be living in a Phase 3 area, which means I can now dine in at a restaraunt or go inside a bar to hoist a pint and numerous other activities, if I so choose.  And therein lies the most important part, choice.  I guess you could say that I'm a Pro-Choice kind of guy.

As everyone knows, the reason emergency measures were brought in was in order to "flatten the curve" and to save our health care system from being overwhelmed.  That never happened, Ontario is a province of ~14.5 million without about 500 hospitals across the health care network.  Back on June 1 there were less than 800 Covid patients being treated in all of Ontario Hospitals, and only 118 patients in ICUs with 90 of them on ventilators.  

Ontario never came close to the nightmare "best case" scenario Ontario Premier Doug Ford told us was forecast by the computer modelled simulations he was given to base decisions on.  Ontario was supposed to be looking at 1,300 patients in ICU critical care beds, and again that was if we did really well with social distancing and all the rest.  In other words if thousands of tickets weren't handed out to people for things like get togethers and back yard parties, if "yahoos" didn't protest lockdown measures at Queen's Park, if there weren't massive 10,000 person gatherings at a park like Trinity Bellwood, and no large BLM demonstrations.  All these activities were supposed to make it even worse.  Yet even with all those supposedly horrendous acts we never even got close to the forecasted numbers.

So now we're finally moving into what I'm calling the personal responsibility stage.  Businesses that had to sit back and watch the Wal-Marts, and Amazons of the world remain open despite outbreaks in their locations, now finally have a chance to try and stave of bankruptcy.  Sadly for many it's already too late, they've shuttered their doors and will never re-open.  

Maybe they could have stayed open and done a better job of preventing outbreaks than all the supposedly essential workplaces that were allowed to stay open regardless.  That is now a moot point of course, those businesses that have managed to survive despite forced closure can now at least try to salvage something including people's livelihoods.

To those who are losing their minds, terrified that Ontario will turn into disaster areas like New York and New Jersey which lead the U.S. in Covid deaths on a per capita basis....relax.  You do not have to patronize any business unless you want to.  If you don't think indoor restaraunt dining should be allowed, then don't go, it's not rocket science.  And the same goes for bars, gyms, movie theatres or anything else.  

I do  expect we're going to see case numbers and hospitalization numbers climb, perhaps as high as they were back at the start of June.  But that isn't that high in a province of Ontario's size with the number of hosptials we have.  Let's face it, SARS-Cov-2 is going to be with us for a long time yet, we can't stay hunkered down for years hoping on a vaccine that ultimately may never come.  And even if a vaccine is developed it is very possible it could be no more effective than the seasonal flu shot.  Even with a vaccine 8,511 Canadians are reported to have died of influenza in 2018 as per StatsCan, the #6 leading cause of death that year.

It strikes me that reasoned thinking is finally starting to gain some traction in spite of all the fear and panic.  Eighteen esteemed medical experts, including Canada's first Chief Public Health Officer (this one with an actual medical degree) have signed a joint letter speaking to what I have been advocating since the start, that Canada as a whole needs to start managing Covid instead of trying to eliminate it.  Micromanaging human behaviour in an effort to stamp out a virus has always been an exercise akin to herding cats.  

I know some will ignore the letter, but for those who are still capable of critical thinking here's the link:  

Wednesday, July 15, 2020

Will a second wave cause another panic?

Before I get rolling with this post I want to provide some persepctive.  Putting a situation in its proper context is not covering up the truth, it is the truth.  These are the top 10 causes of death as per Statistics Canada for the year 2018, the most recent year for which numbers are available:
  1. Cancer - 79,536 deaths
  2. Heart Disease - 53,134
  3. Stroke - 13,480
  4. Unintentionl Accidents - 13,290
  5. Chronic lower respitory diseases - 12,998
  6. Influenza and Pneumonia - 8,511
  7. Diabetes - 6,794
  8. Alzheimers - 6,429
  9. Self Harm Suicide - 3,811
  10. Kidney related disease - 3,615

Over 287,000 Canadians died in 2018, in 2017 the number was over 282,000 and in 2016 over 274,000 people died.  Without going into detailed statistical analysis I think it's fairly safe to say that over 290,000 people were likely to die in Canada during the year 2020 before the pandemic.

That's a lot of death, but it is something Canadians have accepted year after year.  Could we do something to mitigate this loss of human life?  Certainly, banning smoking would undoubtedly reduce numbers 1 and 2 and likely impact number 5.  Banning the sale of deep fried food and putting a strong focus on healthy living and exercise would likely reduce many of the other categories as well.  

But we've never even seriously discussed banning smoking in this country.  Canadians have always accepted the fact that people die.  Even if some deaths could be prevented, nothing much has ever been done about it.  We certainly never turned our entire world upside down.  Until Covid-19 came along of course, a disease that has claimed the lives of almost 8,800 Canadians so far and climbing, putting it just ahead of deaths from flu/inluenza in 2018.  

Did SARS-Cov-2 cause most to panic?  In my opinion, unquestionably.  And for many the panic has never ceased.  

Tossing millions of Canadians out of work, cancelling life saving procedures like cardiac surgery and cancer screenings, shuttering schools forcing young children to isolate at home with out of work anxious parents, all while declaring the sale of booze essential.  I don't think you need a PHD in the social sciences to know that this is a recipe for a tsunami of health problems, especially when so many support networks were also shut down. 

I have to wonder how Covid is going to affect the numbers when it comes to death from other causes for 2020.  Given that so many of the top 10 causes of death in this country are listed as contributing factors to Covid being serious and potentially fatal, I will not be surprised if deaths from: cancer, heart disease, strokes, lower respitory illness, flu/pneumonia, diabetes, alzheimers and kidney dieseas dips lower for 2020.  Toronto's health department has publicly declared that a heart disease patient who dies after a heart attack is listed as a Covid death if there's a positive test for SARS-Cov-2.   

With around 80% of our deaths coming from Long Term Care Type facilities it makes sense that death from other diseases/conditions will likely drop when you consider the health of people in these nursing home establishments.  Ontario's Long Term Care Association provides a snapshot of the overall health of residents from the year 2019 and it is not a pretty picture.  

I can't say I really blame people for being hyper concerned about Covid, even more than we worry about death from accidents despite accidents killing far more Canadians than Covid has.  We'd need over 4,000 more Covid deaths to reach a year's worth of accidental deaths in this country.  And who knows, maybe Covid will prove to be as deadly as accidents typically are in any given year.  

The reason I don't blame people is because we've never seen this kind of laser like focus from government and media on one disease ever before.  Imagine if every news broadcast led off with a report of over 200 people dying of cancer, and another 150 dying of heart disease in one single day.  A lot of Canadians would probably be scared into pursuing healthier lifestyles.

I know I am farting into a hurricane here.  It reminds me very much of the Iraq war when so many of my friends and acquaintances were all in on the need to eliminate Iraq's Weapons of Mass Destruction: "Are you an intelligence expert?  I'm smart and listen to what they say".  I wasn't, I joined the small minority of people outside the U.S. consulate in Toronto and protested.  And lest you think Canada didn't support that war, do some reading about the number of Canadian military personnel who were sent over to assist.  

Death sucks, everyone is against it.  But someone dying of Covid-19 is not more dead than someone who is killed in a car accident, or from conditions like cancer or heart disease or anything else.  The emergency measures employed have enormous health consequences as well.  Just because the news isn't giving a daily suicide report doesn't mean it isn't happening.  If you know someone in law enforcement ask them what they're seeing.  

Some are losing their minds at the prospect of schools opening back up in September, but these same regrettable virtue signallers have never said a word about shutting down Amazon fulfillment centres, Wal-Marts and grocery stores, or about having hydro workers and ISP techincians stay home instead of maintaining the grid and internet connectivity.  So long as "THEIR" needs are being met to heck with young children, just suck it up little ones.  

Bottom line is that we are the government, we are not ruled...people are the rulers in a democratic society.  And for now we've abdicated that role, scared into submission by one branch of science, elected politicians and their media moutpieces.  Epidemiolgits and infectious disease experts don't study the causes of depression and suicide, they're not schooled in the horrors of spousal and child abuse, they have ideas and theories about how to slow the spread of a virus, not about the impact of cancelling life saving hosptial procedures like bypass surgery.  

Canada needs Captain Kirk at the helm, not Dr. Mckoy.  Those who like living in the kind of country Canada is turning into should pack up and move to China or North Korea, they would feel right at home.