Saturday, May 23, 2020

Long term sustainable pandemic measures need to be decided upon now....

What a mess.  

Like many I'm overdosing on all things Covid.  Given that I'm in Ontario Canada I'm going to focus my remarks on the situation to my home country and province for the most part. 

One thing is crystal clear, Ontario's health care system is at the breaking point.  

We already knew this of course, the novel coronavirus has merely put this reality front and centre.  Even before the pandemic the term 'hallway medicine' was a campaign issue.  Ontario's hospitals didn't have the capacity or funding to deal with current health care needs let alone an outbreak of a new virus.  

A report by the prestigious Imperial College of London was predicing that a country of Canada's size could expect ~200,000 deaths, with critical care space in hospitals being exceeded eight times over.  Non pharmaceutical Interventions (NPIs) could mitigate the death toll, cutting it by half, but hospitals were still excpected to be overrun. 

In order to prepare for the anticipated surge in Covid-19 cases Ontario's health ministry chose to sacrifice other patients.  The old and sick were moved out of hospitals and into Long Term Care facilities, people needing vital cardiac surgeries were told they'd have to wait, same for people needing life saving cancer screenings.  

And in an effort to reduce the number of cases mitigation was employed, so called lockdown measures designed to reduce the number of infections.  Like many I now know about things like R0 or R naught, the basic reproduction number, how many people will get the virus from a single infected person.  Its almost like a large swath of the Canadian population has now taken Infectious Disease 101.  

And for the most part, it seems to have worked.  Unlike places like northern Italy and NYC there are no stories of Canadian hospitals being overwhelmed.  In fact there's been reporting that many Canadian hospitals are operating far below normal capacity.  CTV ran a story on April 30th with this headline:  

I'm not one who is given to drawing cause and effect relationships, they're too simplisitic.  But with that being sad I do think its more than reasonable to assume that lockdown measures did help to limit the spread of this virus and helped our healthcare system cope.  

But its come with one helluva price tag.

3+ million Canadians have gone from being gainfully employed taxpayers to relying on government welfare.  Schools have closed their doors, chruches are no longer meeting, in person services for the mentally ill and other vulnerable sectors have stopped.  We're seeing reports of a looming mental health pandemic.  Talk to law enforcement about the number of suicides they're seeing, as well as cases of domestic violence and abuse.  And let's not forget all the aforementioned patients wating for vital and life saving medical care that were indefinitiely postponed.  

Things are bad.  Its almost like the Titanic in my mind.  Before hitting the coronavirus iceberg life was pretty darned sweet.  Then it was time to get in the lifeboats, but there weren't enough of them.  Some people had to be left in the freezing cold waters of the North Atlantic.  

Those of us in these metaphorical lifeboats don't have all the wonderful things we had on the ship, but at least we're safe and secure.  Most people are still earning a living, still able to put food on the table and pay their rent/mortgage and utility bills.  Those in the freezing water are worried about losing their housing, feeding their kids, having enough money to keep the lights on.  But if we go to rescue them they'll swamp the lifeboats with Covid and we'll all get dragged down.


The efforts to slow the spread are at least as bad as the virus itself, if not worse....and perhaps much worse.  Canada isn't alone, most every developed country in the world has responded in similar fashion and the resulting slowdown in the global economy has UN hunger experts predicting a global famine of biblical proportions.  We could be seeing hundreds of thousands of people dying each and every day for about three months starting later this year, many of them young children.

The novel coronavirus isn't going away anytime soon, and it may never go away.  Every day there's encouraging news about potential vaccines, but this normally takes years, and success is not assured.  

I for one am not too keen on being injected with any agent that was rushed to market, we've been down that road before and it hasn't ended well, science takes time.  

Are we prepared to stay locked down for a year and quite possibly longer?  I don't think so.  Thankfully Ontario, like many other jurisidictions is starting to ease up.  Some businesses are being allowed to re-open, people can go to public parks again, just not on the playground equipment, golfers and tennis players can swing their clubs and raquets once more.  

Will this lead to an increase in cases?  I imagine it will, but more importantly will it lead to hospitals being overwhelmed?  I don't know the answer, I haven't seen any information put out that indicates what the capacity is like in our hospitals to cope with Covid-19 cases.  

According to a CTV story published on Friday May 22nd there are currently 961 patients in Ontario hospitals being treated for Covid, 153 of whom are in ICU with 120 on ventilators.  Given that we're opening up with these numbers I'm assuming that our hospitals can shoulder at least this load.  Can they handle more, and if so how much more?  

This is the data I'm going to be looking at most going forward.  So long as our hospitals are not being pushed beyond their capacity to cope, then in my view we have to start steering the lifeboats into the freezing waters where so many people were tossed aside.   

1 comment:

Anonymous said...

This link is to my favourite observer and commenter on world affairs, and for some years at that. He bases it all on his deep knowledge of history. An American from the South who escaped that quagmire, who went to Europe, taught in Germany and retired to Portugal recently at only 60.

Diving into his stuff at the deep end is a bit daunting. He's wry in an academic way. He assumes you have at least some clue, so his writing is condensed. The article I'm linking is his latest, which I read four times to fully get the gist. It eventually involves Covid-19 and social distancing (faschion dressing with masks), so hang in there because I sense you might appreciate it. If you don't, well no harm, no foul. Death is the new thing being pushed by the western global cabal, a initial trial for population control. Death of close interaction as we all remain trussed up at home by government and distanced "for our own good and for not over-running hospitals".

If you can get through that, there's many more articles in his inventory. He makes me think and reflect a lot, and realize how superficially we face each new "disaster", never going back to the fundamentals of the way our society was formed and has played out. We tend to look only at today and miss the reasons why we are played like instruments. Every new generation thinks it's the first ever to have faced a bad situation, and disregards the history, that's for old fuddy-duddies and on a superficial level may well be true. But what about beyond the top present layer we all tend to default to?

Slightly different topic. I'm an engineer myself and wonder at all the Covid-19 graphs on various sites that never seem to get down to brass tacks. All these epidemiologists employed as public health officials seem to have had the same textbook and courses, whether in the UK, Canada or the US. It's a bit too opaque for me. They're not engineers, just like economists aren't. We used to make merry hell for the econ profs at university who happily slapped "graphs" up on the board, but had no practical mathematical clue, so we used to wonder at the supposed conclusions drawn. Wouldn't have got them a Bachelor of Engineering, that sloppy thinking. In many ways quite laughable. Newly minted PhD economists don't like being questioned by third year lamentables like engineering students on basics they never grasped.