This is an excerpt from Second Opinion, a weekly roundup of eclectic and under-the-radar health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.
Stay home. Do nothing. Save lives.
That might well end up being the story of how Canada conquered the terrible pandemic of 2020.
While Italy and other countries waited to act until cases were flooding hospitals, Canada has a chance to get out ahead of the COVID-19 crisis, according to the researchers who have been watching the coronavirus wreak deadly havoc around the world.
“We can’t afford to wait until we see how bad it is,” said Dr. David Fisman, a University of Toronto epidemiologist. “That just means that you’ve missed the boat.”
But social distancing is one of the most challenging things many Canadians have ever been asked to do.
Up close, it’s messy. As schools close and events are cancelled, it looks like a society in retreat.
But in fact, it’s a society taking control of a situation — a country pulling together in a collective effort to head off disaster.
One Toronto critical care physician published an open letter Thursday warning that this is Canada’s one brief chance to change the course of this epidemic.
Thanks for posting. I hope other <a href=”https://twitter.com/hashtag/physicians?src=hash&ref_src=twsrc%5Etfw”>#physicians</a> have sent something similar. This is no time for incrementalism. Politicians are inching us towards the degree of <a href=”https://twitter.com/hashtag/SocialDistancing?src=hash&ref_src=twsrc%5Etfw”>#SocialDistancing</a> required. To slow down the progress of <a href=”https://twitter.com/hashtag/COVID19?src=hash&ref_src=twsrc%5Etfw”>#COVID19</a> we all need to <a href=”https://twitter.com/hashtag/ShutItDown?src=hash&ref_src=twsrc%5Etfw”>#ShutItDown</a> now. <a href=”https://t.co/9qoyXCQvt4″>https://t.co/9qoyXCQvt4</a>
“I simply want you to know that the COVID-19 situation is dire and may soon be completely out of control,” wrote Dr. Michael Warner, the head of the ICU at the Michael Garron Hospital in Toronto.
He wrote a cri de coeur and sent it to 200 colleagues and his Twitter followers with the hope that it might reach people in time to make a difference.
“We have some time before the surge in patients hits Canada,” he said. “At least one week or longer.”
Warner said he wrote it while he still had the time.
“Two weeks from now I’m going to be too busy to do anything but work.”
His message is blunt:
- Avoid all close contact with people unless necessary.
- Never shake hands.
- Cancel/avoid all travel.
“The only hope to slow the virus is based on community behaviour — that’s you, your neighbour, your family…everyone,” he wrote.
“The current risk to the individual remains low, but the risk to society is immeasurable. I implore you to follow these recommendations to slow the spread of the virus.
“Begin social distancing NOW — do not wait for a politician to tell you it is necessary.”
‘We have to shut this down’
Fisman, of U of T’s Dalla Lana School of Public Health, said he almost shed tears of relief when he heard that Ontario announced Thursday it was closing its schools for three weeks.
He got the news while visiting some colleagues in an ICU, dreading the impending crisis and the risks that his friends could soon be facing.
“I feel a great sense of relief that we’re starting to get it,” he said, adding that Canada might just be learning from the mistakes made by other countries. “If you wait until things are bad, you’ve waited too long.”
“We have to really shut this down in order not to have our health care system collapse in the way we’re seeing in other countries. The time to do this is now.”
Fisman has been following the outbreak since early January, when the world first heard about a new coronavirus circulating in China. He calculates that the time to act is before critically ill patients start flooding hospitals.
He calculates the disease progression this way: It takes about five days (on average) from infection to first symptoms, and about seven more days for the infected person to get sick enough to see a doctor.
Add another three days at least before patients become critically ill and end up in the ICU.
Italy learned the hard way, waiting for those first ICU cases before testing for the coronavirus and then shutting down the country. Now horrific stories about overwhelmed hospitals are shocking Canadians into action.
Warner said the stories coming out of Italy prompted his letter.
“Patients are dying. Resources are being rationed. Non-COVID patients with treatable disease are not getting treated,” he said. “I’m not scared of disease and getting sick. I’m scared of not being able to help people.”
‘Hell demon of a virus’
Other lessons Canada still has time to learn: the coronavirus loves a crowd. Church groups, cruises, large medical conferences — all have seeded outbreaks.
“That’s how this hell demon of a virus operates,” said Fisman. “I think we have time because we’re not in the soup yet.”
Canada’s cases are growing, but so far hospitals are not yet reporting large numbers of critically ill patients.
That’s why the country is in the midst of a surreal and unprecedented experience of watching major sporting events cancelled, jury trials postponed, theatres postponing performances and social events disappearing from the calendar one by one.
“None of us has lived through a time like this,” said Fisman, who said the closest comparison is probably the 1918 Spanish flu pandemic. And studies of that experience can also guide behaviour now.
One 2007 study comparing Spanish flu in two U.S. cities is suddenly getting wide circulation.
Philadelphia allowed a large parade to happen even though the city already had cases of the Spanish flu. St Louis imposed social distancing within three days of the first cases, dramatically reducing the city’s death rate.
Is it all an over-reaction? That’s something that will only be decided in hindsight.
“I think only retrospectively will we know if it was the right time, but I think we have to use science to guide us,” said Warner. “We have enough science from China and Italy to inform us of what appropriate decisions to make.”
If the social distancing experiment works, and Canada slows the viral spread, the experts say the skeptics might have the last laugh after all.
Fisman hopes the people who call this an over-reaction will be able to gloat in six months.
Because that will mean Canada successfully dodged the worst of the COVID-19 pandemic of 2020.
To read the entire Second Opinion newsletter every Saturday morning, subscribe by clicking here.
'No easy path': PM Trudeau on national COVID-19 death projections – CTV News
Under the current public health measures up to 44,000 Canadians could die from COVID-19 in the months ahead. However, federal modelling shows the death rate could skyrocket if efforts stopped.
Speaking to these projections during his daily address on Thursday, Prime Minister Justin Trudeau said keeping the number of deaths as low as possible depends on what each person does now, but it will “take months of continued, determined effort.”
Federal projections released by Health Canada detailed the overall best- and worst-case scenarios for the pandemic’s spread and impact in Canada, varying on the degree of actions taken by governments and Canadians.
Referencing the data, Trudeau said the peak of cases in Canada may come in late spring, with the end of the first wave in the summer.
“We have the chance to determine what our country looks like in the weeks and months to come. Our healthcare systems across the country are coping for the time being, but we’re at a fork in the road, between the best and the worst possible outcomes,” Trudeau said. “The best possible outcome is no easy path for any of us.”
“There will likely be smaller outbreaks for a number of months after that. This will be the new normal, until a vaccine is developed,” he said, adding that some estimates show that some level of public health measures could be needed for the next six to eight months, or for as long as a year and a half.
Trudeau said this, coupled with more than one million jobs being lost in March, is obviously “difficult news.”
“We are unfortunately going to continue to lose people across this country in the coming weeks… We can continue to do what is necessary for the coming weeks and months to get through this first wave in the right way so we can get back to being there for each other in the coming year,” he said.
The prime minister also said that the work underway to develop more sophisticated testing and contact tracing is going to improve the global grasp on the virus that’s kneecapped global economies and changed how societies act.
WIDE RANGE OF SCENARIOS
The scenarios indicate that, depending on the containment efforts, between 4,000 and 300,000 people in Canada could die from COVID-19 over the course of the pandemic. Though, the current reality of the virus has Canada closer to the lower end of that spectrum and the two more developed scenarios from Health Canada under the current strong measures show that the range is likely somewhere between 11,000 and 22,000 Canadian deaths.
The short-term federal projection on the spread of COVID-19 shows that between 500 and 700 Canadians could die from COVID-19 in the next week, with the number of cases rising to between 22,580 and 31,850 cases.
If 2.5 per cent of the population contracts the virus, that would mean:
- 934,000 Canadians get sick;
- 73,000 could be hospitalized;
- 23,000 people could end up in the intensive care unit; and
- 11,000 people could die.
If the percentage of the population that gets sick hits 5 per cent, that would mean:
- 1,879,000 contract COVID-19;
- 146,000 could be hospitalized;
- 46,000 people could end up in the ICU; and
- 22,000 people could die.
If that grows further to 10 per cent of the population, approximately 44,000 people in Canada could die.
With no control efforts in place, up to 80 per cent of Canadians could contract the virus. That scenario could result in a summertime peak and more than 300,000 deaths, which is approximately equivalent to the total number of deaths from all causes in Canada each year.
Health Canada says the current pandemic parameters Canadians are living under are considered strong controls, such as physical distancing, and quarantining travellers, whereas if fewer people stay home or do not act like they could be carrying the virus there will be a weaker hold on the disease.
The data and modelling released Thursday is informing the current national public health measures in place to combat the spread of the novel coronavirus.
Chief Public Health Officer Dr. Theresa Tam called the numbers “stark,” but cautioned that these possible scenarios are imperfect given the different regional epidemics, and the outcomes will ultimately be determined by Canadians’ actions.
Tam said that means everything that can be done, must be done, to keep Canada’s trajectory within the range of best-case scenarios, “despite all the hardships and cost.”
Tam said that community transmission in Canada started later than in other countries, our per capita testing rate is higher than most countries, and the increase in total number of cases has been slower here than in other nations.
“In the last weeks a lot has been done, and we will need to monitory every single day the evolution of the outbreak and the trajectory so we can recalibrate as needed,” she said.
Chief Public Health Officer Theresa Tam responds to a question a news conference in Ottawa, Thursday April 9, 2020. THE CANADIAN PRESS/Adrian Wyld
PEAK ‘WON’T BE THE END’
Under all scenarios the peak appears to be coming sometime between late spring and early fall.
Deputy Chief Public Health Officer Dr. Howard Njoo said it appears that the first wave of the virus will last until the summer, and “that won’t be the end.”
He said it’ll be up to each region of the country to monitor their curves and change their local public health approach accordingly.
As Trudeau echoed, Health Canada cautioned that in the absence of a treatment or vaccine, the fight against the disease is likely going to require waves of epidemic controls, spanning months.
For example, Canadians could still be instructed to distance themselves from others and practise hand hygiene; international and domestic travel restrictions could remain in place; and incoming travellers could face mandatory 14-day isolations.
Calling the potential second and third resurgences of the novel coronavirus that could come before a cure is found “wavelets,” Trudeau said Canadians will be “much better equipped” to handle them.
“We will have developed both tools and habits that will allow us to be much more resilient and resistant to further outbreaks and spreads,” Trudeau said.
Also playing a factor in the scenarios is the increase in health care capacity, from stocking up on lifesaving supplies like ventilators, to having enough workers able to respond to the surge of patients.
Prior to physical distancing and other steps being taken, Health Canada estimates that each infected person in Canada passed the respiratory disease on to more than two people on average, but that has since been decreased, but we have not yet reached the point of stopping all spread.
Several provinces have already released their best- and worst-case projections for the number of deaths and cases, as well as how long they estimate it will take to contain the virus that’s already infected more than 20,000 Canadians and killed more than 500 people nationwide.
‘CAUGHT OFF GUARD’
Facing questions about how Canada ended up a month into a global pandemic with months ahead of us and thousands of deaths expected, Trudeau said countries around the world were “caught off guard” by COVID-19.
“The challenges that we’ve faced in terms of getting Canadians protected are echoed in challenges faced around the world, and some countries are handling it better than others… And of course, there’ll be lots of lessons learned from this,” the prime minster said.
“I think we all know that this was a situation that we’re adjusting as best we can to. We took the advice of experts, we move forward in significant ways. As we look back at the end of this I’m sure people will say: ‘Oh you could have done this a few days before, or maybe you did this one too quickly and you could have taken a few more days to reflect on it.’ Every step of the way we make the best decisions we can, given the information we have. And if it’s not exactly right, we fix it and we try and get it better as we move forward.”
Evoking war-time language, and noting that Thursday marks the anniversary of the start of the First World War battle of Vimy Ridge, Trudeau said Thursday that things will get better, but first Canadians will have to sacrifice and do what can be done to prevent as many deaths as possible.
Almost 3,600 Canadians died during this battle, and more than 7,000 were injured.
“As historians have noted reflecting on Vimy, it was a moment ordinary people did extraordinary things… And their legacy lives on in our women and men in uniform who are there for us in times of need, in our nurses and doctors who put themselves in harm’s way for us all to stay healthy, in everyone who steps up, and asks what they can do for their fellow Canadians,” Trudeau said.
“That’s what makes Canada strong. And that will always be our path forward, no matter what tomorrow may bring.”
Even with strict containment measures, officials project up to 22,000 COVID-19 deaths in Canada – CBC.ca
Federal health officials are projecting there could be nearly 32,000 cases of COVID-19 and between 500 and 700 deaths in Canada by April 16, and even with relatively strong control measures in place, there could be between 11,000 and 22,000 deaths over the course of the pandemic.
The figures came Thursday morning as officials released modelling on how the COVID-19 crisis could unfold in the country, and suggested that containment measures such as physical distancing and quarantines could be in place for months to come.
The longer-term projections look at scenarios for when strong controls are followed (one-10 per cent of the population infected, called the “green zone”), weaker controls (25-50 per cent infected, called the “blue zone”) and no controls (70-80 per cent infected, called the “red zone”).
With strong controls, if about 2.5 to five per cent of the population became infected, that would mean between 934,000 and 1.9 million cases. That would also mean up to 22,000 deaths and between 23,000 and 46,000 ICU admissions.
If no containment measures had been taken, which was not the case in Canada, there would be a worst-case scenario of about 300,000 deaths.
Officials said the caseload in Canada is doubling every three to five days, which is considered a relatively positive trajectory compared to other countries. Tam said that is in large part because of lessons learned from other countries about how strong control measures can limit the spread of the virus.
Tam said she is hopeful Canada can stay in the green zone and keep infections and deaths relatively low.
‘Prevent every death that we can’
She warned that measures that can create “hardships” are critical to keep ICU admissions and deaths as low as possible.
“We can’t prevent every death, but we must prevent every death that we can,” she said.
Tam said it’s early to know how close Canada is nationally to seeing a “peak” in transmission. But she cautioned that even as there’s a decline in transmissions, Canadians must stay the course with preventative measures as there is a risk of the virus re-igniting.
“What we do together now will buy us more time to further understand the virus and to develop treatments and vaccines,” she said.
“We are the authors of our fate. Together we can plank the epidemic curve.”
Tam said if 2.5 per cent of the population were infected, there would begin to be strains on the health-care system.
The analysis of how many people could become infected, get sick or die from the virus comes just before the long holiday weekend.
Tam said models are “imperfect” but they can help understand the state of the pandemic and where it might go, along with the effect of public health measures on the transmission of the virus.
Prime Minister Justin Trudeau has repeatedly told Canadians that how fast and far the virus spreads will depend largely on how stringently Canadians follow public health advice, including physical distancing, handwashing and staying home whenever possible.
Several provinces have already released projections. Ontario estimates the number of deaths in the province could reach between 3,000 and 15,000 people over the course of the pandemic, which could last up to two years.
Tam has cautioned that models that try to predict how many people could become infected and die from the coronavirus are not “crystal balls,” and that it’s important to focus on data on what is happening in real time.
How projections actually play out depends largely on actions taken by individuals and governments, she said.
Canadians overwhelmingly support stronger measures to fight COVID-19, Ipsos poll suggests – Global News
A new Ipsos poll suggests a strong majority of Canadians would support a wide range of government measures to further limit the spread of COVID-19, from stricter physical distancing laws to limiting personal movement.
The poll, released Thursday on behalf of Global News, also found 84 per cent of Canadians surveyed would support whatever deficit that Ottawa would say is necessary to get Canada through the coronavirus pandemic.
While the poll found strong support for extending or strengthening measures already in place, like enforcing physical distancing, it also suggests a majority of the country would accept even harsher measures — even down to invading personal privacy.
The highest majorities were found when Canadians were asked about more empathetic initiatives. Ninety per cent of those surveyed said they would either strongly or somewhat support the military building field hospitals for COVID-19 patients, while 87 per cent were supportive of the government using empty hotels to house the homeless.
The same majority of Canadians surveyed — 85 per cent — supported both stricter physical distancing measures enforced by legislation, and large fines for anyone caught breaking those orders. Those moves would strengthen existing laws and penalties meant to keep people apart.
Yet the poll also suggests that 76 per cent of Canadians would approve of government-imposed restrictions on who can leave their home and when, a measure that has gained traction in other parts of the world.
Coronavirus outbreak: Is Canada considering using phone tracking to enforce social distancing?
A relatively slim majority of those surveyed, 65 per cent, said they would even support the federal government using cellphone data to track Canadians who are supposed to be self-isolating. If enacted, the move would echo measures taken by governments from South Korea to Poland.
Ipsos CEO Darrell Bricker said the fact that majorities were found across the board suggests that Canadians are prepared for the government to do “whatever it wants” to fight the pandemic.
“We’ve had some commentary from experts saying the government has overstepped some of its boundaries of what they consider appropriate for this circumstance,” he said. “But they have pretty strong public support for doing whatever is necessary in order to deal with this situation.
“Whatever the limit is, we certainly didn’t find it in this survey.”
While most of the above measures found strong support across gender, age groups, provinces and household incomes, both phone tracking and running deficits saw their support dip among some groups. Respondents in more conservative provinces like Alberta and Saskatchewan were less supportive of allowing a deficit, for example, while younger people were more wary of the government invading their privacy.
Many provinces and municipalities have threatened to both fine people and put them behind bars if they continue to gather in large groups or not self-isolate. The Canadian government has enacted legislation that requires all returning travellers to self-isolate for 14 days, with fines up to $750,000 and jail sentences up to six months for those who don’t comply.
Another recent Ipsos poll suggested a full quarter of Canadians admit they’re not following social distancing guidelines as much as they should, even though 95 per cent of those surveyed believe social distancing will slow the spread of the novel coronavirus.
Coronavirus outbreak: WHO searches for balance between privacy and protecting communities
Bricker said the two polls together highlight a mentality among some Canadians that other people are the problem, not themselves.
“If you look at the initiatives that we’re asking people to approve of, one is limiting my own personal movement, but almost everything else is really things that they feel should be done to other people,” he said.
Health Minister Patty Hajdu has said the federal government is prepared to use “every measure in our toolbox” to battle the pandemic, including enforcing self-isolation and even physical distancing.
But Canada’s chief public health officer Dr. Theresa Tam has expressed resistance to limiting personal freedoms like privacy and mobility, arguing a “proper balance” is needed.
With officials saying Canada must brace for physical distancing measures to remain in place until at least the beginning of summer, Bricker says the poll data suggests people are transitioning from fear of the virus to frustration over when life will return to normal.
“People don’t really have a significant amount of fear about the potential damage to their own health; really, the effect they’re feeling much more directly is the effect that [the pandemic] is having on their ability to earn an income,” he said.
“What they really want to have happen is for government to take whatever action is necessary both to guarantee their income … and get people behaving in the right way so we can move on and put this issue behind us.”
Exclusive Global News Ipsos polls are protected by copyright. The information and/or data may only be rebroadcast or republished with full and proper credit and attribution to “Global News Ipsos.” This poll was conducted between April 3 and April 7, with a sample of 1,006 Canadians from Ipsos’ online panel. The precision of Ipsos online polls is measured using a credibility interval. This poll is accurate to within plus or minus 3.5 percentage points, 19 times out of 20, had all Canadian adults been polled.
© 2020 Global News, a division of Corus Entertainment Inc.
OnePlus CEO posts comparison pictures with 8 Pro and 'another flagship' – MobileSyrup
Can Pets Contract the Coronavirus? – Slate
What Makes Barrick (GOLD) an Attractive Investment Option – Yahoo Finance
Iran anticipates renewed protests amid social media shutdown
Popular Richmond BBQ spot speaks out about coronavirus rumours after man collapses outside restaurant – Vancouver Is Awesome
Real Estate Board of Greater Vancouver reports January housing sales up 42.4 percent
- Health15 hours ago
U.S. CDC reports 374,329 coronavirus cases, 12,064 deaths – Financial Post
- News6 hours ago
Even with strict containment measures, officials project up to 22,000 COVID-19 deaths in Canada – CBC.ca
- Tech24 hours ago
Coronavirus: Photo appearing to show lineup outside Costco in London, Ont., raises concerns – Global News
- Art10 hours ago
Latest Images Reveal Near Completed MVRDV's Art Depot for Museum Boijmans Van Beuningen – ArchDaily
- News21 hours ago
Doug Ford blasts 'unacceptable' level of COVID-19 testing as Ontario cases top 5,000 – CBC.ca
- Science17 hours ago
New head of MUHC research institute withdraws from role – Montreal Gazette
- Health17 hours ago
Coronavirus tips: 14 ways to help keep yourself safe when you leave the house – CNET
- Sports19 hours ago
NHL Draft Stuetzle atop final ranking of International skaters for 2020 Draft – NHL.com