The COVID-19 pandemic

[tomh009]

150M? For a population of less than 10M? Maybe that's one zero too many?

Anyway, Israel is a bit of a special case. US (which also has state-controlled health care) is probably a better point of comparison.

I agree Israel is an outlier.

I would like it if we aimed higher than the failed state that is the USA though.

I agree we should aim higher. But in almost every country in the world, vaccine availability is limited. Only two vaccines approved by Health Canada (as well as multiple other countries). AstraZeneca's phase 3 trial was a mess, so they are not likely to be approved soon. J&J is progressing but they are behind schedule. And the Chinese vaccine manufacturers have released no real data at all, just random press releases with widely varying numbers.

At the moment, the most important thing is still to clamp down on the infection rates.

[danbrotherston]

Oops, typo yeah. But still, they've done a lot better job than we have. I know our geography impacts things to an extent, but still, the vast majority of Canadians live in developed urban areas. We could be doing a lot better than we are.

A small, compact country (less than half the area of Nova Scotia), with a single-level government and super-high emergency preparedness. This is not at all like our country or society -- just as we are not like Taiwan. As of yesterday, they had inoculated about 20% of their population* with the first dose, which is indeed a lot, about 2M people. They got additional supplies of the vaccine by basically signing the entire country up to be part of an extended trial for BioNTech/WHO.

While there have been some fits and starts to the provincial vaccination programs, the primary limiting factor for us is the vaccina availability. While we have signed up for hundreds of millions of doses, only BioNTech and Moderna have been approved, and we need to wait for them to deliver vaccines to us. Where do you see the big gap? Are the provinces not vaccinating, and the stocks are piling up? Or is the federal government not accepting available deliveries of the vaccine?

* That, of course, doesn't include the 4.5M Palestinians in the Israeli-occupied territories, whom Israel doesn't consider their responsibility to vaccinate.

I believe things are improving as of last week, but for a while, our stockpiles were rising much faster than vaccinated numbers.

Further, I still haven't seen rampup goals or targets which would enable us to hit the numbers that we need to hit achieve mass vaccinations, when we do start to get large numbers of deliveries. After the hickups at the beginning, I want to see those plans...we're paying a lot of money for them after all.

[tomh009]

I believe things are improving as of last week, but for a while, our stockpiles were rising much faster than vaccinated numbers.

Further, I still haven't seen rampup goals or targets which would enable us to hit the numbers that we need to hit achieve mass vaccinations, when we do start to get large numbers of deliveries. After the hickups at the beginning, I want to see those plans...we're paying a lot of money for them after all.

I do think the plans exist, even if they don't publish all of them. What I did see was that once we get past the January/February manufacturing constraints was that we should be getting 1M doses of the BioNTech/Moderna vaccines per week. That's still pretty high level information, though.
https://www.cbc.ca/news/politics/vaccine...-1.5872766

For the most part, neither the feds or the provinces are publishing details of their plans much in advance.

[creative]

I was just thinking about vaccination timeline numbers. If we started doing 100,000 injections a day, that would be 3,000,000 injections a month and 30,000,000 injections over 10 months. But everyone needs a second injection so that means 15,000,000 people fully vaccinated after 10 months. Considering that we are nowhere near 100,000 a day, is in even feasible to get up to 200,000 injections a day to meet the September timeline?

[tomh009]

I was just thinking about vaccination timeline numbers. If we started doing 100,000 injections a day, that would be 3,000,000 injections a month and 30,000,000 injections over 10 months. But everyone needs a second injection so that means 15,000,000 people fully vaccinated after 10 months. Considering that we are nowhere near 100,000 a day, is in even feasible to get up to 200,000 injections a day to meet the September timeline?

Currently we are supply-constrained: there is not enough vaccine inventory to do as much as we want.

Come April, we are due to have 4M doses coming in per week, which translates to about 150K per day, and a bit less on weekends. At that point the risk is that we will be process- or infrastructure-constrained. I think the only way to deliver that many doses will be to engage the pharmacies into this process. They have indicated their willingness/desire to do so, but any discussions or negotiations are not public at this point.

[danbrotherston]

I was just thinking about vaccination timeline numbers. If we started doing 100,000 injections a day, that would be 3,000,000 injections a month and 30,000,000 injections over 10 months. But everyone needs a second injection so that means 15,000,000 people fully vaccinated after 10 months. Considering that we are nowhere near 100,000 a day, is in even feasible to get up to 200,000 injections a day to meet the September timeline?

Currently we are supply-constrained: there is not enough vaccine inventory to do as much as we want.

Come April, we are due to have 4M doses coming in per week, which translates to about 150K per day, and a bit less on weekends. At that point the risk is that we will be process- or infrastructure-constrained. I think the only way to deliver that many doses will be to engage the pharmacies into this process. They have indicated their willingness/desire to do so, but any discussions or negotiations are not public at this point.

We were deployment constrained for weeks. That's weeks of excess deaths we could have avoided.

And that was a situation where we had 4-8 months of prep time. We didn't know when the vaccines would come, but we knew they would, and we were unable to start deployment quicky.

So I no longer have trust that when we do start getting millions per week, that deployment will ramp up. It is unacceptable if we have wait 2-4 weeks while vaccines sit in freezers because our government wasn't prepared for something that was entirely expected.

[creative]

That was my point. Not availability but how do you administer that many doses.

[tomh009]

We were deployment constrained for weeks. That's weeks of excess deaths we could have avoided.

And that was a situation where we had 4-8 months of prep time. We didn't know when the vaccines would come, but we knew they would, and we were unable to start deployment quicky.

So I no longer have trust that when we do start getting millions per week, that deployment will ramp up. It is unacceptable if we have wait 2-4 weeks while vaccines sit in freezers because our government wasn't prepared for something that was entirely expected.

That's some deaths that could have been avoid, how many, I really cannot tell. Not massive numbers, though, as the number of doses is still fairly small.

The provinces really need to quickly ramp up the readiness for mass vaccination. I haven't seen anything that would give me the confidence that any of them are ready for this yet.

[danbrotherston]

We were deployment constrained for weeks. That's weeks of excess deaths we could have avoided.

And that was a situation where we had 4-8 months of prep time. We didn't know when the vaccines would come, but we knew they would, and we were unable to start deployment quicky.

So I no longer have trust that when we do start getting millions per week, that deployment will ramp up. It is unacceptable if we have wait 2-4 weeks while vaccines sit in freezers because our government wasn't prepared for something that was entirely expected.

That's some deaths that could have been avoid, how many, I really cannot tell. Not massive numbers, though, as the number of doses is still fairly small.

The provinces really need to quickly ramp up the readiness for mass vaccination. I haven't seen anything that would give me the confidence that any of them are ready for this yet.

Those deaths prevented would have been minimal if the vaccine was not targeted, because the vaccine is targeted at the most vulnerable people, it's likely that it would be a significant fraction of deaths, although I don't want to speculate on specific numbers.

We certainly agree on the second point.

[tomh009]

MONDAY 2021-01-18

Waterloo Region reported 84 new cases today (8.5% of the active cases) plus 19 more for yesterday; 885 new cases for the week (-62), averaging 12.0% of active cases -- previous week was 17.7%! 906 active cases, -163 in the last seven days.

Ontario reported 2,578 new cases today with a seven-day average of 3,035 (-108). 2,826 recoveries and 24 deaths translated to a drop of 272 active cases and a new total of 28,621. -2,011 active cases for the week and 421 deaths (60 per day). 40,301 tests for a positivity rate of 6.40%. The positivity rate is averaging 5.30% for the past seven days compared to 6.43% for the preceding seven.

394 patients in ICU (-1).

• 52 cases in Lambton: 39.7 per 100K
  
• 507 cases in Peel: 36.7 per 100K
  
• 151 cases in Niagara: 33.7 per 100K
  
• 815 cases in Toronto: 27.8 per 100K
  
• 28 cases in Chatham-Kent: 26.4 per 100K
  
• 97 cases in Windsor-Essex: 24.9 per 100K
  
• 121 cases in Hamilton: 20.9 per 100K
  
• 51 cases in Wellington-Dufferin-Guelph: 18.8 per 100K
  
• 36 cases in Eastern Ontario: 17.8 per 100K
  
• 67 cases in Middlesex-London: 16.6 per 100K
  
• 31 cases in Southwestern Ontario: 15.5 per 100K
  
• 15 cases in Huron Perth: 15.3 per 100K
  
• 79 cases in Halton: 14.4 per 100K
  
• 85 cases in Waterloo: 13.8 per 100K (based on provincial reporting)
  
• 151 cases in York: 13.6 per 100K
  
• 65 cases in Simcoe-Muskoka: 12.0 per 100K
  
• 76 cases in Durham: 11.8 per 100K
  
• 92 cases in Ottawa: 9.2 per 100K
  
• 12 cases in Brant: 8.8 per 100K
  
• 8 cases in Thunder Bay: 5.3 per 100K
  

   

[plam]

Two digit numbers (even after adjusting) in WR are definitely better than three digit numbers! Maybe it would be good to post the adjusted yesterday number as well since these numbers always seem to come with a little extra now.

[tomh009]

Two digit numbers (even after adjusting) in WR are definitely better than three digit numbers! Maybe it would be good to post the adjusted yesterday number as well since these numbers always seem to come with a little extra now.

Sure, I can start doing that. The adjustments used to be small but in the last month or so there have been a lot more corrections.

[tomh009]

10-day averages for key regions in Ontario, plus the weekly trend as of 2021-01-17 (posting this every two days).

Region	Cases today	per 100K	10-day average	per 100K	Weekly trend
Windsor-Essex	81	20.8	171	43.9	-32%
Peel	346	25.0	552	39.9	-16%
Lambton	28	21.4	49	37.6	-36%
Niagara	52	11.6	155	34.6	-31%
Toronto	550	18.8	874	29.8	-22%
Middlesex-London	73	18.0	102	25.2	-40%
York	235	21.2	259	23.3	-25%
Waterloo	79	12.8	140	22.6	-48%
Huron Perth	37	37.8	22	22.4	+37%
Southwestern Ontario	22	11.0	40	19.8	-57%
Eastern Ontario	14	6.9	39	19.3	-45%
Wellington-Dufferin-Guelph	31	11.4	49	18.1	-9%
Hamilton	63	10.9	104	18.0	-18%
Durham	82	12.7	115	17.8	-38%
Chatham-Kent	13	12.3	17	16.2	-17%
Halton	71	12.9	77	14.0	-23%
Brant	5	3.7	18	13.4	-64%
Simcoe-Muskoka	48	8.9	67	12.3	-26%
Ottawa	41	4.1	122	12.2	-28%
Thunder Bay	5	3.3	10	6.5	-32%

Note that the Toronto number for today is missing some data and should likely be a few hundred cases higher.

[Coke6pk]

I do like seeing all that green in the last column....

Coke

[tomh009]

For sure, it looks good. Even if I assume another 200-300 cases for Toronto, it looks like we are back to the pre-holiday levels. And the trend has been down, positivity is down and the active cases are (slowly) dropping. Maybe the "shutdown" and "stay-at-home" orders, as weak as they were, actually have had some impact on the behaviour of the public?

We're nowhere near out of the woods yet, though.