The COVID-19 pandemic

[tomh009]

Suspected, confirmed COVID-19 patients filling roughly 1 in 4 Ontario ICU beds

Apparently here in Waterloo the figure is 40%, the highest in the province.

Of the 434 cases in ICU province wide, only 92 are confirmed. The number has increased from 138 to 434 from March 21 to March 28.

According to the CBC article, 30 beds in the region are being used for COVID-19. However, as of this morning the region is reporting only 19 total hospitalizations, including non-ICU. So something doesn't match here.

Unless patients from other regions are being brought to ICU here?

[tomh009]

There are 103 positive and presumptive cases in Waterloo Region. On Friday there were 69 cases.

https://www.regionofwaterloo.ca/en/healt...egion.aspx

The region is now posting totals by category rather than a list, which is easier to understand. Comparing to Wednesday, five days ago (for a larger sample):

• Total cases: 103 total 45 new (18% increase per day)
  
• Confirmed: 60 total 37 new
  
• Presumptive: 43 total 8 net add
  

Clearly some of the previous presumptives are now confirmed.

19 people hospitalized, up from 11.

[tomh009]

The best day in a while for Quebec, at 13% (albeit still nearly 350 cases):
2020-03-23 778 (+258%)
2020-03-24 1040 (+34%)
2020-03-25 1339 (+29%)
2020-03-26 1629 (+22%)
2020-03-27 2021 (+24%)
2020-03-28 2498 (+24%)
2020-03-29 2840 (+13%)
That's pretty close to the average number of cases for the last six days, but improved as a growth rate.

212 new cases (19%) in Ontario added today. No reporting from the Waterloo Region on the weekend.

A total of about 23,000 tests completed in Canada in the last 24 hours, with roughly 2.2% positives. The backlog appears to be about 20,000, or a bit less than one day.

Quebec reported a second day with an increase below 20%, although it's still almost 500 new cases.
2020-03-23 778 (+258%)
2020-03-24 1040 (+34%)
2020-03-25 1339 (+29%)
2020-03-26 1629 (+22%)
2020-03-27 2021 (+24%)
2020-03-28 2498 (+24%)
2020-03-29 2840 (+13%)
2020-03-30 3430 (+17%)

Ontario reports 1706 total cases now, as of Sunday afternoon. But they caught up a big chunk of the testing backlog and the reporting methodology has changed (Et tu, Brute!) to use iPHIS data now, so they are saying "N/A" for the day-to-day increase.

19,362 tests completed in Canada over the last day, but the number of positives is over 8%. That seems really high compared to the previous days, but not clear yet what the cause of the discontinuity is. The total number of tests to date is about 215,000 with a positive rate of about 3.3%.

[MidTowner]

Suspected, confirmed COVID-19 patients filling roughly 1 in 4 Ontario ICU beds

Apparently here in Waterloo the figure is 40%, the highest in the province.

Of the 434 cases in ICU province wide, only 92 are confirmed. The number has increased from 138 to 434 from March 21 to March 28.

According to the CBC article, 30 beds in the region are being used for COVID-19. However, as of this morning the region is reporting only 19 total hospitalizations, including non-ICU. So something doesn't match here.

Unless patients from other regions are being brought to ICU here?

That sounds like a good guess. Some places would have only a handful of ICU beds for the entire county, and it would be routine to transfer patients to Hamilton or GRH if they need ICU. But I wonder if we would have received a dozen of those already.

[tomh009]

According to the CBC article, 30 beds in the region are being used for COVID-19. However, as of this morning the region is reporting only 19 total hospitalizations, including non-ICU. So something doesn't match here.

Unless patients from other regions are being brought to ICU here?

That sounds like a good guess. Some places would have only a handful of ICU beds for the entire county, and it would be routine to transfer patients to Hamilton or GRH if they need ICU. But I wonder if we would have received a dozen of those already.

Right. And surely not all hospitalizations are in the ICU.

But I think I just figured out par of the answer: it's Waterloo-Wellington. CBC's 42% is based on 71 beds, but I believe there are at least 91 (28 in GRH, 29 in St Mary's, 12 in Cambridge and 22 in Guelph), which would take the percentage to 33%.

But Wellington-Dufferin-Guelph reports 26 cases, of whom only two are hospitalized, and only one in ICU. So that's only 21 hospitalized in Waterloo-Wellington, and 20 or less in ICU. So it's still not the whole answer.

[tomh009]

Suspected, confirmed COVID-19 patients filling roughly 1 in 4 Ontario ICU beds

Apparently here in Waterloo the figure is 40%, the highest in the province.

Of the 434 cases in ICU province wide, only 92 are confirmed. The number has increased from 138 to 434 from March 21 to March 28.

Something is not right. G&M's data is very different:

Quebec had 235 COVID-19 patients in hospital Monday, an increase of 43. Among them, 78 were in the intensive care unit, an increase of six. By comparison, Ontario, with 72-per-cent greater population, had 72 patients in intensive care.

Does Ontario have 72 cases in ICU, or 434? That's a massive difference. And if Waterloo-Wellington has 21 hospitalized cases, Quebec's ratio would indicate maybe seven of them in ICU, not 31.

https://www.theglobeandmail.com/canada/a...yrocketed/

[jgsz]

I'm getting a bit skeptical about the number of cases and the changes in the way data is collected.  Is there something else at play here?

A couple of days ago the New York Times ran an interesting article about how much information people should be given.

How Much Should the Public Know About Who Has the Coronavirus?
[/url]
[url=https://www.nytimes.com/2020/03/28/us/coronavirus-data-privacy.html]Amid calls for more transparency, a debate is raging among public health experts over how much data on the spread of the virus should be released.

[danbrotherston]

Something telling here: "Residents are clamoring to see whether the virus has been detected in their neighborhoods so they can take more steps to avoid any contact"

You should always act as though COVID is in your neighbourhood. If you are waiting to see if someone is infected, you are acting wrongly.

The most interesting thing about all this, is almost all of our efforts are to protect the community, but it seems like most people interpret them personally, "I will social distance so *I* don't get sick". Or, "I don't care about getting sick, so I won't social distance".

I don't know if this is true in all cultures, I suspect that it is not, but this kind of attitude leads to suboptimal outcomes, because people are optimizing for the wrong goals. Some people are incredibly ridiculously careful to a degree that is not justified unless you are a high risk individual, while others spend little effort. But the whole point is that everyone makes some effort, and speed of spread reduces. You might get sick or you might not, but the community as a whole stays relatively healthy. Instead we get people going to McDonalds for a coffee and dousing the whole place in santizer and throwing garbage around.

[robdrimmie]

I don't know if this is true in all cultures, I suspect that it is not

It isn't. In very broad strokes, eastern cultures value community over individual, and western cultures value individuals over community [1]. The US is way further on the individuality spectrum than anyone else, which in part leads to hordes of New Yorkers crowding together to watch a  ship enter the harbour, apparently without regard to the fact that is literally a hospital ship coming to increase ICU capacity.

[1] There's lots of writing on the topic. One such piece is: https://www.bbc.com/future/article/20170...erent-ways

[tomh009]

Quebec reported a second day with an increase below 20%, although it's still almost 500 new cases.
2020-03-23 778 (+258%)
2020-03-24 1040 (+34%)
2020-03-25 1339 (+29%)
2020-03-26 1629 (+22%)
2020-03-27 2021 (+24%)
2020-03-28 2498 (+24%)
2020-03-29 2840 (+13%)
2020-03-30 3430 (+17%)

Ontario reports 1706 total cases now, as of Sunday afternoon. But they caught up a big chunk of the testing backlog and the reporting methodology has changed (Et tu, Brute!) to use iPHIS data now, so they are saying "N/A" for the day-to-day increase.

19,362 tests completed in Canada over the last day, but the number of positives is over 8%. That seems really high compared to the previous days, but not clear yet what the cause of the discontinuity is. The total number of tests to date is about 215,000 with a positive rate of about 3.3%.

Quebec reported 732 cases, just over 20%.
2020-03-23 778 (+258%)
2020-03-24 1040 (+34%)
2020-03-25 1339 (+29%)
2020-03-26 1629 (+22%)
2020-03-27 2021 (+24%)
2020-03-28 2498 (+24%)
2020-03-29 2840 (+13%)
2020-03-30 3430 (+17%)
2020-03-31 4162 (+21%)
G&M points out the spring break timing as well as some close ties with France, Italy and New York City as contributing factors to the burgeoning positive case numbers.

260 new cases in Ontario today (well, really, they are reporting for 4 PM the previous day, but for a 24h period nevertheless) for a 15% increase.

No report today from Waterloo region.

16,164 total tests completed in Canada since yesterday, with a 6.2% positive rate. That's the second day in a row with a high number of positives. Ontario has an 8% rate but at only 5000 or so tests per day, other provinces (and particularly Quebec) are influencing this rate much more.

[tomh009]

Quebec reported 732 cases, just over 20%.
2020-03-23 778 (+258%)
2020-03-24 1040 (+34%)
2020-03-25 1339 (+29%)
2020-03-26 1629 (+22%)
2020-03-27 2021 (+24%)
2020-03-28 2498 (+24%)
2020-03-29 2840 (+13%)
2020-03-30 3430 (+17%)
2020-03-31 4162 (+21%)
G&M points out the spring break timing as well as some close ties with France, Italy and New York City as contributing factors to the burgeoning positive case numbers.

260 new cases in Ontario today (well, really, they are reporting for 4 PM the previous day, but for a 24h period nevertheless) for a 15% increase.

No report today from Waterloo region.

16,164 total tests completed in Canada since yesterday, with a 6.2% positive rate. That's the second day in a row with a high number of positives. Ontario has an 8% rate but at only 5000 or so tests per day, other provinces (and particularly Quebec) are influencing this rate much more.

14,200 new tests in Canada

426 new cases in Ontario today for a 22% increase, worse than yesterday.

Quebec reported 449 new cases, only about 11%. Encouraging, but it's only one day.
2020-03-23 778 (+258%)
2020-03-24 1040 (+34%)
2020-03-25 1339 (+29%)
2020-03-26 1629 (+22%)
2020-03-27 2021 (+24%)
2020-03-28 2498 (+24%)
2020-03-29 2840 (+13%)
2020-03-30 3430 (+17%)
2020-03-31 4162 (+21%)

In Waterloo region, we have

• Total cases: 117 total 14 new (7% increase per day)
  
• 39 hospitalized (22 in ICU)
  
• 26 travel, 37 close contact, 47 community contact
  
• 28 health care workers (24%!)
  

Infections reported at both Sunnyside Home and Highview Residences.

[jamincan]

The Waterloo Public Health site is providing a lot more information than they have in the past: https://www.regionofwaterloo.ca/en/healt...egion.aspx

[danbrotherston]

@tom009 For methdology, are you counting tests when the results are released, or are you regressing the data back in time to when the test was sent or when symptoms presented?

Public health is presenting data in this way right now: https://www.canada.ca/en/public-health/s...cases.html

It helps correct for the bias of the testing backlog--and even more, for the backlog decreasing (which biases results towards now, even though they were earlier). Obviously, it also has limitations, that is incomplete information for the duration of the backlog, but in any case, the results are encouraging.

[MidTowner]

Suspected, confirmed COVID-19 patients filling roughly 1 in 4 Ontario ICU beds

Apparently here in Waterloo the figure is 40%, the highest in the province.

Of the 434 cases in ICU province wide, only 92 are confirmed. The number has increased from 138 to 434 from March 21 to March 28.

Something is not right. G&M's data is very different:

Quebec had 235 COVID-19 patients in hospital Monday, an increase of 43. Among them, 78 were in the intensive care unit, an increase of six. By comparison, Ontario, with 72-per-cent greater population, had 72 patients in intensive care.

Does Ontario have 72 cases in ICU, or 434? That's a massive difference. And if Waterloo-Wellington has 21 hospitalized cases, Quebec's ratio would indicate maybe seven of them in ICU, not 31.

https://www.theglobeandmail.com/canada/a...yrocketed/

There were 72 confirmed cases on March 27, along with 324 suspected cases. Part of the CBC article highlights the fact that briefings from Ontario's Associate Chief Medical Officer used data that were a few days out of date. That G&M article was published on Monday the 30th, so I surmise that it used info from the Sunday briefing, which showed 72 (again, confirmed) cases in ICU.

[tomh009]

@tom009 For methdology, are you counting tests when the results are released, or are you regressing the data back in time to when the test was sent or when symptoms presented?

Public health is presenting data in this way right now: https://www.canada.ca/en/public-health/s...cases.html

It helps correct for the bias of the testing backlog--and even more, for the backlog decreasing (which biases results towards now, even though they were earlier).  Obviously, it also has limitations, that is incomplete information for the duration of the backlog, but in any case, the results are encouraging.

I'm reporting the summary data from Waterloo Region Public Health, the raw data is not available so it's not possible to do any more advanced analysis. (The same applies to Ontario and Quebec data.) I believe their numbers include both confirmed cases as well as presumptive (tests still in the backlog) cases.

And unfortunately today was the first time they reported the size of the backlog, so it's hard impossible to account for the effect of reducing that backlog.

On the national level, they do report the total number of patients tested and the number of positive/negative tests; the difference gives us the backlog. The number of tests per day is averaging around maybe 13-14,000; the backlog has stayed around about one day (but do note that the backlog in any given province may be either higher or lower than that).