The COVID-19 pandemic

[tomh009]

485 new cases in Ontario today for a 5.1% increase; the first day-over-day drop in a week, in spite of the new record in the number of tests. 319 recovered and 36 dead for a net addition of 130 active cases.

146,454 people tested to date, 9,462 more than yesterday. 828 cases currently hospitalized (-1) and 250 in the ICU (+5).

Quebec added 723 cases today, up 4.3% (and 1650 cases) today. 158,770 tests done to date -- about 5,000 again for the past day, half of what Ontario is doing now, but with a higher rate of positives. 1130 currently hospitalized (+54) and 258 in ICU (+51). Not a good day in La Belle Provence for the hospitalization numbers.

March
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 (+21%) 2020-03-31 4162 (+21%)
April
2020-04-01 4611 (+11%) 2020-04-02 5518 (+20%) 2020-04-03 6101 (+8%) 2020-04-04 6997 (+15%) 2020-04-05 7944 (+14%)
2020-04-06 8580 (+8%) 2020-04-07 9340 (+9%) 2020-04-08 10031 (+7%) 2020-04-09 10912 (+9%) 2020-04-10 11677 (+7%)
2020-04-11 12292 (+5%) 2020-04-12 12846 (+5%) 2020-04-13 13557 (+6%) 2020-04-14 14248 (+5%) 2020-04-15 14860 (+5%)
2020-04-16 15857 (+7%) 2020-04-17 16798 (+6%) 2020-04-18 17521 (+4%)

[robdrimmie]

Yes. Not clear yet why the big jump. But LTC case count is now up to 195 so I suspect they have been doing more testing at LTC facilities. Based on the region's data, the infections are not new, the symptoms already set in some time ago, so it's people who had symptoms but did not get tested earlier. My guess (and it's just a guess) is that they had not been doing enough testing in LTC facilities so they are now uncovering these cases. Revera Forest Heights is up to 118 cases ...

There's an article in yesterday's Record about expanded testing in Waterloo Region. It notes a "previous expansion into long-term care facilities" which may be having an impact. It reads to me like the article supports your thinking here perhaps? Or is the impact of those changes something unrelated?

[tomh009]

Yes. Not clear yet why the big jump. But LTC case count is now up to 195 so I suspect they have been doing more testing at LTC facilities. Based on the region's data, the infections are not new, the symptoms already set in some time ago, so it's people who had symptoms but did not get tested earlier. My guess (and it's just a guess) is that they had not been doing enough testing in LTC facilities so they are now uncovering these cases. Revera Forest Heights is up to 118 cases ...

There's an article in yesterday's Record about expanded testing in Waterloo Region. It notes a "previous expansion into long-term care facilities" which may be having an impact. It reads to me like the article supports your thinking here perhaps? Or is the impact of those changes something unrelated?

Yes, that sounds even more likely, then.

Really, we should have been testing at the LTC facilities far earlier already.

[MidTowner]

I found this interesting: Santa Clara County COVID-19 cases could be 50 to 85 times higher than reported, Stanford study finds

Santa Clara County officially had 956 confirmed cases as of April 1, and 1870 as of yesterday. Researchers, based on three thousand blood tests for antibodies, estimate that between 2.49% and 4.16% of the population had been infected, making the real count up to 85 times higher than the official one.

For context, Ontario has conducted about 50% more tests on a per capita basis than California, resulting in about the same number of confirmed cases per capita, and the first cases in each jurisdiction were within a day of one another.

From the article in the Stanford newspaper:

Medicine professor and study co-lead Jay Bhattacharya said in a Friday press conference that the study results put coronavirus’ fatality rate “about on par with the flu,” but he warned that the lack of a vaccine means the two situations aren’t equivalent.

[panamaniac]

There's an article in yesterday's Record about expanded testing in Waterloo Region. It notes a "previous expansion into long-term care facilities" which may be having an impact. It reads to me like the article supports your thinking here perhaps? Or is the impact of those changes something unrelated?

Yes, that sounds even more likely, then.

Really, we should have been testing at the LTC facilities far earlier already.

Ontrio only stopped transferring people from hospitals INTO LTC facilities two days ago. 

[tomh009]

I found this interesting: Santa Clara County COVID-19 cases could be 50 to 85 times higher than reported, Stanford study finds

Santa Clara County officially had 956 confirmed cases as of April 1, and 1870 as of yesterday. Researchers, based on three thousand blood tests for antibodies, estimate that between 2.49% and 4.16% of the population had been infected, making the real count up to 85 times higher than the official one.

On the other hand, Austria did random antibody testing of 1544 people, and found that only 0.33% (5 of 1544) had the antibody markers present. Based on the likely margin of error, they estimate that less than 1% of the population had been infected.
https://www.theguardian.com/world/2020/a...tudy-shows

Why such a big difference? Are the infection rates really that far apart? Or is it a difference in the testing technique or methodology? Each antibody test has a different level of sensitivity (percentage of actual antibody cases that are detected) and specificity (percentage of non-cases that are rejected). Typically both of these numbers are somewhere in the 90% range for approved tests, meaning up to 10% of false negatives and 10% of false positives. See here for data on available tests:
https://www.centerforhealthsecurity.org/...ID-19.html

Abbot claims to have developed a new one with nearly 100% sensitivity and specificity. Haven't seen any external validation of it yet.
https://www.kiro7.com/news/local/breakth...VSEVRRPYQ/

[tomh009]

Looking at the numbers from New York State is quite sobering. Next door to us, not so different demographically, one could imagine a similar situation here, had we not clamped down early enough. Things got out of hand there, and it has been a massive struggle for them to get them under control again. Cases are now increasing at only 3% but that's less impressive when you consider that 3% still translates to over 7000 new cases per day, half again as much as the total active case load in Ontario.

Just imagine where we could easily be in Ontario, if we were at similar levels:

• 180,000 cases, 18x what we have today
  
• 13,000 dead, 25x what we have today
  
• 3,100 people in ICU, 12x what we have today (and well exceeding our capacity)
  

And those would be much worse yet had Cuomo not locked down the state.

There is a heavy financial cost to the restrictions we have, no doubt. But we don't need to think about Italy, Spain or Iran to see what it could have been like when we can see the impact just across the border.

[tomh009]

568 new cases in Ontario today for a 5.7% increase. One-week average increase is 6.0%; the cumulative number of cases has taken 11 days to double. 334 recovered and 39 dead for a net addition of 195 active cases. There are now 4,816 active cases.

156,097 people tested to date, 9,643 more than yesterday. 809 cases currently hospitalized (-19) and 247 in the ICU (-3).

Quebec added 836 cases today, up 4.8% today. 163,540 tests done to date, a little less than 5,000 tests in the last 24h. 1102 currently hospitalized (-28) and 183 in ICU (-75). The Quebec ICU number is bouncing up and down wildly, so I don't have a lot of confidence in it at the moment.

March
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 (+21%) 2020-03-31 4162 (+21%)
April
2020-04-01 4611 (+11%) 2020-04-02 5518 (+20%) 2020-04-03 6101 (+8%) 2020-04-04 6997 (+15%) 2020-04-05 7944 (+14%)
2020-04-06 8580 (+8%) 2020-04-07 9340 (+9%) 2020-04-08 10031 (+7%) 2020-04-09 10912 (+9%) 2020-04-10 11677 (+7%)
2020-04-11 12292 (+5%) 2020-04-12 12846 (+5%) 2020-04-13 13557 (+6%) 2020-04-14 14248 (+5%) 2020-04-15 14860 (+5%)
2020-04-16 15857 (+7%) 2020-04-17 16798 (+6%) 2020-04-18 17521 (+4%) 2020-04-19 18357 (+5%)

[tomh009]

606 new cases in Ontario today for a 6.9% increase, and the first time more than 600 cases were added. 306 recovered and 31 dead for a net addition of 269 active cases. There are now 5,085 active cases.

One-week daily average of incremental new cases is 5.9%, and incremental active cases at 6.9%.

164,840 people tested to date, 8,743 more than yesterday. 802 cases currently hospitalized (-7) and 247 in the ICU (+0). The total number of hospitalized cases seems to have stabilized, and the ICU population has been stable for almost two weeks now.

Quebec added 962 cases today, up 5.2% today. 167,801 tests done to date, about 4,300 in the last 24h. 1169 currently hospitalized (+67) and 198 in ICU (+16).

March
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 (+21%) 2020-03-31 4162 (+21%)
April
2020-04-01 4611 (+11%) 2020-04-02 5518 (+20%) 2020-04-03 6101 (+8%) 2020-04-04 6997 (+15%) 2020-04-05 7944 (+14%)
2020-04-06 8580 (+8%) 2020-04-07 9340 (+9%) 2020-04-08 10031 (+7%) 2020-04-09 10912 (+9%) 2020-04-10 11677 (+7%)
2020-04-11 12292 (+5%) 2020-04-12 12846 (+5%) 2020-04-13 13557 (+6%) 2020-04-14 14248 (+5%) 2020-04-15 14860 (+5%)
2020-04-16 15857 (+7%) 2020-04-17 16798 (+6%) 2020-04-18 17521 (+4%) 2020-04-19 18357 (+5%) 2020-04-20 19319 (+5%)

[ac3r]

The Region of Waterloo has moved to providing results through a new website called Health Myself. The last time I was tested, they called up with the results to tell you whether they are positive or negative. Now, they will only phone you if they are positive. Otherwise, you check on the Health Myself website (or the Ontario.ca website, but I don't think our region is submitting data to them).

I've had to get tested again, and now I've been waiting almost 6 days for results, which is unusually long. I'm actually not sure if the region is providing negative results on Health Myself, or if you are to just assume that if you don't see anything there after 48 hours (the time they said it should take to get results), that you are negative and you just need continue to wait until you self-isolate for 14 days. It'd be nice if they could phone you or just send out an e-mail, but I can understand not having enough resources to keep doing that.

Edit: It seems the province is not providing negative test results anymore. So, if you get tested and hear nothing back within a couple days stating you're positive, you should assume you are negative and just continue to self-isolate for 2 weeks.

[ac3r]

Cases rise by 25; 4 more deaths in Waterloo Region.

3 long term care homes are no longer in outbreak (in regards to LTC homes, an outbreak is usually declared if 5 people have a confirmed infection, but in the case of Covid-19 they were declaring a single case to declare an outbreak due to the severity of the virus). Good work for all of those who work and live in those residences. They've done a lot better at responding than Revera Living, who have close to 30 facilities across the country with infections, with one of the worst being in Kitchener where they have had 9 deaths and 137 positive cases.

[panamaniac]

24 of today's 38 new deaths in Ontario are people in LTC facilities.  Heartbreaking.

[ac3r]

24 of today's 38 new deaths in Ontario are people in LTC facilities.  Heartbreaking.

Two were in long term care homes in Waterloo Region. This post on Reddit gives some explanation as to why it's a challenge. Staffing shortages, low pay, residents are clustered into small spaces, dementia/alzheimer residents who roam around. It's interesting that it's primarily private, for-profit facilities that are facing the worst blows from the virus. The one in our city operated by the Region of Waterloo seems to be doing a pretty good job at containing this...likely due to higher paid staff, the culture of regional employees and perhaps having better access to Public Health/Infection Control support.

[tomh009]

3 long term care homes are no longer in outbreak (in regards to LTC homes, an outbreak is usually declared if 5 people have a confirmed infection, but in the case of Covid-19 they were declaring a single case to declare an outbreak due to the severity of the virus). Good work for all of those who work and live in those residences. They've done a lot better at responding than Revera Living, who have close to 30 facilities across the country with infections, with one of the worst being in Kitchener where they have had 9 deaths and 137 positive cases.

I don't think Revera is necessarily all bad at a corporate level: they have four LTC facilities and five retirement homes in the region. Apart from Forest Heights Revera, there are three retirement homes with a single infection each, and the other five facilities have none at all. But maybe their management standards/processes are not strict enough, or else they slipped badly in Forest Heights and no one noticed.

[tomh009]

551 new cases in Ontario today for a 4.9% increase. 291 recovered and 38 dead for a net addition of 222 active cases. There are now 5,307 active cases given 5,806 recoveries and 622 deaths. 589 of the 622 deaths to date (95%) were people 60 or over, and 417 (65%) were 80 or over.

174,170 people tested to date, 9,330 more than yesterday. 859 cases currently hospitalized (+57) and 250 in the ICU (+3).

Quebec added 707 cases today, up 4.2% today, the lowest percentage increase yet. 171,520 tests done to date, about 3,500 in the last 24h. Quebec's testing is trending down while Ontario is increasing its activity. 1224 currently hospitalized (+55) and 201 in ICU (+3).

March
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 (+21%) 2020-03-31 4162 (+21%)
April
2020-04-01 4611 (+11%) 2020-04-02 5518 (+20%) 2020-04-03 6101 (+8%) 2020-04-04 6997 (+15%) 2020-04-05 7944 (+14%)
2020-04-06 8580 (+8%) 2020-04-07 9340 (+9%) 2020-04-08 10031 (+7%) 2020-04-09 10912 (+9%) 2020-04-10 11677 (+7%)
2020-04-11 12292 (+5%) 2020-04-12 12846 (+5%) 2020-04-13 13557 (+6%) 2020-04-14 14248 (+5%) 2020-04-15 14860 (+5%)
2020-04-16 15857 (+7%) 2020-04-17 16798 (+6%) 2020-04-18 17521 (+4%) 2020-04-19 18357 (+5%) 2020-04-20 19319 (+5%)
2020-04-21 20126 (+4%)