The COVID-19 pandemic

[jeffster]

Current 7-day Covid-19 cases per 100k

• Eastern Ontario Health Unit 850.0
• City of Hamilton Public Health Services 841.2
• Lambton Public Health 809.4
• Toronto Public Health 770.3
• York Region Public Health 757.5
• Halton Region Public Health 716.7
• Wellington-Dufferin-Guelph Public Health 702.5
• Brant County Health Unit 701.0
• Hastings Prince Edward Public Health 693.8
• Porcupine Health Unit 691.5
• Peel Public Health 685.2
• Durham Region Health Department 680.9
• Middlesex-London Health Unit 680.2
• Kingston, Frontenac and Lennox & Addington Public Health 665.7

• Region of Waterloo Public Health and Emergency Services 660.6

• Leeds, Grenville & Lanark District Health Unit 646.8
• Ottawa Public Health 644.7
• Simcoe Muskoka District Health Unit 634.9
• Haldimand-Norfolk Health Unit 596.1
• Public Health Sudbury & Districts 567.8
• Southwestern Public Health 554.1
• Niagara Region Public Health 541.8
• Peterborough Public Health 539.3
• Northwestern Health Unit 536.1
• Windsor-Essex County Health Unit 534.6
• Renfrew County and District Health Unit 522.9
• Huron Perth Public Health 513.7
• Haliburton, Kawartha, Pine Ridge District Health Unit 479.0
• Grey Bruce Health Unit 472.1
• Timiskaming Health Unit 452.8
• Algoma Public Health 403.7
• Thunder Bay District Health Unit 389.4
• Chatham-Kent Public Health 385.6
• North Bay Parry Sound District Health Unit 355.3

• TOTAL ONTARIO 679.8

[jeffster]

Current Covid-19 rate (7 day average) per 100k based on vaccination status:

Unvaccinated: 78.14
Partially vaccinated: 78.88
Fully vaccinated: 101.40

[tomh009]

Current 7-day Covid-19 cases per 100k
(...)
• TOTAL ONTARIO 679.8[/color]

With testing now severely restricted, will the case statistics still be meaningful?

[plam]

If the early Omicron severity data proves to be correct (and that's still definitely an "if") the (Omicron) risk to a vaccinated person will likely start to approach the risk from the seasonal flu. Maybe not yet at that level, but going in that direction.

So, flu is bad, and omicron is also bad. Is omicron more bad among vaccinated? I dunno. Maybe. But it is true that we don't currently have hard data.

What is definitely very bad is overwhelming the health system by everyone getting omicron at once.

The "omicron is mild" crowd, to me, seems to be encountering the "hospital systems overwhelmed" facts. Quebec is at an all-time high. Ontario is currently at 50% of the delta peak with respect to hospitalizations.

I wonder if it's just easier to mandate vaccines at this point? We had a national campaign to get vaccinated and most of us did. We were told we could return to normal once that happened. Just pull out your QR code first, of course. Now the vaccinated have been locked down again from living life. So what was the point? Force the anti-vaxxers to get it or let it burn through them like wildfire. I don't get why the rest of us get to have our very own lives restricted yet again. This is nonsense.

I've lived through an actual lockdown (two). This is very far from that. OK, gyms and indoor dining is closed. Would you go? (OK, I would go to the climbing gym wearing an N95 at low-occupancy times. I would not go to a normal gym, and I would sure as hell not eat in a dining room right about now).

FWIW...as a result of this pandemic, I'm much more aware of the harm caused by the flu. It kills (in the US, where the numbers I saw are from) tens of thousands of people including hundreds of children every year. I'm no longer satisfied with our public health response to the flu. Our flu vaccination programs should be much more widespread, and it's shocking to me that the flu vaccine isn't free everywhere in Canada.

The flu vaccine is not free in some provinces? It is not free in NZ, which is shocking to me. The other unfortunate thing about the flu vaccine is that the efficacy is actually pretty low.

[danbrotherston]

...

FWIW...as a result of this pandemic, I'm much more aware of the harm caused by the flu. It kills (in the US, where the numbers I saw are from) tens of thousands of people including hundreds of children every year. I'm no longer satisfied with our public health response to the flu. Our flu vaccination programs should be much more widespread, and it's shocking to me that the flu vaccine isn't free everywhere in Canada.

The flu vaccine is not free in some provinces? It is not free in NZ, which is shocking to me. The other unfortunate thing about the flu vaccine is that the efficacy is actually pretty low.

It's not free in BC except for vulnerable people. I was also surprised, I don't know about other provinces.

It's also not free in the Netherlands, again only for vulnerable people.  In both cases you can pay to get it.

The efficacy isn't that high, although I think the goal is to improve it.

The other thing, as we've now all learned, is that efficacy is a complicated thing, I think the efficacy of "you won't get the flu" is low (although still very significant, more than the current 2 dose COVID vaccines are proving to be with Omicron), but the "your flu will be less severe" is much harder to measure.

[ac3r]

Quick! Ban the French haha. I love how it says it possibly originated in Cameroon, but then the very next sentence says it has not been detected anywhere except France, but I guess it's easier to blame certain people for things.

https://www.fox5dc.com/news/new-covid-19...-in-france

[tomh009]

FWIW...as a result of this pandemic, I'm much more aware of the harm caused by the flu. It kills (in the US, where the numbers I saw are from) tens of thousands of people including hundreds of children every year. I'm no longer satisfied with our public health response to the flu. Our flu vaccination programs should be much more widespread, and it's shocking to me that the flu vaccine isn't free everywhere in Canada.

The flu vaccine is not free in some provinces? It is not free in NZ, which is shocking to me. The other unfortunate thing about the flu vaccine is that the efficacy is actually pretty low.

It's free here, which is good. But the efficacy is highly variable depending on which flu you happen to encounter. In this regard (the pre-Omicron version of) COVID-19 has been much easier to fight, as a single vaccine has worked rather well against all (pre-Omicron) variants.

For fighting the flu, facemasks would really help more than the vaccine. Maybe there will be less stigma associated with wearing a mask in the future.

[danbrotherston]

The flu vaccine is not free in some provinces? It is not free in NZ, which is shocking to me. The other unfortunate thing about the flu vaccine is that the efficacy is actually pretty low.

It's free here, which is good. But the efficacy is highly variable depending on which flu you happen to encounter. In this regard (the pre-Omicron version of) COVID-19 has been much easier to fight, as a single vaccine has worked rather well against all (pre-Omicron) variants.

For fighting the flu, facemasks would really help more than the vaccine. Maybe there will be less stigma associated with wearing a mask in the future.

There are a number of stable co-existing strains of the flu virus (unlike with corona, where so far different variants [why do we use a different word?] seem to replace less competitive variants), and yes, the vaccine only targets some of them (and experts must guess at which will be most prevalent) so yeah, it depends on which one you get how effective the vaccine is. I believe the numbers they give are effectively averaged, I don't think there is broad testing for the particular strain of the flu people get, just enough sampling is used to try and inform the choice for future vaccines.

So the numbers for vaccine efficacy are across all strains of the flu, which given that you don't get to choose which strain you're exposed to makes the numbers fairly relevant individually as well.

I'm not sure facemasks would help that much, or at least, face masking in most contexts, I don't expect masking would be done in, family, school, visiting friends, non-public work contexts, but would probably apply in public settings like shopping and transit. (There are a lot of different policies available here). My understanding of the flu (which may be wrong--and frankly, epidemiologists may also be wrong as they were for COVID) is that it requires close contact, so it's most often transferred between those with close contact, when you are unlikely to wear a mask. It's also possible to be contagious before you feel symptoms.

As for future mask wearing stigma, maybe, maybe not, I suspect the mask will continue to be part of our culture war between those with empathy and those proudly without.

What I do think however, is that the vaccine has more potential. Masking will always be limited by human behaviour. Even if we expend massive effort and make people more prosocial, mistakes will still be made.

On the other hand, the flu vaccine is constantly improved, scientists increase the number of strains it can target and the generality and strength of the antibody response it generates. They can use more effective vectors.

Ultimately, if I've learned anything as an adult it's that science is easy in comparison to people. Solving people problems (like mask wearing) is almost universally more difficult.

In light of that, I'd argue that improved ventilation is probably even as effective as masking, if the flu is airborne as COVID is.

[plam]

Quick! Ban the French haha. I love how it says it possibly originated in Cameroon, but then the very next sentence says it has not been detected anywhere except France, but I guess it's easier to blame certain people for things.

https://www.fox5dc.com/news/new-covid-19...-in-france

Not actually new. Bad reporting. Couldn't outcompete Delta, first reported in December. https://twitter.com/sailorrooscout/statu...6072410118.

It's free here, which is good. But the efficacy is highly variable depending on which flu you happen to encounter. In this regard (the pre-Omicron version of) COVID-19 has been much easier to fight, as a single vaccine has worked rather well against all (pre-Omicron) variants.

In addition to the nasal spray vaccine, there is also a pan-coronavirus vaccine whose Phase I data is being analyzed. So that's also helpful (and also hopefully will reduce the need for variant-specific boosters). Science really does help.

For fighting the flu, facemasks would really help more than the vaccine. Maybe there will be less stigma associated with wearing a mask in the future.

Also true for COVID! I don't love being out and about during this wave, especially unboosted (not eligible until January 24), but I think the N95s are actually fairly effective. I'm wearing an N95 indoors everywhere now and I started wearing a surgical mask outdoors when walking with people.

[tomh009]

For fighting the flu, facemasks would really help more than the vaccine. Maybe there will be less stigma associated with wearing a mask in the future.

I'm not sure facemasks would help that much, or at least, face masking in most contexts, I don't expect masking would be done in, family, school, visiting friends, non-public work contexts, but would probably apply in public settings like shopping and transit. (There are a lot of different policies available here). My understanding of the flu (which may be wrong--and frankly, epidemiologists may also be wrong as they were for COVID) is that it requires close contact, so it's most often transferred between those with close contact, when you are unlikely to wear a mask. It's also possible to be contagious before you feel symptoms.

"One 2013 study looked at how masks could help people with the seasonal flu limit spreading it when they exhale droplets containing the virus. Overall, researchers found masks led to a more than threefold reduction in how much virus people sprayed into the air."
https://www.healthline.com/health/cold-flu/mask
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3591312/

[danbrotherston]

I'm not sure facemasks would help that much, or at least, face masking in most contexts, I don't expect masking would be done in, family, school, visiting friends, non-public work contexts, but would probably apply in public settings like shopping and transit. (There are a lot of different policies available here). My understanding of the flu (which may be wrong--and frankly, epidemiologists may also be wrong as they were for COVID) is that it requires close contact, so it's most often transferred between those with close contact, when you are unlikely to wear a mask. It's also possible to be contagious before you feel symptoms.

"One 2013 study looked at how masks could help people with the seasonal flu limit spreading it when they exhale droplets containing the virus. Overall, researchers found masks led to a more than threefold reduction in how much virus people sprayed into the air."
https://www.healthline.com/health/cold-flu/mask
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3591312/

Fair point, I think I misspoke a little bit, or perhaps I should say, I was wrong in my thinking.

I shouldn't say that masking isn't effective, we have more data now than ever showing it's effective for COVID, and clearly would be (and is) also effective for the flu. But given the way I see masking working in even in optimistic contexts, I still don't think it would be more effective than the vaccine.

[tomh009]

"One 2013 study looked at how masks could help people with the seasonal flu limit spreading it when they exhale droplets containing the virus. Overall, researchers found masks led to a more than threefold reduction in how much virus people sprayed into the air."
https://www.healthline.com/health/cold-flu/mask
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3591312/

Fair point, I think I misspoke a little bit, or perhaps I should say, I was wrong in my thinking.

I shouldn't say that masking isn't effective, we have more data now than ever showing it's effective for COVID, and clearly would be (and is) also effective for the flu. But given the way I see masking working in even in optimistic contexts, I still don't think it would be more effective than the vaccine.

All right, so allow me to agree that an improved vaccine could be more effective than masking. I'm not convinced that the current vaccines are more effective. CDC says 40-60% efficacy in a season when the viruses are a good match for the current vaccine.
https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm

Now, a combination of a high degree of vaccination and masking (at the minimum, sick people masking up, plus anyone vulnerable) would be quite helpful in reducing the incidence of flu, and, in particular, hospitalization and deaths.

[plam]

Fair point, I think I misspoke a little bit, or perhaps I should say, I was wrong in my thinking.

I shouldn't say that masking isn't effective, we have more data now than ever showing it's effective for COVID, and clearly would be (and is) also effective for the flu. But given the way I see masking working in even in optimistic contexts, I still don't think it would be more effective than the vaccine.

All right, so allow me to agree that an improved vaccine could be more effective than masking. I'm not convinced that the current vaccines are more effective. CDC says 40-60% efficacy in a season when the viruses are a good match for the current vaccine.
https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm

Now, a combination of a high degree of vaccination and masking (at the minimum, sick people masking up, plus anyone vulnerable) would be quite helpful in reducing the incidence of flu, and, in particular, hospitalization and deaths.

There's the whole droplets vs aerosols thing which is fascinating in terms of paradigm shifts that we will hopefully see. The establishment killed the miasma theory of infection but really it is actually miasmas, er, aerosols sometimes.

Flu is bad and selective measures, including better vaccines and occasional use of masks, really could decrease the incidence of flu. We really don't know about how often flu is transmitted via fomites either. It would have been too hard to study for not enough payback.

[robdrimmie]

why do we use a different word?

This piqued my curiosity, and a lot of it is the sort of typical result of colloquial use of technical terms. The difference between a variant and a strain doesn't appear to have hard lines in definition, but generally speaking mutations in reproduction cause variations. When those variations cause enough difference in behaviour, they become a strain.

SARS-CoV-2 is a strain of coronavirus with many variants. Those variants may end up diverging enough that they become distinct strains of coronavirus. From what I've read about this over my lunch break (and I'm a really shitty biologist, so consume with sodium and all that) some folks do argue that the variants of interest are in fact strains because they bind to different receptors and - especially in the case of Omicron - really do seem to have different behaviours.

My deeply uneducated guess is that there's a general consensus to call everything variants because it's the language that people know now in the context of Covid19, and generally speaking the masses don't do so great with nuance.

[tomh009]

Omicron hospitalization/death probability currently estimated at 65% lower than Delta, accounting for age, sex and vaccination.
https://www.publichealthontario.ca/-/med...sc_lang=en

Now based on 11,622 Omicron cases, up to 25 December.