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The spread of COVID is really controlled by three key factors:
Contact: the contact between an infected person and others. The more contacts there are, the faster it will spread. This is what a lockout aims to eliminate (and what restrictions on mass events etc do to a lesser extent).
Exposure: the ease with which viruses can spread during the contact. Social distancing, shields and facemasks all reduce the exposure levels, extended contact increases it.
Duration: the length of time that an infected person is making contact with others. This can be reduced through increased testing (identifying infected persons) and trough contact tracing (identifying both source of infection and others potentially infected).
The point is that lockout is one way to address this. If people behave well to rigorously minimize exposure, that will have a big impact, too. And if we can reduce the duration that infected people are "out in the wild", combined with exposure reduction, that combination may well be sufficient to eliminate the the need for a full lockout.
Unfortunately, we are not doing as well as we should be on the exposure and duration fronts at the moment.
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(09-30-2020, 09:26 PM)tomh009 Wrote: The spread of COVID is really controlled by three key factors:
Contact: the contact between an infected person and others. The more contacts there are, the faster it will spread. This is what a lockout aims to eliminate (and what restrictions on mass events etc do to a lesser extent).
Exposure: the ease with which viruses can spread during the contact. Social distancing, shields and facemasks all reduce the exposure levels, extended contact increases it.
Duration: the length of time that an infected person is making contact with others. This can be reduced through increased testing (identifying infected persons) and trough contact tracing (identifying both source of infection and others potentially infected).
The point is that lockout is one way to address this. If people behave well to rigorously minimize exposure, that will have a big impact, too. And if we can reduce the duration that infected people are "out in the wild", combined with exposure reduction, that combination may well be sufficient to eliminate the the need for a full lockout.
Unfortunately, we are not doing as well as we should be on the exposure and duration fronts at the moment.
There are two other factors, (or at least one factor, and one aspect to one of your other factors).
First appears to be some individual factor, many people do not spread the virus, a few spread it to a lot of people. It isn't entirely clear to me how to use this information since the 'superspreaders' cannot be identified beforehand AFAIK.
The second is the context in which the exposure takes place....or maybe you must just want to call it part of exposure, which is to say, outdoors is best, indoor space with ventilation is better than indoor space with no ventilation. We've used this improve safety as well (outdoor patios, improved ventilation in schools (apparently)).
We've never had a "full lockout", but we had a pretty aggressive lockdown at the beginning. Given that we now understand things much better, I think we could achieve the same result with a much more targeted lockdown if we chose too. Sadly, it seems our government is unwilling to take those actions at this point. The problem is every day we wait the problem grows, and as the problem grows, our other mitigations become less effective, and a ligher lockdown becomes more insufficient.
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Yes, outdoor exposure is less risky than indoor, forgot to include that. Sorry.
There is for sure individual variation. But if you look at things at the level of an overall population, be it Waterloo Region, Ontario or Canada, you can take action on any one of the three factors I mentioned, you can't alter the individuals but the three factors will reduce the spread overall with the population mix.
One point the Economist article made (don't know whether you had a chance to read it) is that the second wave looks very bad but it's not actually as bad as the first wave. That's because we are using the confirmed cases as our metric, and the increased testing will increase the number of confirmed cases. As a corollary to that, it will reduce the mortality rate as we will detect more of the existing cases but the number of deaths will not vary. So, that is yet another factor in why the mortality rate is lower now.
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Can we agree to use a different word than “lockdowns?” Lockdowns have such negative connotations that it’s not surprising so many people rebel at the thought of being in a lockdown. It sounds like prison to many.
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(09-30-2020, 10:44 PM)tomh009 Wrote: Yes, outdoor exposure is less risky than indoor, forgot to include that. Sorry.
There is for sure individual variation. But if you look at things at the level of an overall population, be it Waterloo Region, Ontario or Canada, you can take action on any one of the three factors I mentioned, you can't alter the individuals but the three factors will reduce the spread overall with the population mix.
One point the Economist article made (don't know whether you had a chance to read it) is that the second wave looks very bad but it's not actually as bad as the first wave. That's because we are using the confirmed cases as our metric, and the increased testing will increase the number of confirmed cases. As a corollary to that, it will reduce the mortality rate as we will detect more of the existing cases but the number of deaths will not vary. So, that is yet another factor in why the mortality rate is lower now.
I don't think anyone can claim that it is "not as bad"...merely that we don't know if it is worse yet. That being said, there are numerous reason to believe it will be worse, first and foremost because we are not implementing the same precautions.
We, as a society, CHOOSE exactly how bad this will be. There is nothing inherent about the virus that makes the waves better or worse, (or indeed have waves at all) it is our behaviour and choices which determine that. I believe the second wave will be worse, because we are choosing for it to be worse by not implementing the similarly strong precautions that we took the first time (and I say similarly strong, because now that we have a better understanding, we can use more targed, less broad precautions, but we aren't doing that either).
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(10-01-2020, 07:33 AM)jgsz Wrote: Can we agree to use a different word than “lockdowns?” Lockdowns have such negative connotations that it’s not surprising so many people rebel at the thought of being in a lockdown. It sounds like prison to many.
I am sympathetic to the idea that language matters, do you have a suggestion? I think there is also a need for communicating the situation, both specific actions, and their seriousness clearly.
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(10-01-2020, 07:45 AM)danbrotherston Wrote: (10-01-2020, 07:33 AM)jgsz Wrote: Can we agree to use a different word than “lockdowns?” Lockdowns have such negative connotations that it’s not surprising so many people rebel at the thought of being in a lockdown. It sounds like prison to many.
I am sympathetic to the idea that language matters, do you have a suggestion? I think there is also a need for communicating the situation, both specific actions, and their seriousness clearly.
No suggestion, unfortunately. But there must be a word that captures the seriousness and gravity of the situation.
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(10-01-2020, 07:44 AM)danbrotherston Wrote: I don't think anyone can claim that it is "not as bad"...merely that we don't know if it is worse yet. That being said, there are numerous reason to believe it will be worse, first and foremost because we are not implementing the same precautions.
We, as a society, CHOOSE exactly how bad this will be. There is nothing inherent about the virus that makes the waves better or worse, (or indeed have waves at all) it is our behaviour and choices which determine that. I believe the second wave will be worse, because we are choosing for it to be worse by not implementing the similarly strong precautions that we took the first time (and I say similarly strong, because now that we have a better understanding, we can use more targed, less broad precautions, but we aren't doing that either).
Right. As I had mentioned, it seemed people are letting their guard down. And if it gets much worse, while I don’t expect a full shut down, I do expect very strong rules that many, myself included, won’t like. But it needs to be down to avoid crippling the economy.
Outdoor spaces, for example, mask people, if the area is crowded (St. Jacobs Farmer Market). Less inclusive social bubbles, and smaller ones (something I don’t like, but is absolutely needed).
We can get the numbers down again, without hurting the economy, but it’s going to be a pain in the ass. It needs to be done though.
As for those with medical issues, they’ll need to figure a way so that they don’t unintentionally infect others.
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(10-01-2020, 07:33 AM)jgsz Wrote: Can we agree to use a different word than “lockdowns?” Lockdowns have such negative connotations that it’s not surprising so many people rebel at the thought of being in a lockdown. It sounds like prison to many.
The thesaurus suggests "solitary confinement" and "isolation", neither of which helps. How about "protective vigilance"? 
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(10-01-2020, 07:44 AM)danbrotherston Wrote: (09-30-2020, 10:44 PM)tomh009 Wrote: One point the Economist article made (don't know whether you had a chance to read it) is that the second wave looks very bad but it's not actually as bad as the first wave. That's because we are using the confirmed cases as our metric, and the increased testing will increase the number of confirmed cases. As a corollary to that, it will reduce the mortality rate as we will detect more of the existing cases but the number of deaths will not vary. So, that is yet another factor in why the mortality rate is lower now.
I don't think anyone can claim that it is "not as bad"...merely that we don't know if it is worse yet. That being said, there are numerous reason to believe it will be worse, first and foremost because we are not implementing the same precautions.
Based on their analysis of the data, they believe that the actual number of cases (as opposed to the published number of confirmed cases) is still far below that of the first wave, because the testing during the first wave was far too low, so only a small portion of the cases were actually detected.
Whether it will get worse than the first wave is indeed still to be seen. But I will note that the actions don't need to be the same as for the first wave, only that they need to be equally or more effective. (We had no masks or contact tracing, for example, during the first wave.)
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THURSDAY 2020-10-01
Waterloo Region reported 14 new cases for today (9.0% of the active cases) -- with six additional cases for yesterday (now 11 cases total, 7.1% of actives). 64 new cases for the week (-10), averaging 5.9% of active cases. 156 active cases (-1 in the last seven days).
Next testing report on Friday.
Ontario reported 538 new cases today with a seven-day average of 536, still going up quickly. 515 recoveries and another three deaths translated to an increase of 20 active cases and a current total of 4,975. A weekly total change of +1,201 active cases. 39,646 tests for a 1.36% positivity rate. The positivity rate is averaging 1.34% for the past seven days.
The new cases are 10.8% of the number of active cases, averaging 11.9% over the past seven days.
ICU patient count is at 36 (+1). Total hospital population is up to 162 (+12).
- 229 cases in Toronto: 7.2 per 100K population
- 101 cases in Peel: 10.1 per 100K
- 66 cases in Ottawa: 6.6 per 100K
- 43 cases in York: 3.9 per 100K
- 13 cases in Waterloo: 2.1 per 100K (based on provincial reporting)
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10-01-2020, 11:56 AM
(This post was last modified: 10-01-2020, 11:58 AM by danbrotherston.)
(10-01-2020, 11:09 AM)tomh009 Wrote: (10-01-2020, 07:44 AM)danbrotherston Wrote: I don't think anyone can claim that it is "not as bad"...merely that we don't know if it is worse yet. That being said, there are numerous reason to believe it will be worse, first and foremost because we are not implementing the same precautions.
Based on their analysis of the data, they believe that the actual number of cases (as opposed to the published number of confirmed cases) is still far below that of the first wave, because the testing during the first wave was far too low, so only a small portion of the cases were actually detected.
Whether it will get worse than the first wave is indeed still to be seen. But I will note that the actions don't need to be the same as for the first wave, only that they need to be equally or more effective. (We had no masks or contact tracing, for example, during the first wave.)
I am aware they claim the "actual" cases are lower. I am arguing that there is no way to know, there are too many unknowns, and it basically amounts to speculation.
I agree, that the actions we take must be equally effective, I said exactly that in the second paragraph. The thing we have gained now is the ability to use more precise targeted options...but we are still not doing that either.
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(10-01-2020, 11:56 AM)danbrotherston Wrote: I am aware they claim the "actual" cases are lower. I am arguing that there is no way to know, there are too many unknowns, and it basically amounts to speculation.
There is no absolute fact, I agree. But neither can we absolutely rely on confirmed cases or or confirmed deaths. We know we don't capture all actual cases because not everyone is tested. And we know not all COVID-related deaths are recorded as such. So, regardless of whether we use the confirmed numbers or combine those with serological test data, excess deaths data and work on correlating case and death data, either way we have a bunch of assumptions. Note that it's the same with unemployment data and GDP numbers, there are a lot of assumptions and projections involved
there as well.
In the end, each one of us can naturally choose which numbers to use. (I do use confirmed cases for my daily summaries because on the daily level there is no better data available.)
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It really is more than two weeks. Sri Lanka shut down for 67 days but eliminated:
https://medium.com/indica/covid-underdog...6eca164a35
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Yes. It really worked for them. Not so sure people here would have co-operated at the same level. But after the lockdown, they were seeing only about 10 new cases per day in September.
And on the flip side, Taiwan never did a lockdown. They reacted early -- which helped -- but still reached 400 cases by mid-April. Since then? Only about 100 more. 26 total cases in September!
There is more than one way to beat this virus.
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