The COVID-19 pandemic

[danbrotherston]

IMO, we need to rethink how to handle this. What we are doing is NOT working. It's not like this is yersinia pestis we're fighting - it's a virus that has an ever so slightly higher mortality rate as seasonal influenza. At this point, the vulnerable are dying because they are not being protected correctly. Instead of banning healthy muscle freak gym bros from going to the gym, figure out a way to prevent this virus from getting into places where such vulnerable people can get it.

To be fair, I think it was working pretty well with delta. Omicron is harder because it's much more transmissible and breaks through the vaccine much better. I don't know what the ideal Omicron strategy is apart from keeping it out. It is possible that an actual lockdown would work, but it seems like people here wouldn't go for that.

Many other countries have managed Omicron...but those countries already handled the rest better than us, and actually invested in tools to handle it, and you know, decided to do something about it, instead of just shrugging and protesting that "everyone will get it anyway" as they did for delta before it.

[plam]

To be fair, I think it was working pretty well with delta. Omicron is harder because it's much more transmissible and breaks through the vaccine much better. I don't know what the ideal Omicron strategy is apart from keeping it out. It is possible that an actual lockdown would work, but it seems like people here wouldn't go for that.

Many other countries have managed Omicron...but those countries already handled the rest better than us, and actually invested in tools to handle it, and you know, decided to do something about it, instead of just shrugging and protesting that "everyone will get it anyway" as they did for delta before it.

I'm actually not sure of that, aside from by closing the border. Like, countries that suppressed Delta was already a small list. Who do you think is open and has actually controlled Omicron?

I am all for stricter lockdowns, but I'll also admit that even Auckland's most recent 3-month lockdown was starting to exceed popular consent. It was much more locked down than Ontario though. (And I was in Wellington, not Auckland).

[danbrotherston]

The graph is from OWID, so I trust the data, I'm sure there are things which are not directly comparable, but there's clearly countries which have handled this.

https://twitter.com/lisa_iannattone/stat...6660600833

(As an aside, the twitter embedding isn't working anymore?)

[tomh009]

I'm actually not sure of that, aside from by closing the border. Like, countries that suppressed Delta was already a small list. Who do you think is open and has actually controlled Omicron?

I'm not convinced that anything less than a NZ-style border closure (which surely could not work here) would have kept Omicron out. And even that may not end up working longer term in NZ. It's pretty hard to implement a successful Zero COVID strategy.

[ijmorlan]

Feel free to question my intelligence if you want, but if you support all of this bullshit at this point …

I’m not questioning your intelligence. In fact, right in my message I said that I think you’re quite intelligent — just pointed out that one specific thing you said is really dumb. Specifically, the whole notion of “what do vaccinated people have to fear from the unvaccinated?”.

Unfortunately you’re not alone in saying this. Many of the people saying this are constantly saying dumb things; but many aren’t. You’re in the second group, of people who mostly say smart things but for some reason still feel a need to suggest that vaccinated people have nothing to fear, even in the same message as you acknowledge that the vaccines aren’t perfect. Which is why vaccinated people still have something to fear. Plus some of us care about the involuntarily unvaccinated.

[tomh009]

So, isn't it better to start focusing on how we can protect the more vulnerable people out there by both protecting and isolating them (aka a so called "Iron Ring"), then allow the healthy people to begin to return to normality so we can have more people and resources to pool together to improve things?

So, let's assume we want to take this strategy. We build virus firewalls around hospitals, retirement homes, hospices, urgent care centres and other medical offices. That's a lot of firewalls, but let's assume it can all be done.

But, how do we protect and isolate the elderly people living alone? The homeless people? The indigenous? The chronically ill or immunodeficient that are still living independently? We can't build protections around everyone's residence, let alone their workplaces.

I understand the concept of what you are proposing, but I don't see how we would be able to make it work in practice. Is there a country out there that has successfully implemented this that you could point to as an example?

[ac3r]

Oh Jesus christ this is ignorant.

Again, I don't know why you aren't hearing this.  We've had multiple code red paramedic situations in the region in the past week. This means if you call 911 and say "I'm dying please help"...they might as well send a hearse.

Healthy people need healthcare too. And this magic idea that we can somehow segregate the vulnerable parts of society (and never mind that isolation might harm them too) has never and can never work. Just because you want a unicorn doesn't mean they exist...those "muscle freak gym bros" are at the same gym as the nurse who takes care of my grandmother.

If seasonal influenza hospitalized 1% of people who get it and had an R value in 3-6 range, you better fucking believe we'd be more worried about it.

Can we do better, absolutely, but this idea that we can just do what we did before and it'll be fine so long as we somehow make the vulnerable people go sit alone in their rooms for the rest of their lives is magical thinking.

Honestly, I'm done with this pandemic, but I'm especially done with the bad takes I've been hearing for 2 friggin years.

Lol...

Not sure what you mean by Code Red? In health care that refers to a fire.

But anyway, I'll unpack. Paramedics are getting overwhelmed is mostly due to the problems with how we distribute paramedic services and due to our shitty health care system, which is an entirely different problem. It's not because people are dropping dead in the middle of the street because of Covid-19. It's because people call paramedics for nonsense or because they are getting sick due to not having the same protections as other EMS staff so they're working on a skeleton crew.

Next. If the healthy need to be protected against a small, miniscule minority of unvaccinated people...then something went wrong somewhere along the line. If you wish to cower in fear because someone gets too close to you in Zehrs, that's your problem, but I went ahead and got vaccinated because I have tried to understand the scientific mechanisms of them and trust that they'll protect me. That's what has allowed me to return to travelling, going to night clubs, seeing friends, eating out within reason. 2 years in and I have not once caught this thing despite doing the opposite of hiding in my house all day - hell, I have even dusted off my old resume in 2020 to work in long term care, despite being a practicing architect with a Doctorate degree. I saw the problems and wanted to help. Thankfully we handled it okay. For those people out there that can't or won't get it, then I think it's time for them to stay home. I spent 2 years doing that for them, now it's their turn. Don't hold the rest of us hostage.

Next. The R-naught of SARS-CoV-2 in Waterloo Region is actually 0.9, so please don't make BS numbers up to fear monger. It hit a high of 1.9 in late December - which is still much lower than any previous spikes - but has continued to fall into an abyss. The University of Waterloo data on wastewater surveillance - which provides very solid data on infections well before PCR or antigen testing does - is already suggesting we've plateaued with this wave so the R-naught should continue to drop even lower and thus so should hospitalizations.

Hospitals are coping okay, though they are getting stressed but much of that is due to staff being temporarily let go, getting infected or being redeployed to other units. But the good news is that there are only 12 people in the ICU (in a region of 620'000+! That's 12 people spread across 3 intensive care units...in other words, basically nothing). 106 in total are hospitalized, but that is spread amongst 4 hospitals and not all of those cases are severe. In fact, many are just patients or staff who happened to catch it due to being in a specific unit - mental health, surgery, medicine etc. Yet they are doing fine...I have 3 family members who work in health care and get pretty good anecdotal information about what goes on. There's no hallway medicine, no triaging, there are rarely deaths etc. The issues we are seeing is very much a result of political impacts on the Canadian health care system, not the virus.

In contrast to LTC/hospital/shelter outbreaks, community spread is bad, but again - plateauing in so far as we can determine. This is all just more proof we need to be better protecting those sort of environments and those amongst us who are vulnerable. Here's an analogy: when an enemy is attacking you, you put up defenses first. Sandbags, Czech hedgehogs, landmines. You don't immediately cower away in underground bunkers and let the enemy run over you and capture the city until they are overwhelming you. We are not being overwhelmed in this region and we really have never been.

But I'm sure none of what I wrote will really matter to you.

[danbrotherston]

So, isn't it better to start focusing on how we can protect the more vulnerable people out there by both protecting and isolating them (aka a so called "Iron Ring"), then allow the healthy people to begin to return to normality so we can have more people and resources to pool together to improve things?

So, let's assume we want to take this strategy. We build virus firewalls around hospitals, retirement homes, hospices, urgent care centres and other medical offices. That's a lot of firewalls, but let's assume it can all be done.

But, how do we protect and isolate the elderly people living alone? The homeless people? The indigenous? The chronically ill or immunodeficient that are still living independently? We can't build protections around everyone's residence, let alone their workplaces.

I understand the concept of what you are proposing, but I don't see how we would be able to make it work in practice. Is there a country out there that has successfully implemented this that you could point to as an example?

Even this is absurd...okay, let's build a wall around hospitals.  Alright, anyone working there must isolate, and their families, and now anyone they come into contact, we need special schools, special grocery stores, special post offices, special jobs for their spouses....we need a whole new society.

It simply doesn't work...we are a society, this is what people mean by "we are in this together". The only people who can get away are those who can afford to build themselves their own private society.

[ac3r]

So, let's assume we want to take this strategy. We build virus firewalls around hospitals, retirement homes, hospices, urgent care centres and other medical offices. That's a lot of firewalls, but let's assume it can all be done.

But, how do we protect and isolate the elderly people living alone? The homeless people? The indigenous? The chronically ill or immunodeficient that are still living independently? We can't build protections around everyone's residence, let alone their workplaces.

I understand the concept of what you are proposing, but I don't see how we would be able to make it work in practice. Is there a country out there that has successfully implemented this that you could point to as an example?

We truly can't achieve that IMO. The thing is, this pandemic threw everyone into some hyper reactive mindset. Suddenly, we want to protect the elderly, the immunocompromised, Indigenous and other minorities etc. But we cannot reach every single one of them. Sorry to say, but that's just philosophical pragmatism and reality. [Edit: We can and should be doing so much more to reach certain groups, such as the Indigenous or eldery who live alone. We can organize volunteer groups to reach out to them or blame public health for that, but indeed, we can be doing more for such people.] No matter what we do, we're going to have people impacted by this and some will die. If this was a war, well, there are only so many people you can fit into bomb shelters, meaning many are going to senselessly die. We can do our best to combat that, but there is only so much we can do before we start impacting the lives of others who may not have any risk from this virus/disease, but may find themselves homeless, taking drugs, starving, sinking into debt, finding their relationships failing and the entire economies of nations falling apart etc.

If we really cared about all lives, then we'd all be out there getting flu shots each season, but so many of us don't. I don't want to suggest we put certain people at risk - family members, others and even my own self know we are all at risk for one reason or another - but we're eventually going to hit a point where we have to accept that we cannot protect everyone by forcing everyone to do A or B. So we need to force the rest who will not cooperate to do C and D, so that the majority can return to normal life. The virus is likely going to be endemic for some time, so IMO we need to begin readjusting our strategies on how we deal with that reality on a long term basis.

I just think we're starting to hit a point where...we need to accept this virus is out there and uncontainable right now. It's not going to go away for a long time. We dropped the ball already and there is no fixing it at this point, but we likely could have...who knows, we haven't faced a virus of this magnitude in a very long time. There is so much more suffering happening that is not directly related to infection/disease but is still harming and even killing people. We need to start rethinking how we handle this as it continues that allows civilization to continue to function whilst protecting those remaining people who are predisposed to having poorer odds should they contract this and improving the lives of those who have already been infected by this (whether they got sick, lost a loved one, a business, ended up on the streets, addicted to drugs, fell into poverty etc).

We've got the short term strategies down alright - masks, vaccines, limitations - but it's time we think longer term to figure out how we deal with what is likely doing to be an endemic virus so we can stop curtailing freedoms everyone wants, otherwise, you're just going to alienate more and more people. The political divisiveness is already very extreme and may only worsen and I am not sure people really comprehend how much that matters to us as a nation/planet. The PPC and all these reactionaries aren't going to just go away when the WHO says this is over, for example. This will have serious, century long impacts on how we function as a civilization.

[ac3r]

The Liberals in Ontario are backing the idea of an extra tax on anti-vaxxers: https://www.cbc.ca/radio/thehouse/vaccin...-1.6315262

And whilst not directly related to SARS-Cov-2, there have been more human cases of H5N6 detected in China, although still no proof of human to human transmission (despite 1 single individual offering an anecdote that they never came in contact with a bird, somehow): https://www.reddit.com/r/worldnews/comme..._bird_flu/

[tomh009]

I just think we're starting to hit a point where...we need to accept this virus is out there and uncontainable right now. It's not going to go away for a long time. We dropped the ball already and there is no fixing it at this point, but we likely could have...who knows, we haven't faced a virus of this magnitude in a very long time. There is so much more suffering happening that is not directly related to infection/disease but is still harming and even killing people. We need to start rethinking how we handle this as it continues that allows civilization to continue to function whilst protecting those remaining people who are predisposed to having poorer odds should they contract this and improving the lives of those who have already been infected by this (whether they got sick, lost a loved one, a business, ended up on the streets, addicted to drugs, fell into poverty etc).

So, if your point is that the current COVID-19 policies are not sustainable for the long term, I think most people would agree with you. And I would, too.

If what you want to say, however, is that we should drop all restrictions today and allow the fittest to survive, that's a whole different statement.

I agree that we need policies that are suited for a COVID-19 endemic. And I do think we were starting to move into that direction in the fall, before Omicron threw a spanner into the works. At this time, 19 January, I don't think we understand Omicron well enough to be able to entirely drop our guard. Hopefully the situation will be different soon, from the point of view of hospital loading and infection spread, that we can have a rational discussion (as a society) of what this "new normal" should look like.

[plam]

The graph is from OWID, so I trust the data, I'm sure there are things which are not directly comparable, but there's clearly countries which have handled this.

https://twitter.com/lisa_iannattone/stat...6660600833

(As an aside, the twitter embedding isn't working anymore?)

The other part of my question was about being open: which countries are open and have controlled omicron. Japan, S. Korea, Taiwan, China, and to my chagrin, New Zealand, are definitely not open (even though I have a valid visa to NZ). Japan closed to all but Japanese citizens in the face of Omicron.

I'm not convinced that anything less than a NZ-style border closure (which surely could not work here) would have kept Omicron out. And even that may not end up working longer term in NZ. It's pretty hard to implement a successful Zero COVID strategy.

I think it's clear that you have to close the border if you are trying to contain Omicron with today's tools. NZ experts are saying that it's just a matter of time before it gets out. In fact an MIQ worker tested positive in surveillance testing for Omicron today, having caught it from some cases inside the facility. But they (and especially people working in MIQ) are heavily contact-traced. I hope NZ dodges this bullet again, to give it enough time until the hopefully successful Omicron vaccine, but at least until 5-11 (opens tomorrow) and booster rollout.

Next. If the healthy need to be protected against a small, miniscule minority of unvaccinated people...then something went wrong somewhere along the line.

I wouldn't have worried as much about delta, but I do worry about omicron, because my two doses of vaccine (until January 24) and even three doses of vaccine don't do a great job against infection, even if they protect against hospitalization. And COVID makes some people unhealthy in the long term with long COVID. It's a lottery that I'd rather not enter.

Next. The R-naught of SARS-CoV-2 in Waterloo Region is actually 0.9, so please don't make BS numbers up to fear monger. It hit a high of 1.9 in late December - which is still much lower than any previous spikes - but has continued to fall into an abyss. The University of Waterloo data on wastewater surveillance - which provides very solid data on infections well before PCR or antigen testing does - is already suggesting we've plateaued with this wave so the R-naught should continue to drop even lower and thus so should hospitalizations.

You mean Rt; R0 is the fundamental number in the absence of any measures.

But anyway, the wastewater result says maybe plateaued in Kitchener and Cambridge and still rising in Waterloo, so that's not quite true. I just think that the fact is that there is a lot of COVID circulating in this community.

[danbrotherston]

The graph is from OWID, so I trust the data, I'm sure there are things which are not directly comparable, but there's clearly countries which have handled this.

https://twitter.com/lisa_iannattone/stat...6660600833

(As an aside, the twitter embedding isn't working anymore?)

The other part of my question was about being open: which countries are open and have controlled omicron. Japan, S. Korea, Taiwan, China, and to my chagrin, New Zealand, are definitely not open (even though I have a valid visa to NZ). Japan closed to all but Japanese citizens in the face of Omicron.
...

Fair point, I'm not certain what measures are in use, but it is pretty clear that it is possible to deal with it.

Next. If the healthy need to be protected against a small, miniscule minority of unvaccinated people...then something went wrong somewhere along the line.

I wouldn't have worried as much about delta, but I do worry about omicron, because my two doses of vaccine (until January 24) and even three doses of vaccine don't do a great job against infection, even if they protect against hospitalization. And COVID makes some people unhealthy in the long term with long COVID. It's a lottery that I'd rather not enter.

I similarly don't want to be involved with this, and it should not be up to others whether I am forced into it.

Next. The R-naught of SARS-CoV-2 in Waterloo Region is actually 0.9, so please don't make BS numbers up to fear monger. It hit a high of 1.9 in late December - which is still much lower than any previous spikes - but has continued to fall into an abyss. The University of Waterloo data on wastewater surveillance - which provides very solid data on infections well before PCR or antigen testing does - is already suggesting we've plateaued with this wave so the R-naught should continue to drop even lower and thus so should hospitalizations.

You mean Rt; R0 is the fundamental number in the absence of any measures.

But anyway, the wastewater result says maybe plateaued in Kitchener and Cambridge and still rising in Waterloo, so that's not quite true. I just think that the fact is that there is a lot of COVID circulating in this community.

Yes, this is on point, I may not have been specific, but the basic reproduction number of Omicron is very high much higher than any other variant, and COVID has always been much higher than the flu.

It isn't fear mongering and it isn't BS, but quoting the Waterloo number when even the provincial numbers are much higher IS cherry picking data.

It is also absolutely the case that we do not know what the Rt value is today. I watched the testing centre, it was empty, literally empty for hours at a time. We are not measuring Rt in a meaningful way right now, lets not pretend otherwise.

As for wastewater, that too, isn't a clear signal, again, we have never measured levels even remotely this high so we don't understand the limits of measurement. Further, if you're looking at the graphs, they switched them to a log scale a few days ago, makes it harder to see a plateau.

[plam]

The other part of my question was about being open: which countries are open and have controlled omicron. Japan, S. Korea, Taiwan, China, and to my chagrin, New Zealand, are definitely not open (even though I have a valid visa to NZ). Japan closed to all but Japanese citizens in the face of Omicron.

Fair point, I'm not certain what measures are in use, but it is pretty clear that it is possible to deal with it.

I'd actually say that it's not clear what to do about Omicron beyond closing the border. I think the only country that has Omicron and no explosion is South Korea, and I don't know the situation well enough to say why that is the case. NZ has no Omicron except for that MIQ worker; it's pretty clear to me that the measures currently in place would actually have a catastrophic spread of Omicron. It's possible that a harsh lockdown could work, but apart from China, I don't think anyone has tried it recently.

By the way, we were sort of talking about locking down the unvaccinated elsewhere in this thread. That's kind of what NZ has? There is a vaccine pass and there really aren't a lot of things that unvaxxed can do aside from groceries, takeout, etc. There are also some occupational mandates for various workers and from various employers (as directed by the government).

It isn't fear mongering and it isn't BS, but quoting the Waterloo number when even the provincial numbers are much higher IS cherry picking data.

It is also absolutely the case that we do not know what the Rt value is today. I watched the testing centre, it was empty, literally empty for hours at a time. We are not measuring Rt in a meaningful way right now, lets not pretend otherwise.

As for wastewater, that too, isn't a clear signal, again, we have never measured levels even remotely this high so we don't understand the limits of measurement. Further, if you're looking at the graphs, they switched them to a log scale a few days ago, makes it harder to see a plateau.

For those of us in Waterloo, if the numbers were reliable, that would be the primary data point about everyday risk; I just see it as "extremely high" right now because the numbers aren't reliable. They don't say that much about how the province-wide control measures are going.

Wastewater: Yes. The plateau was sort of visible on the graph and was what the textual description on the website was saying.

[jeffster]

Todays numbers are out.

Current 7-day Covid-19 cases per 100k

• Durham Region Health Department 765.2

• Region of Waterloo Public Health and Emergency Services 615.0

• Peel Public Health 599.3
• Lambton Public Health 583.4
• Halton Region Public Health 564.1
• City of Hamilton Public Health Services 543.8
• Windsor-Essex County Health Unit 541.9
• York Region Public Health 530.9
• Niagara Region Public Health 517.9
• Eastern Ontario Health Unit 500.2
• Brant County Health Unit 489.7
• Chatham-Kent Public Health 467.5
• Public Health Sudbury & Districts 460.2
• Haldimand-Norfolk Health Unit 448.8
• Simcoe Muskoka District Health Unit 427.6
• Toronto Public Health 426.2
• Thunder Bay District Health Unit 421.4
• Middlesex-London Health Unit 415.2
• Northwestern Health Unit 373.0
• Southwestern Public Health 324.8
• Ottawa Public Health 322.8
• Wellington-Dufferin-Guelph Public Health 322.2
• Porcupine Health Unit 321.2
• Peterborough Public Health 319.6
• Hastings Prince Edward Public Health 314.6
• Haliburton, Kawartha, Pine Ridge District Health Unit 299.6
• Timiskaming Health Unit 293.7
• Renfrew County and District Health Unit 286.3
• Algoma Public Health 282.3
• North Bay Parry Sound District Health Unit 225.8
• Grey Bruce Health Unit 225.4
• Kingston, Frontenac and Lennox & Addington Public Health 221.9
• Huron Perth Public Health 210.4
• Leeds, Grenville & Lanark District Health Unit 190.0

• TOTAL ONTARIO 467.5