NS COVID-19 Update for 17 April 2020

Daily briefing

Nova Scotia reported a fourth COVID-19-related death — and a third for Cape Breton — on Friday, a woman in her ’80s who died as a result of “complications related to COVID-19.” The province has identified 27 new cases, 13 of which are in long-term-care facilities (LTCF), bringing total confirmed cases in the province to 606 and total active cases to 425.

Additionally, Shannex announced two more residents at the Harbourstone Enhanced Care facility in Sydney had tested positive for COVID-19, bringing the total there to three:

Two additional residents from the Fishermen’s Cove neighbourhood at Harbourstone Enhanced Care have tested positive for COVID-19. The remaining tests for residents on this neighbourhood and the adjacent neighbourhood have returned negative. The first resident remains in hospital and the additional two residents who have tested positive have been transferred to a designated care/cohorting area (DCA) within Harbourstone.

Dr. Robert Strang during the COVID-19 Update for 17 April 2020.

Dr. Robert Strang during the COVID-19 Update for 17 April 2020.

I found today’s briefing really annoying because a lot of reporters asked the same questions they’ve asked before or the type of question that is a total waste of time (“The prime minister announced a program to support small businesses three hours ago. What small businesses in Nova Scotia will be helped?”)

Part of this is down to the same outlets being allowed to ask questions day after day. (Tim Bousquet was given a question today after being shut out for a few days and it was a good one, which I’ll get to in a minute.)

Frank Magazine has been shut out completely and whether you like Frank or not, you have to worry anytime it’s left up to a government communications person to decide what is and is not a valid news source. (Interestingly, I have never had problems getting responses — which are not always the same as answers, but you know what I mean — from federal or provincial governments but even in a pandemic, Mayor Cecil Clarke’s spokesperson feels free to ignore my emails.)

I will cover anything that seemed worth covering from today’s virtual scrum, but mostly I’m going to talk about information I gathered during a webinar sponsored by the Munk School.

 

Numbers

Total new cases: 27

Total cases: 606

Total hospitalized: 11

Total in ICU: 5

Total recovered: 177

Total deaths: 4

Total long-term-care facilities (LTCF) affected: 8

LTCF residents: 55

LTCF staff: 43

Total positive and negative tests:  20,112

Age range of patients: under 10 to over 90

 

Homecare

Strang said the numbers he gave yesterday for COVID-19 cases in continuing care included only staff in long-term-care facilities and he apologized for stating that they also included homecare workers.

He said they were trying to figure out how to present statistcs for homecare workers.

I don’t know why this is so complicated so I’m going to segue rather awkwardly into Tim Bousquet’s question which was about LTCFs.

Bousquet began by pointing out that while both BC and Ontario have banned staff from working in multiple facilities, Nova Scotia is simply limiting this practice for fear of leaving facilities understaffed.

Bousquet asked if Strang figured this was because the province allows LTCFs to operate “on the cheap,” refusing to hire workers full time because they don’t want to pay them properly or offer them benefits, forcing them to work more than one part-time job.

Dr. Strang stepped nimbly right over the question and talked instead about protocols for staff working in multiple facilities.

 

False negatives

A reporter asked Dr. Strang about BC Provincial Health Officer Dr. Bonnie Henry’s contention that up to 30% of COVID-19 test results could be false negatives.

Strang said that is not a fact that has been raised in any of his conference calls with the country’s public health officers and that the head of the microbiology lab in Halifax, Dr. Todd Hachette, has great faith in the integrity of the test results.

I found the clip of Dr. Henry, it’s from April 13. She says testing people too early in the course of the illness produces false negatives. (I actually think Strang said something similar himself, when explaining why they didn’t simply test everyone getting off an airplane.)

 

 

Virus School

I sat in on a Munk School discussion today that involved the following people:

Peter Loewen
Professor, Munk School of Global Affairs & Public Policy and Department of Political Science

Lynette Ong
Associate Professor, Asian Institute at the Munk School of Global Affairs & Public Policy and Department of Political Science

Dr. David Fisman
Professor and Faculty Division Head of Epidemiology at Dalla Lana School of Public Health

The moderator was Peter Mansbridge who didn’t bother me as much as he usually does.

The conversation, the official title of which was, “A Question of Trust: Politics, perception and the COVID-19 pandemic,” was quite wide-ranging but I would like to summarize some of what I heard for you because it was interesting:

 

Trusting China’s data

Fisman said that despite initial concern about China’s attempts to downplay the epidemic, the epidemiological data coming out of the country has “held up.” For example, Chinese researchers recognized the disease was more dangerous for the elderly and more fatal to men than women.

Where the data hasn’t been as reliable — Fisman noted China’s “relatively small attack rate” — there are a couple of possible explanations other than “they’re lying.” For one, Chinese researchers have estimated they may have missed missed 80% of China’s COVID-19 cases.

Another likely factor in keeping the attack rate low, he said, was China’s Draconian lock-down measures, which involved rounding people up in the streets (a tactic Dr. Ong said was usually reserved for combating terrorism). As the virus is what Fisman described as “exquisitely sensitive” to physical distancing, these measures were likely very effective.

 

Exit Strategy

Physical distancing is so very “potent” against the coronavirus that Fisman says it is our “door out” of the first wave of this pandemic.

Moreover, he says the numbers suggest we’re approaching the end of this first wave in Canada as a whole and in most regions, including the Maritimes, although he also noted that in Ontario the disease has “split into two parallel epidemics,” one in the community, which “looks okay” and a second in institutions like long-term-care facilities and prisons, where it “looks to be taking off.”

But let’s say we are close to the end of this first wave, the “paradox of protection,” Fisman says, is that it maintains susceptibility in the population. He used the metaphor of putting out a forest fire, which a good thing to do, because you put out a forest fire, but it leaves behind a lot of dried brush thereby increasing the likelihood of another forest fire.

So as we open the economy back up, physical distancing measures will be “repeatedly strengthened and relaxed” and “to do that in a smart way, you need really good surveillance.”

By surveillance, Fisman doesn’t mean calling 911 on your neighbor, he means sero-epidemiology — testing people to determine who has immunity — and he predicts that over the next six months “we’re all going to learn a lot” about it.

Dr. Ong agreed, saying if we re-open too quickly or don’t have sufficient surveillance measures in place, we’ll be hit by a second or third wave which could be worse than the first — which has apparently happened in Singapore.

Clockwise, L-R: Dr. Peter Loewen, Peter Mansbridge, Dr. David Fisman, Dr. Lynette Ong

Clockwise, L-R: Dr. Peter Loewen, Peter Mansbridge, Dr. David Fisman, Dr. Lynette Ong

 

Monday morning QB

There was a brief but helpful discussion of epidemiological modeling which Fisman began by quoting the statistician George Box, “All models are wrong, some models are useful,” and by “useful” he meant, they provide insights.

The example he used with the coronavirus was that understanding the “lags built into this disease” — the time between getting infected and being admitted to hospital then ICU, then leaving (preferably alive) — helped policy makers realize that you had to make the hard political decisions about shutting down the economy before things looked that bad:

If you wait until ICUs fill up to introduce public health measures, you’ve missed the boat.

That’s what happened in Spain and Italy and New York, said Fisman, who gave Ontario Premier Doug Ford “two thumbs up” for making the hard decisions to shut things down when it still looked quiet.

Of course, he said, if the strict measures work, and your healthcare system is never overwhelmed, there will be “a lot of Monday-morning quarterbacking” suggesting the social distancing was “all for naught.” But:

“What you do in Public Health,” said Fisman, “is make things not happen.”

 

Lessons learned?

Fisman said he personally will believe that we’ve learned something from this pandemic if he sees the search for a SARS coronavirus vaccine added to the World Health Organization’s (WHO) priority vaccine list because it’s not there now, even though this pandemic was not just foreseeable — it was foreseen.

People who study these things knew it was just a matter of time before an animal virus jumped to humans and hit the sweet spot between “transmissability and virulance” that SARS-CoV-2 has displayed.

Fisman said he would also hope to see a change in the way we interact with animals — both domestic and wild.

 

Political capital

Peter Loewen had some interesting insights into the response of Europeans and Canadians to government measures to combat the virus.

He said they’d surveyed people in 15 European countries before and after lock-downs (including “severe” lock-downs in eight of those countries) and found that people had greater trust in government following the lock-downs, despite the serious curtailment of civil liberties involved.

Loewen said they survey 2,500 Canadians each week and have noted there is no partisan disagreement on the severity of COVID-19 — knowing how someone votes is no indicator of their attitude toward the virus. He said the vast majority of Canadians believe the threat is serious, are taking precautions and approve the way their provincial and federal governments are handling the crisis. Loewen said for him, this has been a “remarkable story of government focusing and getting something done.”

That said, he acknowledged this cross-party consensus can only last so long and some fissures are beginning to show over issues like recalling parliament. He says these will be exacerbated when the Prime Minister and premiers begin making decisions about re-opening.

Loewen said he thinks Canadian are mature enough to realize that trade-offs between economics and health will be made, but what they won’t tolerate is “opacity” about the plan and he feels Canada has been slow in articulating the re-opening conditions and giving a clear picture of when and how it will happen. (His example of someone doing this well was New Zealand PM Jacinda Ardern.)

He said he senses Canada’s PM  “has several more weeks of good will to draw on.”

And here’s a revelation I particularly enjoyed: Canadians are basically all-in now, doing what’s necessary to “flatten the curve,” but when they’re presented with information about possible future economic costs, Loewen said they say they expect OTHERS will begin violating the social distancing rules, at which point they will have no choice but to do so themselves.

He said governments will have to “get creative” about social distancing and he mentioned the example of the Germans who have “figured out how to use parks” again. Kids, he said, shouldn’t be cooped up in their homes as the weather gets nice, especially if those homes “aren’t good places to be.”

 

Tonight’s Distraction

My career as a gamer began and ended one afternoon in the late 1980s when my brother made me play Super Mario Bros. with him and I died three times in rapid succession and he took the controller away from me and said “Stop that” and I did.

All by way of explaining why I can’t actually vouch for the value of these offers, but here’s what some companies are offering to help gamers survive the pandemic:

PlayStation 4

Starting Wednesday at 11 p.m. ET/8 p.m. PT, PS4 owners can download “Uncharted: The Nathan Drake Collection” and the game “Journey” for free. Once you download the games, you can keep them. But you must download the games by May 5.

GOG.COM

“Even if the sun is shining and the flowers have already started to bloom where you live, health and safety are on everybody’s mind right now. Closing the shades and playing video games can be one of the good ways to relax and pass the time when you stay at home. We’re here to help you choose your next great adventure with this selection of free games from our catalog. We also invite you to check the latest releases and best game deals on the GOG.COM front page.”

Google

Google is offering free access to its Stadia game for two months (starting Wednesday).

children playing video games

Gamesingear / CC BY-SA