December 31, 2021

Talk about a perfect storm… a surging variant, a ridiculous cold snap, and this period of time between Christmas and New Year’s when everyone is barely working… and those who bother showing up are basically phoning it in. The reporting arm of the health department in Alberta has actually given up. “Yeah, we think today’s number is around 4,000… use that for now. Ask us next year. See you January 4th”.

Who can blame them; the temperatures are dipping to the levels where it doesn’t matter whether you measure it in Fahrenheit or Celsius because it’s the same number. You know, sort of like the snowfall forecast we got around here two days ago… you can expect 10 (mumble) of snow. Ten what? Centimetres? Inches? Whatever.

Well… not all things are “whatever”.

The staggering number of new cases around the country (and the entire continent… and, while we’re at it, the entire planet) beg some questions that require some answers but, due to all of the above, the simple responses are not so forthcoming.

Trying to consolidate the numbers with respect to new cases and hospitalizations and ICU admissions has been a real exercise, but what’s most important aren’t actually the case counts; at least, not around here. Dr. Henry made a statement which alluded to the fact that there are far more cases out there than we know about. That’s been the case since the start, but it’s far more pronounced in recent weeks. Her guess is 3x to 5x, but that’s what I’d have guessed months ago. These days, we don’t have the proper testing infrastructure to get accurate numbers and, even if we did, that majority of people aren’t going to get tested. Depending who you ask, in fact… people are being told not to go get tested. You’ve got symptoms? Pretend you have it. Isolate, take care of yourself… and don’t bother us unless you need medical attention. And those who actually tried to go get tested found multi-hour waits, or got sent home with a rapid test, or found that the testing site that’d been shut down because of the cold.

A quick note about those rapid antigen tests: they’re nearly useless. I say nearly, but not entirely… only because they probably work just fine if they’re used correctly, and if the test patient has a high-enough viral load to register. Unfortunately, neither of those things seem to overlap enough to get accurate results. A positive result certainly means you have it, but a negative result doesn’t mean anything.

If you’re taking a rapid-antigen test – and I am speaking now from direct experience, having subjected myself to be a guinea pig for a friend who was trying to figure out the validity of these things – you need to scour deeply — approaching your brain — for ten seconds a nostril, complete with long, uncomfortable swirls — to get a valid result. I took a few of these tests; a gingerly tickle of the inside of your nostril does nothing. Even a medium-sized dip into your nose doesn’t do it. Unless that gargantuan Q-tip makes your eyes tear up and cause you to cough, you didn’t do it right. And it was only when I did that *and* was symptomatic that I got a positive result.

Anyway, that aside, getting a positive test these days is somewhat secondary to what it implies. Around here, with our enviable “fully-vaxxed” rate, it’s pretty good. The daily new case numbers (5,000 on paper, closer to 100,000 in my opinion) are not translating to hospitalizations. At least not yet, but for now, that’s really good news. As a general statement, if you have a normal healthy immune system and you’ve been double-vaxxed or better, the overwhelming evidence implies that you’ll suffer some cold-like symptoms at worst, and that’ll be it. It still needs to be taken very seriously because, of course, you might end up passing it along to someone who wouldn’t handle it so well… and none of that has changed. Older, immune-compromised, at risk people… they’ve been taking the necessary steps to stay safe, and we need to do the same for their benefit.

The relative success story (for now) that we’re seeing here seems to be consistent with other places with high vaccination rates. Those with lower rates are being hit hard, but only because the sheer volume of cases at some point is going to translate to an overwhelming amount of more serious cases.

Looking at the graphs below, you’ll see that hospitalization rates have not gone up dramatically in Western Canada. Ontario and Quebec are indeed seeing more hospitalizations, but barely an increase in ICU cases. Manitoba, too… to a lesser extent. But West of that, numbers are actually down.

I’ve added a third row of graphs today. While the top two rows are the cases, hospitalizations, ICUs and deaths since September 1st, the bottom row are the daily new case counts starting at the very beginning of the pandemic. They’re interesting to look at for numerous reasons… like, you can see clearly the different waves… but have a look at Quebec, from day 1. Near the very beginning, in that first little wave, there’s a notable spike. That spike was from early May, 2020… when over a 3-day period, they saw more than 4,000 new cases and over 300 deaths. It’s interesting to note just how insignificant that little spike looks compared to what came after, especially what’s going on now. But, back then… that was honestly the moment were all thinking that we’re totally screwed. That we, here in BC, were two weeks away from a tidal wave of cases and deaths.

We’ve learned a lot since then, and one of the most important is the realization of just how effective these vaccines are. We see today’s skyrocketing case numbers and we’re nowhere near as freaked out.

On that note… I haven’t written about Trump in a while, but it’s worth mentioning this: For as long as this pandemic has been going on, he’s been talking out of both sides of his mouth. He initially played it down, no big deal, it’ll be gone in a few weeks… and it became the rallying cry of his most-extreme base. His fervent supporters were as anti-mask, anti-vaxx and anti-science as he pretended to be… notwithstanding he took great pride in being responsible for funding Operation Warp Drive which indeed had a lot to do with developing these miraculous vaccines. You know, the ones he claimed we didn’t need and don’t do anything anyway because the virus is no big deal BUT I’ve created the greatest vaccine ever to combat the China virus BUT you don’t really need the vaccine BUT yeah, I got the vaccine, as did my entire family… we all got it quietly while nobody was watching, as did every Republican politician in Washington BUT really, you’re fine, forget vaccines and masks BUT yeah, we all got the booster too BUT….

Recently, and this is the eyebrow-raising part, Trump has been announcing to his followers that yeah, he got the booster and, you know what, they should get it too. But rather than listen to their fearless leader, they boo him and disagree with him. He, of course, doesn’t care… but why is that? It’s a 180, and it needs to be understood.

From the people’s point of view, they’re so deeply sunk into that mindset that they can’t, at this point, admit it’s wrong. They’ve already drowned in the Kool Aid. A lot of them can be heard saying they’d rather die of Covid than get the vaccine, and many of them will get that wish granted. Trump doesn’t care; he never did. But he does care about making himself reasonable and relevant for 2022 and beyond, so now he’s pandering to the bigger Republic base… those that aren’t so anti-everything. And that leaves those fringe people completely abandoned, discouraged and betrayed. And, in a bit of trouble if they don’t change their mind because that’s the demographic that makes up the vast majority of pandemic-related deaths. The anti-vaxx crowd.

Our BC fully-vaxxed rate is 90%. The majority of people in hospital for Covid come from that remaining 10%. The math isn’t complicated. And the American fully-vaxxed number isn’t even close to 90%… more like 62%. Unfortunately, for some select demographics, it could get quite ugly.

Last year, at exactly this time, I wrote a relatively optimistic piece about how the worst is over. Vaccines are just around the corner, and once we all get them, this will all have been a bad dream. Well, that was a little naïve, but I’m going to say the same thing again. Given the direction of Omicron and where we are with all of this, by this time next year, Covid won’t be a distant nightmare from the past that’s still haunting us. Rather, it’ll be an endemic annoyance for which we’ll have an armada of weapons: Vaccines, treatments, prevention therapies, whatever. Every day is one step closer to C19 becoming the common cold of the future, but we’re not there yet. Next year…

So… wishing you all a Very Happy, Prosperous and – most of all – *Healthy* 2022. All the best… and Cheers!

December 23, 2021

There are some words you never hear. We’re all familiar with “overwhelmed” and “underwhelmed”, but what about just whelmed? What does it even mean?

The words originate from the marine world and have been around for centuries, and these days, whelmed means where the water is coming right up to the sides of the boat, and some of it is splashing onto the deck… but it’s no big deal. Overwhelmed is where the water is pouring in from all sides, and things are heading in a catastrophic direction, ie. sinking or capsizing. And underwhelmed, of course, means nothing too exciting is going on.

We hear a lot about our medical system being at risk of being overwhelmed, but it’s not just hospital beds at risk. Long before a Covid case gets to hospital, there’s a lot that needs to happen… and every step of the way is potentially at risk of becoming a choke point. And once you have a choke point, the effects spill over to other areas.

What happens when the choke point is right at the beginning of the sequence? What if the boat is overwhelmed before it even leaves the harbour?

Two weeks ago, I drove by the Covid testing centre that’s been set up in the parking lot of St. Vincent’s Hospital. You head down 33rd, westbound, and turn right, into the lot. There were three cars waiting in line… probably a 5-minute wait. When I went to get my test a week ago, the lineup went all the way up to Cambie and then occupied the right-most southbound lane for about a block-and-a-half down. I joined the line at around Cambie and 31st, and from there it took close to 90 minutes to get tested.

I happened to drive by there today, and the lineup not only spilled onto Cambie; it now took up the two right lanes. And it went all the way down, past 26th Ave, almost to the intersection of King Ed. Two solid lanes for eight blocks, and that’s before the right turn onto 33rd for the final little bit.

My understanding is that people were being told it’s a close-to 6 hour wait.

So, here is exhibit A of an overwhelmed system. Funny how, two weeks ago, driving by there, I thought… huh, so much infrastructure for so little. A couple of piddly little cars waiting…and, for that… all these cops and nurses and tents and generators and infrastructure. It’s way too much. Ha Ha. And now, there’s only one word that applies. Overwhelmed. And here’s a spillover effect that has nothing to do with Covid: Cambie street is a designated emergency corridor. Indeed, if you’re downtown and need to get to… City Hall? VGH? The airport? It’s that straight line which, ostensibly, always has an open lane… just in case. But not today; two-thirds of the southbound lanes are a 6-hour line-up, and the other single lane is occupied by traffic which, of course, needing 300% of the allocated space, was backed up all the way to the Cambie Bridge. This would be a really bad time for an earthquake.

So… all these people being tested. Let’s start by being very clear that the startling increase in cases in no way reflects the actual reality. There are far, far more new cases today than the already eyebrow-raising 2,000+ would imply. How many people got to the line-up and said to hell with it? And at how many different testing sites? More than stuck around would be my guess. Their thinking makes some sense. Why wait it out? Go home, isolate, etc… we all know what we’re supposed to do. If it gets serious (and, overwhelmingly, if you’re double-vaxxed, it won’t), just go home and ride it out like any illness you’ve ever had. Why stress the overwhelmed infrastructure – and yes, that’s exactly what it is. A six-hour wait to get tested is nobody’s idea of whelmed.

And all of that leads into the topic-du-jour, which is an awful lot of pissed-off people. We heard a lot of “Hopefully by Christmas” ideas until recently. Until it all went to hell. The new restrictions have just added to the confusion and the anger. People have had enough, and it’s psychologically very difficult to keep adjusting to goalposts which seem to move haphazardly, and have been doing so for two years. Gyms are ok, gyms are not ok, family gatherings are not ok, restaurants yes, sort of…, clubs no, etc etc. Who makes these rules? Why are they messing with us?

The science behind these restrictions, as random as it might seem, is entirely based on likelihood of transmission. Closed indoor spaces with bad ventilation, ie gyms, are, with a bug as contagious as Omicron, a bad place to be. Big parties in enclosed restaurant party rooms? If there is one person in that room who has Omicron, after 3 hours of jovial partying, everyone will have come into contact with it. And this time, vaxxed or not, you’re at a much higher risk.

The number of people saying “So what. Enough. Who cares.” is higher than it’s ever been, and why wouldn’t it be. People who’ve been planning for months (if not years). People who’ve heard this version isn’t so serious. People whose airline tickets and hotels have crossed beyond the refundable window, and their measurement of risk/reward makes sense to them.

There are no simple answers. Indeed, there are many scenarios imaginable that technically violate the orders… yet people are comfortably wrapping their heads around ways to justify their decisions.

There are still too many variables to figure out what’s ok and what isn’t. It’ll all shake out in hindsight, but for now, everything in place is there to prevent one thing: overwhelming the medical system. But hey, guess what… the overwhelming is already happening.

The question to which we’d all love an answer is just how, where and what is being overwhelmed. What’s the effect of a virus that’s not as serious but a lot easier to catch? The math of “A third as serious but 10x easier to catch” nets out to more hospitalizations. Enough to break the system?

Around here – in fact, in all of Canada, the staggering growth in cases in not translating to hospitalizations except in Quebec, where they’re seeing a bit of a spike… but still, not even close to proportional to their new cases.

There’s no good summary to any of this; this variant hit at the worst possible time. Here’s another word where perhaps it’s fair to use the less-common form. Whereas in the past, everything we experienced was unprecedented, this is all feeling somewhat precedented at the moment. Hopefully not for long. I’d like to feel gruntled again.

In the meantime… for those who celebrate it, Merry Christmas… and may this be the last of the “memorable” ones, at least in this context.

December 17, 2021

OK – it is indeed time for an update. I meant to do this a couple of days ago, but…

There are a lot of questions floating around these days, and it’s frustrating when, for some of them, there are no real answers. Let’s start with the obvious one… you can guess what that is. It rhymes with notthisshitagainicron.

I am still sticking with the cautious optimism that as contagious as it is, the symptoms are, and will remain, mild. And, on that note…

A few days ago, I started feeling a little under the weather. Headache, fatigue, cough… but also, fever. The sort of thing where in the old days you just bundle up for a day or two and are ok, but these days, our minds go elsewhere. Yesterday afternoon, I went and got tested… and waited in an 80-minute lineup to do so. A week ago, that lineup was three cars when I drove past it.

Test results take 24 hours, but I mentioned this to a friend… who came over with a rapid antigen test – which came back negative. Excellent. I thought so, but better safe than sorry. I was already feeling a little better, and then I had a good night’s sleep. I woke up without a fever and feeling pretty ok.

So… it was a rather blunt kick in the face to receive the official PCR result a few minutes ago: Positive.

Well… shit.

So, now… instead of speculating, here’s what I can tell you. Knock on wood that I’m past the worst of it, because if this is as bad as most double-vaxxed otherwise-healthy people get this thing, we are well on our way to seeing an end to it. I’m looking at the silver lining, which is… now, getting sick, coupled with two shots, I’m good to go – perhaps to the end of this entire nightmare. Like so many others whose second vaccine dose was in late June, I’ll be getting my invitation for the booster next week. I’d been hoping to avoid Omicron for a few more weeks, because the AZ/Moderna/Moderna series seem to be very effective against it, but things don’t always go as planned. Looks like I’ll be developing immunity the old-fashioned way.

But this brings up another of those yet-to-be-answered questions with respect to the mildness of these symptoms… how many people are walking around with Omicron-Covid19 right now? I’m going to guess – a lot. Far more than will ever get tested. I say that because while we all have little slip-ups once in a while, I’m exceptionally careful with respect to masks and open spaces and proximity to people and all the rest of it. Where and when the hell did I get infected? I sincerely don’t know. And if I can get this thing, anyone can get it… and, like I’ve said, it’ll eventually hit us all… though, ideally, when you’ve already received your three-shot course.

Which leads to another question, one I’ve heard 20 versions of… what do we do? And the preamble to that has a lot to do with airline tickets and hotel reservations, many of which at this point are non-refundable. Do we go? Do we bail? Help.

The answer very much depends on a number of variables which are very different and vary wildly from person to person. If you’re not worried about getting sick (and a plane-full of double-vaxxed and masked people heading to a place of warmth and sunshine and outdoor restaurants is actually a pretty safe place), what’s the problem? Well, WestJet threw a valid question back at the government a couple of days ago; where’s the science? Why are you telling people not to travel? They do have a point; on this fourth go-around, the one thing we’ve learned is that travel restrictions do nothing to prevent the spread. If they were perfectly implemented and 100% enforced, they would. But that’s not the case… and as we’ve seen with exponential growth, that 99.9% “good enough” decays to 80%, 30%, zero very quickly. A travel restriction might, at best, delay some numbers for a few days… but as we already have seen, by the time the whistle was blown on Omicron, it was already everywhere. The hastily-imposed travel restrictions on ten African countries have been lifted because they did absolutely nothing.

So why advise people not to travel? There may be many reasons such as the pressure on the testing infrastructure and the risk of being stranded overseas and the risk of wherever you’re going imposing some unforeseen restrictions on you; all of those are valid concerns, but they have nothing to do with preventing the spread of the disease. Questions related to needing to be back on a certain day or you’ll lose your job – are perhaps more relevant. At the end of the day, the government has to do *something* — so, we get travel advisories if for no other reason than if this all goes to hell, they can say they didn’t do *nothing*.

Can it all go to hell? Unfortunately, yes. I am basing this on my now-personal experience that Omicron symptoms are generally mild. If that turns out not to be the case, given how contagious it is, we could overrun our health-care system… and that’s what they’re trying to avoid. Dr. Henry’s rather specific list of restrictions imposed today target the sorts of gatherings that are highest risk; she just wants to be sure we don’t run out of hospital beds. Fair enough.

For the moment, this eternal optimism of mine always tries to look at the bright side, and while we see a frightening rise in cases, we’re far from seeing a frightening rise in hospitalizations and ICU admissions. On the contrary; the numbers are significantly down over the last 10 days. Around here, with our excellent vaccination rate, we’re in good shape. Red states down south? It remains to be seen. Around here, new-case numbers will go up, as they are all across Canada. The implications of that remain to be seen. But if you look at the pretty picture, while the unprecedent growth in new cases is alarming, look below it to hospitalizations and ICU cases. It’s a good counterpoint.

As far as I’m concerned, my positive test has certainly derailed our holiday plans, but whatever… we’ll make the best of it. On that note, let’s try to turn my positive test into a positive for you.

I have two pairs of tickets (great ones: center-ice row-3 club seats) for this Sunday’s Canucks game (7pm against the Coyotes) that I suddenly won’t be using… so let’s have a good old-fashioned contest like the old days. I’d base it on BC numbers, but they don’t publish over the weekend… so our neighbours to the east will help us out. Over the last three days, here are the new-case numbers:

Ontario: 1,808 2,421 3,124
Quebec: 2,386 2,736 3,768

The complete list since Nov 29th is on the pretty picture.

So, guess away! Submit two guesses per entry – your guess for Saturday’s numbers for Ontario and also for Quebec. Something like “ON: 4,000 / QC: 5,000” and whoever is closest for each province wins a pair of tickets. Ties go to whoever guessed first.

See? Here’s how we make lemonade out my particularly lemony test result… good luck!

And now, if you’ll excuse me, I’m going to go off and curl up in bed for 10 days.

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