British Columbia

Day 12 – March 28, 2020

There’s that feeling you get when you sit down in a rollercoaster… first of all, what the hell am I doing, do I really need to be doing this… but once the thing starts moving, there’s no way out, so the impending dread as you start going up that first big hill… click-click-click as the chain underneath pulls the train slowly… wow, this thing is going a lot higher than I thought… click-click-click… this was such a stupid idea… click-click-click… ugh, this is a lot steeper than it looked… click- ohh.. no more clicks. We all know that means…

… and as the train gains momentum and sends you flying down that first huge drop, two things will come to mind… one, this part of it will thankfully be over soon and two, now you have a clear idea just how steep it was. Which serves to illustrate where we are today with respect to the numbers coming our way in the next little bit… there is a finish line to them, a week to ten days… and we once we hit that bottom, we will know exactly how steep things were.

Given where we are today and as per what I wrote yesterday, I don’t think we need to close our eyes and scream and hope for the best. It’s looking better than that. At least, on paper and at least, for now.

In B.C., although we had the largest one-day increase in cases yet, it’s perfectly in-line with our linear growth. Dr. Henry, for now, would like to see that number consistent at 12% which is roughly where it’s been. The average of the last 10 days is actually 11.1%. Today’s number was 11.6%. Yesterday was 9.2%. Nice solid straight yellow line, right in the sweet spot. And might I add, I am tracking total cases as they accumulate, not factoring in recoveries and deaths. The outcomes of these cases is a whole separate topic. But on that note, while we saw an increase of 92 new cases, we also saw 121 cases moved to the “recovered” column. As far as these numbers are concerned, today in B.C., there are less active cases than yesterday.

Canada’s number is bigger, but also consistent and also, slowly, hopefully, for now… going down day by day. Yes, of course the number of cases is increasing, but that rate of increase is itself decreasing. See that column… 4 out 5 days of green numbers. The rate of growth is slowing. For now. Are we still following the U.S. trajectory? Visually, and numerically, we’re not. Not so long ago, and you can still see it on the chart, Canada’s data was almost exactly perfectly 8 days behind the U.S: Feb 29, Mar 1, Mar 2… the U.S. had 68, 75 and 100 cases. 8 days later, Mar 8,9,10 — Canada had 66, 77, 94 cases. Perfect lockstep. And if you eyeball those numbers as you slowly go down the two columns, you see them in lockstep… and then they slowly start drifting apart.

The hope is that we wouldn’t follow them down the hellhole-course they’re presently on, and, for now, we’re not. We’re at 5,655 nationwide cases. 8 days ago, the U.S. was at 24,218. Had we “kept up”, today’s number would be 4x what it actually is. We’re now more than 11 days behind them.

So what does it all mean…

I’d like to address some of the comments that question the usefulness of these numbers in general, how the testing is inadequate, this isn’t reality, this is a useless exercise because the numbers are all bullshit. That the real case numbers are anywhere from 10x to 50x and it’s anyone’s guess. And therefore, blahblahbblah.

So, first of all, the way to solve big problems is to break them in half. Solve each half independently, and once you do, the big problem is solved. And if one or both of those halves is too complicated to solve, break it in half again and solve that. Keep breaking it in half until you have manageable pieces to solve.

The enormity of our present situation requires breaking it into hundreds of pieces, but here are some of the big ones, each of which needs to be broken down into many smaller pieces:
– the actual number of cases out there, factoring in recoveries
– the actual number of cases that require hospitalization
– why are some demographics hit so differently than others
– the testing infrastructure, and the strategy and adequacy of it
– the ability of our medical infrastructure to handle the cases
– the actual number of people dying from this
– the economic implications of allowing this to go on too long
– the herd immunity thing
– the treatment options, effectiveness of therapies, and timelines
– when and where is the vaccine

Without tackling all of that, notwithstanding each of those topics is its own book, and that’s only a small snippet of topics that need addressing, where we’re at right now is trying to solve chunks of a problem with incomplete information. One thing we have to our great advantage is learning from what others have or haven’t done ahead of us. Like one big change that was implemented today here is that the number of patients on ventilators doubled. Because suddenly a lot more people got a lot more sick? No. Because we learned from data elsewhere that putting people on ventilators sooner has a huge impact on positive outcomes. We didn’t know that two days ago, and now we do, and now we use it to our advantage.

Just because we don’t know something is no reason to throw our hands in the air — “these numbers are all crap anyway” — but to tackle this particular aspect…

Knowing the actual number of cases out there would have a profound effect on many aspects… first of all, how many actual new cases are there each day… how many of them will the person never even know, how many will they get sick but not too sick, how many will need a hospital, how many will die. If we could snap our fingers and know all that, it’d be great. One school of thinking that might kick in is that if actually the number is not 10x or 50x but actually 500x, and many of us have had it and never even knew it, and now we’re immune and will be for several months and even if we’re not, who cares, clearly I can fight this thing off so let me get a little sick and impose my herd immunity and get back to work since the actual mortality rate is only 0.2% etc.

Don’t think everyone has their heads stuck in the sand thinking the published numbers are the extent of this. One day, in hindsight, we’ll know those numbers. It’s possible that one day, we will have instant, cheap and available tiny-traces antibody testing. You’ll be able to wander into Starbucks, and along with your chai latte, spit into some throw-away little thing that’ll turn red if you’ve had it, stay blue if you haven’t. But until we get to that point, to a great extent, all we’re doing is buying time. Flattening the curve to suppress the load on our medical infrastructure. Isolating ourselves so we don’t infect others, especially those who are much likelier to get lethally ill. Keeping this thing controlled and contained until we’re certain we can manage it. It’ll likely never go away, and the waves of it appearing in the future will hopefully wind up in the “no big deal” pile.

But for now, the published numbers, the important numbers… the ones that are putting load on our medical system… the 884 confirmed, the thousands of others likely presumed but not confirmed… don’t think they don’t know about it. Don’t think when they tell you to stay home for 14 days, pay attention to your symptoms but don’t come in — that they’re not tracking you. You, who may well have it who think you don’t count — trust me, you do. Not in my numbers, not in their published active-cases numbers, but you’re out there somewhere, included in all of the projections of what might happen and how they’re going to take care of you if you get really sick. Some of you think you have it, but don’t. Some of you have it and don’t know it. Neither of you got tested, so hey what the hell they don’t know what they’re doing this is bullshit… yeah, no. Not at all. They’re not going to waste a test to confirm a mild test. There’s an N% chance you have it, depending on your age and other risk factors. Take care of yourself with the provided guidelines, and you’ll most likely be ok. And if you’re not, critical care awaits you with open arms. As opposed to everyone who thinks they might have it coming in and overwhelming a system that, certainly at the moment, is not prepared to test 2 million people overnight. If you’ve had it, one day you’ll know.

The fact that our hospitals are not overrun… the fact that we’re prepared at present to handle anything but the absolutely worst-case scenario… the fact that were are notably flattening our curve, both provincially and nationally… and the fact that we’re doing that with incomplete information, tackling big, multi-faceted problems… don’t worry too much about absolute numbers and how you feel they don’t reflect reality. They’re serving us well.

Speaking of serving us well, please take a moment to step outside at 7pm tonight (and every night) to cheer the heroes of this nightmare — hope you never need their help, but the army of medical workers of this province and this country, and indeed, around the world… deserve to (loudly) hear our gratitude and appreciation.

None of us like this. They don’t. You don’t. I don’t. But let’s remember… as hellish as it may be, the rollercoaster ride eventually ends.

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Day 11 – March 27, 2020

To circle back a bit on something I said yesterday… with a bit more detail…

The incubation period of a virus (which is up to 14 days in this case) indicates the period of time where someone might be infected, but not show any symptoms. Some viruses can be contagious during that time… as is this one.

In B.C., we were told to go home (and stay home) sometime around March 16th — 11 days ago. It was a bit of a loosey-goosey following to begin with… but it tightened up a few days later… 19th or 20th. Let’s call it 8 days ago.

With an incubation period of max 14 days… and without a serious lockdown until 8 days ago, we have a trailing 6 days where we were all going about our daily business, feeling fine and possibly not too concerned about the possibility of either passing this off or getting this from — someone else. Unfortunately, during that time, both of those things could have happened.

Which means, at this moment, we have this big unknown for the next 6 days… where we might see a spike in cases. The degree of that spike remains to be seen. That’s the potentially bad news.

The potentially good news, however… is that not all cases take to the last minute to show up, so we can learn a bit about what’s happened so far. During these 8 to 11 days of isolation, cases have certainly shown up… and our (for the moment, and hopefully forever) very capable medical infrastructure has been dealing with them.

Also, every single case that developed during that time in (proper) isolation, infected, at most, the people isolated around them. Let’s say that person is isolated in a home with 2 others. The N went to, at most, 3N.

What would have happened if that person were wandering around, not isolated?

R0 (“R nought”) is the number assigned to describe on average how many people someone who’s infected is likely to themselves infect. COVID-19 seems to have a R0 of around 2.2.

So… that one person, instead of infecting just those closely around them, might be outside somewhere infecting 2 or 3 random people. And those people might each infect more people. And if that’s happening every few days, after 3 weeks, that’s repeated 7 times… and now there are 250 cases. All from that one person, if they, and everyone else below them, infected an average of 2.2 others.

That is exponential growth. That is that scary growing curve we’re seeing in many places, like the U.S. That is why you always try to pay-off your entire credit card. That is why you try to keep your money where it’s earning interest that’s compounding. That’s why you’d better know what you’re doing if you’re breeding rabbits. And that is why physical isolation is so ridiculously important… and, when done correctly, effective. One person can make a colossal difference.

Guess what — that one person may have been you, and you didn’t even know it because you never developed symptoms. But by being responsible and staying isolated and not passing it along to someone else… well, one or more of those 250 could have developed serious (even fatal) symptoms. But they didn’t, because you’re doing the right thing. You may actually have saved a life.

And a bit of further potentially good news… at least here in B.C., there is most definitely a flattening of that curve. The numbers are certainly growing, but the growth is linear, not exponential. Like that N that turned into 3N instead of 250N. It’s growing, but not as steeply as the scary scenarios. Including a spike of 83 new cases 11 days ago, the average increase in cases in B.C. during that time has been 63 daily. Today was 67. Yesterday was 66. That yellow line is so linear you can put a ruler to it. For now.

As for all of Canada… well, there’s a definite separation between us and the U.S. We have had 4 straight days of decreasing growth, on a percentage basis. For now, that national curve is also flattening, and gapping notably with the emerging disaster south of the border.

I find myself saying “for now” a lot, and it’s because we’re dealing with a lot of unknowns. Like what the next week may bring. But if you want to be cautiously optimistic, it would appear that just one week of physical isolation is having a very measurable, positive effect.

And if that is the case, now is the perfect time to not go out rejoicing in the streets. The thing to do is what you’re doing. Stay home. What else are you going to do, anyway… it’s rain for the next several days. Yay Vancouver weather!!

That’s it. It’s not too much to ask. You’re not being called to charge Vimy Ridge. You’re not being called to storm the beach at Normandy. You’re being called to sit on the couch and watch Netflix. I have all the faith in the world you’re up to the task.

 

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Day 10 – March 26, 2020

Fun fact: Both South Korea and the U.S. reported their first case of COVID-19 on the same day: January 20. The present-day outcomes are so different that it’s worth understanding what they did (or didn’t), and where our approach, provincial and national, fits in.

The answers are long and complicated and will be discussed and argued for centuries, but it can all be distilled down to one brief and accurate summary: South Korea did a lot; the United States did not.

One thing South Korea did was test the hell out of this thing, as far and wide as they could. They developed and administered thousands of tests almost instantly — like a week — and were quick to isolate those that tested positive. The U.S.… didn’t. They stuck their heads in the sand for a bit, called it no big deal, and did little except stop incoming flights from China… but as far as I know, the COVID-19 virus is not a member of any particular frequent-flyer club. It doesn’t care what airline it flies, nor where the flight originated. Once it’s on the plane and headed somewhere, it’s landing and it’s sticking around.

It was initially thought that community transmission wasn’t a concern… the U.S. thought it, we in Canada (and here in B.C) thought the same; we will find cases, we will isolate them, the cases will resolve and it shouldn’t be a big deal. The risk to you and me is low. A month ago, there were only 7 cases in BC, and all of them could be traced to close contact.

South Korea’s initial jump of cases had a lot to do with their prolific testing, but what comes after is what’s worth noting. Their impressive flattening of their curve has everything to do with their reaction… isolate. And when it became apparent that community transmission was indeed happening, that’s the only reasonable course of action: Social/Physical distancing.

Since our testing hasn’t reached everyone, and since we don’t yet have antibody tests that would tell us who’s already had it, the only reasonable course of action is to pretend everyone has it, and act accordingly. Indeed, the way to think about it isn’t to assume everyone has it… and keep away. It’s to assume you have it, and take every precaution not to pass it along to anyone else.

We are being warned to expect a jump in numbers in the coming days, due to the difference between incubation times and how long it’s been since the directives were brought in. We may see a sharp increase in cases in the coming days… incubation period of 14 days minus 10 days of distancing equals 4 days where we were all potentially wandering around infecting each other. And as those infections kick in, the numbers will rise… possibly quite sharply.

It’s after that period of time that we should start seeing some real effects of what we’ve all collectively been doing. That black South Korea line is what we want. That blue American line, not so much.

On that note, and again, too early to tell… but here in B.C., our growth is, for now, linear. Good news… for now.

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Day 9 – March 25, 2020

At some point, we are all having “one of those moments” these days… it can last a minute… or an hour… sometimes, all day. The first thing I do when I update these charts every day is to enter the date, and today, when I entered Mar-25, I had one of those moments.

Seeing that date reminded me… that in some non-pandemic-infested parallel universe somewhere, the Canucks are playing the Sharks tonight, and I have tickets to the game.

I was really looking forward to it… because it was bound to be an exciting game. This is exactly the time of year when we’re typically fighting for a playoff spot, and usually, it’s a situation like the Canucks have to beat the Sharks, but also, the Ducks have to beat the Flames. And it’d really help if the Avs could beat the Oilers, just in case we lose, because then, next game, yada yada…

All of that occurred to me because… wow, do I miss that. I would so much rather be doing that sort of math… than this.

But here we are, so let’s look at these numbers… and hope that one day soon, all of us can get back to the things that feel so incredibly far away right now.

And, for what it’s worth, today was a good day. BC had a good day, and Canada overall did as well.

That yellow BC line looks good… for now. That will change in the coming days, and Dr. Henry was asked about how many cases she thinks are out there, as opposed to just confirmed cases. She will discuss it Friday morning, with some detail on the modelling they’re using to arrive at these estimates. There is a big difference between confirmed cases and actual cases… how big remains to be seen. But at least today, around here, it was a sunny day in many respects.

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Day 8 – March 24, 2020

As is often the case with us here in BC, the Wild West of Canada, we’re not always in sync with the rest of the country… and since the majority of people reading this are in BC, I’ve added a whole new set of data and graph… which is us… British Columbia.

I haven’t been following closely other province’s responses. Nationally, yes. BC, yes. But I’m not sure when Ontario or Quebec locked things down, nor the manner in which they did it. The reason that’s relevant is that while we’re seeing some not-so-great numbers out of Quebec today, the last few days here in BC paint a better picture.

We’re still over a week away from seeing the direct impact of the social-distancing order, and numbers will indeed increase between now and then… but the manner in which they increase is important, and for the moment, at least around here, it looks pretty good. The growth is linear, not exponential. At least for now. It’s evident in the BC graph, and it’s very evident when compared to the rest of Canada, which overall continues to pretty accurately track where the US was 10 days ago.

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Day 7 – March 23, 2020

The lack of data over the weekend left a bit of a gap… which I filled in with some guesswork. I know where we were on Saturday, and I know where we are now. How we got here looks to be pretty consistent, but the next few days are more important than the last few. We are tracking very closely to the US, trailing by 10 days… just before things started getting really out of hand down there.

It’s important to note that I’m tracking new cases — not active cases. It was good news to hear that 100 cases in BC considered active have been resolved to “cured”. More than 300 in Canada overall.

As time goes on, we can look forward to that number of resolved cases growing, but note that its growth doesn’t affect tracking new cases. Those will always go up. In fact, at some point, it’s (hopefully) likely we will have “negative” days — where there are less new cases than resolved cases… but the idea of these graphs is to simply track the spread (and control) of new cases. What we do with them is a whole other question, and I’ll be happy to offer my opinion on that as time goes on. So far, comparing it to what’s going on elsewhere in the world, it’s pretty good. And will gradually look a lot better if you all just #stayhome!!

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Day 6 – March 22, 2020

I don't like posting incomplete data, so stick a huge asterisk next to this… because there was no BC update today, so the Canada number is incomplete. Nevertheless, the other numbers are accurate, so here it is… and with tomorrow's update I will back-fill what's missing from today's and we'll see where we're at.

Hope you all got out for a bit of outside social distancing! Because most of the rest of the week is miserable rain, and for once — Vancouver rain — if that's going to stop people from clustering outside on the White Rock pier or the basketball courts at Kits beach… good.

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Day 4 – March 20, 2020

We’re still at relatively low numbers, tracking pretty closely to where the US was 10 days ago. It’s a continual rolling 10-day window to see how effective our efforts have been. It’d be really nice to see that red line detach from the blue one and continue straight across with no upswing and it’d also be very nice for our neighbours to the South to see their line flattening out.

The colour coding on the rightmost two columns of numbers signifies change from the previous day. The growth factor is a comparison between today’s new cases vs. yesterday’s. The column to its right is the percentage increase of cases nationwide. Green is good, because it implies a smaller increase than the previous day. A streak of green days in a row would be very nice to see.

Needless to say, especially this early in the game, these numbers are very susceptible to how many tests are being administered and who’s being tested. As time goes on and numbers get bigger and the data is more generalized, it’ll all mean more and be clearer. The localized clusters we’ve witnessed (especially in B.C.) are not indicative of the entire country. If we based our assumptions entirely on what’s unfortunately happened at the Lynn Valley Care Center, we’d be appropriately far more worried.

Shoutout out to Dr. Bonnie Henry and Adrian Dix, whose 3pm updates are not just informative but also reassuring. And to the sign-language guy… if we are all as passionate in treating this as seriously as that guy is with the way he conveys the message, there’s no doubt we’ll be ok.

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