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I'm writing a tweet thread on what I think COVID in Canada in 2021 will look like. Short version: the next months will be much worse than anything yet--we are nowhere near the bottom--but come summer, the nightmare will slowly lift. (Thread)
There are two variables to reckon with: the vaccines, which are pulling with us, and evolution, which is pushing against us with new viral variants that are much more aggressive (you may have heard of the B.1.1.7 variant from Britain). Both are key to predicting the future.
First the viral variants.
By know, you know that success is measured by keeping the epidemic's growth rate (called "Rt") below 1.0.
These new viral variants have the killer feature (literally) that they are 40-70% more transmissible, meaning that they increase Rt by 0.4 to 0.7.
By know, you know that success is measured by keeping the epidemic's growth rate (called "Rt") below 1.0.
These new viral variants have the killer feature (literally) that they are 40-70% more transmissible, meaning that they increase Rt by 0.4 to 0.7.
Currently, every province from BC to Quebec has an Rt at or near 1.0. In other words, even WITH today's lockdowns they're just treading water.
Now imagine the variant adds 0.7, making Rt = 1.7. You get faster epidemic growth than ever, and that's even WITH today's lockdowns.
Now imagine the variant adds 0.7, making Rt = 1.7. You get faster epidemic growth than ever, and that's even WITH today's lockdowns.
To look at it another way, as the variant virus evolutionarily replaces the "friendly" virus strains we have now, which is certain because it is better at transmitting, these provinces will see the epidemic double perhaps every 10-20 days even with existing lockdowns. YIKES!
Throw school and business reopening on top of that and it's even worse, which is why I think we can't afford doing either right now. I'm really sorry to say this, but viral evolution can't be bargained with. We are where we are and it sucks.
There are only two ways out of this nightmare.
First, drive Rt well below 1.0. Atlantic Canada did this with its "Zero COVID" strategy, and often has an Rt around 0.7. If you do that across Canada, it gives you a bit of a margin to "absorb" the variant's damage.
First, drive Rt well below 1.0. Atlantic Canada did this with its "Zero COVID" strategy, and often has an Rt around 0.7. If you do that across Canada, it gives you a bit of a margin to "absorb" the variant's damage.
Doing an Atlantic Canada is CRITICAL, because it buys you a few months of peace with the variant virus, which is just enough to for the next step, which is...
Second, kick vaccination into high gear. Canada has two problems there: (i) Trudeau dithered far too long to buy vaccines so we are not getting big deliveries before April, and (ii) the little bit we have now is sitting uselessly in freezers rather than reaching Canadian arms.
It is too late to change the sad fact that Canada's going to have a vaccine shortage for months. While other countries expect tens or hundreds of millions of doses, Team Trudeau lined up only 6 million doses by March--enough for under 10% of Canadians. https://www.reuters.com/article/us-health-coronavirus-canada-vaccines/canada-expects-six-million-covid-19-vaccine-doses-early-in-2021-idUSKBN2802IS
Sorry to rewind, but the fact Canada will have no mass vaccine deliveries quickly means that the Zero COVID strategy of Atlantic Canada is EXTREMELY important. If Canada can't buy vaccine, Canada has to buy time instead. There is no other choice--except dying.
Trouble is, Canada's public health establishment is incompetent at rapid vaccination. The provinces received 539,000 doses starting weeks ago, but as of today 80% of doses are still sitting in freezers, rather than in patients' arms! https://art-bd.shinyapps.io/covid19canada/
Don't believe the bogus story that the slow vaccination progress is because of the holidays, because it isn't. Canada has never managed to vaccinate over 14,000 people daily. At that rate, it'll take SEVEN YEARS, which is simply pathetic.
For comparison's sake, Ohio has vaccinated more people than all of Canada. Despite being less populated than Ontario, it has vaccinated quadruple the number of people.
Even tiny Israel has vaccinated nearly ten times as many people as Canada. So yes, we're very far behind.
Even tiny Israel has vaccinated nearly ten times as many people as Canada. So yes, we're very far behind.
Worse, I've seen no plan to get Canadian vaccination numbers up to historical levels .
For example: in 1947, New York City vaccinated 5,000,000 people in JUST TWO WEEKS! Canada has no similar plan for when vaccines arrive in large quantities. https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.37.11.1376
For example: in 1947, New York City vaccinated 5,000,000 people in JUST TWO WEEKS! Canada has no similar plan for when vaccines arrive in large quantities. https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.37.11.1376
Or better, one of the world's poorest countries, Bangladesh, successfully vaccinated 52 MILLION kids in just three weeks in 2014.
NOBODY in Canada's public health establishment is thinking along those lines, which is frankly pathetic. https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-7176-4
NOBODY in Canada's public health establishment is thinking along those lines, which is frankly pathetic. https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-7176-4
I'd like an explanation of why poor Bangladesh is able to kick wealthy Canada's ass at vaccination, and our public health establishment thinks that's just fine. It's frankly disturbing that Canadians don't have the ambition, or apparently leadership, to save their own lives.
I raise this because after April, I expect the taps to open and Canada will have plenty of vaccine. But without a plan for express vaccination, Bangladesh-style, that vaccine will just sit in fridges and freezers from coast to coast to coast. Leadership is failing here.
What vaccines are coming? Surely the Oxford/AstraZeneca one, which is now approved in the UK and India and which I predict will be the world's most utilized vaccine in 2021. And hopefully also the Johnson & Johnson vaccine, which may outperform it (if trials pan out).
The Oxford/AZ vaccine has advantages on the Pfizer and Moderna vaccines: it needs no freezing, it is easily transported, it can be made in huge quantities, and it costs much less. All are 100% effective against serious illness and hospitalization, so I'd take any of them.
To sum up: the variant is a 2021 nightmare, so first Canada has to buy time using Atlantic Canada's approach, and second Canada has to up its game to Bangladesh standards for mass vaccination come April.
OR THE ALTERNATIVE IS DEATH. Sorry to say so, but it's true.
* end *
OR THE ALTERNATIVE IS DEATH. Sorry to say so, but it's true.
* end *
