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embedding a Tweet that was shared today by CBC's Kives from an NYC ER doc who shares observations on how the surge is affecting them and compares/contrasts to the initial 2020 wave. Highly recommend clicking and reading the whole string for anyone interested in an honest, front lines look at what this particular variant is looking to be capable of and what it isnt:
Just leaving the ER.It was a long day. And a stunning amount of Covid.Today I worked in an area that was temporarily converted into a makeshift ICU during the first COVID wave.Here’s what different from then.And also what challenges we’re facing with this surge in NYC: uD83EuDDF5— Craig Spencer MD MPH (@Craig_A_Spencer) January 4, 2022
Just leaving the ER.It was a long day. And a stunning amount of Covid.Today I worked in an area that was temporarily converted into a makeshift ICU during the first COVID wave.Here’s what different from then.And also what challenges we’re facing with this surge in NYC: uD83EuDDF5
The thing that really stands out and that have started to see in a few other places is the idea that in terms of ICU level of severity they aren't seeing a spike, but in cases that are bad enough to require hospitalization it's really taking off to the point where their numbers are the worst in more than a year and a half and still climbing. I want things to get better as much as the next person and I know we'll see the other side of this, but when you see me posting in these threads with this kind of passion its because I see a real incongruence in this community in many between what people are very confident we're facing and what it's entirely possible we could be facing. The "let it rip" crowd who have come to an opinion that this is their ticket to normal and the folks that are stuck on "milder", most if not all of which I'm sure have good intentions, really need to start asking themselves what Manitoba looks like if we have a similar rise in hospitalizations when our system is already taxed. No matter how many people repeat the same thing to each other on social media and whip up through group think, it doesn't change what it's looking more and more like is possible with too much complacency.
No speculation. There are some that are confidently writing off Omicron as “milder. ” Illustrating how a virus that’s tagged as “milder” in terms of average impact on any given person can have a very serious impact on a wider medical system with a fraction of the hospitalization rate if it spreads a lot more easily. We don’t know how serious that impact will be, but the increasing body of info and examples that are avail to us are pointing more and more toward the chance of this becoming something serious. Certainly not at a point (publicly that’s been disclosed at least?) where we can throw some numbers into a calculator, see how many extra hospitalizations we will have and know whether or not it will break our medical system however one defines break. For that, folks with access to more data, current info and medical expertise than you or I look at models for different scenarios, consider what’s likely, what’s realistically possible, what they’re willing to take chances with, what requires further measures to reduce risk and then decisions-makers make calls based on that info. If deemed necessary there are absolutely more tools in the toolbox to reduce contacts, knowing that more contacts means faster spread and more cases at any given point in time. Ontario obviously has models and at least a realistic scenario where their current track could lead to “catastrophic” results… and this in a province that until the weekend had been beating the drum pretty solidly on balancing economy vs virus, on students in class vs remote. Don’t have to be an expert to see that what they announced Monday significantly cuts back on contacts that they’ll have for the next couple weeks that hopefully slows spread enough to blunt whatever impact they’re seeing as possible. In Manitoba our people have been saying that conversations are ongoing and that we need to be ready to pivot, so it’s def not as if they aren’t watching closely within whatever the dynamic is between public health officials and the politicians that take in their advice and make decisions. We will have our own models. I think we agree that it’s time for, just like during the Spring wave, the public to be given a more transparent look at what those models are showing. If there are uncertainties around the delay in testing let's see what the scenarios could be. From there we can understand the path we might be on and, if it’s the case, why we would be different from what Ontario is looking at when we’ve been reminded for weeks that our medical system was already pushing its limits before this latest wave even hit not just in terms of demand for beds but demand for staffing. I would hope that even the most optimistic person with an interest in knowing more about the realties of what we’re facing is at least a little concerned and curious what Ontario officials are seeing that ours might not be. Hope is that ours arent taking different risks on our behalf in the name mainly of a couple weeks of less disrupted business and school.
Cool. Math minor here with heavy emphasis on stats, so no slouch either. I will have spent more time writing this post than I have learning medicine in my life time, so don't hesitate to keep that in mind tho :) All of the noise on assumptions and your definition of fact aside, look at the graph in this tweet below from the same NYC ER doc mentioned above. What does Manitoba look like if Omicron drives an outsized surge in hospitalizations anything like that? Whether or not we can say that will be our exact experience (definite differences between us and there to go with similarities), are we yet taking it seriously enough to guard against what at minimum has to be a realistic possibility?
But still so many needed hospitalization.Right now NYC has over 5,000 Covid hospitalizations.More than last winter’s peak.Higher than any point since May 2020.3 times higher than only two weeks ago.And still climbing higher everyday. pic.twitter.com/xZyKIpwCKT&mdash: Craig Spencer MD MPH (@Craig_A_Spencer) January 4, 2022
But still so many needed hospitalization.Right now NYC has over 5,000 Covid hospitalizations.More than last winter’s peak.Higher than any point since May 2020.3 times higher than only two weeks ago.And still climbing higher everyday. pic.twitter.com/xZyKIpwCKT
Here's the link on the school announce that's coming at 2: https://www.cbc.ca/news/canada/manitoba/manitoba-covid19-return-to-school-update-1.6303606
Province's Youtube channel is at link below where I assume it'll be streamed: https://www.youtube.com/user/ManitobaGovernment/featured
You're trying to calculate the future based on data that's still very much evolving and has very little trend in this country to base on. I suppose where we differ is that you seem to be suggesting that since we don't have that exact information we shouldn't be doing much of anything different, whereas I'm saying that I'm uneasy with us taking the extra chances that we seem to be based on what's showing in for example NYC and what Ontario and Quebec are already doing a lot more than us… tho the announcement just made re Manitoba schools starting in remote learning seems like a step closer to the direction of what those places are doing. Again, this is about risk and how much we're willing to accept. You can't completely discount the identical virus and what it's doing to people from the identical species just because its in a different city or country. One might suggest that there's a chance they'll see an even stronger impact based on how many people they have in tight spaces on a day-to-day basis compared to us, but even that is mainly a guess that's getting more into epidemiological territory that I and I suspect yourself are starting to try punching above our weight to make. To all of this, at today's media conference Dr. Atwal alluded to it taking about another week before they'll have more of a read what to expect in Manitoba as far as outcomes, hospitalizations and the like in what’s referred to as a rapidly evolving situation. It was said that there were issues with the model that they’ve been using, an older model, and that they hope to get an updated model within 24 hours. There was no hint of any further imminent restrictions being considered, though questions were answered in a way that didn't rule it out. Was still not made clear what info Ontario might have that we don't or what makes them a lot different than us, but I take out of that that we can expect more action to be considered by early next week depending on what models at that time show.
There's a concerning number of local folks on social media that have jumped the gun and are confidently dug in on the "milder" messaging to the point of already supporting *less* restrictions. Based on all of the uncertainties still around this and the fact the province has even said that they aren't working with current models, those folks need to at least be open to this taking a turn that it's taken elsewhere and to do our best to make sure it doesn't get any worse from here than it has to. To that I take that the you’s and me’s of the world will both need to do our best to wait until next week for them to have the data they need to better assess where this goes next… and that based on that this could go either direction. Based on how proactive Ontario is being with the same virus and variant I’d personally feel a little better if I was on the Kenora side of the border four hours to the East of here, but it’s clear what our approach is here and about all we have to go on is a level of trust that if they see things continue to deteriorate over these next few days they will take faster action if or as they identify it as justified.
Until whatever next steps are or aren't, I hope we can all meet in the middle on the fact that folks need to as asked do everything they can to limit contacts, limit spread of this virus and follow public health advice on vaccination to limit the impact of whatever this turns out to be.
More on Ontario, where in Toronto today their Mayor said that they're preparing for a worst-case scenario of 50-60% of frontline workers being absent because of being sick or exposed to Covid: https://toronto.ctvnews.ca/toronto-preparing-for-up-to-60-per-cent-of-its-frontline-workers-to-be-absent-due-to-omicron-1.5727358 Same virus, worst-case and not necessarily highest probability scenario, but hopefully in Manitoba we're at least considering a similar scenario and what we would do if found in that sort of spot. More congested urban area if one wants to hang their hat on that impacting things, but would hope that folks focusing on that "milder" narrative folks understand what taking this too lightly could potentially lead us toward.
Winnipeg Sun’s Ryan Stelter raises a lot of important questions after today's school announcement and the, to many, strange packaging of a week of remote learning as prep time to a return to physical school 7 days later despite province admittedly not having current suitable models to work with at the moment:https://winnipegsun.com/opinion/columnists/stelter-province-gets-failing-grade-in-its-return-to-school-plan
Quite the contrast with Ontario one province over, who are being much more direct in referring to closure of schools and move to remote learning until Jan 17 as "subject to public health trends and operational considerations" and connecting their newest measures including school closures to the need to slow transmission, the likelihood that hospitalizations with "ascend rapidly" into late January, preserve hospital bed capacity and respond to what their Premier refers to as an "absolute certainty" that "operating schools, ensuring teachers are on the job and not home sick will be a challenge we cannot overome in the short-term."
I’m not generally terribly entrenched in one political party over the other and have over the last decade voted for parties on each of the three main spots on the political spectrum between federal and provincial. I will say that this fellow (or whoever handles his Twitter account with posts like this as some politicians have) really seems to have found his voice in the opposition role lately. Feet to the flame on a lot of important topics and striking a pretty good balance overall by not picking a lot of the kinds of petty, poorly-timed non-constructive fights for sake of fights that some in that same role can sometimes fall into.
Given their track record in not preparing the health care system for 2 years it doesn't seem likely the PCs will make schools safer in 1 week.Children definitely learn better in-person but we need to take strong, quick steps to make schools safe.— Wab Kinew (@WabKinew) January 4, 2022
Given their track record in not preparing the health care system for 2 years it doesn't seem likely the PCs will make schools safer in 1 week.Children definitely learn better in-person but we need to take strong, quick steps to make schools safe.
What real steps will be taken during 1 week remote learning period to make schools safer for Jan 17? Many things announced today won’t happen until later in the school year.There needs to be a real plan for HEPA filters, & accelerated plans to distribute masks & rapid tests— Wab Kinew (@WabKinew) January 4, 2022
What real steps will be taken during 1 week remote learning period to make schools safer for Jan 17? Many things announced today won’t happen until later in the school year.There needs to be a real plan for HEPA filters, & accelerated plans to distribute masks & rapid tests
I was reading that in BC, their Roussin-equivalent has regular meetings with their opposition leader. Not convinced that’s necessarily the case here but I think it would be valuable to have another voice involved in the process to shift things a little away from this sense that the COVID response from here to 2023 is a tied to the political future for the party in power, and it would open the door to a healthy kind of accountability that if his tweets are any gauge he would prob use responsibly. These last few weeks have really raised questions about the hope I had that Stephenson, whoever's in Premier’s inner decision circle and what seems like same old communications dept are what I had in mind for a new PC party I’d consider voting for after Pallister. As much as hard core partisans would prob scoff at it, maybe the strength and openness to involve a counterpart that does politically represent a lot of ridings would give a new look at a new Premier that seems to be working through some challenges establishing herself over these past few weeks.
An example of what’s prob coming with impact of potential mass isolations within workforces that go well beyond health care workers or, as Ontario has identified, education staff. Winnipeg Police declaring a state of emergency… 170 people including 136 officers... https://globalnews.ca/news/8490194/winnipeg-police-chief-declares-state-of-emergency-for-force-due-to-covid-19/amp/
Another example of of growing effect on staffing. Winnipeg press conference today saying many services are strained with high levels of absenteeism in areas including transit and fire paramedic: https://www.cbc.ca/news/canada/manitoba/update-city-winnipeg-response-covid19-1.6306066
I’ve had a lot of focus on contrast with Ontario, but a look at approaches of a few other provinces unless I’ve missed any last minute changes.
For ultimate contrast, province on the other side of us Sask has gone with full-speed-ahead return to school. Only province to not delay at all and are now back in class. Imagine there will be a lot of eyes in the country on what their experience is as perhaps the first Guinea pig in how Canada schools operate with what’s expected to be level of roving disruptions from this wave be it in workforce or students. Active case stats have to be taken with a good-sized grain of salt these days, but FWIW their stats page shows about 1/4 the active cases that Manitoba's shows despite being not far off from our population: https://www.cbc.ca/amp/1.6304975 BC has sat this week out, returning Monday with expectation of potential for wide scale absenteeism. Have a plan in place that gives individual school districts space to set policy on how they respond in cases where workforce disruption requires change. Story below has a detailed account of how Surrey would, after identifying an unworkable shortage in staff, over the course of three days transition to remote learning. That district expects any of these closures to last 5-7 days before staffing levels bounce back. Again with big grain of salt on the stats, but BC's dashboard shows nearly 50% more active cases vs Manitoba relative to having 3.5x more population:https://www.cbc.ca/amp/1.6304438 Alberta returns Monday. Maybe someone that's learned more will add, but from article at this next link I think it seems focus is more on prev approach of identifying specific classes and grades that have cases and shifting to remote with less overall focus on the staffing concerns raised elsewhere. Double the active cases shown as MB from about triple the population, but with all of these it's difficult to impossible to know actual shear number of active cases: https://edmonton.ctvnews.ca/alberta-parents-and-students-grapple-with-in-person-learning-1.5730759 I’m not sure how much data and how many experiences we can expect to flow next week from these other places or how many days it would take in school to be able to start drawing conclusions, but hopefully the next week off in Manitoba has the effect of giving a chance to see what the experience has been for each of these three (and any others) and apply to whatever our plan ends up being after this week.
As much as some clues are showing up in other workforces, I’m not sure anyone can say they completely know how the dynamic will work out. Everything of course needs to be run through the filter of different regions potentially having different levels of COVID in the progression of this wave, being at different levels of still dealing with Delta effects, different levels of restrictions outside of schools and medical systems in different states to meet any needs for hospitalization. I've gone off the assumption that especially because of our Delta lag we're worse off than any of the above, but thats hopefully where the all-elusive models in this province will hopefully give decision-makers (and extra-hopefully the public) a more accurate picture in assessing where we're at and what our risks are here.
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