1/ This is a lucid and very well thought out article on Covid-19 that touches on the key elements that must be addressed. It’s from a US perspective but Canada is in a better position to implement: jamanetwork.com/journals/jama/…
2/ To date, Canada has largely dealt with the pandemic at a provincial level, as healthcare is delivered that way. The provinces differ in impact but this is largely a result of timing, population density and proximity to US.
3/ So while we can learn from what policies have worked and what haven’t, like much of the world, the relentless nature of the infection means most regions are likely to catch up to case % - just that some will have more time - bought by distancing and other policies.
4/ But, excepting NewZealand, the case curves are just flattening close to their peaks and showing much slower rates of receding compared to their exponential increases. That means on-going transmission that will increase as restrictions are relaxed.
5/ That also means that the increasing pressure to relieve measures due to economic and other stresses will directly face off with the present and future risk of another explosion of cases and deaths.
6/ So how can this rock/hard place dilemma be resolved? Some suggestions (from an amateur observer):
A. People have a hard time with relative risk. Practical education of how SARS-CoV-2 is transmitted and how it’s most likely not helps. People are the vectors, not bags of chips.
A. People have a hard time with relative risk. Practical education of how SARS-CoV-2 is transmitted and how it’s most likely not helps. People are the vectors, not bags of chips.
7/ B. Too much communication appears patronizing. Empower people with knowledge. They’ll make better decisions.
C. Graduate relief of restrictions. Open parks but reiterate distancing. Close roads for safer pedestrian access.
C. Graduate relief of restrictions. Open parks but reiterate distancing. Close roads for safer pedestrian access.
8/ D. Reintroduce elective surgeries by testing patients. This is the pay-off of the effective flattening of the curve.
E. Social distancing means good riddance to hours long waiting rooms at hospitals. Beep people 15 mins before. Empower patients rather than shepherd them.
E. Social distancing means good riddance to hours long waiting rooms at hospitals. Beep people 15 mins before. Empower patients rather than shepherd them.
9/ F. We need radically changes to test and surveillance infrastructure. We can’t simply extrapolate non-pandemic mechanisms. There need to be log increases in testing frequency. This is the new norm. People will subject themselves if it allows greater freedom to live their life.
10/ G. And that needs a federal mandate just like the military. No region or province should find their own solution. This needs a coordinated plan for the future, not a knee-jerk response to a disaster. Because this is a long term problem.
11/ As every epidemiologist and infectious disease expert has been saying, you can’t fight a pandemic without data. A national screening plan will be the ladder out of this hole. And who knows, longitudinal blood analysis might solve a few other health problems too. /fin
