1/n Here's a short thread on COVID-19 deaths in Ontario's second wave.
Why are deaths still relatively low?
After all, weren't we seeing far more people dying in Ontario at this time in the spring?
Well, yes... and maybe no.
Why are deaths still relatively low?
After all, weren't we seeing far more people dying in Ontario at this time in the spring?
Well, yes... and maybe no.
2/n Here's the fall 2nd wave so far, left, compared to the spring 1st wave to its peak by daily cases, which came in mid-April.
As you can see: In the spring, deaths followed soon after cases — we clearly have *not* seen a similar pattern so far in the fall.
As you can see: In the spring, deaths followed soon after cases — we clearly have *not* seen a similar pattern so far in the fall.
3/n But let's remember the spring:
Infections were coming hard and fast.
The system was not prepared.
We weren't testing.
As a result. That case curve *was itself* delayed.
ie: Many infections happened weeks before the case was confirmed; that largely doesn't happen now.
Infections were coming hard and fast.
The system was not prepared.
We weren't testing.
As a result. That case curve *was itself* delayed.
ie: Many infections happened weeks before the case was confirmed; that largely doesn't happen now.
4/n You can isolate this if you replace the spring curve based on the number of cases reported each day (left) with a curve of infections by the estimated date a patient's symptoms began (right).
This is from the province's data, which came after-the-fact.
This is from the province's data, which came after-the-fact.
5/n Notice there's suddenly a *much* bigger delay until deaths show up!
Consider where Ontario was at on March 29:
At the time, were seeing ~300 people infected daily, but deaths were still in the low single-digits.
That starts to look more familiar, doesn't it?
Consider where Ontario was at on March 29:
At the time, were seeing ~300 people infected daily, but deaths were still in the low single-digits.
That starts to look more familiar, doesn't it?
6/n And we were testing much, much more narrowly at that time compared to now, remember?
This is oft-repeated but important: Compared to today, Ontario had far less capacity to test for COVID-19, and was using it on very ill people, mostly.
We're catching many more cases now.
This is oft-repeated but important: Compared to today, Ontario had far less capacity to test for COVID-19, and was using it on very ill people, mostly.
We're catching many more cases now.
7/n Where are we at today?
Well, we're seeing around 750-800 cases daily, with deaths still in the low single digits — now *a lot* more cases than the spring peak, but far fewer deaths.
But what's our true apples-to-apples number vs. the spring?
It's really hard to tell.
Well, we're seeing around 750-800 cases daily, with deaths still in the low single digits — now *a lot* more cases than the spring peak, but far fewer deaths.
But what's our true apples-to-apples number vs. the spring?
It's really hard to tell.
8/n Are we catching 3x as many cases now vs. the spring? 5x? 9x?
I really can't say.
But is 3x at least plausible?
Sure.
... and that would put the current infection rate about where Ontario was at the end of March — before the deaths truly started up.
I really can't say.
But is 3x at least plausible?
Sure.
... and that would put the current infection rate about where Ontario was at the end of March — before the deaths truly started up.
9/n There are other reasons to think fewer people are dying now — younger cases or better treatment, for instance.
But... then, it could be that the time hasn't passed yet.
At least to me, it's not yet clear the 2nd wave won't look like the spring.
There's no rule it can't.
But... then, it could be that the time hasn't passed yet.
At least to me, it's not yet clear the 2nd wave won't look like the spring.
There's no rule it can't.
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