1/ Ontario COVID19 Testing and You (i.e. The Taxpayer)

Conservatively estimated total cost-to-date to Ontarians for PCR testing (incl. asymptomatics)?

Over $350,000,000

At 61,809 tests today, @ ~$52.50/test, that cost you ~$3.25m, or annualized…

~$1.2 billion (with a “B”)…
2/ The province is putting on a masterclass in resource misallocation…

For perspective, the Ontario Gov’t spends ~$4.3b annually on Long-Term Care.

That’s ~$150/day/resident, ~78,000 residents.

We are doing ~62,000 tests/day at @ ~$52.50 per test (again, ~$1.2b annualized).
3/ We should probably ask the question…

Given (i) the age stratified differences in COVID19 mortality, and (ii) that almost 2/3rds of all COVID19 mortality were of LTC residents, does it make sense to spend 27% of the annual LTC budget on mass PCR testing?
4/ It doesn’t.

…to be fair, the Ont gov’t will invest in LTC: in its recent 2020 Budget, it earmarked ~$1.75b to increase LTC capacity by 30,000 beds (not completed ‘til ‘22).

…so your annual testing cost, taxpayer, is in the ballpark of the cost of needed LTC investments.
5/ So just to drive the point home, we are spending on an annual run rate basis ~$1.2 billion for PCR testing, which is 27% of the annual LTC budget, and ~70% of needed long-term LTC investments.
6/ All this spending and resource misallocation (in my view) may come home to roost, as indicated today by the Ontario Financial Accountability Officer…
7a/ Test cost sources:

~$57.50/test: ncbi.nlm.nih.gov/pmc/articles/P…

~$47.50/test: 680news.com/2020/09/30/680…
7b/ An additional estimate here of ~$100-125 per test, given by a #COVIDZero proponent (so my using an estimate of ~$52.50 could be rather conservative).
8/ End thread.

...and another note to the journos…

You need to get to the bottom of three things:

1. The actual all-in cost per COVID19 test
2. The % of tests processed by private, non-public labs
3. The major public lab beneficiaries of this testing spend

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More from @rubiconcapital_

15 Dec
1/

Vaccine debate now brewing on (i) who gets it first, and (ii) vaccine rates required for herd-immunity & getting back to normal.

Public Health says no normal ‘til vax rates are 60-70% (*assumed* herd threshold).

The Toronto data says perhaps just 10.9%...

Let’s explore… Image
2/

I’ll get to the data in a moment, but first, I present two opposing viewpoints, then you can decide what the data says makes the most sense…
3a/

1st view, Dr. Yaffe today in Ontario:

“its gonna take months before…significant % of the pop vaxx’d--usually for infectious diseases 60-70% of the pop is needed for herd immunity; we’re not gonna get there until probably the summer”… 22m:30s:
Read 16 tweets
12 Dec
Link thread of the powerful & thought-provoking short video essays produced by @katewand on lockdown/COVID culture. She's now produced 4 of these incredible videos to date, & frankly I’m a bit shocked her following hasn’t grown faster (although she’s now at 2.3K subs on YT).👇
1. “Lockdown: The Right Side of History”

(essay by @stacey_rudin)

“In the COVID debate, there is a mainstream, 'popular' narrative, and a competing, 'unpopular' narrative — a 'fringe.' The former exploits the common, mediocre desire to be 'popular.'"
2. “Lockdown: The Dark Side of History”

(essay by @katewand)

“The year 2020 has been exemplary for those that believe obedience is a high virtue.”
Read 6 tweets
2 Dec
1/ Windsor, Ontario

Some chatter in Q&A’s in last few daily briefs with Premier/health officials re: rising cases in Windsor & potential for moving region to lockdown (just moved to “Red” zone on Mon, Nov 30).

Concern is hospital “overrun”… local hospital trends shown here…
2/

Case picture: yes, cases are rising, but overwhelming majority are traced to close contact or outbreak. Averaging only ~8 reported community cases of unknown origin per day. Image
3/

Overall new emergency admissions for three main Windsor-Essex hospitals appear to be:

*FLAT* for the entire month of November.

(Entire Erie-St.Clair area including Chatham/Sarnia also flat). Image
Read 8 tweets
22 Nov
1/ Toronto is entering full lockdown.

In this thread, I’ll show the absurdity of a citywide shutdown, simply using by-neighbourhood case/positivity data, w/ census data integration.

Unmeasurable, unnecessary collateral harm is coming; please read/share.

(get a cup of coffee)
2/ Note: if you are not in Toronto/Canada, you will still find this #SARSCoV2 prevalence analysis and its conclusions compelling, as these same dynamics likely exist in many of the world’s major cities.
3/ Quick note: this analysis follows and adds substantially to a previous related thread, found here (tweets 4a/b sites the data sources/limitations, which are the same as used in this current thread). All %pos/cases data is cumulative since Aug 30.
Read 39 tweets
20 Nov
1/ Brief thread… (I promise)

…focusing in on the correlations between (i) Toronto neighbourhood workforce/demographic concentrations & (ii) #SARSCov2 prevalence (cases/100k) identified in yesterday's thread.

Only a few sips of coffee/tea needed

(but this is no less striking) Image
2/ These data and observations *MUST* inform public policy on #SARSCov2/#COVI19, in my view.
3/ In my thread from yesterday, we examined % test positivity and cases/100k by neighbourhood in Toronto (for its 140 hoods) and then compared them to neighb'hood socioeconomic/demographic concentrations from census data to find (or not find) correlations.
Read 15 tweets
19 Nov
1/ Grab a cup of coffee (or tea)

A comprehensive, neighborhood-by-neighborhood review of #SARSCov2 prevalence/trends in the City of Toronto.

% positivity & cases, with weekly trends since Aug, AND:

*cross referenced with neighborhood census data*

The findings are incredible.
2/ Note: even if you are not in Toronto/Canada, I think you will find this data/analysis compelling, and universally applicable re #SARSCov2/#COVID19 learning and public policy implications.

Toronto’s diversity (>51% visible minority) makes it an interesting case study.
3a/ In this thread, I show/illustrate:

1. for Toronto’s 140 neighbourhoods (and groups of hoods, e.g. DT Core, Northwest), which have increasing/decreasing % pos & cases per 100k.

(Some peaked long before the Oct 10th restrictions. Others still increasing despite restrictions.)
Read 36 tweets

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