Four points to make re: @SteiniBrown ’s presentation

1. This is a clear demonstration of how critical communication is to pandemic control.
2. We have a tsunami of deaths coming. I am so sorry. The “casedemic” rhetoric directly contributed to this tragedy, and I hope there are consequences for this who knowingly pushed disinformation.
3. @SteiniBrown is presenting near term epidemic curves that rise and rise. Their fall, if symmetrical, means that we can double the deaths on the way back down.
4. As I have noted previously, there is a *remarkable* degree of consensus on the modeling table around these projections. These projections come from modellers and groups across Ontario.

Everyone is getting the same answer and coming to the same conclusions.
*those
Lastly, I hadn’t wanted to share this prior to the presser but I think it simply reinforces the heat map in the now-public slides. This is test positivity by age in Ontario.

Red and orange are kids.

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More from @DFisman

7 Dec 20
This is a key point. We REALLY need to know that we have good surveillance infrastructure in place for novel vaccine technologies. We haven't used mRNA vaccines at the population level before; nor have we used adenovirus vaccines at scale.
The major issue with vaccine "phase 4" surveillance is mis-attribution of effects via a "post hoc ergo propter hoc" logical fallacy. Just because someone gets an illness after a vaccine doesn't mean they got the illness FROM the vaccine.
My favorite example from my AMOH days...was asked to sign off on a report from an individual who had tripped and chipped a tooth after being vaccinated. This was listed as a vaccine adverse effect.
Read 17 tweets
2 Dec 20
Interestingly there really is something to the idea that individualism vs. collectivism worsens ability to control covid. This is a very simple log-linear regression looking at the Hofstede individualism index vs. cases per million in late November. Red is model fit.
These countries differ in a lot of other important ways; you can run this with GDP, corruption perception index (corrupt places are doing better!), Gini coefficients...but those other indices seem to fall out of the model, and Hofstede stays in.
This is obviously ecological, caveat emptor. Lots of other things we could adjust for: testing rates, age structure, infectious disease vulnerability index (which has basically been invalidated by covid :)), but there's certainly suggestion of a collectivism/individualism effect.
Read 5 tweets
28 Nov 20
I am not sure what’s up with all the angsting about test characteristics of rapid tests. Worried about low specificity and false positives? Repeat the test and only consider repeat positives to be positive.
Worried about sensitivity and false negatives? Test twice and consider negative only if 2 tests are negative.
Tests are just tools to sort something into piles, with each pile enriched in the attribute you’re looking for
Read 8 tweets
26 Nov 20
Ontario will apparently ram through the extension of Dr. Williams' appointment at CMOH in the legislature today, some time around lunchtime.
Thanks to the AG's report, we now know that Dr. W is likely valued by the Ford government BECAUSE he is a weak and ineffective CMOH.
Moving forward, their comms strategy will be to frame any criticism of Dr. W's disastrous leadership as "personal attacks", so watch for that.

Here's my list of 11 reasons why Dr. W needs to be removed as CMOH. I'm sure there are more. These are factual, not personal.
1. Failure to acknowledge community transmission in March, which contributed to widespread hospitalizations and LTC outbreaks

2. Failure to deal promptly with the LTC crisis though the scope and likely toll of the outbreak were obvious by early April
Read 11 tweets
23 Nov 20
This is a great question. Here’s my response

The idea of vaccines is to get you to immunity without having to go through the risk and discomfort of illness, and without you passing through a state where you are an infectious case that creates other cases.

Also:
With vaccines we can actually eliminate disease.

Natural immunity doesn’t eliminate disease at the population level, because rising immunity pushes down R, which makes the current outbreak end but means the disease will resurgences when we re-accumulate sufficient susceptibles
Read 7 tweets
20 Nov 20
Reupping, because I was asked about Ontario ICU forecasts this morning, and want to walk folks through how to use this tool.
Many caveats as per usual:

1. This is a pre-print, currently under peer review. It may b wrong.
2. This isn't a mechanistic mathematical model; it's a simple statistical model.
3. Because I just made this it's not validated (events to validate or invalidate haven't occurred).
Though it does display good "convergent" validity with publicly available ICU occupancy estimates, as well as those from CCS and CIHI.
Read 24 tweets

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