R(t) by province, Feb 12. As @jm_mcgrath noted yesterday, Ontario hasn't managed to get below 0.7 previously, but we are actually there outside GTA right now, and we're at 0.75 in case data today.
Here are estimates from inside and outside GTA, based on inflation for reporting lags and back-estimation of transmission dates. We are at a level right now that would avert a 3rd wave from VOC. But you can't sustain this based on voluntary action and no support.
That's obviously foolish; if we have a March wave, it will cost billions of $, precipitate reactive restrictions, and kill people. The major source of deaths will be (very full) ICUs, as we should now have pretty good protection of most in LTC.
In this light, the Premier should be paying attention to @DorisGrinspun. Schools before businesses, keep working hard to bring case counts down.

A bit of tenacity would bring the province to a place where far lower case counts, the arrival of spring weather, and ever increasing vaccine availability diffuse this crisis without another major death event.
Support people with the hoarded $$ billions, help the province through this. Have the courage to stand up to your powerful friends. Actually do something "for the people", for a change.

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More from @DFisman

9 Feb
Having been recently encouraged to "stick to the science", I'd like to write a bit about COVID-19 disinformation, where it comes from, and how it is undermining our public health response.
Disinformation is a form of misinformation. The latter is incorrect information; the former is incorrect information that is propagated with intent to deceive and manipulate. The word is an anglicization of the Russian "dezinformatsiya", which I believe was coined by the KGB
Clear, accurate information is critical to our pandemic response; let's go now to my favorite paper on rank ordering of effectiveness of non-pharmaceutical disease control interventions. nature.com/articles/s4156…
Read 31 tweets
8 Feb
Some very simple models of covid case trajectories in Toronto based on decomposition of old variants and novel variants (b117 right now).
The dashed lines are forward projections. Solid lines are best guesstimates of fraction old (ov) and new (nv) variants based on lab data.
R for b117 seems around 40% higher than old variants, and that ratio was stable through January. So you can run this model forward assuming that ratio remains constant, and assigning an R to old variants (with nv 40% higher).
Read 9 tweets
5 Feb
So the identity of the @originandclever twitter account (now deleted) has been positively identified. It belongs to a junior physician in central Ontario. I am not going to doxx them on twitter.
But I would like to take a bit of a walk down memory lane in terms of some recent nastiness from this recently graduated physician, writing under the cover of presumed anonymity.
I don't know if this needs to be looked at by @CPSO, @UofTFamilyMed, @McMasterU, @UHN or other organizations this person has been affiliated with in recent years...would love to hear what others think. If journalists want more info, my DMs are open.
Read 25 tweets
5 Feb
I keep getting asked about the possibility that sars-cov2 will be with us for a long time (many of the questions are driven, I think, by Chris Murray’s statement that we won’t simply “put this behind us”). I do think it is likely to become a seasonal, endemic virus
At least for a long time to come. That’s because (a) the virus has show an ability to move from humans to animals and back again (mink) and (b) eradication is hard, even with good vaccines and disease w/o animal reservoirs (polio, measles).
And yet I’m optimistic about a non-reckless return to normalcy over the medium turn. Why?

en.m.wikipedia.org/wiki/You_Are_O…
Read 24 tweets
3 Feb
This is right on.
There is substantial excess mortality right down to age 15.
Absolute death numbers are smaller because baseline deaths are lower
Here’s the most recent estimate I’m aware of.

eurosurveillance.org/content/10.280…

We need to know what fraction of excess mortality in young adults is opioids.
In older adults in the US covid mortality and excess mortality are essentially 1:1

This is a fantastic paper from @AnnalsofIM that reminds us to standardize populations so we make fair comparisons.

acpjournals.org/doi/10.7326/M2…
Read 4 tweets
2 Feb
@DonaldWelsh16 Oh hello.

I knew Dr Rorabeck. He was a wonderful guy. @SchulichMedDent does have much to be proud of. Like any institution, it has its warts.
@DonaldWelsh16 @SchulichMedDent But to respond to your comment: I think you’re referencing the concept of balanced pathogenicity, which probably will will, over the longer term, favour less virulent strains.
@DonaldWelsh16 @SchulichMedDent The difficulty we have with VOC is that they appear to bind better to ace2 (as a vascular biologist I bet you’ve heard of that!) and that may underlie their increased infectivity and increased
Read 9 tweets

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