Post

Tara Moriarty

@MoriartyLab

Apr 3, 2021 • 33 tweets • 24 min read • Read on X

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Apr 2

1 of every 43 #Canadians with #COVID19 has died since Feb 2020

1 in 69 BC
1 in 75 AB
1 in 78 SK
1 in 36 MB
1 in 49 ON
1 in 29 QC

1 of every 5 Cdns w/ C19 in long-term care & retirement homes has died

LAST 28 DAYS: 817 deaths, 1,335 LTC/RH cases, 368 LTC/RH deaths

Apr 2

-#COVID19 is in top 4 largest mortality events in #Canadian history

-Last 28 days: 817 Canadians died of C19

-If every week is like this week, 834 Canadians may die in next 28 days

Apr 2

#COVID19 #Canada

CASE FATALITY RATES

Wave 1 (to Aug 17)
Wave 2 (to Feb 18)
Wave 3 (Feb 19 to date)

Apr 2

Since Feb 2020

For every 1 Atlantic & Northern #Canadian who DIED of #COVID19 this many people died of COVID-19 in other regions*

BC 7X
AB 11X
SK 9X
MB 16X
ON 12X
QC 30X

Rest of #Canada 14X
Rest of World 9X

*after adjusting for population differences

Apr 2

#COVID19 #Canada DEATHS since Feb 2020

Table: Deaths/100K & change last 7 days for provinces, Canada, rest of world

Graphs
-Total deaths (mid top)
-Total deaths per 100K (mid bottom)
-Wkly rate of change in deaths (bottom right)

Apr 2

#COVID19 #Canada

DEATHS/100K

Wave 1 (to Aug 17)
Wave 2 (to Feb 18)
Wave 3 (Feb 19 to date)

Apr 2

1 of every 5 #Canadians with #COVID19 in long-term/ personal care & retirement homes has died since Feb 2020

1 in 5 BC
1 in 7 AB
1 in 5 SK
1 in 4 MB
1 in 8 ON
1 in 4 QC

There are 1,335 LTC/RH cases in last 28 days

Apr 2

#COVID19 #Canada

Long-term care/retirement home CASE FATALITY RATES

Wave 1 (to Aug 17)
Wave 2 (to Feb 18)
Wave 3 (Feb 19 to date)

Note: some of deaths reported in W3 may have happened in W2 due to slow reporting in this sector.

Apr 2

Since Feb 2020

For every 1 Atlantic and Northern #Canadian in long-term care & retirement homes who DIED of #COVID19, this many people in LTC/RHs died of C19 in other regions*

BC 6X
AB 10X
SK 4X
MB 13X
ON 11X
QC 32X
#Canada 14X

*adjusted for population differences

Apr 2

#COVID19 #Canada long-term care & retirement home DEATHS since Feb 2020

Tables: Per capita deaths + change last 7 days, % total deaths in LTC/RH

Graphs:
-Total & per capita values (L)
-% total deaths in LTC/RH (R top)

Apr 2

#COVID19 #Canada

Long-term care/retirement homes
-DEATHS/100K
-% TOTAL DEATHS IN LTC/RH

Wave 1 (to Aug 17)
Wave 2 (to Feb 18)
Wave 3 (Feb 19 to date)

Mar-Nov 14, 2020

For every excess death of Atlantic and Northern Canadians 45+ years

This is how many excess deaths in same age group there were in other regions (after adjusting for toxic drug deaths)

BC 20X
AB 10X
SK 15X
MB 8X
ON 19X
QC 35X
Canada outside Atlantic, North 21X

Mar-Nov 14, 2020

#COVID19 #Canada

Estimated excess deaths/100K in different age groups (all, 45+, 65+) compared to reported C19 deaths and C19 deaths estimated from seroprevalence data and current case fatality rates

Estimated excess deaths are adjusted for toxic drug deaths.

Mar-Nov 14, 2020

#COVID19 #Canada

Reported C19 deaths/100K over time compared to estimated excess deaths/100K in different age groups (all, 45+, 65+)

Estimated excess deaths are adjusted for toxic drug deaths.

Mar-Nov 14, 2020

#COVID19 #Canada

Reported C19 deaths/100K over time compared to estimated excess deaths/100K in different age and sex groups (all, 45+, 65+)

Estimated excess deaths are adjusted for toxic drug deaths.

Mar-Nov 14, 2020

#COVID19 Atlantic & Northern #Canada

Reported C19 deaths/100K over time compared to estimated excess deaths/100K in different age and sex groups (all, 45+, 65+)

Estimated excess deaths are adjusted for toxic drug deaths.

Mar-Nov 14, 2020

#COVID19 #Quebec

Reported C19 deaths/100K over time compared to estimated excess deaths/100K in different age and sex groups (all, 45+, 65+)

Estimated excess deaths are adjusted for toxic drug deaths.

Mar-Nov 14, 2020

#COVID19 #Manitoba

Reported C19 deaths/100K over time compared to estimated excess deaths/100K in different age and sex groups (all, 45+, 65+)

Estimated excess deaths are adjusted for toxic drug deaths.

Mar-Nov 14, 2020

#COVID19 #Ontario

Reported C19 deaths/100K over time compared to estimated excess deaths/100K in different age and sex groups (all, 45+, 65+)

Estimated excess deaths are adjusted for toxic drug deaths.

Mar-Nov 14, 2020

#COVID19 #Alberta

Reported C19 deaths/100K over time compared to estimated excess deaths/100K in different age and sex groups (all, 45+, 65+)

Estimated excess deaths are adjusted for toxic drug deaths.

Mar-Nov 14, 2020

#COVID19 #Saskatchewan

Reported C19 deaths/100K over time compared to estimated excess deaths/100K in different age and sex groups (all, 45+, 65+)

Estimated excess deaths are adjusted for toxic drug deaths.

Mar-Nov 14, 2020

#COVID19 #BritishColumbia

Reported C19 deaths/100K over time compared to estimated excess deaths/100K in different age and sex groups (all, 45+, 65+)

Estimated excess deaths are adjusted for toxic drug deaths.

Apr 2

Since Feb 2020

For every 1 Atlantic & Northern #Canadian DIAGNOSED with #COVID19 this many people were diagnosed with COVID-19 in other regions*

BC 10X
AB 17X
SK 15X
MB 13X
ON 13X
QC 19X
Rest of #Canada 13X
Rest of World 8X

*after adjusting for population differences

Apr 2

#COVID19 #Canada CASES since Feb 2020

Table: Cases/100K & change last 7 days for provinces, Canada, rest of world

Graphs
-Total cases (mid top)
-Total cases per 100K (mid bottom)
-Wkly rate of change in cases (bottom right)

Apr 2

#COVID19 #Canada

CASES/100K

Wave 1 (to Aug 17)
Wave 2 (to Feb 18)
Wave 3 (Feb 19 to date)

Apr 2

Since Feb 2020

For every 1 Atlantic & Northern #Canadian in long-term care & retirement homes DIAGNOSED with #COVID19, this many people in LTC/RHs were DIAGNOSED in other regions*

BC 4X
AB 9X
SK 2X
MB 7X
ON 10X
QC 15X
#Canada 9X

*adjusted for population differences

Apr 2

#COVID19 #Canada long-term care & retirement home CASES since Feb 2020

Tables: Per capita cases + change last 7 days, % total cases in LTC/RH

Graphs:
-Total & per capita values (L)
-% total cases in LTC/RH (R top)

Apr 2

#COVID19 #Canada

Long-term care/retirement homes
-CASES/100K
-% TOTAL CASES IN LTC/RH

Wave 1 (to Aug 17)
Wave 2 (to Feb 18)
Wave 3 (Feb 19 to date)

Apr 2

WHAT TO WATCH FOR:
-Weekly rate of change in CASES

WHY?

This shows:
1) if our efforts over the last month are helping
2) when there are warning signs that epidemic may be speeding up again.

Apr 2

WHAT TO WATCH FOR:
-Weekly rate of change in HOSPITALIZATIONS

WHY?

This shows:
1) if our efforts over the last month are helping
2) when there are warning signs that hospitalizations may be speeding up again.

Apr 2

WHAT TO WATCH FOR:
-Weekly rate of change in DEATHS

WHY?

Shows:
1) if efforts ONE MONTH AGO helped
2) warning clues if deaths may be speeding up

ALSO: Rates of change in deaths help us estimate effects of measures such as vaccination in LTC/RHs, where reporting is slow

https://twitter.com/MoriartyLab/status/1370498078063656961?s=20

Link to explainer of excess mortality estimates and what they mean:

https://twitter.com/MoriartyLab/status/1370498078063656961?s=20

@NoLore

Sources of collated official data (in addition to @StatsCan_eng & provincial sites), with huge thanks:

@NoLore

@RyersonNIA

@CU_IIJ

@covid_canada

@OurWorldInData

Thank you to everyone protecting themselves & others by choosing vaccination.

/end

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More from @MoriartyLab

Tara Moriarty

@MoriartyLab

Nov 17

Parking lot Visits in Your Cars
-FYI- This thread is also available on the C-19 website, starting on page 8, for easier reading. Risk Scenario Estimator Based on Canadian Forecast lookerstudio.google.com/embed/u/0/repo…

One of our volunteers wanted to know the risks of meeting their friends in a parking lot, with their cars side by side. How much risk happens in the air transfer between cars? What a great question!

The answer is – not much!

This scenario used the Average Canadian High Risk family this time, since they are more inclined to need and want to take extra precautions while still socializing.

The answer is – not much!

This scenario used the Average Canadian High Risk family this time, since they are more inclined to need and want to take extra precautions while still socializing.

OK, what’s a “car visit”?
Imagine two parked cars:
* Facing opposite directions
* Cars about 1.5 to 2 metres apart
* Driver windows opposite each other
* It it’s cold, heater may be on
We roll down the drivers’ windows and visit!

This is quite safe, as shown in the data cards.
Enjoy a very low risk way to share each other’s company.

For curiosity and data diving, by comparison, what if all 4 people were in one car?

That’s the second data card. Lots of red and big numbers of risk.

The Good air numbers are with windows open and those numbers are scary high for all but those wearing the best mask. Poor air estimates are with the windows closed.

Because the car is not moving, even with all the windows open there is very little air exchange.

Sitting in a parked car with several other people for any real length of time is Not a good idea!

Read 5 tweets

Tara Moriarty

@MoriartyLab

Nov 11

Canadian COVID Forecast Nov 9-22, 2024

CANADA

SEVERE (no change)

Estimated infections this week: 837,200-1,830,000

About 1 in every 31 people infected

Compared to lowest point of pandemic in Canada:

-Infections ~23X higher
-Long COVID ~23X higher
-Hospitalizations ~27X higher
-Deaths ~23X higher

https://x.com/MoriartyLab/status/1856096543465423033

Prévisions régionales sur la COVID-19 se trouvent ici :

https://x.com/MoriartyLab/status/1856096543465423033

Canadian COVID Forecast Nov 9-22, 2024

NEWFOUNDLAND AND LABRADOR

VERY HIGH (no change)

Estimated infections this week: 7,200-15,800

About 1 in every 48 people infected

Compared to lowest point of pandemic in Canada:

-Infections ~13X higher
-Long COVID ~15X higher
-Hospitalizations ~14X higher
-Deaths ~14X higher

Read 16 tweets

Tara Moriarty

@MoriartyLab

Nov 11

Canadian COVID Forecast: Nov 9-22, 2024

SEVERE: CAN, AB, BC, MB, NB, North, NS, ON, PEI, QC, SK
VERY HIGH: NL
HIGH: none
MODERATE: none

About 1 in 31 people in Canada are CURRENTLY infected.

https://x.com/MoriartyLab/status/1856097573292883987

Notre aperçu national en français :

https://x.com/MoriartyLab/status/1856097573292883987

WHAT'S NEW THIS WEEK?

The Forecast score for Canada is increasing 1%/week (-3% to +5%/week for all regions).

About 1 in 31 people are currently infected (~190,516 infections/day).

The confidence interval for infection estimates is wide this week (-/+ 37%), due to considerable fluctuation in waste water.

Model infection estimates usually increase before waste water signal and we may be at starting a new surge.

Read 10 tweets

Tara Moriarty

@MoriartyLab

Nov 4

INFLUENZA VS COVID-19 DEATHS IN CANADA
This thread is also available on the C-19 website, starting on page 8, for easier reading.
Risk Scenario Estimator Based on Canadian Forecast

#CovidIsAirborne #CovidIsntOver #MaskUp #YallMasking #CleanTheAir
(Liz)lookerstudio.google.com/embed/u/0/repo…

What is the proportion of influenza deaths to COVID-19 deaths currently? Thanks for asking!

This week's illustration compares annual deaths from influenza and COVID-19 in Canada.

There are about 3,500 flu deaths each year in Canada.

From 2022 onward, there have been at least 45,000 untimely ("from") COVID-19 deaths each year in Canada.

The number of people who die from influenza each year would fill the Agnico Eagle arena in Val d’Or QC.

The minimum number of people in Canada who die prematurely from COVID-19 each year would fill the Rogers Arena (SkyDome) in Toronto.
#CovidIsAirborne #CovidIsntOver #MaskUp #YallMasking #CleanTheAir

How many lives could we save each year in Canada with COVID-19 vaccinations?

If everyone 65+ is vaccinated every 3 months we'd save at least 32,850 lives.

If everyone 40+ is vaccinated every 6 months we'd save at least 28,350 lives.

If everyone (all ages) is vaccinated every 12 months we'd save at least 22,500 lives.

#CovidIsAirborne #CovidIsntOver #MaskUp #YallMasking #CleanTheAir

Read 7 tweets

Tara Moriarty

@MoriartyLab

Oct 27

Canadian COVID Forecast: Oct 26-Nov 8, 2024

SEVERE: CAN, BC, MB, NB, North, NS, ON, PEI, QC, SK
VERY HIGH: NL, AB
HIGH: none
MODERATE: none

About 1 in 34 people in Canada are CURRENTLY infected.

https://x.com/MoriartyLab/status/1850674688629920125

Notre aperçu national en français :

https://x.com/MoriartyLab/status/1850674688629920125

WHAT'S NEW THIS WEEK?

The Forecast score for Canada is stable at 0% change/week (-7% to +3%/week for all regions). About 1 in 34 people are currently infected (~157,097 infections/day).

After a long period of similarity, infection prevalence in Canada is now considerably higher than the October 21 estimate for the United States (1 in 115) from @michael_hoerger and team:

x.com/michael_hoerge…

Read 13 tweets

Tara Moriarty

@MoriartyLab

Oct 9

With the transition of Canadian COVID-19 reporting to the combined respiratory virus dashboard, weekly COVID-19 deaths for Canada are no longer publicly reported by @GovCanHealth .

According to the most recent report, participating provinces reported 971 hospitalizations and 131 deaths for the period from Aug 25-Sep 28/24.

During the same period, Quebec, which accounts for 22% of the Canadian population, reported 4,691 hospitalizations and 256 deaths (current INSPQ data).

If hospitalizations and deaths are similar in Quebec and the rest of Canada (likely), the national report for the Aug 25-Sep 28/24 period should include at least 21,323 hospitalizations and 1,164 deaths.

Based on the most recent @CIHI_ICIS reporting of Quebec in-hospital COVID-19 deaths (Apr 1/22 to Mar 31/23), there were 1.28 times more documented COVID deaths in QC hospitals than were reported by INSPQ for the same period. However, CIHI captured only 84% of INSPQ-reported hospitalizations in QC for this period, meaning QC in-hospital deaths were likely ~1.52 times higher than deaths reported by INSPQ.

About 70% of all deaths in QC occur in hospitals (StatsCan), meaning actual COVID deaths were likely ~2.17 times higher in QC than reported by INSPQ, at least from Apr 1/22 to Mar 31/23.

Is QC reporting only "from" COVID deaths and excluding deaths of people who would have died anyway from other causes?

To test this, we can compare excess mortality estimates from @StatCan_eng for the same period, after correcting them to remove excess mortality attributable to toxic drug deaths and excess cancer deaths (stand-in for potential excess mortality attributable to delays in access to healthcare and MAID).

The StatsCan excess mortality program has been paused for the last 10 months, so estimates for QC are only available up to Sep 2/23, and are still incomplete for weeks before this date.

However, weekly age-adjusted per capita all-cause mortality rates for QC and other provinces are still published every month, meaning weekly excess mortality can still be estimated by comparing weekly mortality rates in one year to mortality rates in the same week of the preceding year, and using these ratios to estimate current excess mortality values compared to previous years when estimates are more complete.

From Apr 1/22 to Mar 31/23, there were 2.19 times more excess deaths in Quebec than reported COVID deaths, after adjusting for excess mortality attributable to toxic drugs and cancer.

This is very close to the CIHI-based estimate of actual COVID-19 deaths (2.17 times higher than reported by INSPQ for Apr 1/22 to Mar 31/23).

Taking the average of both methods for estimating under-reporting in QC, we know that for the year ending Mar 31/23, INSPQ reported 46% of "excess/from" COVID-19 deaths.

If we assume the magnitude of under-reporting of COVID-19 deaths by Quebec was similar after Mar 31/23, then from Aug 25-Sep 28/24 there were likely 558 excess/from COVID-19 deaths in Quebec, and 2,537 COVID-19 deaths in Canada.

Recall, the total number of COVID-19 deaths in Canada from Aug 25-Sep 28/24 reported on the new respiratory virus surveillance dashboard from PHAC: 131

So, it's likely that the new national COVID-19 dashboard is reporting, ~5% of "excess/from" COVID-19 deaths in Canada.

However, reporting of COVID-19 deaths by Quebec has actually worsened since Mar 31/23.

How do we know this? Because from Apr 1/23 to Jun 8/24 (the last date when age-adjusted all cause mortality rates are available from StatsCan), there were 6.37 excess deaths for every COVID-19 death reported by INSPQ, after adjusting for excess mortality attributable to toxic drugs and cancer.

So, from April 1/23 onward, Quebec has likely been reporting only 16% of its COVID-19 deaths.

If the under-reporting rate for Aug 25-Sep 28/24 was the same as for Apr 1/23 to Jun 8/24, then there were likely 1,630 "excess/from" COVID-19 deaths in Quebec from Aug 25-Sep 28/24, and 7,407 "excess/from" COVID-19 deaths in Canada during the same period.

Recall, the total number of COVID-19 deaths in Canada from Aug 25-Sep 28/24 reported on the new respiratory virus surveillance dashboard from PHAC: 131

So, it's likely that the new national COVID-19 dashboard is reporting, fewer than 2% of "excess/from" COVID-19 deaths in Canada for the 2024 respiratory virus season to date.

And no, Canada doesn't have exceptionally high COVID-19 mortality rates.

From December 2021 to March 2023, the estimated median weekly COVID-19 infection fatality rate for Canada was 4% LOWER than the median infection fatality rate for the UK calculated from ONS infection estimates and confirmed COVID-19 deaths, even though Canada is slightly older than the UK and has had lower rates of fresh vaccine dose uptake than the UK from 2022 onward.

What was the median weekly SARS-CoV-2 infection fatality rate for Canada during this period? 0.08747%

What was it in the UK? 0.08824%

Open access ref for UK IFRs: ncbi.nlm.nih.gov/pmc/articles/P…

Why are so few of Canada's COVID-19 deaths reported?

It's likely that at least in part it's because many/most(?) provinces now only report deaths in people infected for the first time, as @sarperotto has confirmed for BC via official communications from BCCDC.

From Dec 4/21 to date, the average person in Canada has had ~3.5 SARS-CoV-2 infections. Reporting only deaths associated with first time infections would reduce reporting by ~70%....meaning only ~30% of deaths would have been reported if this policy was in place in every province.

On top of that, testing in Canada during Omicron has declined ten times more than the decrease in infection and fatality rates, meaning that a substantial number of deaths and hospitalizations simply wouldn't be detected because of under-testing.

So, it's probably a combined issue of under-reporting and under-testing, but either way, it's an enormous problem.

As the Office of Canada's Chief Science Advisor Dr. Mona Nemer @ChiefSciCan has pointed out, Canada currently has gaps in the effectiveness of our communication about COVID-19 vaccines. Fewer than 15% of people in Canada got fresh doses in the fall 2023 campaign.

Perhaps if we started reporting more than 2% of actual COVID-19 deaths on our new national respiratory virus reporting dashboard people would better understand why getting a fresh vaccine is so important, and journalists would have real numbers they can use to help communicate about the issue.

I don't know who else to copy in on this post--it's like shouting into the wind, and I don't know what it will take for Canada and ALL provinces to start improving actual COVID-19 deaths and hospitalizations.

@picardonhealth @NightShiftMD @DrGorfinkel maybe you can help resurrect a national conversation on this topic.

Should also copy in @CBCQueensPark, who's still following official public communication about COVID-19 vaccines, or rather, the near absence of official communication about their importance.

Sorry for the oversight, Mike.

Adding to this post after seeing some comments/questions.

1. Some provinces just may be reporting extremely slowly to PHAC, so it's possible those numbers may still come up.....but they'd have to come up a LOT to match what is expected, if fewer than 2% of actual deaths are being reported.

2. Quebec hospitalizations are almost certainly under-reported too. It's likely it's not under-reporting so much as under-testing.

In the UK, during Omicron, there were 5.16 reported COVID-19 hospitalizations for every reported COVID-19 death. That's a mortality rate for hospitalized cases of 19%, which is about 5 times higher than mortality rates for all non-COVID-19 causes of hospitalization in Canada.

However, UK-reported COVID-19 hospitalizations per COVID-19 death are about half the number of hospitalizations per death reported by France, about half the admissions/death ratio reported by CIHI for Canada from 2022-2023, and about half the number of hospitalizations per death reported by Quebec up to March 31, 2022. Canada and the UK have some of the lowest numbers of hospital beds per capita of any OECD country, so the UK may admit fewer people with COVID, even though the mortality rate is high. Hospitalizations are also defined very tightly to include respiratory codes, which likely excludes COVID cases without respiratory codes in patient charts.

If we take the average hospitalizations per death reported by France during Omicron (France was historically an excellent reporter for COVID hospitalizations), by CIHI for Canada from 2022-2023 and by Quebec for Omicron up to March 31, 2022, then we would expect ~9.4 hospitalizations for every death.

For Aug 25-Sep 28/24, when there were an estimated 1,630 COVID deaths in Quebec, we'd expect 15,322 hospitalizations. However, 4691 were reported for this period. This means that about 31% of expected Quebec COVID hospitalizations are currently being reported.

And we would have expected 69,645 reported hospitalizations for Canada. Recall the number reported during this period on the new dashboard: 971

So, likely fewer than 2% of COVID-19 hospitalizations for Canada are being reported on the new dashboard--similar to the proportion of COVID deaths reported.

Again, this may be under-reporting--and it certainly is for many provinces. For Quebec I don't think it's under-reporting of known hospitalizations so much as under-detection of COVID-19 in people who are hospitalized, because of under-testing. And Quebec still tests considerably more per capita than other provinces.

Finally, it's possible that fewer than 2% of the expected 69,645 COVID-19 hospitalizations in Canada were reported for Aug 25-Sep 28, 2024 not just because of under-reporting and under-testing, but also because some provinces may simply be admitting far fewer people with COVID-19 to hospital.

The number of people who report receiving Paxlovid in Canada is almost negligible, so it's not because we're able to avoid admissions because we're prescribing a helpful drug that's now available to help prevent hospitalization. And most people who need to be hospitalized with COVID need hospitalization more than one week after symptom onset--too late for Paxlovid.

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