*This is not a tangential issue*
It directly impacts ICU narrative:

CCSO (live ICU) vs. CCM (gov’t patient database) continue to *DIVERGE MATERIALLY*
CCSO vs. CCM differ 3-fold!

@CriticalCareON & @publicHealthON must clarify:

CCSO daily new C-19 admissions are now almost FORTY-FIVE PERCENT (~45%) of new C-19 hospitalizations

A rising trend since Feb 1st, up from a range in the mid-20%s thru the winter wave

And 3X higher than CCM data (still in a consistent 10-20% band).

Note that for the entire pandemic, the national average of ICU admissions to total hospitalizations has been ~17.5%, according to PHAC weekly updates.

45% of new hospital admits being ICU admits is a massive statistical divergence!

On overall ICU counts in Ontario: notice @DrKaliBarrett only tells half of the story..

*Fluctuations in C19 ICU admits or C19 ICU levels DO NOT HAVE a material impact on # of overall ICU patients* (according to CCSO data)

And note that despite fluctuating C19 daily admissions, the ICU % utilization has been stable, and actually decreasing through the entire winter wave to current.

(Note: ~200 beds have been added since early December per CCSO)

Tagging @PublicHealthON @criticalcareON @ICESOntario @BeateSander @DrKaliBarrett @celliottability @ONThealth @AnthonyDaleOHA

Please address why the CCM pt DB is persistently undercounting "Ever in ICU" pts vs. CCSO? Is there a simple explanation?

Data from CCSO Reports; h/t @JeanMarc for compiling daily since December 2020

CCM ICU/Hospital Data from Ontario Data Catalogue: data.ontario.ca/en/dataset/con…
h/t @JeanmarcBenoit for compiling the CCSO data

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More from @rubiconcapital_

30 Mar
A cherry-picked stat is creating a media frenzy.

- A 50% ⬆️ in % of ICU admits in "younger people" vs. Dec is driven MOSTLY by admits in the 50-59 cohort!

- Yes, some ⬆️ in # of 49&U admits. BUT, the Ontario Science Table should know:

TWO data points DO NOT make a trend👇

The data in the Toronto Database (as of Mar 22) are abundantly clear:

There were just FIVE (5) Toronto residents 49 & Under in ICU (1 39 & U), down from 12 as of Dec 21/’20

The next weekly Toronto database update is tomorrow, and I will update if there is a material change.

Related: an Important data note/inquiry for CCSO (@criticalcareON) & @PublicHealthON:

There appears wide divergence in ICU admits between (i) PubHealth Ontario’s Case & Contact Management (CCM) database and (ii) the CCSO data. (The Toronto data cited above is from the CCM).
Read 7 tweets
25 Mar

The Ontario Science Table on March 23, published this report essentially recommending AGAINST asymptomatic testing of LTC staff, citing:

-Consistent low %pos of staff in screening
-Vaccination protection of LTC residents

Key observations follow...

Observation 1

54% of Ontario C19 deaths were among ~80k LTC residents. OST is essentially confirming this population is protected.

Ex-LTC, Ontario C19 deaths =~23 per 100,000 (in line with flu/pneumonia deaths in 🇨🇦).
C19 Survival rate excluding outbreak deaths 70+ =99.2%

Observation 2

OST indicates/quantifies the extremely low test % positivity of LTC staff in screen testing.

This seems contradictory to the OST conclusion that community incidence of C19 is the key predictor of LTC outbreaks.

Perhaps there is an explanation? cc:@drbobbell
Read 4 tweets
15 Mar
Ontario Science Table lockdown policy, backed by @fordnation, @JohnTory & @epdevilla, appears to have dramatically shifted C-19 disease burden onto the low income, high visible minority, high household density, high service worker areas of Toronto.

Shocking #’s & visuals follow. Image
First, a message to vulnerable communities:

In my opinion, health/govt officials put you in harms way. They⬆️your mobility *relative to the population*, shifting community disease burden onto you. They did not care about you. They cared about themselves and their failed policy.
We know there were relative disease burden differences. But to what degree?
Read 18 tweets
5 Mar
1/ Mass Vaccination – Why Do We Need it in Ontario (or anywhere?)

- LTC residents nearly vaccinated (55% of C-19 mortality)
- Progress in the most vulnerable (70+, 87% of mortality, 12% of pop)

A short thread with clips & charts, based on my recent video
2/ The public health messaging is clear—everybody needs a vaccine.

Dr. DeVilla of Toronto: “the sooner we have needles in arms and the more needles in arms we have, the better off we all are.”

(all clips from March 1, 2021 pressers)
3/ Dr. Williams, the Chief Doctor in Ontario:

“Wait for your vaccine, it's coming, we want everybody vaccinated, not just some, we want everybody done in a timely pattern.”
Read 18 tweets
31 Jan
Sensational article appealing to emotions, claiming Toronto ICUs "struggling with younger C19 patients". The headline may have you think ICU is in onslaught with young kids. ICUs are challenged, but the following charts don't match this narrative. 1/
Here are percentage of total COVID19 ICU admissions by age group in the 1st vs 2nd wave. Extremely low 6% of all ICU admissions in Under 39 ages, with only minimal changes in overall ICU admission mix in older ages. So the age mix of patients is roughly similar.
Here is the actual number of daily ICU admissions by age group... Under 39, 40-69, 70+....
Yes, we see the older ages are increasing... just like they were in the first wave...
Read 8 tweets
25 Jan
1/ It's hopeless, a thread.
2/ In the city of Toronto’s COVID19 update today, @epdevilla confirmed all first-round vaccines have been delivered at *ALL 87* of the city’s long-term care facilities and high-risk retirement homes.
3/ That’s great news !!

54.6% of Toronto’s fatalities occurred in these at risk groups…
…and excluding the high-risk LTC population…
…Toronto’s case fatality rate is 0.68%
…and just * 0.21% * in the under 69 population !

(see graph next tweet)
Read 9 tweets

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