#COVID19AB Balanced Scorecard
13 Sep 21

We're all interested in ICU, but I'll stay consistent with giving all metrics, including signals from Leading Metrics which end up in Severe Outcomes.

Test Positivity has paused at an all-time pandemic record just above 3rd Wave Peak.
@jvipondmd @GosiaGasperoPhD @RajBhardwajMD @TehseenLadha @drdagly @shazmamithani @kwburak @plasercalgary @noelgibney @dupuisj Looking at R for Alberta, we can see the "gas pedal" of R has eased up a bit, but still stays above 1.0, which means still accelerating with exponential growth of COVID-19.

The damage was done in July with that steep rise of R > 1.2 during & after Stampede.
I'm sticking with Leading Indicators of the spread of #COVID19AB, because They. Lead. To. Severe. Outcomes, including Death.

You can't grow ICU Capacity to match exponential growth. You have to stop the spread up front to give your healthcare system a chance, Public + Private.
See R in and within AB, from my friend @Mrhockey1231, who graphs R from Ontario biostatiscian @imgrund, who voluntarily covers across Canada daily.

R > 1.1 from March to May = 3rd Wave.
R > 1.2 in July + R > 1.1 in Aug & Sep = Worse 4th Wave

@Mrhockey1231 @imgrund U of C's Wastewater Sampling helps show momentum of COVID-19AB in Calgary, a day after infection, 5ish days before positive swab.

@imgrund Calgary R does same thing, but more subtly given AB Health suppressing swab testing.

Little uptick in R to 1.19 + Big 💩momentum =
@Mrhockey1231 @imgrund Total Hospitalization: ICU + non-ICU, which Docs & Nurses often call "The Wards".

We've blown away 3rd Wave. Now nearing peak of 2nd Wave, when there was no vaccine.

The Wards all over Hospital from where we're dragging staff into ICU, away from the patients who need them too.
Health Canada counts 🇨🇦 in Hospital, ICU and on Ventilators every week.

91% of the growth in Hospitalization (ICU + non-ICU) across 🇨🇦 in wk ending 7 Sep 2021 was from Alberta.

On 7 Sep: 🇨🇦 in Hospital 1070, ICU 533
On 12 Sep: AB Hospital 803, ICU 198.

Now, ICU.

I've been trying to multitask between @PopAlberta video and this thread. Today's focus is ICU with a physician and nurse as special guests with @jvipondmd & @GermHunterMD.

Please watch it today, and previous episodes.

@PopAlberta @jvipondmd @GermHunterMD Situation in ICU as of Sunday 12 Sep.

The donut graph is vax status.

When AHS CEO Dr Verna Yiu gave her stunning presentation on 17 May [my annotation for the 425 "Max Capacity"] the record was 186. Has been revised to 182 since.

Doesn't matter. We passed 198 yesterday.
Truly appreciate the transparency from @AHS_media to help us sort out:
• how much and how fast is total ICU capacity growing?
• how many Albertans with Covid-19*, and how many Albertans with other critical needs?

* 202 at 11am today, 198 as of Sunday.

@AHS_media As fast as AHS is adding beds, Exponential Growth of #COVID19AB exceeds it
• On Friday, trend* exceeded surge capacity on Tue 21 Sep
• Over weekend, more beds added, more people critically ill
• Today, trend still > new surge capacity on Tue 21 Sep

*quadratic approximation
The last few weeks, I've been hearing doctors and nurses talk in increasingly unhappy tones about Critical Care Triage Framework.

@PfParks & @GermHunterMD Schwartz describe it here. Today's medical experts on the @PopAlberta show explained it further.

ICU situation is Sask is no better. They're maybe a week behind us, but fewer beds.

They don't have a Premier/Health Min/CMOH triad making national news for cruelty.

But it is not like we can drop off 30 ICU patients on the way to help out on the farm.

I got busy with Life yesterday, and forgot/avoided(?) what we're supposed to be preventing:

• 72 Albertans died of COVID-19 in the last week
• More than Ontario, which has 3.3x the population
• AB's 12% of 🇨🇦 has 34% of 🇨🇦 Deaths
• Also.. 📈

There's apparently a federal election coming up, and Mr O'Toole was asked this question by @DavidWCochrane

@DavidWCochrane There's nothing good the federal Conservative leader could apply from #COVID19AB to 🇨🇦.

But his rehearsed answer is Premier Kenney's ABTraceTogether app?!

That 💩 STILL making a ton of sole source Alberta taxpayer $$ for @Deloitte @DeloitteCanada BTW.


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More from @ZiadFazel

14 Sep
Last night @CMOH_Alberta gave a presentation to Alberta family docs, and I got a chance to see it and take screenshots before the video was set to Private.

Whenever a politician wants to give you "Context", be wary of Deceptive Framing.

Have a look at her graphs of BC/AB/SK.
Did you do that yet? No skipping ahead now.

I zoomed in for you.

See it yet?

The axis scales are not the same.
Here are the graphs exactly how they look at


The default shows every province on the same axis for fairness.

See that green "Relative scale". That compares each province to its own peak.

Click it. Gosh - every province looks equally bad now.
Read 8 tweets
12 Sep
Sadly, today is the day we exceed Alberta's baseline ICU Capacity.

• Blue Exponential Growth Curve = Albertans in ICU with COVID-19
• Red line = Baseline Capacity
• Surge Capacity comes from Cancelling Surgeries & Redeploying Doctors, Nurses, other Healthcare Workers
I don't normally do one graph inset into another, but I wanted to show @GosiaGasperoPhD modelled this exactly, on 24 August.

She's a world-class biologist who could be doing this anywhere in the world, saying "Look what is happening over there in AB."

Instead, she's here in Calgary, volunteering her expertise late at night (eg 12.36am for this tweet) to help our province.

And she's wiping the floor with Alberta Health's CMOH team, even though they have access to internal data and high-end computers.

Read 8 tweets
10 Sep
#COVID19AB Balanced Scorecard
Fri 9 Sep

Leading indicators continue to show accelerating spread of infection.

7-day average Test Positivity 11.73% against all-time record 11.75%.

Severe Outcomes: Hospital, ICU and Death all surging faster than ever. Obviously NOT Decoupled.
ICU Capacity taking a huge hit.

169 Albertans just with COVID-19, against total ICU capacity for all needs 173.

Look at the difference two days makes on the curve. See also comparison to AHS CEO Dr Yiu charts on 17 May 2021.
Great presentation by Sarah Mackey of @ab_vax who teaches that we can't just look at the unvaccinated as one big blob, and just write them off.

IIRC, she says we have to look at different reasons:
• Access
• Complacency
• Hesitancy

And count the removal of barriers, not 💉
Read 8 tweets
10 Sep
Big news about COVID-19 Vaccinations in US, UK and Canada to share before @PopAlberta explains this live today at 4pm.

The news is about vaccine mandates, passports, and 3rd doses.

Let's start with Dr Fauci speaking to Americans on @NewsHour, on which we Canadians eavesdrop because:
• he's world class
• Covid in Canada is like a lot of American states
• Alberta (and BC & SK) are like the worst of American states

Then, Dr Fauci gave the 2021 Pumphandle Lecture to @JohnSnowSociety in UK.

See summary from UK Public Health Doc @GabrielScally with some clips of key points, and then the link to full 1-hour lecture.

You & I can get this whether you have a PhD or not.

Read 5 tweets
10 Sep
#COVID19AB Balanced Scorecard
Thu 8 Sep

Slivers of silver lining in Leading Indicators.

I don't trade stocks, but technical analysts seeing that choppiness at top of Test Positivity would say there is a pause.

Not testing enough. Averaging 3/5th the volume of previous peaks.
Severe Outcomes? 😢

Alberta (4.4m people) might soon pass Ontario (14.7m) in Canadians dying of COVID-19 per week.

12% of 🇨🇦population; 32% of the deaths.


Every time I change the axes on my graph, I remember these are families suffering, and grieving.
The number of Albertans going to Hospital & ICU for COVID-19 is exploding, and our healthcare workers are throwing themselves on the blast to try to save us.

One day's data on ICU projection:
• Yesterday: cross baseline on 13 Sep, 250 on 21 Sep
• Today: 12 Sep; 19 Sep
Read 9 tweets
9 Sep
#COVID19AB Balanced Scorecard
Wed 8 Sep

Silver lining on dark clouds today:
• Looks like leading indicators have paused a bit
• Severe outcomes still out of control
• Albertans are going to Hospital and ICU, and Dying at levels not seen since 3rd Wave Peak in May.
I think as a province we're beaten down, and looking for compassionate & trustworthy leadership.

We went into July thinking this would be a turnaround summer. It turned the wrong way.

So enjoy good news when you can. R < 1.1 for first time since mid-July, and Test % Stalled.
Because Severe Outcomes - real people in pain - Ouch.

More Canadians have died from Covid in AB than in any other province but ON:
• 42 in the last 7 days
• 69 in the last 14 days

ICUs are over capacity, causing widespread backups and consequences.

Read 7 tweets

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