#COVID19AB Balanced Scorecard
Thu 23 Sep

Sorry for late start on this - was watching today's @PopAlberta broadcast for a third time. So many good shows there 👀

youtube.com/channel/UCXWbl… ImageImageImage
Last night between 4.16pm and 10.12pm, I assembled a monster Balanced Scorecard thread (rope?) of 31 tweets.

I wanted to give extra attention:
• We're becoming 2 different Albertas with COVID-19
• Non-ICU Wards have become ICU to prevent triage

👀

Finished reading ALL of it?

I'm going to build on it a bit. Remember my analogy that covid-19 under bad government is like riding a canoe on a rollercoaster?

We have two canoes now.
• Calgary and Edmonton, leading/front going down
• Rest of Alberta, leading/front going up.
Example: Test Positivity

AB average going down, now 10.33%
• dominated by Calgary Zone down to 6.95% and Edmonton Zone 8.35%
• while rest of Alberta goes up
• Central 16.3%, North 19.37%, 14.24% and rising

alberta.ca/stats/covid-19… ImageImage
Despite the divergence:
• which is both an outcome of divide-and-conquer strategy by our Premier
• and also enables more
• we still all share the same hospitals
• and deaths outside Calgary & Edmonton are rising Image
We have an entire province glued to social media and news for the point ICU overload triggers triage.

IMHO (see last night's thread) we would have reached it on weekend if not for non-ICU Wards like Internal Medicine saying to ICU:give us as many of your patients as possible. Image
And @AHS_media media Dr Verna Yiu put it bluntly: we would have triggered triage already if not for people dying in roughly same quantity as new admissions.

Life-and-death "equilibrium". For now.

People are still arriving in exponential numbers.

alberta.ca/release.cfm?xI…
Even though today was part of the "Chief Medical Officer Updates" many people have tuned her out.
• sticking to her model and stories about the UK despite the actual evidence from Alberta
• keeping June model secret until too late
• "Endemic"

They are there for Dr Yiu. Image
We're supposed to be getting province-wide wastewater testing results published on Alberta Health stats page soon, right?

@ucalgaryCHI is still publishing. While R for Calgary is slowing...

Trend since 1 July: Number of infected people in Calgary shedding virus still rising. ImageImage
So between the two threads, we're just about through the whole scorecard.

You're ready for the pop quiz now, right?

Deaths & Vax left.

I'll do Vax another day. Want to give it a deeper dive.
Deaths. What we are all trying to avoid.*

New graph, just on this. I don't want to extrapolate the trend out further, and I have already increased the vertical axis more than I want.

Many wonderful people are knocking themselves out to stop this.*

* Notable exceptions. ImageImage
Love and care for each other.

These are tough days now, and ahead.

We're making history - in realtime - that people in all sorts of disciplines will study later.

Influence that for the better, however you can.

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More from @ZiadFazel

22 Sep
COVID19AB Balanced Scorecard
Wed 22 Sep

Publishing my 3 main graphs right away, then I will add analysis on each metric, going down the card, bit at a time.

Yellow highlights on scorecard = idea stolen from @jvipondmd: today's cases x case rate from

covid-tracker.chi-csm.ca ImageImageImageImage
Just finished watching @PopAlberta special on:
• protecting children too young to vaccinate
• learning that the risk in schools SEEMS to be scientific: #COVIDisAirborne but is ACTUALLY political
• Learn how to address this at home, school & your MLAs.

@PopAlberta R

Some people were surprised last night to hear Premier Kenney say R in Calgary & Edmonton was below 1.0.

True per GoA stats, but no thanks to Premier Health Minister, CMOH or SAG.

#yyccc & #yegcc enacted Mask Bylaws at the beginning of September.

That's why they have R<1.0 Image
Read 38 tweets
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

health-infobase.canada.ca/covid-19/epide…

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
13 Sep
#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.
Read 16 tweets
12 Sep
Sadly, today is the day we exceed Alberta's baseline ICU Capacity.

Again.
• 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.

alberta.ca/assets/documen…
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

pbs.org/newshour/show/…
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

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