#COVID19AB Balanced Scorecard
Mon 27 Sep

If you remember my hurricane analogy from yesterday, today we emerged from a weekend without communications from Alberta Health.

There was no sunshine. No respite between bands. Only the 250 km/h eyewall.
@jvipondmd @GosiaGasperoPhD @RajBhardwajMD @TehseenLadha @drdagly @plasercalgary @GermHunterMD @kwburak @PfParks @dupuisj Test Positivity

4th Wave was unusual as Test Positivity was a steep, unhesitating rise.

⬆️not 📈

We have seen that frightening line with Delta all over the world.

Researchers sometimes change their graph to log scale and are shocked to still see it.

covid-tracker.chi-csm.ca
When Test Positivity stuttered in September, then peaked in mid-September (urban mask mandates & restrictions) experts with @PopAlberta kept warning of danger.

My analogy then was a 1000-km wide wildfire at 80 km/h.

Because there weren't strong province-wide safety measures.
So while Test Positivity in Calgary & Edmonton was:
• falling below 10%
• dragging down the provincial average
• masking the choppy rise in North, Central & South.

I remembered @GosiaGasperoPhD warning of (early) exponential growth of B117 Alpha in Jan, and Delta in May.
I'm just talking about leading indicators here: Test Positivity and New Cases.

We always knew the back half of the canoe - Hospitalization, ICU and Deaths- was still rising the roller coaster.

Canoes, Rollercoasters, Wildfires, Hurricanes... sorry about all the metaphors.
Looking again at the @ucalgaryCHI chart, notice how in all 3 previous waves, test positivity would stutter, maybe retreat a bit, and then keep rising.

4th Wave didn't get that, rising without a break from ~0.5% to 11%.

Our CMOH & Premier were beholden to their secret models.
Even India - hit so badly by the Delta variant images of people dying outside hospitals short of oxygen or ventilators - got back under some control.

Not Alberta. We plowed ahead, benchmarking to the worst decisions in the US and UK to cover our own.

coronavirus.jhu.edu/data/new-cases
So where does that leave us after the weekend?
• 29 new admissions to ICU*
• 23 deaths
• 265 people fighting for life in ICU

* 17% of baseline capacity in 1 weekend.
• From 1 cause
• We're not into flu season yet
• And have a long weekend coming

public.tableau.com/app/profile/jk…
Remember this graph from the 3rd-Wave presser? Where @AHS_media Dr Yiu said pre-covid record for a respiratory virus was 31 cases in 2016?

We just admitted 29 people into ICU. 1 weekend.

Alberta is in a hypnotic state. We don't realize how sadistically we are being treated.
Vaccinations.

Looks impressive, huh? That upswing in the last month?

Remove the 3rd doses, which are largely happening in continuing care for the elderly & most vulnerable.

Zoom in some more.

Upswing over. Fizzling out again.
What did GoA do in Sep to stop spread?

Predictably useless $100 incentive that had no effect but to divide Albertans.

alberta.ca/release.cfm?xI…

Bait-and-Switch "Capacity Increase" that was only a $36m taxpayer subsidy to private group homes & home care.

alberta.ca/release.cfm?xI…
This gratuitously frightening, dog vomit of a presser on Wed 15 Sep:
• measures effective at midnight
• Health Min reading Kenmore Canister Vac model 1407 Owner Manual into his chin
• 8pm emergency alert on our phones with link to useless website

alberta.ca/release.cfm?xI…
This meeting of Calgary Metro Region Board on 17 Sep was lauded for Mayor Nenshi response to the Foothills County Reeve's persistence at spreading ant-vax "bs".

(Nice diplomatic work by Chair @GregClarkAB too, trying to stay on topic and on fact.)

livewirecalgary.com/2021/09/24/lie…
The hidden value in that meeting was the metro area board trying to fix the dog-vomit from GoA two nights before:
• leverage Calgary efforts including great Q&A
• High River Mayor Snodgrass blasting GoA for putting his town's businesspeople in danger

8 days ago, this psychiatrist/neurosurgeon in UK wrote "how do you convince people that the people in power actually want them to die?"

See @jvipondmd #intentionallycruelwave or @DuaneBratt "self-inflicted"

IMHO: It's not incompetence; it's intent.

Thanks all, who read all this way as I built the long thread this evening.

Be good to each other. Protect yourself. As much as you can, behave as if there is a hard lockdown.

This is going to be like Italy or New York in Spring 2020.

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More from @ZiadFazel

27 Sep
#COVID19AB Balanced Scorecard
Stats reported Fri 24 Sep

This weekend feels like seeing a Cat 5 hurricane bearing down on a remote island on Fri evening, knowing we won't hear for some days until power & telecom are back, praying for few deaths & devastation when they're out. ImageImageImage
Except we're not a remote island in open ocean. We're in Alberta, supposedly a modern society.

The hurricane has not passed. We've just had outer bands pass through. Rain, wind, storm surge, etc.

The 250 km/h eyewall is still coming. Major casualties. Hail & Devastation. Image
Modern society? Let's compare AB to City of Chicago

Population:
AB 4.4m
Chi 2.7m City (9.6m Metro)

Daily Cases:
AB 1554
Chi 412

Test Pos:
AB 10.11%
Chi 2.9%

Hospital:
AB 1061
Chi 25

Avg Daily Deaths
AB 14.1
Chi 3.57

Fully Vax
AB 62.4%
Chi 57.4%

chicago.gov/city/en/sites/… ImageImage
Read 24 tweets
24 Sep
#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.
Read 13 tweets
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

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