Tara Moriarty Profile picture
Jan 20 15 tweets 7 min read
I think it's too late to do a Zoom for most. Here are key pieces of information journalists may need for today's Ontario news conference.

Reasons why Ontario is least prepared Canadian jurisdiction to re-open quickly:

🧵
1. The people most likely to die and be hospitalized are people 70+. Ontario has the lowest vaccination rates in this age group of any Canadian province/territory except Nunavut and New Brunswick. Source: @GovCanHealth vax update of Jan 14/22
@GovCanHealth 2. Boosters have saved the lives of about 5,000 Ontario residents so far, but ON still has a long way to go with boosters.

ON currently has a smaller % of people 70+ boosted than any Canadian jurisdiction except Atlantic provinces and Nunavut. Sources: same as #1, @PeterCBC
@GovCanHealth @PeterCBC 3. About 15% of Ontario residents have probably been infected since November 15/21. Everything we're seeing is with a minority of the population infected. If everyone is exposed infected, Ontario will likely see 21,000-25,000 deaths, about 10,000-13,000 of which will be reported.
@GovCanHealth @PeterCBC 4. About 8,000 of ON's future deaths will be among unvaccinated people, most of them 50 and older. For many people 70+ vaccine outreach is badly needed, but it takes time, because it requires one on one conversations and people being able to reach their care providers.
@GovCanHealth @PeterCBC 5. Paxlovid has been approved in Canada, but is in short supply. If we slow things down until we have it in place, Ontario may be able to prevent 27,000-38,000 hospitalizations, 10,000-15,000 ICU admissions and 6,000-9,000 deaths.
@GovCanHealth @PeterCBC 6. Paxlovid needs to be started within the first 5 days of symptom onset. For it to work, testing must be easily accessible for the general population and FAST, not just for symptomatic people in high priority groups.
@GovCanHealth @PeterCBC Unless we're testing in the general population with turnaround times of 48 hours or less, Paxlovid won't help a lot. Before relaxing measures testing must be available to all symptomatic people with turnaround times of under 48 hours. This was a key metric in all previous waves.
Economic costs: Based on @CIHI_ICIS reporting of average Canadian COVID hospitalization cost/person, divided by 2 (since hospitalization is 50% shorter for Omicron), the estimated cost of FUTURE Omicron hospitalizations in ON is $2-3 billion.
@CIHI_ICIS Since Nov 15, Omicron hospitalization costs in Ontario have probably been about $300 million. Fiscal responsibility requires us to slow this down. Getting N95 masks to everyone, supporting industries hardest hit by restrictions is a small fraction of future hospitalization costs.
@CIHI_ICIS I can add more, but if any journalist needs sources for any of this, please email immediately. All sources are nationally and provincially reported data from @GovCanHealth @CIHI_ICIS @COVIDSciOntario
FYI, about Canada (and Ontario's) restricted testing policy. We're only medium or high income country in the world currently restricting testing. We are WAY out in uncharted territory.

P.S. I don't give a rat's ass if you cite me or not--sources are all publicly available. Just ask the questions. I'll provide endless background interviews/group Zooms to help point journalists to where to find data, which are summarized publicly here: docs.google.com/spreadsheets/d…
FYI for those dubious about why you should carefully consider what I'm saying. I led the Royal Society of Canada's report on mortality in Canada during COVID. I'm one of most expert people in the country on this topic. I don't yell unless I have to. I've been yelling since Dec 15
Finally, for those looking at that complex spreadsheet linked above, here are the takehome columns:

Columns T-V expected future hospitalizations, ICU admissions, deaths

Column AB: future deaths that will be reported

Column AF: expected influenza deaths/year, for comparison

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More from @MoriartyLab

Jan 21
Here are Canada's expected, expected reported and actual reported deaths to Jan 20.

Deaths we're seeing now are from period starting the week of Dec 20, when it was hard to access PCR testing.

The estimates of expected deaths are likely under-estimates from here on in. Image
Both QC and ON, which have driven most deaths reported until recently are also showing an upswing now that suggests estimated infection numbers from @IHME_UW and ICL that I use to estimate expected deaths are likely too low. Hopefully there will be new estimates from them today. Image
@IHME_UW Certainly, I don't think QC deaths are about to level off, as the model suggests, and it would be surprising if ON deaths increased in a linear, not an exponential fashion.

We're definitely about to move into the upper confidence limit range for Canada's deaths for next 2 wks.
Read 5 tweets
Jan 19
Here's an illustration of reporting differences between Ontario and Quebec that mask magnitude of ON deaths in current wave.

First, note that by the end of January, ON's new daily deaths will likely exceed QC's new daily deaths during 1st wave.

But we won't "see" them.

Why?
🧵
This graph shows the expected deaths in each province, based on IHME and ICL estimates of true case numbers.

My method for estimating expected deaths using these case numbers is described in the thread linked here.

Yes, the estimates take into account previous C19 deaths in each region, age-specific vax rates, reduced Omicron severity, changing protection vs infection and severe outcomes from boosters. It's all in the linked thread, as are estimates of total future deaths we may see.
Read 15 tweets
Jan 15
Estimating actual and reported COVID-19 deaths in Canada in the coming months

🧵
It's Saturday and I have a little more time than during the week, so here's an explainer of how I'm estimating future COVID-19 deaths.

There are MANY yelling in my mentions that this is impossible.

Friends, it's due to exponential growth, which humans aren't good at estimating.
To estimate future deaths, you need a couple of key pieces of information.

1. The actual number of infections
2. The death rate for those infections
Read 45 tweets
Jan 14
Boosters are having a big impact on future severe outcomes of Omicron wave in Canada

Between Dec 28 and today, boosters have reduced the maximum percentage of people in Ontario who can get infected from 88% of population to 69%.

🧵Why does this matter?

Source @COVIDSciOntario
@COVIDSciOntario Let's extend the Ontario booster data to Canada.

On Dec 28, it was possible that 88% of the Canadian population could be infected in the current wave. That's about 34M infections.

If we reduce the maximum to 69%, this means 26M infections, a reduction of about 8M infections.
@COVIDSciOntario With current vax protection vs severe Omicron outcomes, % each age group fully vaccinated and assuming Omicron is 50% less "severe" than Delta:

🔵Estimated current Canadian infection fatality rate for those infections is 0.17%.

Multiply that by 8M. Nearly 14K prevented deaths.
Read 7 tweets
Jan 14
Most people assume that Canadian COVID-19 deaths occur mainly in hospitals and long-term care, retirement and assisted living homes.

They don't, especially since vaccines became available.

It's not clear how many people die AFTER going to hospital, or how many never go.
In Canada, the full impact of COVID-19 waves is largely seen in reported deaths, which often are reported long after the wave has passed, especially outside QC (probably also MB).

As I say over and over, watch QC and assume same is happening in your region or will soon.
Deaths in hospital account for a minority of total deaths. We're about to find out soon if LTC will surge with breakthrough deaths.

Again, watch Quebec for the fastest death reporting in LTC/RHs and all locations.

If QC deaths in LTC start surging the ROC will be close behind.
Read 8 tweets
Jan 13
Dear @COVID_19_Canada Vaccine Q&A friends

Just finished going through survey data for program participants (with Janet Cho, @emeraldclover5 @sillenojunior)

The Q&As resulted in a significant 12% shift toward intention to vaccinate.

For vax hesitancy that's big.

Way to go!
@COVID_19_Canada @emeraldclover5 @sillenojunior If this pattern held true for all 35,000 people we've spoken with since Jan 4, 2020, this means the program may have convinced more than 4,100 people to get vaccinated. The average age of respondents was 48. Estimated lives saved: 18-36.
Hopefully the 35,000 people we've spoken with went on to support others to get vaccinated too.
Read 7 tweets

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