Tara Moriarty Profile picture
Nov 22 33 tweets 18 min read
The Nov 18 @COVID_19_Canada Canadian COVID Index and associated data are now live.

SEVERE: PEI
VERY HIGH: CAN, AB, BC, MB, NS, ON
HIGH: NB, NL, North, QC, SK

All regions improving or stable.

Link: covid19resources.ca/covid-hazard-i…
@COVID_19_Canada The index scores correspond to the percent excess all-cause mortality due to COVID we expect.

For example, we expect ~6% excess mortality for the week ending Nov 18 in Canada.
@COVID_19_Canada The annual average % excess all-cause mortality for the epidemic to date in Canada is 7% (after adjusting for any excess deaths attributable to accidents, suicie, toxic drugs and heat dome).

That's about 21K untimely (extra) deaths/year. From QC data it looks like most is COVID.
@COVID_19_Canada We don't have all-cause mortality reporting for 2022 for most of Canada, but we do have it to Sep 3/22 for 4 fast-reporting provinces: AB, BC, QC and NL.

So far, during Omicron avg % excess mortality in these provinces is 12%. Their average for the epidemic to date is 9%.
@COVID_19_Canada A MAJOR concern is that excess mortality (black line in graph) has been increasing quickly in these provinces over 2022, and is currently at the highest point of the epidemic so far.

This is without all reporting in yet, especially the most recent deaths.

We should be concerned
@COVID_19_Canada If we are seeing 12% excess mortality across Canada during Omicron, this means 36,000 excess (untimely) deaths by December of this year.

By our estimates, as of Nov 18 there have been over 37,000 Omicron deaths in Canada, with 52% of these deaths undetected/unreported.
@COVID_19_Canada I focus a lot on deaths because they're the easiest indicator to assess using data sources independent of provincial data reporting differences.

They're the tip of the iceberg indicator--they give a sense of the scale of the underlying problem.
@COVID_19_Canada You can find a lot of the details in the weekly report linked at the top of this thread, and in our Excess Mortality Tracker at the link here:

covid19resources.ca/public/excess-…
@COVID_19_Canada Our estimates of total COVID mortality during Omicron are similar to the % excess mortality we expect for Canada, based on fast-reporting provinces (12-15%).

They're also similar to COVID mortality estimates from models such as IHME.

Anyway, for all the difference it makes.
@COVID_19_Canada OK, following are the weekly COVID "weather reports" for individual provinces.

Yes, we will have less number-y, easier/faster to read versions soon. These are a placeholder!
@COVID_19_Canada I suspect that "HIGH" may be the baseline. Estimated total infections have been declining from a high peak in late October, but that decline looks like it may be slowing.

Several provinces that have been stably high (NL, QC, SK) have increasing waste water signal.
@COVID_19_Canada These provinces don't appear to have gone through surges as intense as other regions over the last few weeks (see coloured grid below), so I'm not sure if this means they're about to go through the same as others.
Here are the weekly weather reports.
CANADA

VERY HIGH COVID hazard, but improving slowly
1 in 39 people infected
0.8-1.1 million infections per week

If this keeps going, Canada may fall to HIGH hazard in next week or two.

#WearAMask
#StayHomeWhenSick

A good one--N95-type.
NEWFOUNDLAND & LABRADOR

HIGH COVID hazard.
1 in 66 people infected
11,000-15,000 infections per week

NL is stable, but may start increasing again. And stably high isn't great.

#WearAMask
#StayHomeWhenSick

A good one--N95-type.
PRINCE EDWARD ISLAND

SEVERE COVID hazard, but improving slowly
1 in 19 people infected
7,000-10,000 infections per week

If this keeps going, PEI may fall to VERY HIGH hazard in next week or two.

#WearAMask
#StayHomeWhenSick

A good one--N95-type.
NOVA SCOTIA

VERY HIGH COVID hazard. Improving steadily now (finally).

1 in 51 people infected
10,000-14,000 infections per week

If this keeps going, NS may fall to HIGH hazard in next week or two.

#WearAMask
#StayHomeWhenSick

A good one--N95-type.
NEW BRUNSWICK

HIGH COVID hazard. Not much change recently.

1 in 65 people infected
6,500-9,000 infections per week

It should be possible to drive this down to ELEVATED hazard in the next week or two, with consistent effort.

#WearAMask
#StayHomeWhenSick

A good one--N95-type.
QUEBEC

HIGH COVID hazard.

Stable but waste water signal increasing.

1 in 53 people infected
121,000-167,000 infections per week

If people start taking more care, it might be possible to get down to ELEVATED hazard.

#WearAMask
#StayHomeWhenSick

A good one--N95-type.
ONTARIO

VERY HIGH COVID hazard. Improving slowly, but Ontario is like a ship--hard to slow down.

1 in 31 people infected
300K-415K infections per week

Hopefully Ontario falls to HIGH hazard in next week or two.

#WearAMask
#StayHomeWhenSick

A good one--N95-type.
MANITOBA

VERY HIGH COVID hazard. Improving slowly. Hope it continues.

1 in 25 people infected
41K-56K infections per week

Hopefully Manitoba falls to HIGH hazard in the next week or two. You can help it get there!

#WearAMask
#StayHomeWhenSick

A good one--N95-type.
SASKATCHEWAN

Still HIGH COVID hazard and remaining stable, although waste water increasing.

1 in 80 people infected
9K-12K infections per week

Time to take care to prevent surging higher.

#WearAMask
#StayHomeWhenSick

A good one--N95-type.
ALBERTA

VERY HIGH COVID hazard.

Stable...hope it can go lower in next week or two.

1 in 56 people infected
52K-72K infections per week

Please help the healthcare system!

#WearAMask
#StayHomeWhenSick

A good one--N95-type.
BRITISH COLUMBIA

VERY HIGH COVID hazard.

Stable...hope it can go lower in next week or two.

1 in 38 people infected
97K-133K infections per week

Please help the healthcare system!

#WearAMask
#StayHomeWhenSick

A good one--N95-type.
Unfortunately, no data were posted by PHAC for any Northern Territory this week, although we finally have waste water tracking for Haines Junction at the entrance to the beautiful Kluane National Park, Yukon!!!
Usually, as long as we have test positivity data for the 3 territories and data for at least the Yukon, we can try to estimate the situation compared to neighbouring provinces. However, this week we only have waste water from Haines Junction (signal is declining there BTW).
So, unfortunately this week I won't share the COVID weather report for the North (although based on trends in last week's data and waste water I think the hazard is likely currently HIGH but declining).
Sorry about that, Northern friends. We try really hard to do a report for you, but we need a bit more data. I'm hoping that we haven't lost all national reporting for the region. I may have to start digging around to see how we can standardize territorial government sources.
Finally, need incentive to start wearing your (high quality) mask again?

Here's the current @IHME_UW projection for how many lives could be saved if 80% of Canadians started masking again today.
@IHME_UW By Christmas Day, we could cut daily COVID deaths in half if 80% of Canadians start masking again today. We were doing that until Feb or March of this year. We can do it again.

What better present could we give than saving a life and preventing the grief of so many families.
@IHME_UW Without 80% of us wearing masks again, the IHME projection predicts that we'll continue to grind along for months much as we are now, with a steady 5-6% excess mortality and hospitals at 5-10% over-capacity from COVID alone, not to mention flu and RSV.
@IHME_UW Reducing excess mortality from 5% to 2.5% by masking in high risk periods might prevent 7,500 untimely deaths/year. That's double the average annual mortality of flu in Canada.

#StayHomeWhenSick
#WearAMask

Take care of the people you love and your community.
@IHME_UW That's it for the thread for tonight. It was a teaching day, and I'm wiped.

Don't forget, you can always join our Wed, Thurs or Sat evening free, anonymous COVID kitchen table-style discussions.

Here's the link to sign up.

Love to all. You matter.

covid19resources.ca/discussions/

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More from @MoriartyLab

Nov 22
I think it's important that people understand why PEI is still rated as SEVERE COVID hazard, and why we use this term.

I'll use PEI as an example, but we could use any province.

🧵
First, let's look at how many COVID deaths PEI reported to PHAC last week.

It was 2, 3 the week before, 4 the week before that. For the last 4 weeks, PEI has reported 2.75 deaths/week.

health-infobase.canada.ca/covid-19/
During Omicron, PEI has reported 2.9 times fewer deaths per capita than Quebec and Manitoba, the Canadian provinces that do the best COVID death reporting.
Read 52 tweets
Nov 15
As of Nov 6, only 20% of people living in Canada have received a new COVID vaccine dose or completed their primary series in the last 6 months.

BC 28.1%
QC 22.3%
NL 19.1%
MB, ON 18.7%
NB 18.5%
SK 16.5%
NS 16.2%
YK 16%
AB 13.1%
NWT 9.3%
NUV 6.8%

Source: @GovCanHealth
@GovCanHealth As of November 6, only 43% of people 60 AND OLDER in Canada have received a new COVID vaccine dose or completed their primary series in the last 6 months.

BC 54%
QC 50%
MB 49%
NL 41%
ON 40%
NB 39%
SK 38%
NS 31%
AB 28%
YK 27%
NWT 22%
NUV 11%

This is not, not good.
@GovCanHealth PEI has not yet reported any data about numbers of people with new doses/completed primary series in last 6 months, so we don't know the situation there.

Link to data: health-infobase.canada.ca/covid-19/vacci…
Read 12 tweets
Nov 15
The Nov 11 @COVID_19_Canada Canadian COVID Index and associated data are now live.

SEVERE: MB, NS, ON, PEI
VERY HIGH: CAN, AB, BC, North
HIGH: NB, NL, QC, SK

Most regions are improving somewhat, but situation is still serious across the country.

Link: covid19resources.ca/covid-hazard-i…
@COVID_19_Canada Following are summaries for each province.

These are a temporary version of our weekly COVID "weather reports". We're working on versions with fewer numbers that are faster to read and understand.

You can find the link to download them here: datastudio.google.com/reporting/23a4…
@COVID_19_Canada CANADA COVID Hazard: VERY HIGH

🟠~1 in every 34 people currently infected
🟠~0.8-1.1M infections this week
🟠Infections, long COVID: SEVERE (~9x higher than pandemic low point)
🟠Hospitalizations: VERY HIGH (~7X higher than low point)
🟠Deaths: HIGH (~5x higher than low point)
Read 15 tweets
Nov 13
Hi folks,

Some updates to the @COVID_19_Canada Excess Mortality Tracker this weekend.

We're now adjusting for (any) excess deaths due to all accidents (not just toxic drugs), suicide, heat dome.

covid19resources.ca/public/excess-… Image
@COVID_19_Canada For comparisons of reported and expected COVID deaths and excess mortality, we're now using 15 week averages for all.

Why? Because we want to be really sure we're not overestimating excess mortality in younger age groups where death numbers are smaller. Image
@COVID_19_Canada It looks a bit different than it did previously, but it's also easier to compare curves, especially if our estimates of when mortality waves happened in each province are off by a week or so.
Read 18 tweets
Nov 11
This is a good thread about mask evidence.

I disagree about the benefit of small effect sizes...on a population scale they can be really important, especially given situation we're in. We routinely accept <50% effect sizes in medicine. And there are no safety risks of masking.
Because I'm so attuned to the COVID situation in Canada I URGENTLY believe we need mask mandates. We've slid into a situation where we need every bit of help. Frankly, we've been here for a year, but I only know that from following the epi data closely.
But Dr. Saxinger is right in that it's hard to point to large numbers of unequivocal studies if policy makers want pure black and white data to support decisions.

She's trying to point out some of the complexity.
Read 10 tweets
Nov 11
The Nov 10 Canadian excess mortality tracker is now live

Major concern at moment:
Rapidly increasing excess mortality from spring '22 in fastest-reporting provinces (NL, QC, AB, BC)

Excess mortality currently highest of pandemic to date in Canada

Link: covid19resources.ca/public/excess-…
Here's an annual comparison of reported severe COVID outcomes and excess all-cause mortality in Canada to Sep 3/22.

There is still a LOT of outstanding death reporting in Canada:

Min deaths not yet reported to CVS-D: 66K
Min outstanding cause of death reporting: 134K
For 2022 (up to Sep 3), at least 56K expected deaths have not yet been reported to Canadian Vital Statistics (CVS-D).

Cause of death reporting is not yet complete for at least 92K deaths in 2022.

There is still a lot of outstanding death reporting for 2021.

Numbers will go up
Read 53 tweets

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