2020-11-22 - COVID strategy
COVID-19 cases are rapidly growing in Alberta. If we don't
act quickly, we'll soon have case loads comparable with our
US neighbours. That's crazy! We're better than that.
What's driving the growth? Nobody knows for sure, but my guess
is a few things:
- It's cold outside. Everybody has moved indoors. Transmission
is much worse indoors.
- COVID fatigue. We're all tired of restrictions and there are
all sorts of people who are just ignoring the rules. Large
house parties, weddings, late nights at the bar, etc.
- Thanksgiving. Canadian Thanksgiving was a little over a
month ago and lots of people probably had large family gatherings.
This created a big bump in transmission.
Interestingly, some things don't seem to be big drivers
- Schools. Given the huge number of kids in schools and the
high population density, the case loads in schools are tiny.
This is likely due to the fact that COVID-19 is not particularly
hard on kids (low infection rates, low viral loads from infected
kids, limited symptoms) and robust procedures to contain disease
- Stores and restaurants. Stores are limiting the number of
concurrent customers and requiring masks. Restaurants have
reduced capacity and staff wear masks.
- Outdoor activities -- hiking, running, biking, skiing, snow
shoeing, etc. This bug is just not that good at infecting
people outdoors, thankfully.
Some things are a "maybe" - they look like they should probably cause
accelerated spread, but I haven't seen evidence to back that up.
This includes spin studios, gyms and religious gatherings.
Make no mistake, the infection numbers are large. While we
can't directly compare positive tests against those early in the
pandemic due to increased test capacity, we can compare daily
hospitalizations and deaths -- those don't depend on how many
tests are available. The growth is alarming and shows that the
disease is much more prevalent now than it was in May:
COVID metrics in Alberta
Since spread is exponential, we have to respond quickly or
else things will get out of control. It's hard for humans to
think about exponential growth processes, but we must, because
nature doesn't care. Unchecked, the first impact will be that the
health system will stop being able to support non-COVID patients,
as COVID patients overwhelm both regular and ICU hospital beds.
After a while, again if we don't manage transmission, it won't
be possible to treat even all COVID patients. AHS is already
losing the capacity to support non-COVID patients.
So what should we do?
- Manual contact tracing is no longer useful. It can't possibly
keep up. Consequently, we have to switch to patients doing
their own contact tracing. The best way to do that is with
a tracing app:
- ABTraceTogether was an early success, but apparently
still doesn't work well on iOS.
- ABTraceTogether is designed to notify human contact tracers
of positive cases and their contacts. This model does not
- It's time to adopt the national contact tracing app!
The federal app was late to the party but seems to have better
technology and is designed for self-service tracing - a more
- There is no need to migrate legacy users to the new app.
People who were "with it" enough to deploy one app will
deploy the new one. There is not much legacy data to
migrate over, so it's better to just cut over now!
- Contact tracing apps are only useful if widely adopted:
- Neither ABTraceTogether (in Alberta) nor COVID Alert
(elsewhere in Canada) is widely adopted.
- We have to drive higher adoption now!
- Part of that is a renewed public awareness campaign.
- Another, more useful strategy would be for businesses
to require that employees and visiting customers
prove that they have a phone with an active contract
- We really need another app, or another mode in COVID
Alert, which just displays the signal strength from nearby
phones with the same app.
- Businesses would use this to control entry to indoor
spaces -- blocking entry by adults who don't have a phone
with the app on their person.
- It's time to lock down some businesses again.
None of these are essential. Businesses should be compensated
for their losses, to help them survive this.
- Salons and spas.
- Gyms and spin studios.
- Churches and other religious gatherings.
- We have to get a handle on personal gatherings. Most of the
transmission is likely happening in homes.
- Citizens should call the police when their neighbours
have large gatherings.
- Yes, I know this is a terrible thing! But death
by COVID is worse.
- Police should try to educate, not ticket and certainly
not arrest anyone.
- Repeat offenders should be ticketed. Large fines --
thousands of dollars.
- The media needs to focus on the human cost of COVID-19.
Lots of people don't seem to "get it" and hopefully putting a
human face on it will help.
- A daily story, picture or interview with tired healthcare
- A daily story, picture or interview with families who have
lost loved ones.
- A daily story, picture or interview with patients who have
had COVID-19 and now suffer from long-term side effects.