Canadian COVID-19 News

[Montanan]

Meanwhile down under Canada:

As of Monday, . . . there are 104,737 Americans hospitalized with covid-19, including nearly 20,000 in intensive care units. It’s the first time since early September that this many people have been hospitalized and the third time overall during the pandemic. These hospitalizations aren’t just affecting adults, either. Though the raw number of children being hospitalized with covid-19 remains low, the rate of pediatric hospitalizations has surged recently in several states.

Deaths in the U.S. have been on the rise since December as well, following a lull in the fall, with nearly 2,000 reported Monday. But it’s cases that have jumped sky-high recently, with record numbers being reached in the last week. On Monday, just over a million cases were reported, though many of those were attributed to a backlog of reporting over the weekend and holidays. Even accounting for this delay, the current seven-day average of cases is now approaching a half-million.

The data is very clear by now that an individual case of Omicron is milder on average than an individual case of Delta. This mildness is partly due to the immunity that many people carry to the coronavirus—immunity that may not prevent infection but still can blunt its harm to the body. There’s also growing evidence that Omicron is inherently less likely to cause severe illness because it doesn’t infect lung cells as readily as previous strains of the virus. The exact degree to which population immunity and Omicron’s behavior accounts for its mildness is still unclear, and to someone with no immunity, Omicron may not be any less risky.

https://www.msn.com/en-us/health/med...cid=uxbndlbing

[GordMay]

Originally Posted by Mike OReilly

... What I'm sure is concerning to experts is the possibility that there will emerge another variant; one with the infectious characteristic of Omicron, and the virulence of Delta.

Enter “IHU” [a new Pangolin lineage named B.1.640.2] ➥ https://www.cruisersforum.com/forums...ml#post3549322

➥ https://www.medrxiv.org/content/10.1...74v1.full-text

[GordMay]

Bearskin Lake First Nation besieged by COVID-19 'overwhelmed' by donations, supplies from area communities

In the week since the first cases of COVID-19 were detected in Bearskin Lake First Nation, the community in Ontario has been forced to rapidly shut down.

More than half of the about 400 people living in the remote northern community — including most essential workers and First Nation leadership — are now in quarantine, either as a confirmed case or because they live with someone who has tested positive for the virus.

More ➥ https://www.cbc.ca/news/canada/thund...isis-1.6303874

[Mike OReilly]

G&M: Hospitalizations rising countrywide as Omicron threatens to overrun the health system

The Omicron variant is driving a rapid rise in hospitalizations in much of Canada, prompting provinces to find ways to maintain staffing levels in health care systems already pushed to the brink.

With our testing systems overwhelmed, we can't know the case numbers anymore. Hospitalization and ICU numbers are the only reliable measures now. Not good, but maybe it will be short-lived ... maybe.

[Lake-Effect]

Originally Posted by Mike OReilly

G&M: Hospitalizations rising countrywide as Omicron threatens to overrun the health system

With our testing systems overwhelmed, we can't know the case numbers anymore. Hospitalization and ICU numbers are the only reliable measures now. Not good, but maybe it will be short-lived ... maybe.

Reliance on individual testing at this point is sort of like standing on the beach as a hurricane bears down, and thinking "but how windy IS it, actually?". It's a hurricane, take shelter, end of story.

They are doing more wastewater (sewage) testing now, which gives a pretty good measure of the prevalence of COVID in the whole community, not just those who choose to get tested.

Large-scale preparations that haven't been made yet, won't be made. At this point, the governments can only keep pounding in the vaccines, and trying to impose restrictions that might slow the rate of spread, but will never stop it. And beef up (or reconfigure) our medical capabilities to try to cope with the possible loads.

On this last point, Canada continues to disappoint me. We're almost two years into this thing, but the governments seem reluctant to add any reserve capability or backstops to our medical systems. Just push it til something breaks, then triage and call out the army.

Anecdotally (is this a word?) ... I'm finding that just about everyone around us has a recent COVID story now. Either they had it briefly in late 2021, or know someone who does. We spoke with a young friend this morning who likely had Omicron - positive fast test, and two days of a sore throat and slight fever - but he had to cancel plans to visit family over Christmas. My friend and neighbour - his son and partner tested positive, and my friend visited them briefly, then visited us same day. My neighbour hasn't yet developed symptoms, and there's little chance that he would himself have been infectious just hours after his possible exposure... but here we are.

I think Omicron is Mother Nature saying "here, hold my beer" and doing the job of ending the pandemic that we're unable to finish ourselves. It's pretty much down to individual choices now - vaccination, and avoiding as many scenarios for exposure or transmission as possible. And I still believe that it will peak before February. Good luck, and get vaccinated in case your luck isn't good.

[Mike OReilly]

Originally Posted by Lake-Effect

On this last point, Canada continues to disappoint me. We're almost two years into this thing, but the governments seem reluctant to add any reserve capability or backstops to our medical systems. Just push it til something breaks, then triage and call out the army.

The challenge is largely on the human resource side. We can, and have, greatly expanded our ICU capacities across the country. Most provinces that I'm aware of have added up to 50% more beds to the system. The problem is, we can buy and install the technology, but it takes a lot longer to train and hire ICU-calibre staff. Normally we're talking years.

To toss in another analogy, we can (and have) seconded non-ICU personnel to work in ICUs, but that's like using a retail electrician to run a power plant.

One can argue we should have greater capacity in the system. But that is costly. Decades of demand for lower taxes have resulted in Canada's healthcare systems being systemically under-funded (that's my assessment).

One indicator of this is, we used to be the second-highest in expenditure/capita. We're now down in around the 10th spot compared to other wealthy countries.

As with most things in life, you get what you pay for.

[Pelagic]

Originally Posted by Mike OReilly

The challenge is largely on the human resource side. We can, and have, greatly expanded our ICU capacities across the country. Most provinces that I'm aware of have added up to 50% more beds to the system. The problem is, we can buy and install the technology, but it takes a lot longer to train and hire ICU-calibre staff. Normally we're talking years.



To toss in another analogy, we can (and have) seconded non-ICU personnel to work in ICUs, but that's like using a retail electrician to run a power plant.



One can argue we should have greater capacity in the system. But that is costly. Decades of demand for lower taxes have resulted in Canada's healthcare systems being systemically under-funded (that's my assessment).



One indicator of this is, we used to be the second-highest in expenditure/capita. We're now down in around the 10th spot compared to other wealthy countries.



As with most things in life, you get what you pay for.

Well said..... and in effect suggests that the cards have already been dealt all over the world.
We can only hope and be proactive, while accepting fate in trying to mitigate the outcome, wherever we are.

This is very apparent in poorer countries like the Philippines.

Had my 3rd dose yesterday
(2 x AZ + 1 Pfizer) and could see the concern in the health care workers eyes as they jabbed as many as they could, while donated stocks last.

I asked if they were worried?
Most answers were "Well we can only pray"

The number of ICU beds here is dismal as noted 2 days ago by Philippine's health Minister in a wonderful understatement for a population of 112 million.

......He added the government is also preparing its temporary treatment and monitoring facilities (TTMFs).

"We only have about 115 TTMF beds all over the country. That means if you have an exponential growth in this Omicron, we might have problems in terms of isolation or quarantining these Covid-positive patients," he said."

https://www.pna.gov.ph/articles/1164396

Happy New Year Mike!

[GordMay]

Originally Posted by Mike OReilly

The challenge is largely on the human resource side. We can, and have, greatly expanded our ICU capacities across the country. Most provinces that I'm aware of have added up to 50% more beds to the system. The problem is, we can buy and install the technology, but it takes a lot longer to train and hire ICU-calibre staff. Normally we're talking years...

To become a registered nurse, in Ontario, you must:

- complete a [post-secondary] Bachelor of Science in Nursing degree offered by a university, college, or through a college-university partnership*
- complete the national registration examination
- be registered and in good standing with the College of Nurses of Ontario
* Programs are typically four years in length. However, some compressed and accelerated options are available for students with prior education and experience.
IIRC: There's only 2 programs, in Ontario.


Nursing Graduate Guarantee – If you are within 12 months of registering with the College of Nurses of Ontario, and approved to participate in this program, Ontario will guarantee you have the opportunity for full time employment.

Community Commitment Program for Nurses – Newly graduated nurses [registered nurses and registered practical nurses] may be eligible to receive $10,000 in exchange for a one-year commitment to an employer, in an Ontario hospital or long-term care home in an area of high need, and an education grant of $1,500 to employers for each professional they hire through the program.

[Lake-Effect]

Originally Posted by GordMay

To become a registered nurse, in Ontario, you must:

...

Useful info of course. But in time of need, it wouldn't be unreasonable to deploy student nurses in appropriate situations.

You want only qualified and experienced nurses in ICUs, of course. But less Omicron hospitalizations are ending up in ICUs and on ventilators, so the basic COVID care is probably becoming rote by now, which means that student nurses (under supervision, of course) could be drilled just on this sort of care. And other helpers (eg military, reservists, trained first-aiders) can perform more of the less critical support roles.

Desperate times call for desperate measures.

[danstanford]

[QUOTE=Lake-Effect;3550007

Desperate times call for desperate measures.[/QUOTE]

You couldn't be more right.

Many things can be modified in the same way that our protocols have changed as we become more desperate.

It sure is nice to hear/see some discussion about these kinds of issues.

[Mike OReilly]

Originally Posted by danstanford

You couldn't be more right.

Many things can be modified in the same way that our protocols have changed as we become more desperate.

It sure is nice to hear/see some discussion about these kinds of issues.

This is fine for a short-term fix, and I bet student nurses have stepped up in many places. But if we really want to build greater capacity in our healthcare system, we need to increase the funding and resources provided to our education and healthcare systems. This means raising taxes.

But we (collectively) keep demanding lower taxes and more efficient public spending. You can't have both. You can't run at maximum efficiency, while still maintaining excess capacity that can quickly be ramped up to deal with, oh I don't know... say a 100-year pandemic.

The problem is that we now run our healthcare systems like we do most businesses. We've forced the system to operate with razor-thin excess capacity. We've "cut all the fat," as the adage goes. And we run it like a JIT (just-in-time) business.

[danstanford]

Originally Posted by Mike OReilly

This is fine for a short-term fix, and I bet student nurses have stepped up in many places. But if we really want to build greater capacity in our healthcare system, we need to increase the funding and resources provided to our education and healthcare systems. This means raising taxes.

But we (collectively) keep demanding lower taxes and more efficient public spending. You can't have both. You can't run at maximum efficiency, while still maintaining excess capacity that can quickly be ramped up to deal with, oh I don't know... say a 100-year pandemic.

The problem is that we now run our healthcare systems like we do most businesses. We've forced the system to operate with razor-thin excess capacity. We've "cut all the fat," as the adage goes. And we run it like a JIT (just-in-time) business.

So what would this look like? Would we pick a number like 10% or 25% excess capacity and have people and facilities without any demand for their services? How would we prevent adoption of more potentially excess processes that likely wouldn't go away when we needed the capacity?

Don't get me wrong, I have great respect for those in the medical profession and have had nothing but great service any time I needed them.

As for the tax situation, it seems to me that we (collectively) have a role in the budgeting process which is to advocate for more efficient expenditure of our precious tax dollars. Though it may be a chicken/egg situation, taxpayers see a need to balance the perpetual call from these systems to be better funded.

We do not need to look far in any direction to see where more public money could be spent to protect and enrich our lives. From falling down bridges to unfunded arts groups to education to the health needs referred to above.

[GordMay]

Originally Posted by Lake-Effect

... Desperate times call for desperate measures.

“Desperate times call for desperate measures” may be derived from Hippocrate’s ‘Aphorisms’: "For extreme diseases, extreme methods of cure, as to restriction, are most suitable."

A similar phrase occurs in Erasmus's Latin ‘ Aphorisms: "For extreme diseases, extreme methods of cure, as to restriction, are most suitable.". A similar phrase occurs in Erasmus's Latin ‘Adagia’: "Desperate diseases must have desperate remedies."

[Scorpius]

Originally Posted by danstanford

So what would this look like? Would we pick a number like 10% or 25% excess capacity and have people and facilities without any demand for their services? How would we prevent adoption of more potentially excess processes that likely wouldn't go away when we needed the capacity?

Don't get me wrong, I have great respect for those in the medical profession and have had nothing but great service any time I needed them.

As for the tax situation, it seems to me that we (collectively) have a role in the budgeting process which is to advocate for more efficient expenditure of our precious tax dollars. Though it may be a chicken/egg situation, taxpayers see a need to balance the perpetual call from these systems to be better funded.

We do not need to look far in any direction to see where more public money could be spent to protect and enrich our lives. From falling down bridges to unfunded arts groups to education to the health needs referred to above.

There are lots of businesses with cyclical demands. Firemen, for example have lots of time when they are not fighting fires. Night shifts sleep, but day shifts do education, building inspections, equipment maintenance, training, etc.

We could do the same thing with health care. We are a long, long way from it but if we had excess capacity there are lots of opportunities in preventative programs, community health, outreach, etc. I'm sure quite a few nurses would be pretty good at doing long-term care home audits for example.

We had the same sort of thing since we were in the project business (large computer system development). Staffing demands were up and down all the time but, with some imagination, we were always able to keep our people busy and productive between assignments.

[Mike OReilly]

Originally Posted by danstanford

So what would this look like? Would we pick a number like 10% or 25% excess capacity and have people and facilities without any demand for their services? How would we prevent adoption of more potentially excess processes that likely wouldn't go away when we needed the capacity?

But there's the rub though. How do we maintain a system with a bit more capacity in it, so that it can more easily accommodate the occasional upsurge in demand. But also be cognizant and responsible in the use of taxes. What's the balance?

And on what basis do we plan our capacity for? Is it the 100-year pandemic event? Most engineering is geared to accommodate the 100-year event. Should we fund a healthcare system that can do this? Or should we run it to the edge, as we do now, and then deal with these rare events on an ad-hoc basis (as we are doing now).

I don't have the answers. I do know that one costs more than another. And I also know that, against the constant drum beat of "lower taxes!", it's hard for politicians to sustain public services and goods, be they the healthcare system or bridges.