Wednesday, March 25, 2020

 

Coronavirus Resources & Community Make

I've been personally involved in Community Make, our idea is to basically help coordinate independent makers and small business which have e.g. 3d printers or sewing machines in order to help with supplies (masks, etc) for the coronavirus epidemic here in Ontario. Turns out the big need is for face shields - which are more protective than facemasks, plus easier to make & use properly, as well as being easier to reuse safely. So that's been super interesting and has kept me busy several hours of every day. If you've got a 3d printer, laser cutter, or sewing machine, we'd like to hear from you.

Lots of other groups are organizing in Ontario/Toronto as well. The most awesome resource I've found is this: COVID Resources (Toronto mostly), it's a spreadsheet with links to a lot of different kinds of info, such as how to help (volunteer, etc), support services (e.g. government and not-for-profit groups), mental-health info, etc.  It links to this more detailed breakout of Impacts and Supports for helping specific types of people, etc.

Here's an amazing log-plot chart comparing countries response to each other, based on day-1 = when each country had 150 cases. The USA looks to be heading to real disaster (mostly because of the super poor behavior in New York, which is almost half of all US cases now). Log-plots are super important because they let you see the growth rate in constant terms - basically the slope of the line in the log plot tells you about the growth rate.  You need to see the slope flattening to zero as quickly as possible.  You can also get up-to-date log-plots for the Canadian provinces and US states individually here: 1point3acres COVID-19 in US and Canada.

The big boys are also getting into emergency manufacturing: Ford, 3M, GE and the UAW to build respirators, ventilators and face shields for coronavirus fight, which is great news.  Wish it had happened 2 weeks ago, of course, given the extent of the problem in the USA, but hey, better late than never!

Also in good news, there are tons and tons of clinical trials that are starting for treatments and for vaccines.  The Milken Institute has a great tracker for all of them, it currently lists 39 vaccines and 65 treatments, and if you want details there is a PDF about all of them updated daily.  The hydroxychloroquine treatment is listed under "other" for it's mechanism, and every treatment and vaccine has links to Sources for more info. I'm just not biomed enough to be able to actually parse most of that stuff, but it's super cool to see that thousands of scientists are working hard.

As a final note, most locked-down Chinese cities opened today, two months and a day after they locked down.  Wuhan itself they plan to keep on lockdown till at least April 8th. The big question is whether this is too soon, and they will start to see rising numbers and community transmission again, and thus have to lockdown all over again - a problem which has already occurred to some extent in Hong Kong and South Korea. It's great to have China running that experiment now, we can basically keep an eye on them to judge our own future response. Realistically the lock-down they did in China is far harsher than our own has been to date (or realistically ever could be), and so we can expect our lock-down to need to last longer. So: at least 10 weeks, maybe more, it will depend a lot on our collective behavior, our ability to ramp up testing, and of course our actual case counts.  Unless new tools or treatments can somehow make a new strategy possible - wildcard, who knows. Anyway, I guess my realistic scenario from a couple of days ago may be quite optimistic... I think maybe I'll make a more pessimistic timeline prediction for my next post, with some economic thoughts thrown in as well.

Sunday, March 22, 2020

 

Coronavirus: Tracking & Realistic Futures

There are a number of awesome tracking websites springing up.

USA: COVID Tracking Project, has data from all the states apparently 57 now, so must include the districts, etc). They are taking screenshots of their data sources (since many, like Toronto and Ontario, don't bother to show a history themselves), and actually rate the data quality, which is cool.  Data only though - no chart or graphs.
USA & Canada: COVID-19 in US and Canada, they have decent charting, and if you scroll down to the middle section (about 1/2 to 3/4 of the way right now) there are several pretty awesome data animation widgets/infographics, which are really cool.
Why You Must Act Now: COVID Act Now, generates predicted hospitalization case loads given four different scenarios: no action; social distancing, shelter in place, wuhan-style lockdown. I have no idea how accurate their models are (in fact it's probably hard to know or even measure how effective "social distancing" really is), but it's super scary that they show social distancing as basically only delaying the overload of hospitals by a month or so.  Presumably Ontario/Toronto are more optimistic about the effectiveness of social-distancing, otherwise we'd be implementing more harsh control measures...

Two days ago I gave an optimistic future vision for Ontario. Today I want to lay out a more middle-of-the-road type prediction.

First a few bits of news. Tracking Spreadsheet for Ontario/Toronto.  Ontario's new cases March 19/20/21: 44, 50, 69, total now 377.  Toronto: 18/33/32, total now 193.  Ontario increasingly has a massive testing backlog (meaning: samples which have been taken from patients, but are waiting to actually go through test procedures to get a results. The backlog is 7239, and daily test quantity is typically about 1-2k, so we have at least a 3 day backlog now. There are conflicting reports about whether testing will increase or decrease over the next week or so - some say we're having serious shortages of reagents and staff fatigue, while others claim we have new labs ramping up and will get to 5000 test/day soon. Apparently the source of a lot of those backlogged tests is returning travelers, which is terrifying to contemplate - imagine returning to Ontario, being told to self-isolate, but actually not knowing for sure if you have it. Do you take it seriously? Is there even any food in your house, since you just got back? Lots of ways I can imagine those people spreading the disease in the time between sample taking and them actually getting the positive result...

Today's numbers in Ontario are already a bit scary, that's for sure. It's also true though that there is a considerable lag between when measures are put in place and when you can expect to see the difference in the test results:  because of the lag in the testing itself, but also because of course people don't even know to get tested until they have symptoms. Realistically that total lag is 5+ days.  So today's numbers are infections that actually happened at least 5 days ago, and we can expect to see numbers continue to rise for AT LEAST a few more days, since Ontario didn't lock down effectively until Tuesday (3 days ago) or so...

We HAVE acted quickly, but my impression so far is that we're not acting strongly, i.e. the state of our "lockdown" isn't very severe compared to what's possible.  According to the model I've been using (http://gabgoh.github.io/COVID/index.html) we need to get under 40% of the previous infection rate, and ideally less than 25% or so, in order to keep this epidemic well under control (feel free to play with the sliders yourself[1]). Do you think existing measures will result in less than 25% of the previous infection rate? It does seem plausible, but I just don't understand infection dynamics enough to be actually confident.

Anyway, what does it all add up to? Here's my best guess of a 'realistic' scenario for Ontario. We've already gone through week one, so here's the scenario from here:

1) Week Two: we keep moving forward on stricter social distancing and hygiene measures, getting our "lockdown" better - better measures at supermarkets, more people taking it seriously, better compliance of non-essential businesses, etc. Our testing rate hopefully scales a bit, and the return of travelers from abroad slows down (most everyone is back), so our testing lag will hopefully only grow for the next day or two, and then start reducing again. The number of new cases rises for the first few days, and then plateaus, between 100 to 150 (Ontario).

2) Week Three: we reach April 5th, and number of new cases/day starts slowly falling, but we're still recording many new cases, way too many to contemplate reducing our control measures. So, the government announces the extension the social distancing period for 3 more weeks, to April 26th (plus or minus a week). Sadly, people are going somewhat crazy from being cooped up so long, and so our previously tightening measures are loosening a bit, but we probably still have levels similar in effectiveness to the week one average. The economic effects of this are crushing for many families, but government money is flowing, so hopefully we can avoid wide-spread despair or poverty. Hospitals have a lot of patients, but we ARE under their total capacity, and this week sees the hospitalized patient population hitting the top of it's curve. Several treatments (like the hydroxychloroquine) potentially prevent at least some of the deaths from occurring.

3) Weeks Four & Five: number of new cases is still falling, though not as fast as everyone is hoping, we reach ~10 by the end of week five. There may be announcement of further, harsher measures, for instance, the closure of parks and public transit, though this obviously results in it's own whole world of compensatory behaviors which increase spreading almost as much as the cancellation reduces spreading. We're all more than a little tired of being co-oped up, especially parents of small children, but it IS widely understood how important obeying these measures is, so we're just "suffering in place". Testing has ramped and we're on top of new cases, etc, the disease itself is increasing under very good control.

4) Week Six: we record several days of only low single-digit new infections.The government lays out a plan for us emerging from our lockdown that consists of everyone being hyper vigilant about symptoms and self-isolation if they are sick, some continuing social distancing, being prepared for more regional lockdowns, and crazy levels of testing. Many people (e.g. TTC drivers, grocery store clerks, etc) will have to wear significant personal protective equipment for the forseeable future. But we DO go ahead with opening back up at the end of week six. There are several treatments now actually available as well which also encourages us to take this risk - the chance that people will die if they get sick is considerably smaller than before.

5) Weeks Seven-??: measures work in most places, though a couple of cities DO end up have to restart more extreme measures when they have a "super spreader" situation happen.  Flights to some countries which also have the disease well under control start to be more popular again.  The economy starts to recover. Things like restaurants are slow to get back to their former levels of business, but it does happen as people's fear recedes.

6) Eventually (at least 4 months from now): Canada is able to reopen it's borders. The economy is back to being mostly regular. Treatments are great and widely available - perhaps even enough for "everyone" to get treated.  We can let the virus actually infect the entire population, and we basically do, though perhaps it's staged and controlled somehow. The virus and disease become endemic, and various mutations of it are a seasonal disease that people can get, just like the flu, and probably roughly as dangerous (which is to say: still quite horrible really).

Obviously it can easily go worse or better than that, but I feel like this is a sort of middle-of-the-road scenario that is fairly plausible.

Eric


[1] Note that the model shows "populations" of people in each group, NOT daily or cumulative totals.  So it's a bit hard to compare directly to the numbers in the spreadsheet, you sort of need to compare one days numbers to the next in the model, in order to get a feel for the rates. If someone is a super awesome hacker, I'd love to see a fork where there are three charts: the existing population one; a daily change chart, and a cumulative total chart.  The second two charts would be fixed outputs (i.e. no sliders etc on them). There could also be a table version of any of those, that might be handy.

Friday, March 20, 2020

 

Coronavirus Ontario/Toronto Update

I found the (draft) scientific paper for the french Hydroxychloroquine and azithromycin treatment, and it's amazing! Results are even better than the previous announced "75% tested negative after 6 days" result. There was a 6-patient subgroup which also received the antibiotic azithromycin, and they had a 100% negative test result.  Obviously that's a tiny sample, but it's super promissing.  The FDA already approved it and several groups are doing larger studies, so it's conceivable that in just a few more days we could start to widely use this drug combo on the most ill & most elderly patients, and save thousands of lives. We don't deserve this miracle (what are the odds that an existing widely used drug would just happen to be so effective against a new disease?!?), but we might get it anyway, and that's just amazing. Thanks science, and thanks to the people in China who identified this drugs action in-vitro, and the team in France who did this study. You're all heroes if this pans out.  Note that what I write about deaths below still assumes this kind of miracle doesn't happen. We might be able to save most of them yet, and obviously an effective treatment means it's less scary to let the disease propagate a little bit (but we can't let it go wild since we certainly don't have enough drug to treat EVERYONE).

In local news, Ontario and Toronto are progressing along the epidemic at about the rate that seemed likely to me when I wrote first email. Ontario is still on track for low-thousands of cases with a dozen or two death total. In the last three days (March 17, 18, 19), the province reported 22, 44 and 36 new cases, total now 251 with 2 deaths. Toronto: 20, 7, and 18, total now 128 and zero deaths, 11 people hospitalized, 4 in intensive care.  So MUCH depends on the testing coverage, i.e. are we actually catching/testing most (>50%?) of the actual cases, or is there widespread untested infection? If you assume that our testing IS good (it's been pretty good to date, as proven by the fact that our epidemic is later than most places and surprisingly late for how well connected internationally Toronto is, and by the fact that deaths are in-line with 1% of infections), then these only slowly rising numbers are very positive sign that we'll get away in the end with low-thousands of total cases. To actually get there though, we NEED TO STAY in lockdown at least as strong as we are now ("extreme social distancing" and widespread business closures/limitations), and our public health teams need to continue to find and isolate infected people at high efficiency.

The city of Toronto is actually doing daily media briefings, and they are *incredible*.  I am so impressed with Dr. Eileen de Villa, she is calm, well rested, super clear in her communications, and she gives full, accurate, and true answers to every question.  She doesn't hide her ignorance when doesn't know, and she explains why we do things even in our state of uncertainty about how the virus works. She mixes in both carrots and sticks to encourage people to behave responsibly. It's worth going back and watching some from the previous days if you have questions or curiosity about public health and how and why things are done. If, when this is all over and Toronto has escaped any serious death toll, it will be her and her team at the city that we owe thanks to. I'm already grateful: thank you Dr. Eileen de Villa. Plus, she breaks me up and makes me cry with her statements about how we all love this city, you can feel the love.

In my optimistic vision of how this is going to go for Toronto/Ontario now, we basically stay where we are now in term of lockdown till April 5th (as opposed to being forced to implement stronger measures due to ever higher numbers of infections). Total cases could be something like 1000-2000, with perhaps a dozen or two deaths (though half of those deaths probably haven't happened by April 5th). At that time, if there haven't been any new community cases in a few days (ideally at least a week!), we could potentially allow things to go back to more normal business-as-usual, opening school and business, etc. The MOST IMPORTANT part of a program to allow opening up would be for all citizens to be hyper vigilant about symptoms, confining themselves immediately if they feel even the tiniest bit sick, and also informing anyone else around themselves who were close enough to catch it to do the same. Because obviously if that doesn't happen, we get back to needing city or province wide social distancing again in less than two weeks; this whole cycle would have to repeat. I guess we might be able to do such lockdowns more regionally, if we were certain of the patient zero and their travels in each area, but man it seems hard to be certain like that... perhaps one part of opening up might be some regional travel restrictions, basically, telling people to limit travel outside of their own region? That doesn't seem super practical, but I guess it's more practical than what we're doing NOW, so there's that... The possible drug treatment above also helps us to be ok staying more open, since we can tolerate a few more cases because the risk is lower - though as I said above, we still can't let the virus run rampant, so if cases rose too much (>5/day?), especially if they were public transmission cases (i.e. not linked to an existing known positive case), we'd still have to lock down again.

In conclusion, stay home, distance yourself greater than two meters from others on required trips out, and stay healthy. We're going to get through this together.

Wednesday, March 18, 2020

 

Coronavirus Futures: USA and Global

My previous post Coronavirus Futures: Toronto & Ontario covered only the local situation.  Here's a more global look.

First, some resources:
Nice tracking for Canada (with charts and data downloads): Covid19Canada (by some UoT people)
Global Tracking: Coronavirus.app
Handy Tool for projecting the future: Epidemic Model
USA: CDC test tracking (I don't know WHY that page is missing so much data even though they keep updating it, but it's the best info I've been able to find).

Second, some local updates: As expected, the Canada-USA border has been tightened again, by mutual consent, it's closed to American's now, which is great. I kinda figured the delay was political (the USA wouldn't agree to not letting American's cross), so it's great to have them aboard for this, and within two days of the original announcement.  Toronto numbers on Monday were scary, with 20 new cases in Toronto, some of them community spread cases, but numbers yesterday were *amazingly low* at 8 (I would have bet money on 40+), so that's great.  We're basically tracking with my previous hopes for where we'd be at locally, I still think it's possible for Ontario to keep it to low thousands of cases.  Try plugging some values into that model I linked above, it's very informative.  A sort of "middle of the road" scenario where you assume that Ontario had 200 community cases before we locked down shows that we end with only 62 fatalities, and need only 240 hospital beds, which is obviously bad, but it sounds manageable to me.

Now on with the main event.

Near-term US Futures (next 2 weeks): Many US states will become like France, Italy and Germany: overwhelmed health care systems and thousands or tens of thousands of patients. This is already inevitable based even on the confirmed cases. Given that the testing in the USA has been embarrassingly bad, their true cases are *much* higher than reported.  Honestly my "best case" scenario for the USA at this point is 1M cases, and 50k deaths; that's going to start in the next few weeks in places like NYC & Seattle. New York, with thousands of confirmed cases, still is not properly locked down even today; they will soon have hundreds of deaths every day. The miracle they need: everyone in the county to go into immediate, total lockdown. Nobody even leaves the house for a week, and they try to avoid infecting each other in the household as well. Since that's obviously not going to happen, they face a much longer isolation period than e.g. China has faced - and to be clear, they locked down Jan 23/24 and most cities are STILL in lockdown now, almost 8 weeks later. Trump keeps talking about 15 days to slow the spread, but that's an atrocious, misleading, horrible lie about the true reality of this situation. The American political response at all levels has been abysmal, and is likely to continue to be so (let's not even talk about the mayor of NYC and his actions...).  Americans: please please please lock yourselves down if you live in the USA.

Near Term Globally, obviously it's as bad in Europe, they are perhaps 3-5 days ahead of America in general, but facing a very similar scenarios. Their political responses have also not been very good; with some such as the UK and the Netherlands actually announcing plans which essentially call for the deaths of 1-5% of their own citizens. Craziness!!!  Now the UK has actually retreated from that plan, but the bonkersness of it really blew my mind.

The rest of the world appears to be several weeks behind in terms of infection counts, but it's so hard to know if the numbers of confirmed cases is telling a true story.  To be sure, you need to know about the state of testing in each country, and I haven't had time to do much digging for anywhere but Canada and the USA. So I won't comment more broadly here, other than to say: if you are detected ANY community cases (meaning: you can't trace a confirmed case back to travel or a close connection) then the time to lockdown was YESTERDAY.  Every delay of 1 day causes 40% more cases, and potentially more than that in deaths if you go far enough to overload your medical system.

Medium Term (months) Futures: well, we have EXCELLENT NEWS from France today: Sanofi offers potential drug to beat COVID-19. They say "In a recent clinical trial, the Plaquenil drug was tested on 24 patients, and after six days, the virus had disappeared in three quarters of them".  Now that isn't actually very encouraging by itself, since actually most people recover from the disease pretty quickly anyway. But there is additional info in a (french) video: Coronavirus: “promising” chloroquine clinical trials in Marseille, government announces larger trials where they reveal that they had a control group of 24 other people, and after the same 6 days all 24 of them still tested positive.  Meaning: the drug helps to rapidly reduce viral drug load in peoples bodies. From what I understand of what causes people to die (an immune system freakout due to super high viral overload), this drug is probably a great treatment, based on these results!  And better, the drug is already used for several different things, so it seems likely that lots of countries have at least some small stockpiles of it. Assuming more can be manufactured quickly, it could radically change the OUTCOMES of the infections we already have underway, and thus save a lot of lives. And medium term, it makes a real difference in how our future looks, if it proves out with e.g. older people, and reduces mortality to e.g. flu levels or below, it's actually BETTER than a vaccine. So that's super hopeful, the first good break we've gotten in awhile on this problem.

In terms of a plausible medium term future in the USA, I sort of gave it above, but you can imagine that drug helping, and I hope that they get it together nationally and start lockdown properly everywhere. Assuming that happens, they can keep it to 1M infected and 50k dead, less if they have enough of the drug to treat large numbers of people.  If they don't get things under lockdown, well, just keep multiplying. Here's your catch phrase: a global pandemic is a mandatory exam in national competence, and America has been failing so far.

Long Term: well, that miracle drug has greatly improved my long-term outlook. Obviously it may not work, but it's increased my confidence that such treatments will be discovered / will work. So a different 3+ year scenario than last time: we rapidly scale up manufacturing of whatever drug works. There is a widespread distribution scheme, where basically every household ends up with enough pills to treat a couple of people for the full length of treatment; these pills come with instructions on when and how to take them, and ideally with a home test for the drug too.  Then, life can sort of go back to normal, except that everyone may occasionally have to check themselves (basically when you get a suspicious set of symptoms, cold like: fever, cough, but no sneezing) and enter a brief period of treatment and isolation if they test positive. Retirement homes and similar places will need to be super vigilant. But life in general could be "fairly normal" I think, there is just going to be a wide spread level of paranoia about the common cold that doesn't happen now, and in general there will be a huge increase in public spending on public health resources, pandemic fighting, etc (hopefully that boost actually lasts long enough to be helpful for the next potential pandemic, which is probably 5-20 years away).  So that's much more normal than my previous long-term prediction, reflecting the optimism I have gained from that reported successful treatment.


 

New Quarantine Hobby: Painting

Seeing many weeks of 'shelter at home' coming, I stocked up on entertainment (and food, but I'm not worried about that). Before the libraries closed, I got six of the largest sci-fi books I could find out of the library (three are anthologies of short stories, which I love). And thanks to some inspiration from my housemates, and a previous experience at paint lounge (I painted a happy robot), I decided to take up painting. We bought over $200 worth of acrylic painting supplies at currys: paint, canvas, practice paper, and brushes.

And now I present to you: COVID-1, my first masterpiece. Way I figure it I have 17 more practice paintings of COVID before I have to make the final piece in the set :-). I learned a lot on this one, mostly importantly:
  1. I need to set the paper higher on the easel, bending over for an hour+ makes my back hurt!  Ideally it's only a bit short of eye-level, I think. Also we need proper tarps and I need some paint clothing or coveralls (though I did miraculously not get any on me this time, I doubt my luck can hold).
  2. We need smaller brushes; the smallest brush we have still makes lines which are ~4mm wide, so detail is just impossible.  Fortunately I know that I have a huge collection of brushes in the garage *somewhere* from my former "Machina Lisa" watercolorbot phase (I made the robot paint the Mona Lisa, very badly, over and over again with parameter variations, it was entertaining), and many of them are tiny, so I just need to spend 2+ hours turning the garage upside down... probably a good project for this quarantine time anyway!
  3. It's important to think very carefully about what's to be painted first. There were some objects which should be partially behind other objects, and that means you have to paint them first, because you can't add them later and actually have it look correct, especially not with these battleship brushes which can't do detail! Also in sequencing, it's very important in some cases to let the previous layer DRY before starting on the thing above or beside it. Sometimes it's ok to get some mixing due to things not being dry, but other times it's super bad!
  4. It's great to follow a picture of what you want to paint; and I was correct that choosing something high contrast makes for at least a potentially good painting, even if my amateur mistakes clearly left it sad if you look too closely.  Overall I'm super happy with how this second painting turned out.  Great start :-)
Anyway, my idea basically is to make a new painting every day of this extended lockdown phase, and hopefully by the end I'll actually be decent at this. Some ideas for future paintings:

 

Coronavirus Futures: Toronto & Ontario

Here's the emails that I sent out at noon on March 16th (Monday):
I agree we should cancel open house, sad as that is. I will not be there to make the dinner tomorrow.
 
The pandemic has been all but confirmed here too now, unsurprisingly: https://www.cbc.ca/news/health/coronavirus-community-transmission-canada-1.5498804

I've been doing a lot of research since I have a lot of time and some science background.  Here's a sort of outline of our future:

[TL;DR: short term we all need to isolate and lockdown. Medium and longer term are uncertain but mostly depressing and tragic]

Short term: if we maintain a reasonably strict lockdown for a few weeks (3-9), we can hope to keep the number of Ontario cases in the low-thousands. Because we've acted quickly compared to our confirmed cases, and our testing has been decent. That count is low enough to not overwhelm our healthcare system, hopefully.  I AM a bit terrified about all of the Canadians returning from abroad; hopefully the vast majority of them manage to self-isolate effectively, otherwise that alone is likely to doom us to pandemic. The critical numbers to watch will be cases over the next week or so.  You can watch those here:


Lockdown info: The most important thing you can do personally is to maintain isolation and high hygiene. Do not go anywhere unless it's required; remain at least 6 feet from people at all times. Wash hands after touching any public surface, i.e. always immediately when returning home, and as many other times as you can practically manage. Do not touch your face or rub your eyes if your hands are not clean; wash hands before eating. If you have COVID-19 symptoms (most obviously fever or a dry, continuous cough), CALL your healthcare provider first (do not visit them or the hospital unless so instructed!). Super huge amounts of info here: https://arstechnica.com/science/2020/03/dont-panic-the-comprehensive-ars-technica-guide-to-the-coronavirus

If you are young and do not have any elder care responsibilities, also consider volunteering to help out - you personally are at low risk, and could help out others. Canada will get through this by working together.  https://www.theglobeandmail.com/canada/article-canada-heres-how-we-are-going-to-survive-this-pandemic-together/  Volunteer for UHN near the bottom of this page: http://uhnopenlab.ca/project/hotline/

Medium term: things are looking a lot more dicey. I'm hoping that Ontario can remain one of the "green zones" (where the virus/disease is under control in general, vs "red zones" where it is not), but given our proximity to the USA (e.g. New York State, one of the worst places right now in terms of infection count and pathetic political response), maintaining that status is going to depend on some very tight borders and massive testing/self-isolation systems (read up on what Korea has been doing). Realistically we face years of these kinds of controls, as epidemics spring up and die down all over the world. Ontario itself will probably go through several lockdown periods, each caused by a failure to catch a case, which then spreads until another lockdown is required. There is some hope for effective treatments and a vaccine which might help reduce the problem 6-18 months from now, but these are by no means certain. Canada has been acting quickly on that kind of research, which is very encouraging (https://cihr-irsc.gc.ca/e/51868.html), though the total amount of money remains too small IMO.

Long term: A depressing but somewhat-plausible 3+ years-from-now future is that the disease has become endemic, like the flu, with dozens of mutating strains, and eventually everyone gets it, not just once but on a regular basis; with all that entails for ICU usage and deaths. Your yearly Coronavirus vaccine shot will be more important than your yearly flu vaccine shot; good treatments are available so it's probably not more than 5x worse than the flu (currently it's between 10-500x). It's harder to be an old person, since they are disproportionately at risk (as if it wasn't already hard enough being old). The more friendly long-term futures, where this disease is contained or even eradicated worldwide just seem like super remote pipe-dreams at this point - how could we possibly get there from here?

Eric
Followed by an update that evening:
Sorry I missed the call.


Of particular relevance to our open house, starting at midnight, restaurants are no longer allowed to serve food on premise, only for take-out and delivery. All people are supposed to stay home as much as possible.

Canada itself also announced sweeping new travel restrictions today, which begin on Wednesday. Only Americans and Canadians will be let in. Nobody with symptoms will be allowed on flights. All people entering will be forced to acknowledge that they are being requested to self-quarantine for 14 days.  IMO these measures are likely to get considerably stronger in the next few days.  The amount of push back they got during the Q&A on that "Americans" bit was intense.

Toronto recorded over 20 new cases today, many of which are community transmission cases. The epidemic is well underway here now - if we CAUGHT 20 cases, that means there are likely 10x as many out there uncaught. I cannot emphasize that previous statement enough, please read it again. As with all epidemics, the sooner we start serious public health measures to control transmission, the smaller the epidemic will be, and also, the shorter the lockdown period will have to be. We HAVE started measures earlier than almost any other place in North America. It's still possible for us to keep it to low-thousands of total cases in Ontario if we complete our lockdown quickly.

San Francisco / the SF Bay Area (where I used to live, and still have many friends) just put in place something they call "shelter in place": it's a misdemeanor offense to be outside in public unless you are going for groceries or medicines. IMO Toronto will likely get there officially in 2-5 days.  https://www.sfchronicle.com/local-politics/article/Bay-Area-must-shelter-in-place-Only-15135014.php

Obviously you should get yourself unofficially to full lock down ASAP; there is no point waiting for the government to force you do it. We're all in this together.

Eric

 

Coronavirus Quarantine Blog

Like everyone else, my life has been cancelled and I'm 'sheltering at home'. As anticipated this is going to be a frustrating period with two main emotional themes - existential horror, and boredom. It's a weird mix. Super bad things are happening in the world, but other than trying to keep my own city (& household, family, friends, etc) safe, and maybe doing a bit of organizing to spread good ideas around, there isn't much to do other than entertain myself at home.

In the spirit of those first two items, I've been writing emails to groups and people I am involved with, trying to convey the shape of the likely future. TL;DR is obviously "this is the worst and largest crisis of our lifetime", it makes things like the great recession and 9/11 look like tempests in a teapot. It didn't have to be this way (this was an avoidable/preventable crisis), but you could have said that about both of those other two events as well, and been roughly as correct.

My plan for this revived blog: post those updates and models and info that I have been sending out to people anyway. Also share the human side of quarantine, though as always I am very careful of the privacy of the others, so it's likely to be a bit one-sided, or gappy or whatever.

Stay safe, stay healthy.

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