Wednesday, March 18, 2020
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.Followed by an update that evening:
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:
Canada: https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html
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
Sorry I missed the call.
Update from the city today: https://www.toronto.ca/wp-content/uploads/2020/03/95bc-MOH-Statement_16March2020.pdf
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
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