Wednesday, December 9, 2020

A Tougher Action Is Needed to Handle COVID-19 in SK before It’s Too Late

1. Situation of the Virus Spread

The author has done a comprehensive comparison of the data as of 26 Nov 2020, and has reached the conclusion that Saskatchewan has come to a critical moment when strict government interventions have to be made. The doctors, nurses, patients and the general public should not be let down with a timid, underwhelming and disappointing plan. The percentage of the number of active cases in total cases is the second highest in the country, and the percentage of active cases in the population is the third highest. When compared with Manitoba, Saskatchewan has a much higher percentage change of actives cases and of hospitalized people over the last month, yet the patient recovery is half slower.

 

 


 

 

 

Item

QB

ON

AB

BC

MB

SK

NS

NB

NF

NV

PEI

YK

NT

Cases

136,894

109,361

51,878

29,973

15,288

7,362

1,257

465

327

155

70

39

15

Population

8,574,571

14,734,014

4,421,876

5,147,712

1,379,263

1,178,681

979,351

781,476

522,103

39,352

159,625

42,052

45,161

% of Cases

1.597%

0.742%

1.173%

0.582%

1.108%

0.625%

0.128%

0.060%

0.063%

0.394%

0.044%

0.093%

0.033%

Active Cases

11,456

12,871

14,052

9,591

8,845

3,146

114

105

28

150

2

15

0

% of Active in
Cases

8.369%

11.769%

27.087%

31.999%

57.856%

42.733%

9.069%

22.581%

8.563%

96.774%

2.857%

38.462%

0.000%

% of Active in
Population

0.134%

0.087%

0.318%

0.186%

0.641%

0.267%

0.012%

0.013%

0.005%

0.381%

0.001%

0.036%

0.000%

Deaths

6,947

3,593

510

384

266

40

65

7

4

0

0

1

0

% of Deaths in
Cases

60.641%

27.915%

3.629%

4.004%

3.007%

1.271%

57.018%

6.667%

14.286%

0.000%

0.000%

6.667%

0.000%

People Tested

2,136,210

5,869,990

1,432,852

769,465

344,807

252,048

134,690

56,736

60,578

4,064

56,736

5,113

6,270

Percentage of
Tested in Population

24.913%

39.840%

32.404%

14.948%

24.999%

21.384%

13.753%

7.260%

11.603%

10.327%

35.543%

12.159%

13.884%

Daily Avg in
Last 7 Days

1207.7

1427

1297.3

716.4

400.9

244.4

14.6

10.4

2.7

11.6

0.3

1.9

0

Statistics Canada: Population Estimates Quarterly for the 3rd Quarter of 2020, https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1710000901; Government of Canada: Coronavirus disease (COVID-19): Outbreak update, https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html?&utm_campaign=gc-hc-sc-coronavirus2021-ao-20200059834796012&utm_medium=search&utm_ source=google_grant-ads-107802327544&utm_content=text-en-434601690164&utm_term=covid; New York Times: Canada Covid Map and Case Count, 27 Nov 2020, please check the website by clicking https://www.nytimes.com/interactive/2020/world/canada/canada-coronavirus-cases.html#states.

 

Item

30 Days Prior
(October 27, 2020)

26-Nov-20

Change


SK

MB

SK

MB

SK

MB


Total Cases

2,841

4,532

7,362

15,288

259.13%

337.33%


Active Cases

652

2238

3,146

8,845

482.52%

395.22%


Hospitalized

24

83

108

307

450.00%

369.88%


Recovered Cases

2,164

2,236

4,176

6,177

192.98%

276.25%


Deaths

25

58

40

266

160.00%

458.62%


Government of Saskatchewan: Cumulative Cases, 27, Nov 2020, https://dashboard.saskatchewan.ca/health-wellness/covid-19/cases; Caitlyn Gowriluk: 70% of COVID-19 deaths in Manitoba happened this month, top doctor says as he announces 383 new cases, CBC News, 26 Nov 2020, please take time to read the article by clicking: https://www.cbc.ca/news/canada/manitoba/manitoba-covid-19-update-1.5817264; the Canadian Press: The latest numbers on COVID-19 in Canada for Tuesday, Oct. 27, 2020, https://www.thereminder.ca/the-latest-numbers-on-covid-19-in-canada-for-tuesday-oct-27-2020-1.24227732; Shane Gibson: Manitoba reports record-setting coronavirus case count, 3 deaths Tuesday, 27 Oct 2020, https://globalnews.ca/news/7424823/manitoba-reports-184-new-coronavirus-cases-3-more-deaths-tuesday/.





 

Date

26-Nov-20

08-Dec-20

Change


Item

MB

SK

MB

SK

MB

SK


Total

15288

7,362

19376

10597

126.74%

143.94%


Active

8845

3,146

5379

4663

60.81%

148.22%


Hospitalized

307

108

311

144

101.30%

133.33%


Recovered

6177

4,176

13577

5848

219.80%

140.04%


Deaths

266

40

420

66

157.89%

165.00%


Government of Manitoba: COVID-19 BULLETIN #279, 8 Dec 2020, please also see the article by clicking https://news.gov.mb.ca/news/?archive=&item=50002 ; Government of Saskatchewan: COVID-19 Update: Six Deaths, 183 New Cases, 144 in Hospital, 279 Recoveries, 8 Dec 2020, please see the articlke by clicking https://www.saskatchewan.ca/government/news-and-media/2020/december/08/covid19-update-six-deaths-183-new-cases-144-in-hospital-279-recoveries; Caitlyn Gowriluk: 70% of COVID-19 deaths in Manitoba happened this month, top doctor says as he announces 383 new cases, CBC News, 26 Nov 2020, please take time to read the article by clicking: https://www.cbc.ca/news/canada/manitoba/manitoba-covid-19-update-1.5817264.







 

As put by a reporter, the exponential growth rate in MB is slightly slower than that in SK, and Saskatchewan is roughly 17 to 18 days behind Manitoba, with Manitoba hitting 60 average cases per day on Oct. 10 Saskatchewan doing the same on Oct. 29, 19 days later; and with Manitoba hitting 120 average cases per day on Oct. 25, and Saskatchewan doing so on Nov. 10, 16 days later[i].

With the number of cases exploding, Saskatchewan has a limited capacity to accommodate the situation, with a high hospitalization rate and an inadequate number of ICU beds. The SHA said on November 26 that province-wide ICU capacity was at nearly 100 per cent (note that with other health services being offered, the average daily ICU capacity in Saskatchewan sits at a little more than 97 per cent) and in Saskatoon, there are only three available ICU beds. Chief Medical Officer Dr. Susan Shaw said the situation in hospitals was something she’d never seen before. The data shown from the comparison between 26 Nov 2020 and 8 Dec 2020 give us an even bleaker picture as SK is turning worse and MB is turning better with MB’s faster speed of recoveries over hospitalized, with the death toll in the last 17 days accounting for half of the total and Dec. 8, marking the largest single-day increase in the number of coronavirus-related deaths in Saskatchewan to date[ii]. Surging our ICU capacity by 449 per cent means adding more ICU beds than there are in all four of Canada’s Atlantic provinces combined. Tracing contact is difficult, as 450 cases per day would create 72,000 hours of work for contact tracers over a two-week span, or an average of more than 5,000 hours per day[iii]. Doctors and nurses are stretched thin. Other patients like heart attack patients could be pushed to the back of the line. However, the province will utilize field hospitals as a last resort should current hospitals become too crowded.

2. The Provincial Government’s New Policy to Cope with COVID-19

On 25 Nov 2020, Saskatchewan Premier Scott Moe and Chief Medical Health Officer Dr. Saqib Shahab announced new restrictions. They include cancelling sports competition and further limiting gathering sizes for sports practices, restaurant meals, weddings and other activities. All restaurants and licensed establishments (bars, taverns, and nightclubs) are limited to seat four at a single table set at 2 meters apart from another with barriers or 3 meters without. Restaurants and licensed establishments must maintain guest/reservation information on all patrons. Indoor public banquets, conferences, church services, wedding and funeral receptions in public venues will be limited to 30 people. Food or beverages may not be present or served. Night clubs, worship services, bingo halls, casinos and other locations will be allowed to continue operating, but under reduced capacity (to a maximum of 30 people). The maximum allowable gathering size for private gatherings in the home setting remains at five, except for essential service providers. Training groups should be below 8 people except for coaches and trainers. Masking continues to be required in indoor public areas that have installed barriers. Large retail locations are required to limit customer access to 50 per cent capacity or four square meters of space per person, whichever is less[iv]. 

3. Responses to the New Policy

1) Worry of Some Doctors

University of Saskatchewan epidemiologist Nazeem Muhajarine said the numbers are astounding, and it's unbelievable the government is still allowing people to eat and drink alcohol unmasked together for hours at a time in restaurants, pubs, bars, night clubs and other venues. He and others have advocated a short-term shut-down of these "high-risk" venues with better supports for affected businesses and workers. Actually doctors showed their concern in an open letter to the premier in early November. Dr. Dennis Kendel said he was surprised casinos, bingo halls and other non-essential services were not ordered to close temporarily, and he added that there should be specific, public declarations about how many cases or hospitalizations would trigger further restrictions. Kendel and others also want more enforcement of the rules with fines or other measures, rather than expecting business owners and employees to deal with violators. According to Saskatoon pediatrician Dr. Ayisha Kurji, who signed two open letters to the Premier in early November along with other 400 other doctors urging swift and decisive action, the new measures are unlikely to control the spread of the virus and worry hospitals — especially intensive care units — could soon be overwhelmed. We'll see what's happening in Manitoba, where the health-care system can't cope. Kurji would also like to see increased contact tracing efforts, as good decisions can only be made with good data. Regina cardiologist Dr. Andrea Lavoie believes the curve can be flattened with a strict but unified approach from government, businesses, community groups and the public[v].

2) Consequences Raised

What consequences will be there if the government doesn’t follow the doctors’ advice? Well, things will be similar to the US and Quebec with more critical illness and more deaths. When we go beyond that point, it will then be too late to adjust. If we continue to dither and ignore the evidence, a bleak picture will become one of catastrophe. The government may not want to sacrifice jobs and economic development, but we need to be aware of the priority. Actually, according to Goldman Sachs, China is the only big country with a positive economic growth this year, and all its retail business has already resumed[vi]. Do we want exchange a little short-term gain for a massive long-term pain?

3) Additional Measures Put Forward

Besides the measures already put forward like more tracing, more hospital room and temporary shutdown of non-essential businesses or a temporary lockdown, some of the following measures could be taken:

l  Penalty or fines as in MB and QB at an amount for more than $1000 to businesses and $500 to individuals ($100 to kids, except for those handicapped people) for not wearing masks at indoor public venues

l  Rewards to those essential service providers in terms of PPE provision, vaccination and priority in receiving subsidies

l  Encouraging working at home and virtual meetings

l  Screening and checking temperature and breathing at public venues like airports, train stations, bus stations and border checkup points and as well as checking and monitoring of blood and nucleic acid at hospitals for everyone

l  Requirement of a healthy code on the mobile phone app for access into a bus or government organizations as in Chengdu of China and an alarming system over the phone to send information about the traces of those affected with COVID-19 especially regarding bus routes, restaurant and other public venues visits

l  Segregation of COVID-19 patients and their immediate contacts in cabin hospitals or mobile hospitals set up temporarily to accommodate increased COVID-19 patients and shutdown of businesses with COVID-19 cases for at least a week

l  Online school for everyone during the pandemic so as to standardize the quality of education and alleviate the parents’ worries over their kids’ safety as in AB

4. Issues to Ponder and Comments

Without a vaccine or a wonder drug, there is only containment. Successful containment is built on five pillars: a) knowing what works; b) policies to implement what works; c) consistent and committed execution of the policies; d) clear rules for what people can and cannot do; and e) widespread public adherence to and enforcement of the rules. That is what China is doing.

Governments are responsible for pandemic control. It's unfair to expect governments to get everything right with absolute precision, every restriction perfectly targeted, every risk perfectly quantified. But it's fair to alert the government when they ignore very good evidence and put people in harm's way. Doing nothing is guaranteed to spread it rapidly throughout the population.

In Victoria of Australia, which has a population 5 times that of SK, it went from 150 cases in July to 0 in November with mandatory masking both outdoors and indoors, limitations on social interactions, an 8 pm curfew and heavy penalty for violations in place[vii].

The US and many countries in Europe are reporting record numbers of new coronavirus cases. But countries like Australia, Taiwan, and China successfully controlled their outbreaks. In South Korea and Melbourne, Australia, residents who don't wear a mask in public and businesses that do not enforce mask-wearing can be fined. Also, testing and tracing is one of the most effective tools in containing spread because the contacts are cut off from the other people. China, for example, tested 2.8 million people in one day after a single case was reported in Kashgar. That led authorities to catch and contain an additional 137 cases. For this tool to be effective, anyone with exposure — the suspected cases — must isolate. The same goes for people coming into the country from abroad. In South Korea, health authorities will have those tested positive or undetermined download self-quarantining apps that monitor their condition and set off an alarm on a user's phone reminding them not to venture out of a designated quarantine area, and foreign travelers will be transported straight from the airport to a government quarantine facility. Some of the successful strategies are: universal masking, robust testing, segregation and contact tracing, and a consistent federal plan that's clearly communicated[viii].

5. Conclusion

According to some experts, the US's first step should have been to get its surge under control; then cases could get back to a level where testing and tracing are once again effective. Action must be taken before it is too late as then you will have to cry over spilled milk. Saskatchewan is facing an imminent fire, and we need a quick and decisive action of the firefighters.

 



[i] Brian Zinchuk: Saskatchewan, Manitoba, North Dakota all seeing growth in COVID-19 cases, Weyburn Review, 16 Nov 2020, as shown from: https://www.weyburnreview.com/news/local-news/saskatchewan-manitoba-north-dakota-all-seeing-growth-in-covid-19-cases-1.24240148.

[ii] paNOW: Six more COVID-19 deaths, half of all fatalities in last 17 days, 8 Dec 2020, please atke time to read the article by clicking the link https://panow.com/2020/12/08/six-more-covid-19-deaths-half-of-all-fatalities-in-last-17-days/.

[iii] Lara Fominoff: ICU capacity at nearly 100 per cent in Saskatchewan, 650 CKOM, please take time to read the article by clicking at the link https://www.ckom.com/2020/11/26/icu-capacity-at-nearly-100-per-cent-in-saskatchewan/; Jeremy Simes: Sask. escalates response to COVID-19 as ICU capacity nears 100%, CTV News, 26 Nov 2020, https://regina.ctvnews.ca/sask-escalates-response-to-covid-19-as-icu-capacity-nears-100-1.5205690.

[iv] Government of Saskatchewan: COVID-19 Update: New Measures in Effect November 27, 25 Nov 2020, https://www.saskatchewan.ca/government/news-and-media/2020/november/25/covid-19-update-new-measures-in-effect-november-27.

[v] Jason Warick: Half of all Sask. hospital beds could soon fill with COVID-19 patients: report, CBC News, 27 Nov 2020, https://www.cbc.ca/news/canada/saskatchewan/sask-hospital-beds-covid-19-patients-report-1.5819241; Jason Warick: Doctors call Sask. government's COVID-19 plan timid, disappointing, CBC News, 26 Nov 2020, https://www.cbc.ca/news/canada/saskatoon/doctors-call-government-covid-19-plan-timid-1.5817527.

[vi] Saloni Sardana: China will be the 'most important marginal driver of global GDP,' ex-Goldman Sachs economist Jim O'Neill says, 22 Sep 2020, Business Insider, https://markets.businessinsider.com/news/stocks/china-economy-gdp-goldman-oneill-2020-9-1029609792.

[vii] Steven Lewis: Sask. has ignored good evidence for slowing the spread of COVID-19, which could be catastrophic, CBC SK Opinion, 1 Dec 2020, https://www.cbc.ca/news/canada/saskatchewan/analysis-steven-lewis-pandemic-evidence-covid-1.5821978.

[viii] Aylin Woodward: Countries controlling the coronavirus have 3 strategies in common: masking, robust testing and tracing, and a consistent federal plan, Business Insider, 3 Nov 2020, https://www.businessinsider.com/how-countries-controlled-coronavirus-masks-testing-tracing-plan-2020-11.