2021-04-12 BC

Ontario

Someone asked me last week why Ontario is getting slammed and we are not, given that they have about the same daily case count and hospitalizations as we do. At that time, Ontario had about 2.3 cases per day per 10K population, vs. 2.1 cases per 10K for BC; Ontario had about 54.6 people in hospital per million vs. 58.8 per million for BC. However, Ontario had 31 ICU patients per million of population, while BC had approximately half (17.6).

There are two explanations:

  1. They have been doing this for two weeks longer. Their inflection point (using date reported) was on 7 March (see Figure 1A), while ours was more like 21 March.
  2. Once someone no longer tests positive for COVID-19, they get dropped from the hospitalization numbers. I don’t know how Ontario does it, but they might keep the patients in the hospitalization tally. (I can see valid reasons for both ways of counting.)

It’s possible that it’s #2, but I bet the far bigger factor is #1.

In Ontario, I see the future. That’s us in two weeks. Fffffffffffffff…..

Hockey

The Canucks were set to start practicing again when yet another player went on the observation list.

Quarantine

This article says that people coming in are sometimes declining to quarantine, taking a ticket instead.

Press Briefing

Non-age-based-vaccinations

Dr. Henry spent a fair amount of her prepared remarks talking about how they have/will use vax outside of the age-based tracks. I suspect she has been getting a little heat about doing all-of-community vaxing in Whistler, as well as the constant cries of “my interest group deserves to go earlier!!!”

She announced that they are going to start vaccinating first responders and school staff in Surrey and White Rock as well as doing all-of-community in Whistler, and asked everybody to be patient: that she’d love to vaccinate everybody at once, but they can’t, so they have to prioritized based on where the hot spots are.

She reiterated that they want to give the minimum disruption to society as possible, which is why they try to target restrictions, and why there are the new Orders (which go into effect tonight at midnight) which allow shutting down individual businesses for ten days if there are three people there who are sick.

Dix talked about hospital capacity. In addition to spewing numbers about province-wide regular bed and surge bed capacity, he talked about specific regions. Readers, it’s not looking good. While we have surge bed capacity in general, he said that in specific, hard-hit hospitals in the Lower Mainland, that they are stretched thin, to the point where they are starting to cancel surgeries for those hospitals. (He made it clear that they are not doing a system-wide cancellation of surgeries like we did during the first wave, because that was so destructive.)

I do not know if we have “dipped into” our surge bed capacity or not.

He also said that we have plenty of ventilators, that those were not a limiting issue.

One of the things that he mentioned was that they do have some ability and practice doing load-balancing by shifting patients around to other hospitals which are not as slammed. I remember they did that when UNBC got slammed.

He also talked about the vaccination programs, that we have now delivered 1,112,101 doses to more than 24% of eligible BCers. He said that more than 80% of the people over 80 have been vaccinated, and over half of those over 65.

He reiterated that we have more capacity to deliver vax than we have vax to deliver, and that we are using it about as fast as we can. (NB: it looks like we are falling behind a little because we have this huge glut of AZ which people don’t really want to take. We actually only have about 4.5 days of the mRNA vax on hand at the moment.)

He talked a little about the supply, what was coming. I don’t have it in my notes, but I believe he warned that we saw a peak in deliveries from mid-March to now, and it’s going to go down a little bit for a while. (NB: Pfizer will be sending us more than twice the current amount starting in June, it’s just May which might be kind of lean.)

Q&A

Note: these are heavily, HEAVILY and snarkily paraphrased.

Q: Do you have contingency plans for if the Pfizer vax doesn’t come in? A: No. Well, we’d have to cancel clinics. Fortunately, since Pfizer beefed up its manufacturing line in January, they have been super-reliable, bless them. And Modena? Well, we’ve always known they were flakey, so we don’t count on them.

We do get anxious on Monday afternoons, waiting for the Pfizer to show up.

Q: What do you think is going to happen with our hospitals. A: We’ve got some things we can do to move people around, we’re rescheduling surgeries, and oh my goodness the teams there have been working so hard and so well I am so proud of them.

Q: How bad does it have to get before you close schools? A: Did not answer the question, deflected. Our schools team — which includes absolutely all the stakeholders — talks EVERY FUCKING DAY. We know there are hotspots, that’s why we vaxxed all the Surrey school staff. We keep telling you that transmission in kids goes up when they are out of school, and when we had the schools shut down last year, everybody told us it had really bad consequences.

Q: With Whistler, what are you going to do about cracks in the system, like there are some construction workers contracting some renos at a hotel and outrage they aren’t even eligible because they don’t live there and technically don’t work there?!?!?! A: Yeah, there’s always corner cases, but we are trying to keep the requirements strict to cut down on cheaters. Look, this is for the people who LIVE there, not the people who fly in for a weekend to eat brie and drink wine in their hot tub. Remember, I am paraphrasing heavily and snarkily.

Q: How much is diverting the mRNA to the occupation-track going to slow down the age-track? A: Not much — order of days, not weeks. Note: Whistler only has 11K residents, some of whom have already been vaxxed. Meanwhile we’re vaxxing at about 30-40K doses per day. That means that doing all of Whistler is going to slow your vax down by a few hours.

Q: Are you concerned that the vaccines won’t work against the variants? A: No. I stand with Dr. H on that. All the studies I have seen say that the vaccines work just fine against variants EXCEPT AstraZeneca is shit against B.1.351. Good news: we have almost no B.1.351 in BC.

Q: There are immunocompromised kids, why can’t their parents get priority? A: Because we can’t vaccinate everybody at the same time. And something she said a week ago(?) was that parents only interact with the kid, while other people on the priority list interact with lots of people.

Q: We know some people don’t respond well to one shot, shouldn’t we prioritize getting them a second shot? A: something something NACI something something.

Q: Why do first responders in Surrey and White Rock get to go first, when the Vancouver boss is begging, begging I tell you!, for her people to get vax? A: Because the big problem is in Surrey and White Rock. Look, you’re on the list, everybody is going to get one, but we can’t do everyone at once and we have to prioritize to where the problems are.

Q: Eighteen deaths over the weekend is a lot, who keeps dying? Is it still mostly the elderly? A: All of the deaths this weekend were people who were in the hospital, mostly people in their 60s and 70s. Mostly we’re seeing community-dwelling old people who are not yet protected. The risk is still mostly by age.

Q: In India, they have extended the shelf life of AZ from 6 months to 9 months, are we going to do that? A: That’s up to the feds, not us, but it’s not surprising. It takes a while to figure out what the expiry date should be, so they start short and lengthen it as they learn more. Having said that, I expect that the next SII shipment we get will have a 9 month expiry date on it.

Q: Some transit hub workers say they are getting vaxxed tomorrow, eh? A: Not that I know of, I don’t know where that rumor came from.

Q: Adult fitness classes are closed, can kids go to gymnastics classes? A: Yes, but if you live in an area with a lot of transmission or have immunocompromised people in your household, you might want to skip them. These activities are important in child development, but ya gotta think about your own risk profile.

Q: People who are getting fined are getting them thrown out of court, whaddaya say? A: I don’t know of that happening. There was an injunction for a church thing, but the courts sided with us on that.

Q: You used to advertise days for age cohorts to book, now you are advertising to register, isn’t that confusing? A: Dix: We said “registration” and not “booking”, so I think it was clear.

and let me tell you how many people have registered:

  • 65-69 year-olds have 183K registrations
  • 55-59 year-olds have 66K registrations
  • there are a total of over 300K registrations

The additional 156K Clinically Extremely Vulnerable people slowed things down for the previous cohort, but they we are done with the CEVs, so things are moving faster now.

Tone

The tone today had a hard edge to it. While Dr. H did close with kind/calm/safe, there was a definite, firmer, no-nonsense tone today.

Statistics

Fri/Sat: +1283 cases
Sat/Sun: +1036
Sun/Mon: +970 cases
+18 deaths, +86,944 first doses, +138 second doses, +14966 AZ doses over the weekend.

Currently 368 in hospital / 121 in ICU, 9937 active cases, 15900 under monitoring, 101216 recovered.

We have 291K doses in the fridges, which will take ~10 days to get through at today’s rate. We have put more doses into arms than we had 12 days ago.

We have ~114K mRNA doses, which will take ~4.5 days to get through at the rate we’re giving mRNA.

There was no VOC information today due to a “data glitch”, but Dr. Henry said that VOCs are “about half” of all the cases now.

Charts

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