2022-01-11 BC

Transmission

In today’s BC Ministry of Health press conference, Dr. Henry said that she thought that cases were going to start to come down soon. A reporter challenged her on that, given that we only have data from South Africa, which has very different demographics. Dr.H said that the data from the UK is also suggesting a steep spike, but also that infectious diseases with very short incubation periods tended to have very swift rises and also very swift falls.

She’s right about the data from the UK:

This article reports that New York City is also showing a decline in cases:

In addition, there are a number of BC-specific indicators which suggest that we’re seeing the case curve flatten here. The positivity rate has gone down ever so slightly at the same time as the testing rate has dropped slightly:

Now, it is true that testing is a shitshow, and that means everything is more uncertain. The testing has gone down since the December peak:

However, usually when testing goes down, positivity goes up (because people who feel marginally sick don’t get tested).

The case counts clearly and obviously do not reflect reality, but there are clues in there as well. From this Twitter thread:

You will note that at around Christmas, the VCH (red) line flattened due to testing capacity maxxing out. However, the FH (blue) line did not flatten out, showing that they still had adequate testing capacity. Thus I think when we see the blue line going down, that’s not a testing artifact, that’s real. Also the red line is going down, below the capacity limits, so that looks real to me as well. (Yes, the case counts are still going up outside of the Lower Mainland, that’s also not terribly surprising.)

On the other hand, in this thread, the BC COVID-19 Modelling Group says that they think BC is undercounting cases by 6x right now by assuming that all the over-70 y/os are getting counted, and that the shape of the over-70 and under-70 curves should be the same.

Note: they used the wrong reported cases number for 9 Jan, it should be 2,287. If the true number of cases is 12,583, then that’s off by 5.5x, not 6x.

Press Briefing

I am getting bored with press conferences. Things they said today that weren’t “yeah, I already knew that”:

  • Dr. Henry said that she thought we’ll see a decline in cases soon. (See above!).
  • She said that she expected that very soon we’d have good treatments (e.g. Paxlovid), and that meant (though I didn’t follow the connection) that restrictions on gatherings were unlikely to change soon.
  • Almost everyone in hospital is unvaxxed.
  • Dr.H said that you were 60-70% less likely to need hospitalization up to six months after you get a second dose of vax. She said the age-risk (of catching it? of hospitalization? I wasn’t sure) was 35/100K if you are unvaxxed and 4/100K if you are vaxxed.
  • She said they’ve seen some recent studies from the UK and Denmark that show that you are less likely to transmit Omicron if you are vaxxed. I have not seen those studies, I will keep my eyes out for them.
  • There are currently two unvaxxed people in their 20s and one in their 30s in the ICU.
  • Dix gave lots of numbers. (If you want all the numbers, check the transcript of the video starting at about 20m.)
    • There are now 700 pharmacies participating in the booster program, with another 200 set to come online this week.
    • There are about 4100 slots open. I just looked, and I see a ton of slots at the Vancouver Convention Centre starting next week through the third week of February, but the drug stores I looked at generally had one or maybe two slots left in January, and nothing in February.
    • BC has received 4.8M RATs to date and has deployed almost 3M to date. That leaves an inventory of ~2M. 561K require a machine to use or administration by trained personnel, so can’t be taken away and self-administered. That leaves 1.3M that can be self-administered (of which 959K arrived yesterday).
      • 90K were immediately deployed to acute care facilities for testing of symptomatic HCW.
      • 90K are being repackaged to send to testing sites.
      • 200K are being prepared for symptomatic K-12 staff.
      • 100K will be deployed to businesses and organizations in the point-of-care screening program.
      • The rest will be repackaged and allocated per the plan they outlined in detail on 21 Dec. I am not sure which plan that is. I looked at my blog post for BC for 21 Dec, and didn’t see anything about RATs.
    • 95% of base regular beds and 24.9% of surge beds are occupied. 87.5% of base ICU beds and 7.3% of surge ICU beds are occupied. So it’s tight but not overwhelmed at a system level. It might be that there are HAs which are over surge capacity, but he didn’t mention any specifics.
    • From Jan 3 to Jan 9, there were ~28K shifts where people called in sick. (If you were sick for a week, that’s five shifts.) He broke it out by HA, you can look those up yourself.
    • They are looking into opening a field hospital in the Lower Mainland. He repeated and emphasized that “We are NOT moving to stand up a field hospital at this time, but we want to have all the options available in these difficult weeks.” One possible site is the Convention Centre, where the big mass vax clinic is right now. I presume that means they would stop giving vax there. He said that it could be stood up in five to seven days.
    • Of the ~3K surgeries which were deferred between Oct 2020 and Jan 2021, 92% of them have since been completed.

I was struck by how worried they didn’t seem, not like during the height of previous waves. Also, in mid-December, they talked incessantly about how everybody needed to respect the difficulty HCWs were facing please please please go get vaxxed and boosted! Today, there was almost none of that. My spouse suggested that maybe they were looking at Omicron as a blip that would just be annoying for a month. I told Spouse that I thought it was more likely that they were going “Oh whew, it’s not going to be nearly as bad as we were afraid of!”

Q&A

Q: Are we going to put a tax on unvaxxed people or mandate vaccines like in Quebec? A: No. He took the opportunity to brag on our high vax rates, which in fact are really really good.

Q: There was an heartbreaking article about a kid who can’t get her surgery sob sob are you going to reconsider that? A: Dix: C’mon, I can’t talk about individual cases, you know that. We let the doctors decide on cases and we will continue to let doctors make the decisions. I thought he missed an opportunity to say that it wasn’t the doc’s fault that cute little girl didn’t get her surgery, it was COVID’s fault.

Q: Are you going to do anything to fast-track credentialing of HCW from outside the province? A: We already started. We made it easier to transfer in from other provinces several years ago. We’ve made provisions for students and medical graduates from other countries to be able to participate in vax clinics, for example, but we have to maintain our standards. We are working with colleges to shorten the time, and with the HCAP program, we’ve hired 6K LTCH workers.

Q: Dr.H, you wear a cloth mask, why don’t you wear an N95-class? A: I wear a three-ply cloth mask when I am at places which are lower risk, like big well-ventilated rooms with the same few people I see all the time. In medical settings, I wear a medical mask.

Q: I hear that pregnant people are having a hard time booking appointments. (I think the issue is that the system won’t let them book until dose2 plus exactly six months, but by that point, all the close-in appointments are booked.) A: Yeah, our system is overly rigid, we’re working on it. We really do want pregnant people to get their boosters.

Q: All LTCH visitors must get rapid tests, why don’t we have the same policy for LTCH staff before every shift regardless of whether or not they have symptoms? A: Every facility has a process in place for testing staff. The answer given was about testing symptomatic staff, not asymptomatic staff, so didn’t really answer the question. I suspect that the true answer would have been “because we don’t have enough RATs”.

Q: Stats on kiddie vax? A: There have been about 152K kids 5-11 who have been vaccinated and 173K booked out of 189K registered. There are about 160K who have yet to register.

Q: The seniors’ advocate again requests that you declare that every LTCH homes allow one visitor per resident, chosen by the visitor. A: We went through this already, that’s in place. I have the impression (again) that the reporter was asking (again) “why won’t you enforce this?” and DrH was answering the question, “why don’t you have this policy?” DrH again clarified the distinction between essential visitors who provide logistical support and [social] visitors who can visit once procedures are put into place to ensure that it can be done safely.

Q: How are incentives for nurses in NH working? A: We’re trying, but it’s hard to recruit nurses to NH and hard to retain them. Part of the answer needs to be training more nurses up there, but that’s a slower process. The incentives are helping some, but it’s just a really really really hard problem.

Q: Can you clarify when parents should keep their kids home from school? A: This has to be up to the parents, because parents know their kids, know what is normal for them and how likely their chance of exposure has been. But if they have any fever at all, keep the kids home. And for now, have a bit of a lower bar for keeping them home.

Dix said goodbye, but then there was a coment off camera that I couldn’t hear — I think probably in French because he answered in French — and he pushed back whatever the question was by saying that young adults were really leading in the vax effort. He did not lie. From this tweet, the 18-29 y/o cohort is the most vaccinated cohort:

Statistics

+2,239 cases, +3 deaths, ​​+2,924 first doses, +1,364 second doses, +42,571 other doses.

Currently 469 in hospital / 97 in ICU, 36,087 active cases, 244,551 recovered.

Positivity rate of 15.0%.

first dosessecond dosesthird doses
of adults92.6%89.9%28.6%
of over-12s92.2%89.4%26.8%
of over-5s88.8%83.2%*
of all BCers86.4%80.9%24.3%

Charts

From this Twitter thread:


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