Public-health officials are cautious by nature, sometimes so careful that they even play down good news.
Case in point: Tuesday’s release of federal modelling numbers was a dry affair.
There were just two significant numbers released: It was forecast that there will be between 53,196 and 66,835 cumulative COVID-19 cases in Canada by May 5, and between 3,277 and 3,883 deaths by that same date.
Bear in mind that currently there are already 47,327 confirmed cases and 2,617 deaths, according to the Public Health Agency of Canada.
What that means, practically, is that we can expect somewhere between 838 and 2,787 new cases and somewhere between 94 and 180 deaths a day over the next week.
While Theresa Tam, Canada’s Chief Public Health Officer, didn’t say so, there’s a fair bit of good news hidden in those numbers.
Currently, we’re seeing about 1,800 new cases and 150 new deaths daily. The increase in both cases and deaths is dropping a bit every day and overall numbers are levelling off. In other words, we’re trending toward the more optimistic forecast.
Cases are now doubling every 16 days in Canada. That’s a dramatic improvement over the three- to five-day doubling rate before public-health measures were widely instituted.
New COVID-19 cases are now overwhelmingly occurring in three provinces – Quebec, Ontario and Nova Scotia. The epidemic curve is flattening in every other province and territory.
New infections and deaths are also concentrated in hot spots such as long-term care homes, prisons, shelters and industrial settings, including meat-packing plants.
That is not to suggest that residents or workers in these places are unimportant – but spread of the coronavirus should be easy to stop in these settings with concerted efforts.
Seventy-nine per cent of all deaths are in long-term care. If we get our act together in institutional care, we will go a long way toward solving our COVID-19 problem, at least in the short term.
There appears to be very little spread of coronavirus in the general community. That bodes well as provinces and territories actively start planning to loosen restrictions.
The concentration of new cases in hot zones such as care homes tells us isolation and physical distancing measures are working elsewhere. It’s important for the public to know their sacrifices are paying off.
Still, while there are some positives in the numbers, there are also caveats.
Flattening the curve is important, but it’s a beginning, not an end in itself. We can’t be satisfied with a decrease in the increase in cases and deaths. We need to see absolute reductions before we can start thinking we are out of the woods even for the first wave.
(The long-term projections from PHAC did not change. The best guess is still that we will see between 11,000 and 22,000 deaths before the pandemic is over. The second wave, likely in the fall, could very well be worse than the first.)
The measure of success will be what epidemiologists call the R0 (pronounced r-naught), or basic reproduction number. Left relatively unchecked, each person with coronavirus will infect more than two others and, at that rate, case numbers multiply rapidly.
To slow or stop a pandemic, the R0 needs to be less than one, meaning each carrier infects fewer than one other. That’s why isolation and aggressive physical distancing are important. You can’t infect others if you don’t interact with them.
Currently, Canada’s R0 is still above one.
It always bears repeating, too, that we don’t know how many people are really infected. The confirmed cases are the tip of the iceberg.
The infectious people in the community are like embers and they could spark another fire once people start returning to work and school, and sharing germs.
It is highly unlikely we will eliminate the spread of coronavirus in the community in the foreseeable future. But we can contain it and limit the carnage.
However, to do so, we need to be able to test suspected cases and do contact tracing quickly – within 24 hours. With that approach, hard-hit jurisdictions such as South Korea and New York have brought down their R0 to 0.3 and 0.8, respectively.
Until provinces have the commitment and capability to testing and contact tracing, and the results are reflected in sustained reductions in number of coronavirus cases, we have to proceed very cautiously as we begin lifting restrictions.
The projections can give us glimmers of hope but, ultimately, it is results, not estimates, that matter.
The Globe and Mail
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