Covid-19 & HRM economy

[Keith P.]

Originally Posted by someone123

But this story is kind of misleading since it's not clear that the 35 year old really would bump the 70 year old off the list under normal circumstances. Both should get treatment. The need to make trade-offs comes into play in extreme cases like ventilators that are used to capacity during a pandemic. And the differences are even starker than the life expectancy tables suggest because survivability drops off. If you've got a 90 year old with other conditions, their 5 year survivability odds are poor on or off a ventilator, while an otherwise healthy 20 year old might have 30% odds of living another 50 years if given a ventilator.

This is a twisted version of the original point and thus not relevant here. I was not discussing life-and-death situations where things like ventilators are needed to survive. Indeed, I began my original post with a disclaimer about ER cases where urgent care was required. I was and am talking about chronic condition treatment - things like knee and hip replacements, rheumatology, cardiac, orthopedic, and other surgical procedures - that have a significant impact on day to day quality of life. These are absolutely rationed and doled out only following a decision process that takes into account the "future utility" of doing them.

[someone123]

Originally Posted by Keith P.

This is a twisted version of the original point and thus not relevant here. I was not discussing life-and-death situations where things like ventilators are needed to survive. Indeed, I began my original post with a disclaimer about ER cases where urgent care was required. I was and am talking about chronic condition treatment - things like knee and hip replacements, rheumatology, cardiac, orthopedic, and other surgical procedures - that have a significant impact on day to day quality of life. These are absolutely rationed and doled out only following a decision process that takes into account the "future utility" of doing them.

But I replied to eastcoastal. While the future utility (for our overlords I guess) argument is one possible interpretation that seems to fit the facts, it is not the only one. And it is rational to want to consider life expectancy, survival rates of operations, and recovery time.

[q12]

Only 1 new case in Nova Scotia today. 240 active cases and dropping.

[Keith P.]

The stats are mildly interesting in that they are heading in the right direction and aside from thr Northwood debacle, for which many people ought to be shown the door, the province has escaped much damage, except to the economy. The far more interesting topic of discussion now should be the plan to reactivate normal (to some extent) life and allow businesses to reopen. The version Strang shared with the Chamber of Commerce yesterday was far too cautious and far too slow. It needs input from a broad spectrum to give many businesses even a chance at surviving, not just his overly cautious opinion.

[someone123]

Originally Posted by Keith P.

The stats are mildly interesting in that they are heading in the right direction and aside from thr Northwood debacle, for which many people ought to be shown the door, the province has escaped much damage, except to the economy. The far more interesting topic of discussion now should be the plan to reactivate normal (to some extent) life and allow businesses to reopen. The version Strang shared with the Chamber of Commerce yesterday was far too cautious and far too slow. It needs input from a broad spectrum to give many businesses even a chance at surviving, not just his overly cautious opinion.

The problem is nobody knows what will cause transmission to spike again, and the feedback is very slow. It's a bad combo of potentially rapid spread, mild symptoms for a lot of people, and long incubation. It means it will take 2-4 weeks to know if a new spike is happening after ~0 cases; first there have to be enough new cases that some serious cases happen, then those people need to get out of their incubation period, then the tests need to come back. A hard shutdown after a relapse makes the whole shutdown period 1-2 months longer than it needed to be.

It's a genuinely challenging situation.

Another issue is that NS is closer to the head of the pack now in terms of opening, so there isn't a lot of direction. It was behind the pack as far as infections showing up in the first place.

[Keith P.]

Originally Posted by someone123

The problem is nobody knows what will cause transmission to spike again, and the feedback is very slow. It's a bad combo of potentially rapid spread, mild symptoms for a lot of people, and long incubation. It means it will take 2-4 weeks to know if a new spike is happening after ~0 cases; first there have to be enough new cases that some serious cases happen, then those people need to get out of their incubation period, then the tests need to come back. A hard shutdown after a relapse makes the whole shutdown period 1-2 months longer than it needed to be.

It's a genuinely challenging situation.

Another issue is that NS is closer to the head of the pack now in terms of opening, so there isn't a lot of direction. It was behind the pack as far as infections showing up in the first place.

All well and good, but the reality is that the pressure to normalize will not only come from businesses that are teetering on the brink but from the public at large. How long can anyone reasonably expect the public to go without being able to travel, go to cottages, have friends over, shop without standing in long lines to get inside, eat out, go for drinks, play golf, swim at the beach, whatever, in the absence of new cases? You cannot walk on eggshells forever. The public at large simply won't tolerate it. People have become accustomed to the new normal of wearing masks (and in many cases, gloves) in shops and keeping their hands washed or sanitized. How much leeway would those measures alone buy us? If bad things happen, then they happen, but sooner or later you need to get back to some semblance of normal life.

[q12]

Interesting in Nova Scotia how the virus moved from travel cases in blue ---> close contact ---> community ---> long term care homes.

[someone123]

Originally Posted by Keith P.

All well and good, but the reality is that the pressure to normalize will not only come from businesses that are teetering on the brink but from the public at large. How long can anyone reasonably expect the public to go without being able to travel, go to cottages, have friends over, shop without standing in long lines to get inside, eat out, go for drinks, play golf, swim at the beach, whatever, in the absence of new cases? You cannot walk on eggshells forever. The public at large simply won't tolerate it. People have become accustomed to the new normal of wearing masks (and in many cases, gloves) in shops and keeping their hands washed or sanitized. How much leeway would those measures alone buy us? If bad things happen, then they happen, but sooner or later you need to get back to some semblance of normal life.

I agree with this. I think that there will be a tough decision if this goes on for too long. I don't think that a 24 month shutdown for example would be justified by the current risks (~0.4% fatality). Why give up a good part of 2 years of your live to avoid a 0.4% risk of dying? That would not make sense.

There is also a personal freedom angle. If you wish to move to a cabin in the woods by yourself, you can do this, and your exposure will be minimal. I think we should support folks who wish to continue to isolate (e.g. make sure seniors are set up with good delivery service and, if they are low income, a tablet/phone to use to contact their family), while allowing low-risk people to go about their business.

However, early on in the pandemic there is a lot of uncertainty so authorities might make rational decisions that with the benefit of hindsight look disproportionate to the threat. That's just how it goes.

I hope we can have better public health in the future so this is less likely to happen again. That's the real lesson. It should never even have come here from China, and we should have had better screening and testing. There's some serious soul searching that needs to be done with global supply chains and stockpiles of critical items too. Canada was not prepared.

[Dartguard]

Originally Posted by someone123

I agree with this. I think that there will be a tough decision if this goes on for too long. I don't think that a 24 month shutdown for example would be justified by the current risks (~0.4% fatality). Why give up a good part of 2 years of your live to avoid a 0.4% risk of dying? That would not make sense.

There is also a personal freedom angle. If you wish to move to a cabin in the woods by yourself, you can do this, and your exposure will be minimal. I think we should support folks who wish to continue to isolate (e.g. make sure seniors are set up with good delivery service and, if they are low income, a tablet/phone to use to contact their family), while allowing low-risk people to go about their business.

However, early on in the pandemic there is a lot of uncertainty so authorities might make rational decisions that with the benefit of hindsight look disproportionate to the threat. That's just how it goes.

I hope we can have better public health in the future so this is less likely to happen again. That's the real lesson. It should never even have come here from China, and we should have had better screening and testing. There's some serious soul searching that needs to be done with global supply chains and stockpiles of critical items too. Canada was not prepared.

Actually I see a public policy on the Horizon of Health cards or maybe a phone app that details a persons co morbidity risks and business's and other public spaces having a reduced service policy related to the same.

[IanWatson]

Originally Posted by Keith P.

=How long can anyone reasonably expect the public to go without being able to travel, go to cottages, have friends over, shop without standing in long lines to get inside, eat out, go for drinks, play golf, swim at the beach, whatever, in the absence of new cases?

It sounds like those things (minus travel to anywhere but PEI and NB) will be happening relatively soon, with continued controls to minimize risks of transmission.

I've come around to the idea that opening needs to be very slow, because I think the reality is that it will be absolutely impossible to clamp down again. Yes, people are restless now, but can you imagine what it would be like if you told everyone they could go to the beach, and then two weeks later took that privilege away again? And yes restaurants and other businesses are teetering, but you'd guarantee their destruction if you allowed them to open, restock their refrigerators, rehire staff, invest money in new layouts to meet social distancing, and then shut them down again when cases relapsed.

[Keith P.]

Originally Posted by IanWatson

It sounds like those things (minus travel to anywhere but PEI and NB) will be happening relatively soon, with continued controls to minimize risks of transmission.

I've come around to the idea that opening needs to be very slow, because I think the reality is that it will be absolutely impossible to clamp down again. Yes, people are restless now, but can you imagine what it would be like if you told everyone they could go to the beach, and then two weeks later took that privilege away again? And yes restaurants and other businesses are teetering, but you'd guarantee their destruction if you allowed them to open, restock their refrigerators, rehire staff, invest money in new layouts to meet social distancing, and then shut them down again when cases relapsed.

Yes, that is certainly something to consider on the question of reopening things. Especially since Strang has a track record of doing just that in the now-somewhat distant past. In the 1990s bars and restaurants went to great expense in many cases to construct sealed-off and distinct smoking areas within their facilities as a result of restrictions on indoor smoking that were imposed, only to have Strang render those expenditures useless a short time later with an outright province-wide ban. More recently he convinced his political bosses to enact extreme restrictions on vaping in this province based upon some very dubious "evidence", which will result in many local small businesses in that sector shutting down. He has certainly been no friend to many in the provincial economy, so I can see your scenario coming to pass here.

[someone123]

Originally Posted by IanWatson

I've come around to the idea that opening needs to be very slow, because I think the reality is that it will be absolutely impossible to clamp down again.

Another big problem is lag time. Detecting and adapting to a new spike in cases would be challenging.

The virus was doubling in known cases every 2-3 days in some places, and it can take 1-2 weeks for new infections to develop serious symptoms and be tested.

Then again the worst-case scenario was places with no measures whatsoever (e.g. people going to conferences and St. Pat's parties at bars). I suspect we will find that some modest dinner parties and the like do not increase transmission significantly, and that it's dominated by "super-spreader" events or clusters in high-risk environments like care homes. I think mask wearing will also be a significant improvement with low cost (any cloth mask designed to prevent transmission from the wearer and worn by most people; not necessarily N95 masks).

[q12]

No new cases for two days in a row and down to only 4 active cases in all of Nova Scotia.

[q12]

O Active cases in Nova Scotia.

Nova Scotia, P.E.I. and Newfoundland and Labrador are now COVID-19 free.

[alps]

Great news!

I'm dying to visit but I can't see them lifting the two-week quarantine requirement anytime soon.

[为人民服务]

Could U.S. incompetence benefit Halifax?

https://www.thechronicleherald.ca/ne...sector-465725/

[eastcoastal]

Originally Posted by 为人民服务

Could U.S. incompetence benefit Halifax?

https://www.thechronicleherald.ca/ne...sector-465725/

Possibly... when it comes to the closing paragraph of the opinion piece, I'd suggest that healthcare improvements CAN happen after increasing the tax base, but that improvements to access to high-speed internet might have to happen before. Seems kind of gross to prioritize tech over health, but I suspect it's higher on the list of considerations for most (admittedly not all) tech and knowledge economy workers, and in particular the mobile workforce on which the columnist is setting their sights.