SirBillybob

I entered a thread on it mid-April under the Traveling Members section.

It is also important to check both trip disruption costs and medical expenses in the foreign nation in which you may be ill. They are two different aspects of a policy.

Most do not. You need to check. Mine is Global Allianz (my BMO MasterCard) and it quickly disqualified CoV coverage in March, unless you were mid-trip, because it became widespread enough to be a known risk entity.

They have been open for 4wks&4days.

A few countries including Thailand and French Polynesia now require proof of medical insurance that includes coronavirus, so wise to check this if and when Tahiti plans materialize.

Initial antibody prevalence results suggest about 75% of Canadians CoV+ up to the point just following the Spring infection peak were undetected, leading to a 4-fold correction the likely appropriate metric. Some areas in the world are reporting closer to 90% and a 10-fold correction. However, the Quebec results are not yet included, will be soon, and may drive up the figure because it was the hardest hit province. The results so far, excluding Quebec, suggest a mortality rate closer to about 1 in 50 cases ( where 50 includes under-the-radar cases).

I am not sure whether you refer to better/worse deaths per capita or number of cases per capita. California ranks 28th and 24th, respectively for USA. The USA cases:deaths ratio is 28:1 and California is 52:1 due to extreme variability in this metric to date, comparing all states. This variability among states is no less pronounced than national comparisons. To confound matters, several states peaked and dropped and held in case incidence trajectory, many states started to climb later and continue to do so while not yet peaking, and yet another group rather gradually climbed from early on and have not peaked. Finally, about 20% are demonstrating a 2nd peak within the first wave; they were evidently getting control then weren’t: CO, HI, IN, IA, LA, MD, MN, ND, OH, VA.

We are about 2 weeks out from study results of the more accurate incidence, along with estimates of undetected cases, of Coronavirus that has occurred in Montreal.

Bars closure correlated with flattening the curve. Bars closure correlated with unflattening it. That means the virus has won and knows better than mankind the strategy of a rock and a hard place. Someone should just call it.

Clapping/applause emoji is “appreciative thanks”, correct? Discouraging but not surprising that re-opening experiments do not seem to be succeeding anywhere. It is a respiratory pandemic and we all suck back the same air. Spain itself is now 55% above the EU threshold that had been set for non-EU red zone nations.

Quebec just reached a 7-day average, on an upswing, equal to June 22nd when new case rates were decreasing. The July 1st lifting of many bans had been based on that earlier downward trend. Quebec’s latest mortality figure is also a whopping 5% relative to case count, and we know that metric tends to lag anyway. More accurate national data about truer infection rates, based on antibody serology, will be released imminently. It is about 8-fold in British Columbia. I believe Spain about 5-fold, New York State about 12-fold, and Brazil 5-fold but enormous regional variability there. Brazil’s regional variability, multiples of 1 to 8, corroborates the idea that true prevalence is difficult to pin down both globally and nationally, with some of the variability an artefact of surveillance methodology.

There is already growing pressure to close the bars, due to concern that an increase in infections attributable to drinking establishments along with transmission cascade effect will scupper plans to open schools in 6-7 weeks. Society is more collapsible if parents have to further supervise their kids than if a smaller proportion of people are denied pub life.

Ah, OK. Actually the hours are 24/7, without a period allowed for general traffic, as always. The one vehicle on the video is a police cruiser; getting up closer you can see the label and navy side strip, in front of A&W near Stock. There are actually 3 points of apparently un-breachable boxes. I assume they can be shifted or at least that emergency vehicles have a workaround solution by parallel laneways that do not require a diversion to the main streets parallel to and bookending Ste-Catherine north and south of her.

The recent long lineups, several hours wait-time, for testing of Montreal bar-goers out drinking at least once since July 1st is already yielding a 3% rate of new infection. So far, 14 bars are implicated but few are named and it is not known or published whether any are situated in The Village. The push is to get tested irrespective of where one was socializing in such a venue. Imagine ... going out for a few drinks and having a 1/30 chance of contracting SARS-CoV-2 and often not aware of subsequently shedding it. Yet the official daily new case count the last week of June was less than 1/100,000 !!

Surprise, surprise. Flights from Doha to Montreal on July 3rd and July 6th are among a list just provided to passengers, alerting them of exposure risk and the recommendation to be tested.

A true death or mortality rate is per 100, as no additional calculation is required to obtain a standard percentage, if you are comfortable with some percentages being sub-one fractions. Otherwise, it is essentially ‘dealer’s choice’ and the denominator’s number of zeros is usually chosen to allow the best depiction on a graph or other measurement system where different subgroups are often compared. It is just common sense to adjust the metrics on each axis to enable easier reading and limit the merging of several graph lines. The usual best single denominator will hinge on the range of possible numerator values that are also the easiest to read, usually at least 1.0, and generally easiest to calculate a meaningful percentage.

Oklahoma! ... where the June bugs zoom.

I don’t think that reflects anybody’s deficiency in particular. As you suggest, it is mostly flying blind, no horseshoe bat analogy intended for insight or for batshit crazy mayhem. Best case scenario guidance (essentially, underestimation and dismissiveness) failed miserably and worst case scenario response early on may have beat this thing, nipping it in the bud. Not surprising, then, that worse case scenario is now the predominant compass. Ambiguity sucks ... blood (there I go again). Sure, no disease precursor offers the best comparator, but even within the relative scientific ignorance of 90 years ago common sense strategies made a big difference when and where applied. I wonder what analogy was possibly invoked then, if any. Perhaps European plagues, various pox and fever history. But contemporaneous major war at the time ... my gosh. I think that people generally expect more from governance these days and are more reactive to loss of control and autonomy.

I don’t listen to Cuomo but I think he means that the prevalence will increase in a subsequent “wave”. I do not think he literally means it is coming back (present tense). Perhaps it is a poor choice of words and grammar tense. Essentially, it is not disputed that one must brace for a return of the virus, with an equal or greater attack rate. It is not a metric. It is history repeats itself. The daily NY incidence rate has held steadily higher than the rate that predated the Spring calamity. Think about it. It is at a level that, if introduced to the population for the first time in July, would likely escalate along the same devastating pattern already seen. The Spanish flu’s second surge in Fall 1918 far surpassed the initial wave of late Spring 1918. The cyclical theory of pandemics is somewhat murky, with each pathogen behaving in its own unique way and subject to a large host of variables, but I don’t think it is irresponsible to frame the warning with emphasis.

All the cross streets are mainly residential (not commercial) and need to accommodate vehicle traffic and parking, and vehicles can and need to cross thru St-C at all intersection points. Service vehicles and delivery people with permits can enter the main drag. How would an ambulance or fire truck access an emergency otherwise? The street is not barricaded. All the vertical pylons are flexible and can give way to a vehicle if necessary.

I think I have a bit of an advantage because among my graduate degrees is a Master’s in Medical Science Research Methods, my thesis and much of subsequent ongoing research in the realm of Infectious Diseases, in fact. I also worked in a SARS hotspot in 2003. It is certainly frustrating to witness lack of understanding as well as lackadaisical attitude in relation to this disease. I get CNN up here but I cannot tune in to what is pretty much a train wreck. We have had some derailments but now better on track, for now.

Up here in Canada we don’t have a circus clown & associates proclaiming that testing creates cases that in turn promotes havoc and unnecessary imposition of phases higher in the confinement hierarchy than warranted. I understand curiosity about adding some factor related to testing to the denominator, a denominator that otherwise seems quite fixed on population (ie, per capita). However, it is difficult to combine population surveillance testing, along with confirmatory testing for symptoms or known exposure risk, into a denominator. Moreover, the likelihood that undercounting lowers visible prevalence rates poses a greater ascertainment bias than the skew posed by less than precise tracking of surveillance versus diagnosis in context of more probable infection. Rhode Island has tested the most, 28% of population, and has a separate case positive tally of 1.7% of population in total, while Colorado has tested the least, 7% percent of pop with a separate tally of 0.7% of population reported to have or have had the disease. Now then, this might lead to the conclusion that increased testing yields increased case prevalence. However, there are other checks and balances. Rhode Island has had 3 times the number of pop-adjusted CoV19 deaths as Colorado. In other words, testing rates are irrelevant in this example because the argument that testing inflates case tally is nullified by the reality that testing cannot possibly be proportional to fatality ... increased surveillance testing would simply raise the count of cases that would be under the radar if not detected, and certainly not lethal. I think that the best anyone as an individual can do is to try to drill down and understand the numbers within their own little corner of the world. Personally, I am behaving no differently now that Montreal is really low in prevalence compared to when a few months ago the province of Quebec was among the most affected areas on the planet.

Precaution, caution, reaction, etc, are fluid terms and our individual subjectivity cannot be dictated or aligned collectively. The metrics, purist epidemiological terms, and colloquial terms/expressions all get thrown into the mix and can be difficult to interpret. I personally dislike the metric of ‘total cases’ to date because it tends to be milestone-oriented (eg, just hit 10,000! blah blah, and now we have surpassed X disease and Y natural disaster for casualties! blah blah.) It is also usually nation-centric and described out of context of a population-size denominator. Total count may be useful for corollary considerations but not so much for describing the attack rate of a disease as you are trying to keep up and manage it. I also sometimes look at the logarithmic curve for total cases to detect a visual of exponential-ity. This takes a little bit more experience because this visual should be cross-referenced to the daily case histogram bar depicted with rolling average line. A tilt of the logarithmic line (typically base10 format; 0, 10, 100, 1000, 10000, 100000, 1000000, etc where for example 1 million is ‘log 6’) away from 90 degrees horizontal and towards 0 degrees north/top on the graph suggests a, well, ‘surge’ in case incidence progression. This can be seen in the USA total case curve, ever so slight because log curves maintain greater stability at high counts in the millions, but it is bad news for sure. Total cases also misrepresents the count of active cases. For what it is worth in terms of this disease (ie, what is truly the future of morbidity for some that survived), recovered cases in many countries exceeds the current count of active cases even when daily incidence rates continue to climb. I am mostly interested in the tally of active cases and in the trend of daily new cases. What I would consider worrisome for a disease that has a fairly high mortality rate considering the duration from infection to death, and also considering the resources needed to prevent death among a percentage of cases with severe morbidity, is that the number of recoveries does not keep pace with the number of active cases at a point in time when the needed resources for offsetting a death that could be prevented are depleted or diluted in comparison to a point in time earlier in the pandemic when ‘all the stops can be pulled out’ for the most part at point of critical care. Hyperbolic terms are likely to be pulled out for use in headlines at any point in these cycles but especially when resources are progressively pushed to the limit. To put the USA as a whole in perspective, active cases, as I said above an important metric for some prediction of resource allocation, numbered 181,600 Mar 31st, 868,500 April 30th, and today the tally is 1,760,000 ... that is alarming even if case severity proportion lowers for some reason. Getting back to measurement terms, I look at the new daily cases and their daily rolling averages at a global level. The doubling effect, that is the duration of time for global daily new case incidence to double its respective previous measurement has been quite variable. It was merely 6 days towards the end of March, then it took 2 months to double again, and just doubled again 6 weeks following the previous date at the end of May. That last doubling point, to me, being of shorter duration yet at a much higher case volume, also suggests somewhat of a ‘surge’. So there are a lot of ways to look at the data. They cannot be easily packaged for general consumption.

The city of Montreal is strongly urging ALL people who frequented a bar this month to get immediately tested. Mobile units are set up. So expensive and unrelenting.

Brazil just edged out USA for population-adjusted daily new cases.