SirBillybob

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.

If 01:00 seems harsh, the clubs that are essentially bars with spa/bathhouse features and commercial sex workers in Brazil are re-opening but the typical hours of 15:00-23:00 have been scaled back to 11:00-17:00, so no business following usual end of workday office hours. Pretty much also obsolete is the evening stage show. I suppose one possible effect will be arranging an offsite evening liaison with a working guy, potentially reducing the risk of a more crowded space. Otherwise, the venues are essentially reduced to weekend afternoon events. So count your blessings, Montreal.

This is also exactly how I have been calculating it for a few posts here related to pubs and planes. Multiplying the rolling daily average per 100,000 by 10 for ascertainment bias and again by 15 for contagion period, yielding a proportion infected out of 1. Subtract from 1 to get proportion uninfected. To calculate probability of one infected: 1 minus [uninfected to the power of number of people in gathering]. Multiply by 100 to get standard percentage. Obviously it is not exactly infection risk. It is probability of someone in attendance infected. Mingling would mean greater risk than if everyone is basically stationary. I had arbitrarily chosen the ascertainment bias as 10-fold. Now I feel more anchored in that.

It will likely be legally required to wear a mask in indoor public spaces as of July 27th. The bylaw will probably extend broadly to include bars. Too many outrageously risky gatherings are occurring and increasing transmission.

I have been physically present in The Village but as a rule I don’t go indoors unless (most) occupants wear a mask as I do or I must buy essential goods. Very few are wearing masks in grocery stores in Montreal or indoors in The Village. I have ascertained that the private dance areas in the clubs are operational, masks not mandatory, in keeping with guidelines that measures are but recommended. Only public transit is pushing masks as essential, but it is difficult to enforce. I don’t know details about the private dance choreography but I do not think it is substantially different from pre-pandemic. Staff, understandably, gravitate more to the ‘party line’ of public health when you inquire. Some dancers allude to no restrictions imposed. Most people on the strip are sitting outdoors, but certainly less volume than previous summers, and indoor spaces are very anaemic. I think that Saloon and Club Le Date are recovering the best. Street performers are notably absent.

I have been physically present in The Village but as a rule I don’t go indoors unless (most) occupants wear a mask as I do or I must buy essential goods. Very few are wearing masks in grocery stores in Montreal or indoors in The Village. I have ascertained that the private dance areas in the clubs are operational, masks not mandatory, in keeping with guidelines that measures are but recommended. Only public transit is pushing masks as essential, but it is difficult to enforce. I don’t know details about the private dance choreography but I do not think it is substantially different from pre-pandemic. Staff, understandably, gravitate more to the ‘party line’ of public health when you inquire. Some dancers allude to no restrictions imposed. Most people on the strip are sitting outdoors, but certainly less volume than previous summers, and indoor spaces are very anaemic. I think that Saloon and Club Le Date are recovering the best. Street performers are notably absent.

The entry restrictions will likely be very gradually and gingerly eased over the next 12 months, with basic tourism the lowest priority and essential business & supply chain continuity the highest priority. Some in-between areas in the hierarchy, for example, broadening the criteria for family relations, or American owns property in Canada. All with a watchful eye on infection rates. There isn’t much in the way of Canadian tourism experience that cannot be accessed to a similar degree south of the border, for the broader American public anyway, and considering that outdoor emphasis is promoted. Canadians would endure no less deprivation, especially seeing as winter access to warmer American weather is not off the table, since we are not restricted from entering the USA by air, but likely influenced by reluctance especially among the ‘silver set’. Each group putting money into respective in-country local resources offsets the troubled tourist economy woes with similar net effect.

When I was visiting Mexico my Gr profile was in Spanish but I indicated being from where English is spoken. A few scamppenings reached out in English, invitation to presumably orgiastic events that came with an admission fee. I just assumed it was bogus, would require prepaid or release of account info, and did not take it further.

The rolling fatality rate descent is slowing towards zero degrees from horizontal, as states with current ascending death rates adjust the tally. Two weeks ago it was 68% of the average recorded four weeks ago. Now it is 57% of the average recorded four weeks ago and 84% of the average from two weeks ago.

Apart from mortality lagging behind infection, and testing capturing greater numbers of less severe cases, I think the phenomenon of regression to the mean may partly explain this trend. I think @bigjoey is familiar with the concept. It has occurred worldwide and in many nations. Back to clarifying it in a second. That it has not been as evident in countries with good measurement protocol earlier in the game suggests it is not viral genetic drift. Also as things get more out of control and new case rates speed up it is difficult to keep apace and add both probable but unconfirmed deaths and excess deaths reasonably attributable to Covid-19 to the overall mortality tally. A better option to positioning rolling death against rolling new diagnoses is to review the death:recovery ratio for closed cases, ie known outcomes. This mortality rate curve for most jurisdictions has been descending in a less pronounced fashion compared to absolute deaths taken out of context of recoveries. The ratio fluctuated widely early in the pandemic. You can also see this in the global ratio curves, though smoothed out as a function of averaging out the more pronounced early anomalies and marked ratio changes for individual countries. As volumes increase, the death rate is want to gravitate towards the overall central tendency (ie, mean) that represents the overall 5-month average to date of death/recovery proportions, given also that measurement protocol also stabilizes and reduces overall error ... the discrepancy between observed values and true values. It just so happens that ‘regression to the mean’, a shift in the graph towards the most truly representative likelihood of fatality, has been downward, for all countries whose death curve was considerably variable across time early in the pandemic. One way to discern it is this exact explanation will be an eventual levelling out of the ratio, that is a horizontal direction on the graph (rather than a deviation from horizontality), as has been seen in Germany, for example, or more so globally than nationally.

I don’t see how he can enter the country due to foreign national restrictions and required quarantine even for Canadians arriving back home.

I definitely don’t think it’s taking a break. I thought that the average reader would take from my personifying it’s eagerness to find hosts that I was being tongue-in-cheek. I remain as vigilantly hazard-protected as ever in Montreal.

Quebec has given coronavirus a 2-week construction holiday, roughly spanning St Jean-Baptiste, Stonewall date-centred Pride, and Canada Day festivities. It is a unique tradition, typically applied a little later in the summer but enabling all in the construction industry to halt all projects at once rather than a staggered and more difficult to schedule arrangement over two months for various work roles. Kingston, in Ontario midway between Montreal and Toronto (and once in the running along with Ottawa for national capital city status), foolishly neglected to assign coronavirus a vacation. Kingston had been totally under control for months but got cocky and now has coronavirus and associated testing and tracing ripping through it, the nano-epicentre being 2 nail salons in town. Imagine! Expecting coronavirus to trade off a much needed rest so perfectly groomed feet could show off in fashionable summer footwear, complementing shiny sassy fingernails curled around patio cocktails. Enjoy the break from Montreal, coronavirus. See you back at work in a few weeks.

Your selective visual priorities were in the right place. LOL