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The Facts (Covid-19 News Issue 6)


I know COVID19 is going to change my life.  It is going to change your life  Some of our colleagues are going to lose their jobs.  (Darryl’s note: Despite best efforts to run as many courses as possible, fewer teaching hours will be available and it is contract faculty who will feel that impact.) Some of our friends and relatives may fall desperately ill, and some may die.  Those of us who still have work when this is over will be working differently, not necessarily better, and those without work may never return to the work they lost and will be forced to seek a new career in competition with thousands of others.  The whole world cannot fall sick like this without long-lasting and far-reaching effects.  I want to know what is happening.  If I cannot change it, I want to understand it.  I want the facts.  If you want to know the facts, too, here are some, and they are not easy to come by.

Government reporting on COVID19 is selective.  Information is used as an instrument to support policy objectives, which is entirely understandable, and perhaps even laudable, but I prefer facts.  Give me the numbers and spare me the admonitions.  I will stay home and observe social distance.  I don’t have to be preached at to do it, and I don’t need to be scared into doing it.  Maybe other people (even many people) need the preaching and the fear to do the right thing.  I suspect they do, and I understand why government and media might choose to manage and position facts to help mold and control social behavior, but I believe in facts and data, and I want them.  In short, I want the truth.  If you do, too, read on.

The Ontario Ministry of Health maintains a database of Confirmed Positive Cases of COVID19 in Ontario:

This database is in the form of an Excel spreadsheet listing every confirmed case of COVID19 in the province.  This database is part of the Public Health Information System (iPHIS).  It is somewhat behind the full number of cases reported in the media due to reporting delays from the individual Public Health Units (PHUS), which provide their data to the iPHIS.  However, the iPHIS database is fully accurate up to the number of cases listed.  Currently in Ontario, there are 3,255 confirmed COVID19 cases, with a total of 67 fatalities.  The iPHIS database has progressed (as of April 3) to 2,794 cases reported with 52 confirmed fatalities.  The database provides specific information as to age, gender, location, and transmission type for each recorded case.  This data is not aggregated or summarized; it is presented as raw numbers.  If you want to extract information from the database, you have to mine it.  Here is some of what can be mined:

  • Of the 52 fatalities attributed to COVID19 recorded in the database, as of this reporting, none involve anyone under the age of 40. In Ontario, the fatality rate for COVID19 under the age of 40, since the onset of the pandemic, is currently 0.
  • Of the 52 fatalities reported, 43, or 82.6 percent, are among those 70 years of age or older.
  • Of the 52 fatalities reported, 9, or 17 percent, are among those between the ages of 40 and 69 (inclusive).
  • More than half of all fatalities reported, 53.8 percent, occur among those 80 years of age or older.
  • The database does not include information about underlying health conditions that may have contributed to COVID19 fatality, although we know that underlying health conditions are a contributing factor in fatalities, and a few of the cases reported in the media among those in their 40s and 50s who died of COVID19 in Ontario, involved underlying health conditions.

The takeaway is this, so far in Ontario, COVID19 is an illness that poses a serious threat almost exclusively to the elderly and the infirm, and even more specifically, to the very old and the very infirm.  Social distancing will help reduce the number of cases overall by reducing transmission from the young to the old.  The young are almost exclusively vectors of COVID19, but the old and infirm often die of it.

This is the picture in Ontario now.  It could change.  We do not know what might happen as the density and spread of cases continues.  There is some evidence that sheer volume of exposure to the virus may be a factor in the intensity of symptoms and increased likelihood of death.  This may be why health care workers have died in high numbers in places like Italy.  They work day-after-day with patients sick with COVID in crowded hospitals without adequate PPE, and they are bombarded by virus particles.  If we increase the number of elderly and infirm persons with COVID19, we may potentially increase the number of deaths among younger persons caring for them in hospitals and nursing homes.

Provincial health authorities reported yesterday that the number of deaths in Ontario that could result if no preventive measures were taken might be as high as 100,000 over the anticipated duration of the pandemic (18 months to 2 years).  100,000 represents 0.071 percent of the population of Ontario.  That percentage would be slightly higher than the percentage of the total population of North America who died of the Spanish Influenza in 1918/1919.  100,000 is both a large number and a small number depending on how it is viewed.  100,000 deaths from COVID19 and the health system disruption it would create would also cause deaths from other conditions that were not diagnosed or poorly treated during the crisis.  Lots and lots of people would die, but it would still be a vanishingly small percentage of the total surviving population, just as in China after it weathered the worst of COVID19.

COVID19 may rage terribly in places without a comprehensive health care system where there is high population density.  The Spanish Influenza was most deadly in India and Southeast Asia.  Against COVID19, China, Singapore, and South Korea have fought back effectively, not so Iran and the United States.  Canada is struggling but its civic culture of good order and compliance is helping.

Our regional facts suggest we are doing what we should.  The young and the restless should stay home and avoid large gatherings, although they need not live in terror.  They should associate minimally with the old and infirm.  Those of us who are still reasonably hale in our 50s and 60s have little to fear, but the experience of COVID19 would be unpleasant and is more unpredictable in our aging systems.  Best avoid exposure.  As to the old and infirm, the prospect of dying is in view, but COVID19 is a cruel killer, in part because it imposes isolation and intensifies loneliness, another plague of old age, and health care workers may sicken and die who already care for the elderly and infirm.

This thing will end.  We will back it down or it will burn itself out.  It happened before a hundred years ago, and the world recovered.  The economy will revive in response to pent-up demand, and the world will forget.  Maybe it shouldn’t.  Maybe it can learn this time and put more money in health care and health research and less in sports, spectacle and war. Maybe folks will get off their cruise ships and go to church instead or give back to their communities or sit quietly in a park under a tree reading a book.  Probably not.


Saturday, April 4, 2020