Covid Alert, Covid-19, Ontario, Public health, Toronto

Covid Alert prevents further infections

The cancellation of a curling event in Waterloo after a player was notified by the Covid Alert app that they had contact with a person who tested positive for Covid-19 is a win for the hard-working team that developed this app. A win because this cancellation is a case study of exactly how the app should work.

Imagine we did not have the Covid Alert app and the player was infected. The player could transmit the virus to the other players, the players could transmit the virus to patrons and employees at their local pub, the patrons and employees could transmit the virus to their partners who teach at the local school, and the teachers could transmit the virus to students and other teachers. The curling event would be a bubble connected to the pub’s bubble, which in turn is connected to the school’s bubble. And without Covid Alert we could have had yet another dreaded super spreader event. However, what Covid Alert achieved was to separate the curling event, the pub, and the school into separate bubbles.

Hopefully, the player will not test positive. However, close contact presents a risk which the event organizers did not want to take. Kudos to them for showing a level of responsibility commensurate with the potential gravity of the circumstances. Perhaps they adverted several infections in great part thanks to the Covid Alert app. Certainly, the event organizers have set an example in caring for the safety of their community.

The news is bad these days. Ontario is in a second wave, the contact tracing team in Toronto is overwhelmed, but we can still take positive action: please download the Covid Alert app today. It works.

Covid Alert prevents further infections
Covid Alert, Covid-19, Public health, Toronto

Covid Hotspots in T.O.

Last month, we saw two trends in T.O.:

This week we are seeing a familiar and sad pattern, new cases are concentrated in North Etobicoke and North Scarborough. For example, the postal code M9R in North Etobicoke has had 66 reported cases since August 1, 2020. In contrast, postal codes in Central Toronto are in the single digits for the same timeframe.

We have heard that density is one possible reason why there are Covid hotspots in Toronto. However, when we see far more dense cities like Taipei having defeated Covid, we quickly realize that density is not an excuse.

Certainly, there is a link between Covid cases and income. However, we have the means to help North Etobicoke and North Scarborough. Consequently, we should act by demanding the following from our governments:

Together we have managed to slow the spread of Covid down significantly, together we can defeat it.

Covid cases by postal code T.O.
Covid-19, Public health, Toronto

People under 40 account for 65% of recent Covid cases in T.O.

First, here is the good news: back in late July and early August we saw daily reported Covid cases in T.O. drop to the single digits. Furthermore, so far in August, we have been averaging about 18 new cases a day. Now for some disconcerting news, residents under 40 make up 65 % of the cases seen in August, in other words, two thirds.

It might be easy to imagine crowded indoor bars full of young people not wearing masks and thereby pass judgement. However, we all know that several essential workers are under 40. So, it is not clear what is causing this discrepancy between age groups.

Faced with this uncertainty, perhaps the best course of action is education, such as Dr. Eileen de Villa’s recent announcement. Villa reminds us that despite some encouraging numbers we must all remain vigilant as we enter Stage 3. Otherwise, the consequences can be a second wave of Covid.

One key lesson these statistics teach us is that youth does not mean immunity. The fact that in 2 out of 3 cases the person is under 40 means that we all must be careful, regardless of age.

Under40
Daily Covid T.O. cases in August 2020

Covid-19, Ontario, Public health, Public safety, Toronto

Covid transmission indoors

In early 2020 there was a Covid outbreak in an air-conditioned restaurant in Guangzhou, China. A study about this specific outbreak concluded that,“droplet transmission was prompted by air-conditioned ventilation.” A subsequent study recommended avoiding re-circulated air and maximizing outdoor air supply in buildings. Then the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE) produced a guidance document for re-opening schools and universities.  However, one key fact remains: there is less risk of Covid transmission outdoors than indoors.

We can safely conclude that there is less risk outdoors, because most Covid transmissions have taken place indoors, and there has only been a limited number of outdoor transmission cases, as per Ian Hanomansing’s informative tweet.

This knowledge should be driving our public policy. Specifically, in the following areas:

  • University and school classes need to be outdoors (weather permitting) or better yet completely online,
  • Bars and restaurants need to have open windows or preferably patio seating, and
  • Employers may need to upgrade their ventilation systems and implement engineering controls.

On a personal note, it was sad to see Brothers Food & Wine permanently closed. I have wonderful memories of spending time there with family. However, it was admirable to see the owners of Brothers recognize that it would not be responsible to reopen a locale which did not lend itself to physical distancing.

Likewise, we must all do our part during this pandemic and whenever possible take our activities outdoors. If outdoors is not an option nor is staying at home, employers and educational institutions must rely on professional advice to implement risk mitigation measures, such as engineering controls, personal protection equipment, physical distancing and upgrading of ventilation systems.

brothers
Brothers Food & Wine is now permanently closed.

Covid-19, Mental health, Parkdale - High Park, Public health, Toronto, Ward 4

Mental Health Resources at Parkdale – High Park

While we focus on bringing Covid cases down, let’s not lose sight of mental health, which is equally important as our physical health. Layoffs, lack of social interaction, financial difficulties, strained relationships, and uncertainty have consequences. So, during these difficult times it is only natural to seek help. On that note, here are some mental health resources for those living in the Parkdale – High Park area:

Finally, some insurance plans cover counselling and psychotherapy services. Laid off employees part of a group plan may still qualify for these benefits. For information contact the insurance provider.

In the event of an emergency one should always call 911.

4villages

 

Covid Alert, Covid-19, Ontario, Public health, Public safety, Toronto

The case for Canada’s Covid Alert app

There are five reasons why we should all be optimistic about Canada’s new Covid Alert app:

  1. An Oxford study indicates that Contact Tracing apps have the potential to significantly reduce Covid transmission (noting that half of transmission cases occurred before symptoms were present);
  2. Both, Korea and Taiwan have implemented highly successful Contact Tracing apps;
  3. The low level of virus exposure notifications by some European Contact Tracing apps can be explained by the fact that social distancing measures are still in effect and these apps are still in the early stages of adoption;
  4. The Bluetooth technology used to determine “close contact” might be new, but is continuously improving; and
  5. Apple and Google, which developed the Application Programming Interface (API) used by Covid Alert, prioritized privacy.

Critics of the new app are correct to point out that many essential workers and retired folks might not be able to afford a smartphone to run this app. Nonetheless, these problems can be resolved by implementing new laws requiring employers to provide smartphones to essential workers, just like they are required to provide them with Personal Protection Equipment (PPE). Furthermore, governments should strongly consider providing free smartphones to seniors and anyone who cannot afford them in their efforts to turn the tide against Covid.

Engineers, scientists, and those working with new technologies understand that no innovation is perfect from the get-go. In fact, several iterations may be required to have a successful Covid Alert program. It is not in our spirit to give up when the going gets tough. Otherwise, Canadians would not have invented the electric wheelchair, the pacemaker, or the telephone just to name a few of our innovations.

This blog post is a call to all engineers, programmers, scientists, technologists, and innovation enthusiasts in Ontario to download the Covid Alert app today, and to please help your co-workers, family and friends install it as well. The science says Contact Tracing apps have the potential to significantly reduce Covid transmission. Now it is our turn to use Covid Alert, help improve it, and do what we do best which is to protect the public.

CovidAlert

Covid-19, Public health, Public safety, Toronto, Uncategorized

Preventing a second wave of Covid in T.O.

After months of mostly bad news, the latest Covid figures from Open Data Toronto give us some reasons to be hopeful. In fact, the past two days, we have seen the lowest numbers of daily Covid cases since the start of the pandemic. As relieved as this data might make us feel, it is important to note that the struggle to put an end to Covid in T.O. is not over. Which means that prevention measures, such as: frequent hand washing, physical distancing, staying home if possible, and wearing face masks need to continue for the foreseeable future to avert a second wave.

Furthermore, it was encouraging, but not surprising to see the total number of daily cases drop even further after the TTC and the City made face coverings mandatory. Most notably, daily sporadic cases (i.e. not associated with an outbreak) have been in the single digits the past two days. While there are a number of factors that contributed to this drop, the science is crystal clear, face masks help reduce contagion: https://www.ucsf.edu/news/2020/06/417906/still-confused-about-masks-heres-science-behind-how-face-masks-prevent

While some of us might oppose wearing face masks, as a community we are better off when we follow the advice of professionals and the latest science, especially on matters concerning public health and safety.

Together we have managed to lower the number of Covid daily cases in T.O. significantly. However, we need to be aware that other cities, which achieved similar success and rushed to lift restrictions (without implementing reasonable mitigation measures), later found themselves facing a second wave, and consequently had to shut down their economy once more. Until there is a vaccine, or an effective treatment, or a new technology that prevents transmission in a significant way, at least for now, the best methods we have for reducing Covid cases are: frequent handwashing, engaging in physical distancing, studying or working from home (when possible), and wearing a face mask (especially when indoors).

We The North can enjoy the outdoors (e.g. parks and patios) with a warm jacket in the Fall and even Winter, so even though restrictions will be lifted soon, there should be no reason to go to indoor spaces known for their risk of outbreaks (e.g. crowded bars, large parties or packed restaurants). Stay safe and stay hopeful.

Sporadic

Covid-19, Public health, Public safety, Toronto

Face masks are reducing Covid-19 transmission in T.O.

In a previous post we looked at Covid infections for people in their 30’s, since this age group has been affected more by community transmission than others. One of the purposes of wearing face masks is to reduce the number of community transmissions e.g. when we go to shopping, take public transit, get some take out etc. So, the question is: has community transmission of Covid gone down since July 7th (the date when faces masks became mandatory inside public spaces in Toronto)? The answer is, yes. Specifically, if we look at people in their 30’s the number of daily reported cases has significantly gone down. In fact, as of July 8th we are looking at the lowest numbers since the start of the pandemic.

covid-daily-30

 

Covid-19, Public health, Public safety, Toronto

Covid sources of infections in T.O.

Of the approximately 15,000 Covid-19 cases in Toronto, over 70% can be traced to either “close contact” (e.g. residing in the same household with a confirmed or probable case) or an outbreak. “Community” infections (i.e. not due to travel or close contact or a known location) account for almost 15% as per the chart below.

Covid-all

However, sources of infection vary by age group. First, let’s look at the youngest age group, which is 19 and younger. For this group 77% of cases were due to close contact. While outbreaks account for 10% and community transmission for 7%.

Covid-19

Secondly, let’s look at the oldest age group, which is folks 90 and over. For this age group 93% of the cases were due to outbreaks. This information is consistent with the news of several outbreaks in long-term care facilities.

Covid-90

Thirdly, let’s look at a middle-aged group those between 30 and 39 years of age. For this age group 38% of cases were due to close contact, 24% linked to outbreaks, and 17% caused by community transmission. The fact that community transmission is higher for middle-aged groups (compared to the young and the elderly) is consistent with the fact that middle-aged adults are most likely to buy groceries, run errands, go shopping, work in essential services etc. than youths and the elderly.

Covid-30

From the above we can conclude that youths are more likely to get infected due to close contact, while the elderly are more likely to get Covid-19 because of an outbreak. Furthermore, we can also conclude that community transmission is a risk, since people who get Covid-19 due to community transmission are likely to spread it via close contact to their partners, families, friends, roommates and co-workers. Consequently, we all still need to wear face masks outside of our homes, practice physical distancing and wash our hands frequently. Stay safe and listen to the science.

(Credit: this data comes from Open Data TO)

Covid-19, Public health, Toronto

Covid-19 fatalities/ICU by T.O. postal code (under 70 years of age)

The elderly, especially folks in long-term care have been disproportionately affected by the recent Covid-19 pandemic.

In a recent blog post I pointed out the large discrepancy in the number of fatalities by neighbourhood in Toronto.

Some have singled out the concentration of long-term care facilities in certain neighbourhoods as a possible explanation for these discrepancies. Others have argued that some neighbourhoods in Toronto simply have more people.

Let’s explore these arguments by looking at the Covid-19 data for patients under 70 years of age. Since it is unlikely for someone under 70 to be in a long-term care facility.

A look at Covid fatalities for patients under 70 by postal code reveals that certain neighbourhoods have suffered a disproportionately higher number of fatalities:

  • Two neighbourhoods: Weston and Birch Cliff, Cliffside West account for 14% of Covid fatalities in Toronto for those under 70.
  • Two North York neighbourhoods: Downsview and Northwood Park, York University account for 10% of Covid fatalities in Toronto for those under 70.
  • Some neighbourhoods have had only 1 under 70 Covid-19 fatality. While Weston has had 11 under 70 Covid-19 fatalities.
  • Therefore, there is still a large discrepancy in Covid-19 fatalities by neighbourhood that cannot be explained by the concentration of long-term care facilities.

Noting that fatalities are not the only serious outcome from Covid-19, let’s now look at the number of Covid-19 patients under 70 who were hospitalized in an intensive care unit (ICU):

  • The neighbourhood of Weston has both the highest number of Covid-19 patients under 70 who were in ICU, and the highest number of under 70 Covid fatalities.
  • Two North York neighbourhoods: Downsview and Northwood Park, York University had a high number of patients who were in ICU.
  • Some neighbourhoods have had only 1 patient under 70 in ICU because of Covid-19. While Weston has had 12 under 70 patients in ICU because of Covid-19.
  • Weston does not have 10 times more population than these neighbourhoods. In fact, it has a lower population than some of the neighbourhoods with 1 ICU patient under 70. Therefore, population cannot account for these discrepancies.

Both Public Health Ontario and Public Health Toronto need to investigate what exactly is causing these large discrepancies in terms of Covid fatalities and ICU cases by neighbourhood.

Four postal codes in T.O. with the highest Covid fatalities of people under 70 years of age

Postal Code Neighbourhoods Borough Covid fatalities
M9N Weston York 11
M1N Birch Cliff, Cliffside West Scarborough 9
M3N Downsview North York 8
M3J Northwood Park, York University North York 7

 

Four postal codes in T.O. with the highest Covid ICU patients under 70 years of age

Postal Code Neighbourhoods Borough Covid ICU
M9N Weston York 12
M3N Downsview North York 11
M9V South Steeles, Silverstone, Humbergate, Jamestown, Mount Olive, Beaumond Heights, Thistletown, Albion Gardens Etobicoke 10
M3J Northwood Park, York University North York 8

Covid_fatalities_70
Covid-19 fatalities by postal code (under 70 years of age)