H5N1

What you need to know about COVID-19 in Alberta on Saturday, Nov. 14

Via CBC News: What you need to know about COVID-19 in Alberta on Saturday, Nov. 14. Except and then a comment:

• Alberta reported 1,026 new cases of COVID-19 on Saturday, the first time it's reported more than 1,000 new cases in a single day. The province did not say how many active cases there now are across the province — that number was 8,593 as of Friday, another record high. 

• Another three people have died for a total of 401 deaths. There are 256 people in hospital, 54 of whom are in intensive care beds — also a record high number. 

• The province said the next detailed update on case numbers by region would be available Monday. 

• Starting Friday, much of the province has suspended indoor group fitness programs, team sports and group performance activities, as well as reduce operating hours for bars and pubs until Nov. 27. 

• AHS has introduced an online contact tracing tool that will notify close contacts of positive cases by automated text message. 

• A group of more than 430 Alberta physicians and three major health-care unions sent a letter to Premier Jason Kenney on Nov. 12 endorsing the idea of a "circuit-breaker" lockdown as cases of COVID-19 continue to surge in the province.  

What you need to know today in Alberta 

For the next two weeks, a swathe of Alberta will suspend indoor group fitness programs, team sports and group performance activities. All restaurants, bars, lounges and pubs in Calgary and Edmonton and other areas under enhanced status (areas with more than 50 active cases per 100,000 people) must stop liquor sales by 10 p.m.  

Alberta Premier Jason Kenney also urged Albertans in any area under enhanced measures to not to have social gatherings in their homes. 

The new measures were announced on Thursday. On Saturday, the province reported 1,026 new cases with 256 people in hospital — continuing to break record high numbers.  

"In the days ahead, we all have a role to play in getting case numbers down to protect our health care system, keep schools and businesses open, and protect vulnerable Albertans. This is our last chance to avoid more restrictive measures," Dr. Deena Hinshaw, Alberta's chief medical officer of health, said on Twitter on Saturday.

So the big threat is not the sickness and deaths of countless other human beings, but the resulting inconvenience of "more restrictive measures." Alberta's government doesn't seem to have a very high regard for its citizens' common decency.

COVID-19 on Saturday morning: 53,517,017 cases, 1,305,189 deaths

A screenshot from the Johns Hopkins Coronavirus COVID-19 (2019-nCoV) dashboard:

Mexico looks likely to join the One Million Club today. 

COVID-19 deaths among US clinicians

Via JAMA Network: COVID-19 Deaths Among US Clinicians.

More than 100 000 US health care personnel have contracted coronavirus disease 2019 (COVID-19) since February and at least 641 have died, according to a report by health officials from the CDC and several states. 

Based on data reported to the CDC between February 12 and July 16, the report reflects a 10-fold increase in cases among personnel at health care facilities since the last CDC analysis in April. At that time, nearly 10 000 COVID-19 cases and 27 deaths had been reported. The authors note that the current total likely underestimates the true number of cases among health care personnel because occupational status was available for fewer than one-quarter who had COVID-19. 

Among nearly 7000 health care personnel with COVID-19 for whom workplace data were available, two-thirds worked in nursing homes or residential care facilities. About one-third of almost 6000 cases with their occupation reported occurred among health care support workers—nursing assistants, medical assistants, and other providers or aides. Nurses accounted for 29% and physicians for about 3% of cases. Among nonclinical staff, 581 administrative staff and 330 environmental health workers contracted the disease. 

Health worker deaths from COVID-19 were most common among men, those aged 65 years or older, and Asian or Black adults. Ninety-two percent of those who died had an underlying health condition compared with 41% of workers who survived. More than half of those who died had cardiovascular disease or diabetes; one-third had both.  

The authors recommended ensuring universal mask use in health care settings, screening for illness before entering the workplace, granting nonpunitive sick leave policies, and recognizing the social inequities that put some workers at higher risk in the workplace and at home. 

“Ensuring adequate allocation of PPE [personal protective equipment] to all [health care personnel] in the workplace is one important approach to mitigating systemic inequalities in COVID-19 risk,” the authors wrote.

COVID-19: 5,000 'extra' heart deaths since March

Via BBC News: Coronavirus: 5,000 'extra' heart deaths since March. Excerpt:

Almost 5,000 more people have died from heart problems in England than would be expected since the start of the pandemic, the British Heart Foundation has warned. 

Analysis by the charity found excess deaths are 7% above predicted levels. 

It is urging people not to delay checks or treatment during the second wave of the virus.  

NHS England said hospitals are redesigning services so that care can go ahead safely.  

The BHF analysed mortality data in England between the start of the first national lockdown on 20 March and 30 October.  

It found 73,799 cases where heart or circulatory disease was named as the underlying cause of death. That is 4,785 higher than the number projected by Public Health England over the same time period. 

In around a quarter of the additional or excess cases, Covid-19 was mentioned on the death certificate, suggesting that in the majority of cases other factors were to blame. 

Pandemic impact 

The charity suggested some patients could be delaying treatment because they did not want to put pressure on the NHS, while others may have been concerned about visiting their GP or hospital for fear of catching the virus.  

Pressure on NHS services because of the pandemic has also led to delays to some operations and routine heart care.  

"Going forward, we have to learn the lessons from this pandemic," said Dr Sonya Babu-Narayan, associate medical director at the British Heart Foundation and a consultant NHS cardiologist.  

"It's a new disease and it's understandable that we may not have anticipated every consequence. We wouldn't want the very people who need the NHS the most being the ones staying at home trying to protect it."  

As the UK went into lockdown on 23 March, there was a sharp fall in people seeking help for suspected heart attacks.  

Admissions for the most serious type of heart attack, caused by a complete blockage of an artery supplying part of the heart, fell by about a quarter, while rates of admission for heart attacks caused by a partial blockage of blood supply to the heart fell by 42%, according to research by the University of Oxford. 

Don't ignore chest pain 

Numbers improved over the summer but doctors fear a second wave of the virus and a second lockdown in England will again prevent some patients being diagnosed or treated. 

The British Heart Foundation said it is important people seek medical advice if they have symptoms such as long-lasting chest pain or increased breathlessness.

Iceland's COVID-19 situation no longer red, but orange

Credit: ECDC

Via Iceland Review: Iceland's COVID-19 Situation No Longer Red, But Orange.

Iceland is no longer marked as red in the European Centre for Disease Prevention and Control’s risk assessment maps in support of the European Council’s coordinated approach to the restriction of free movement. The country is now marked as orange, while most of Europe is still in the red. From November 14, travellers from Iceland to the UK will no longer have to undergo a 14-day quarantine on arrival.  

The colour scheme is based on the countries’ 14-day notification rate, testing rate and test positivity and a new map is published every Thursday. Today’s numbers put Iceland’s 14-day cumulative number of COVID-19 cases per 100 000 at 87,8. While the current wave of the pandemic seems to be subsiding in Iceland, the numbers are still high in most of Europe. According to the ECDC’s daily update, most European countries’ 14-day number is in the hundreds, with a few countries surpassing 1,000.  

Areas are marked with orange if the 14-day notification rate is lower than 50 cases per 100 000 but the test positivity rate is 4% or higher or if the 14-day notification rate is between 25 and 150 cases per 100 000 and the test positivity rate is below 4%. If if the 14-day notification rate is lower than 25 cases per 100 000 and the test positivity rate below 4%, the country is marked as green but the only areas currently marked as green are Greenland and a region of Finland. 

The majority of Europe is red, meaning that the 14-day notification rate is 50 cases per 100.000 or higher and the test positivity rate is 4% or higher, or the 14-day notification rate is higher than 150 cases per 100 000.  

Iceland reported 8 new domestic cases yesterday, the lowest daily number of new cases since September 14. Total active cases continue to drop and are now 447. 61 are in hospital and two in ICU.

COVID-19 on Friday: 53,126,651 cases, 1,312,339 deaths

A screenshot from the Johns Hopkins Coronavirus COVID-19 (2019-nCoV) dashboard:

New Zealand's 'mystery' Auckland Covid-19 case linked to previous cluster

Via The Guardian: New Zealand's 'mystery' Auckland Covid case linked to previous cluster. The official response has been no-nonsense. Excerpt:

New Zealand will stay at alert level one but mandatory mask-wearing on public transport in Auckland and on flights may return next week after a new community case was confirmed on Thursday. 

Auckland, which was partially shut down on Friday with about 100,000 people asked to work from home, has reopened and weekend events can go ahead, though the Covid response minister, Chris Hipkins, has urged people to be cautious. 

The warning follows the new case, a student who lives in central Auckland,being genomically linked to a defence worker who was infected at a quarantine hotel earlier this month. On Thursday the student’s case was being described as having an unknown source, but Friday’s genomic link made further undetected spread of the virus “less likely”. 

The defence cluster began with a defence worker passing Covid-19 to a colleague at a work meeting. Hipkins questioned why these meetings weren’t being done virtually and defence on Friday announced that they would be from now on.  

While there was not yet the level of risk to lift the alert level, Hipkins said he would take an order to cabinet on Monday seeking to make mask use on public transport in Auckland mandatory, including all flights in and out of the city. 

The student, who is aged in her 20s, is the fourth case linked to the defence cluster. Work is continuing to try to determine where and how the student contracted the virus.  

Her three close contacts have moved to a quarantine centre and have tested negative. Those who visited places where the student was while contagious have been asked to get tested.  

She reported feeling symptoms on Monday and was tested on Tuesday. But on Wednesday she went to work wearing a mask, in a customer-facing role at A-Z Collections clothing store. Her test came back positive on Thursday. 

While infectious she took a number of Uber rides and visited four central Auckland restaurants and cafes for food and takeaways, as well as one of New Zealand’s major department stores, Smith & Caughey’s. She also briefly visited a city university campus and doctors’ rooms. 

The woman lives in a 170-unit apartment complex, with a shared pool and gym, in the city centre. Residents have been asked to self isolate but some have reportedly been seen leaving carrying overnight bags. In response, public health protection workers were being deployed to secure the building on Friday.

Ontario on track for 6,500 new coronavirus cases daily

Via The Globe and Mail: Ontario on track for 6,500 new coronavirus cases daily. Excerpt:

Ontario could hit 6,500 COVID-19 cases a day by mid-December, surpassing the rates of growth in European countries that are now in lockdown, new projections done for the provincial government show. 

The situation in Ontario has been worsening rapidly, with deaths in long-term care homes rising, and outbreaks and hospitalizations increasing. Ontario reported a record 1,575 cases on Thursday, with 18 more deaths.  

The new models project that within two weeks, the number of COVID-19 patients in Ontario’s intensive care beds will exceed 150 – and hospitals would not have enough beds to carry out all planned surgery. At a growth rate of 5 per cent, which the modellers said could even be viewed as “optimistic,” number of cases would reach 6,500 by mid-December. At a rate of 3 per cent growth figures, they would hit 3,500 by mid-December. 

COVID-19 is surging throughout most of Canada, with Quebec saying it may have to shut schools for a month and Manitoba locking down as the virus spreads dangerously out of control. In Alberta, Premier Jason Kenney on Thursday announced modest measures in response to rapidly increasing coronavirus infections in that province. Bars will have to close early and group fitness classes and team sports will be prohibited for two weeks, and people in places with high rates of infection have been advised to stop social gatherings. 

Adalsteinn Brown, the dean of the Dalla Lana School of Public Health at the University of Toronto, and co-chair of the science advisory group that prepared the Ontario models, said without any further government action, cases will simply continue to climb, with more people in intensive care and more deaths in long-term care.

A nationwide case surge hits US hospitals: This week in COVID-19 data, Nov 12

Via the blog of The COVID Tracking Project: A Nationwide Case Surge Hits US Hospitals: This Week in COVID-19 Data, Nov 12. Click through for the full report with many graphs. Excerpt:

This week, the COVID-19 pandemic in the United States accelerated again, driving record numbers of cases and hospitalizations as healthcare systems around the country warned that they are approaching a breaking point. Cases are up 41 percent, hospitalizations up 20 percent, and deaths up 23 percent. States reported 875,401 new cases this week; 1 in 378 Americans tested positive for COVID-19 this week. 

The seven-day average of deaths now exceeds 1,000 per day, a level not seen since the summer surge. States reported another 7,382 lives lost to COVID-19 in the past week. 

The number of people who are hospitalized with COVID-19 in the United States has nearly doubled in the past two weeks, and hospitalizations increased in 47 states. As project co-leaders Erin Kissane and Alexis Madrigal wrote on our site and in The Atlantic earlier this week, the dangerous spike in hospitalizations suggests that further increases in the number of fatalities are imminent. Twenty-seven states this week hit a record for the number of new cases reported. 

Once again, our metrics reveal a pattern: Cases lead to hospitalizations lead to deaths. The current national case surge has been underway for nine weeks, hospitalizations have risen for seven weeks, and deaths have risen for five. Testing is up 13 percent this week, but as we have written many times, this testing increase, while important, cannot account for a 41 percent increase in cases. Because of substantial inconsistencies in the way states and territories report their COVID-19 tests, we do not calculate test positivity from the public data we can compile. But according to the White House Task Force—which has access to federal reporting pipelines—20 states now have a test positivity rate of more than 10 percent, with many counties at more than 20 percent test positivity. 

Although we have seen cases (and hospitalizations and deaths) spike twice before in the United States, several things about this moment in the pandemic are new: Daily new cases are now nearly twice as high as they were in the Sunbelt surge this summer. 

Hospitalizations have broken the previous national record and are rising very quickly in every US region—something we’ve never seen before.

In fact, hospitalizations are now rising more quickly than we’ve ever seen outside of a brief period in late March. The past three days have seen increases larger than any single day since mid-April.

Where the virus is hitting hardest

For weeks, the states of the upper Midwest have been the most hard-hit, per capita, by COVID-19; now major increases in deaths are following. Kansas now leads the nation in per-capita cases, with North Dakota, South Dakota, Wisconsin, and Iowa close behind. And the death toll—a metric known to lag cases by about three weeks—is already worsening in every one of the region’s 12 states.

COVID-19 in BC on Thursday

A screenshot from the British Columbia COVID-19 Dashboard:

We were doing relatively well until a few weeks ago, and we're still doing better than our neighbours in Alberta and Washington state. But this is not good.