Roberto Rocha, a data reporter at CBC / Radio-Canada, wrote in an article on the “wave” of daily data (cbc.ca/news/health/covid-19-pandemic-data-primer-stats) who states that for the most part the tests in Canada are reserved for those who have traveled abroad and have symptoms and for patients who have severe symptoms. In Saskatchewan, we know that those who attended mass events and who are symptomatic have also been tested, but compared to places like Singapore and South Korea, Canada’s tests are insufficient. Public health officials in different parts of the country have warned that the figures released do not provide a clear picture. These figures do not show potential cases that have not been identified or untested, except for those whose tests are caught in a backlog somewhere. Saskatchewan is fortunate that the tests administered here can be analyzed here, but Saskatchewan public health official Dr. Shahab and Premier Scott Moe are confident that not all people with symptoms have no need to be tested. And while Dr. Shahab reiterates that the majority of people will experience mild symptoms, this “may include pneumonia, but when people think of it mildly, they think it’s like having a cold,” according to Greta Bauer, professor of epidemiology and biostatistics at Western University in London, Ont. “But it just means that they don’t have to be hospitalized. That doesn’t mean they can breathe normally. “In the April 3 provincial update, Dr. Shahab reiterated his position on the tests, stating that among those who have COVID-19, 10% of people will have no symptoms, 20% will. have very mild symptoms, maybe just a cough, and 50% will have more symptoms and will definitely feel sick but can still recover at home. He said it is impractical to test the first 30%, but anecdotal reports from people show that not all 50% of the group are tested either, so how accurate is the data published?
Health Minister Patty Hajdu Warns Canadians: “We must all act as if we are carriers of this virus.” Individual actions are “critically important” in slowing the spread, allowing the health system to continue to function effectively. Our health systems were not designed for a wave of patients of the magnitude that the pandemic could produce, said Hajdu. “Overall, people want to know,” said Dr. Judy Illes, Canada Research Chair in Neuroethics at the University of British Columbia. “Information breeds trust, and trust breeds resilience.” The opposite gives people the impression that they have no control. The models describe a range of possibilities and are based on assumptions and available data. If the data used to formulate the models is inaccurate, the model itself is inaccurate. On Friday, April 3, 2020, Ontario’s chief public health official, Dr. Peter Donnelly, released “strict” numbers comparing the expected number of deaths if no protective measures had been taken with the planned numbers with the current restrictions in place and the projected figures if new restrictions are adopted. The projected difference between these final numbers for the current restrictions and the tighter ones is around 1,400 lives in the month of April alone. That in itself should be a red flag.
Saskatchewan must prepare for the worst. The Saskatchewan Health Authority has looked at the numbers and looked at different scenarios to determine what to do. Taking note of what is going on in the world, SHA plans to form triage committees to make the difficult decisions that should be made in the event of an influx of seriously ill COVID-19 patients. Dr. Shaw, SHA’s chief medical officer, said, “It is important that SHA is transparent about the ethical framework that will guide these decisions.” The committees would save bedside physicians from having to make heartbreaking choices about their own patients. The goal is of course to save as many lives as possible, but sometimes difficult decisions may have to be made if or when the outbreak occurs. The triage committee would be responsible for continuously monitoring and evaluating the status of patients on ventilators to identify conditions of worsening or any new problem, such as organ failure. In a crisis situation where the number of patients is greater than that of ventilators, this could mean withdrawing one person from the survival system and giving it to another. This is a hard truth to hear, but it is the reality in which doctors from countries like Italy have been forced. Dr. Shaw pointed out that if the suppression of ventilation would in most cases lead to the patient’s death, patient care would never stop, they would change and become palliative care, but the patients would not be abandoned.
The wave did not come. In fact, intensive care at the RUH isn’t even as busy as usual, according to Dr. Shaw, and she hopes it will stay that way. The models summarize fairly well what is known at a given time and even if they may be imperfect, the decision makers would essentially work blind without them. Models and plans go hand in hand, with no plan of where to go, arrival is left to chance and in a pandemic like COVID-19, leaving things to chance is not the way to go. “We know the situation is serious,” said Prime Minister Trudeau on Saturday April 4. “What is really going on depends on the choices we make every day. We can change the forecast. “
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