News of the pandemic and Covid-19 cases have dropped off the front pages and largely out of the news for most of the last several months. You would think that the pandemic has passed and that not very many people are getting sick or dying.
However, if you look at the daily death rate from Covid in August, you’ll see that Covid deaths greatly outnumber deaths from automobile accidents and guns.
You can quickly see the Covid case counts in your area by clicking on the Layers icon in Google maps and selecting “Covid-19 Info”. Here’s the map for the New York City and New Jersey area, showing several counties in red that have high case counts (this feature is not available for Canada).
However, case counts are no longer a very reliable statistic for understanding the exposure risk in your area because Covid testing is not as widespread as it was in the beginning of the pandemic. One of the best indicators to see the extent of Covid is the number of hospitalizations.
So you still need to be careful about getting infected with Covid, especially if you are elderly or have any health issues. The best protection is still from a Covid-19 vaccine. But vaccines generally wain after 5 months, so if you are approaching that time since your last vaccination or booster, you should be considering getting another shot.
Quebec announced that it will be providing 5th doses of Covid vaccines in August.
However all existing Covid vaccines were developed to combat the original virus. That virus has not been in circulation for a long time. Currently almost all cases in Canada and the US are Omicron variants. Pfizer and Moderna have developed a new vaccine that specifically targets the Omicron variant. This vaccine will be a lot more effective than the current vaccines. https://globalnews.ca/news/8959603/moderna-seeks-approval-canada-bivalent-boosterd-booster/
However it is not clear when this vaccine will actually be available. So should you proceed with a 4th or 5th dose of the current vaccine or wait for the new one?
The following article suggests that you should get a 4th or 5th shot if you have not received a vaccine or recovered from a Covid infection in the past six months, because your immunity has probably waned.
However, if you have received a booster shot in the past and are under 50 without any underlying health conditions or have recovered from a Covid infection you can wait for the Omicron-specific booster.
The Omicron BA.2 variant is steadily increasing as a proportion of all cases and is dominant in some regions of Canada. This has started a sixth wave in Quebec and Ontario. The rest of Canada will follow soon. The same signs are not as strong in the U.S. right now but will likely follow this same pattern that started in Europe In January.
Here is a frank report by Colin Furness who doesn’t dance around to avoid criticizing government policy but tells it like it is.
“There’s no doubt a sixth wave of Covid-19 is sweeping across Ontario being driven by the highly transmissible BA.2 subvariant. At the same time restrictions have been lifted. We’ve opened the doors to a new variant, then eliminated all of our defenses.” Sixth wave in Ontario driven by lifting restrictions
Like most of the other pandemic waves Doug Ford ignored the recommendations of doctors and his own Science Table and implemented controls too little and/or too late or controsl that didn’t make sense (such as closing playgrounds!) because of his own political reasons, ignoring the principles of public health safety.
As any dummy with two eyes or even one eye can see, even though the number of hospitalizations in Ontario have come down a lot from the peak on Jan 23, the current number of people in hospital is still quite high and has started to go back up.
Removing the vaccine mandate was not actually a bad decision. The Omicron variant can inhabit the nasal passages of people who have been vaccinated. They might not get very sick with Covid or even know that they are infected but they can still pass on the virus to others. The rationale for a vaccine mandate was to provide safe spaces for people who were vaccinated where they could congregate with a low risk of being exposed to the virus. Since people can now catch the virus from other vaccinated people, a vaccine mandate no longer offers the same protection.
However, ending the mask mandate was really a bad decision. There is not a single doctor who agrees with this Ford government policy. .Masks are your last line of defense as summarized in this diagram from an earlier blog.
Everyone who cares about their health should be using a K/N95 mask for maximum 83% protection as summarized by the results in this recent study.
I have pointed out the shortcomings of public health and government policies on many occasions. Many doctors have also been critical of the poor decisions that have been made and recommended actions based on medicine and science. That is what one would expect. However, it seems that under the Ford government, political pressure has been used to “shut up” doctors who are too critical. When people hear about this type of suppression in China and Russia, they are incensed. So how can it happen here?
This is another dimension of how badly Ford and his government have handled the pandemic. At 8:17 in this video the doctor reveals that Doug Ford called the CEO of his hospital to complain about the medical facts that the doctor was saying to warn people. The doctor was soon fired from his role as Director of Critical Care at his hospital. How politics muzzled a doctor.
This was unbelievable. Canadian truckers received accolades around the world from Fox News, right wing U.S. senators and Trump himself to demonstrators in Paris and other cities. But amongst serious people in the world, Canada was a laughing stock. There is not a single country in the world that would have put up with a siege of their capital city and a blockade of its seat of government for this long a time.
How in the world did this all happen?
Fundamentally it was a Perfect Storm of Stupid decisions that just kept compoinding the issue into something that kept getting bigger than it ever should have.
Stupid #1
The Trudeau government brought in a vaccine mandate for truckers crossing the border into Canada on January 15. Was there any science behind this decision? I never saw any numbers.
In mid January there were more than 32,000 cases of Covid being reported per day in Canada (and probably many more since many people have not been able to get tested). About 90% of Canadian truckers were already vaccinated. Were the number of additional Covid cases that would be caused by an unvaccinated truck driver crossing the border make a significant difference? Not likely. Most epidemiologists didn’t think so either. https://www.cbc.ca/news/canada/truck-driver-vaccine-mandate-canada-1.6315936
The Trudeau government should have done this analysis and seen that that it didn’t make a lot of sense. As an incentive to get more truckers to get vaccinated, it would not have made much difference either. Most of the 10% of truckers who aren’t vaccinated had made up their minds by now.
The government also should have had some ears on the ground and realized that the strong willed truckers would react negatively to the mandate. Truckers had been given special consideration as critical workers throughout the pandemic and were exempt from vaccination requirements. This was not the time to change that status for so little gain.
In fact the whole Canadian mandate was a moot point. The US had instituted a vaccine mandate for truckers crossing into the US. It went into effect a week after the Canadian mandate but the net effect was that unvaccinated Canadian truckers could not cross the border into the U.S. So the net effect of Trudeau’s mandate was to prevent a few unvaccinated American truckers from crossing into Canada.
In the meantime various people in the trucking industry were organizing a convoy to protest the vaccine mandate. But the effect of their protest to get the Canadian government to remove its mandate was essentially just going to be for the benefit of unvaccinated American truckers coming into Canada. I wonder how many Canadian truckers who were driving across Canada to protest in Ottawa and other border crossings understood this?
It became the “Freedom Convoy”. But not a single trucker has had his freedoms revoked and been forced to get vaccinated. If a trucker felt he was being coerced into getting vaccinated because he wanted to do business across the border it was in order to comply with the U.S. mandate. Demonstrating in Canada to get the Canadian vaccine mandate for truckers removed would not change that.
At this point the Trudeau government should have seen how futile the Canadian vaccine mandate for truckers was going to be and just withdrawn it. But Trudeau had no vision or understanding of the dynamics.
In fact a retraction may not have dampened the truck convoy movement because the original protest had morphed into a general protest against intrusions into rights and freedoms. This was now a movement which was attracting all kinds of other activists like anti-vaxxers and white supremacists and it was getting millions of dollars in funding, much of it from the U.S.
As the truckers arrived and camped on Wellington Street in front of the Parliament buildings, their horns at full blast, Sloly was interviewed on CBC national news. He said that he thought this could not be handled by the police and would have to be dealt with by other means.
More and more trucks arrived and camped out on the streets creating a disturbance and a public nuisance that intimidated the residents who lived in that part of Ottawa. There was no attempt by Ottawa police to clear vehicles that had been illegally parked for days at a time.
Stupid #4
In the meantime, other trucker protests were tying up border crossings across the country, most significantly at the Ambassador Bridge between Windsor and Detroit. Day after day the NDP opposition in the Ontario legislature was asking questions about what the government was going to do about these blockades. Doug Ford was not even in the house. Nobody knew where he was and there were no statements coming from him.
A few days later some plants in Detroit which depended on shipments of auto parts from suppliers in Windsor were starting to shut down. Joe Biden called Trudeau on it, the governor of Michigan made statements that Canada needed to solve this problem quickly and some Michigan State legislators started to say that the U.S. auto industry should be using American sources for all its parts since Canada was unreliable.
Suddenly Ford appeared and announced that truckers who were obstructing traffic in Windsor would face fines up to $100,000 and jail time. It still took several days for the police to clear the bridge so that critical commercial traffic could flow again.
Ford also said that the truckers were staging an illegal siege of Ottawa and they shuld go home. But no real action followed. While Ottawa may be the capital of Canada, the federal government has no jurisdiction over the city. Ottawa is a city in Ontario and it is the province of Ontario along with the municipality of Ottawa that has jurisdiction over roads and highways in Ottawa, not the federal government.
Why did Ford do so little? He once again demonstrated, as he has so many times throughout this pandemic when he ignored recommendations of his own Science Table, that he is a petty little politician who does not act for the benefit of most of the people in Ontario.
The Result
In the face of this complete gridlock and no prospect of any movement, Trudeau invoked the Emergency Measures Act. The OPP finally sent in reinforcements to Ottawa along with police from Quebec and even some western provinces in order to end the blockade.
PSS (Perfect Storm of Stupidity) = Trudeau x Truckers x Sloly x Ford
The head of the Ottawa police chief has already rolled as did the chair of the Ottawa Police Service Board who hired him. Let’s see if any more heads roll as people come to see how badly this situation has been handled from start to finish. Two of the biggest heads however will continue to bobble and will not roll until the next elections roll around.
“Has Omicron peaked?” seems to be the number one news item.
If you look at overall case counts, it looks like the UK has peaked and is declining, following the pattern seen earlier in South Africa. In Canada and the U.S. people are hoping that the same pattern will follow, and soon.
Because of the shortage of Covid tests, many people who get Omicron do not get tested and so the number of reported cases is much lower than the true number of people with Covid. Here is the forecast for Canada that takes the unreported cases into account.
The January 4 blog predicted that Omicron would peak towards the end of January at about 125,000 cases and return to pre-Omicron levels at the end of February. The Canada forecast here is similar but with a sharper and more rapid peak and decline by the end of January.
If this forecast holds true, it does not mean the crisis will be over by the end of January. Hospitalizations and deaths lag the case counts by a few weeks. There has just been a sharp increase in ICU cases and deaths.
There was another informative email from Dr. Andrew Morris this week. If you haven’t read it, here are some of the key points.
– in previous waves we have seen “false peaks” where it looked like a peak was achieved, when really it was a temporary decline that preceded another increase in cases.
-people in Canada will unnecessarily suffer more from Covid because of a shortage of therapeutic agents (medicines that have been approved for treating people who are sick with Covid). We suffer from insufficient production, insufficient procurement, poor coordination, delayed approvals and mismanagement by some provincial officials.
– one reason Ontario hospitals are struggling is because it has very few hospital beds per capita.
Masks
Because Omicron is so much more transmissible than previous variants, it is highly recommended that people use an N95 or KN95 mask. These masks are almost twice as effective as the more widely used surgical masks or cloth masks.
However, a lot of K/N95 masks that are being sold, even from reputable sources, do not meet the standard of filtering 95% of particles. The following report shows the test results of many masks being sold.
The K/N95 masks generally make it harder to breathe and may be uncomfortable if you need to wear it for a long period of time. I initially used a N95 mask that had two ties that go over the head. I found this very awkward because it was difficult to undo enough of the mask to take a drink of water or wipe your nose. I switched to a KN95 mask that has ear loops which I found to be more flexible and also more comfortable.
More and more people are talking about herd immunity or the pandemic becoming endemic after the Omicron wave. This is all conjecture. I haven’t seen any science. Here is a way to estimate this.
1. Using the basic epidemiological model with an estimate of R0 = 10.0 for Omicron, herd immunity is reached when immunity of the population is at least 90%.
2. Canada’s vaccination rate is currently 78% of the whole population. Not many of the remaining unvaccinated people are likely to get vaccinated. After numerous campaigns, vaccine mandates and various other incentives, most of the unvaccinated are pretty firm in their position. Tracking the spread of the coronavirus in Canada
3. The number of people who have been infected with Covid and received natural immunity is currently about 3 million. Adding in an estimate for the uncounted cases during the Omicron wave will increase this to about 5 million, or 13% of Canada’s population.
4. The total immunity in Canada after the Omicron wave will be 78% + 13% = 91%. This is on the border for herd immunity.
However, because of increasing breakthrough infections in people who have been vaccinated, the effective level of immunity will be less than 91%.
It remains to be seen if Omicron is the last wave, but even if it is, many people will continue to get sick and die from Covid. This is an endemic state, similar to influenza. In 2018-2019, before the coronavirus pandemic, there were 10,000 cases of flu per week in Canada during the winter peak.
Since the major mode of transmission of the coronavirus is between people who are in proximity to each other, it seems intuitive that in societies where there are more crowded living conditions there would be more spread of Covid-19. Since the first days of the pandemic, people have suggested that the virus was spreading more rapidly in areas and countries that were more densely populated.
However this article, in a widely read usually responsible newspaper, argues that the relationship between population density and the spread of Covid-19 is a “myth” and has been “debunked”. Stop Blaming COVID-19 Deaths On Population Density
While there are quite a number of good arguments here, this is a classic case of someone forming his own conjecture without reading the science. I don’t think the reporter who wrote this article reviewed any of the many scientific studies that examined this question. This is a really good example of people who “do my own research” instead of studying the actual science. This lazy approach has been a big reason there has been so much misinformation circulated about the pandemic. It’s not easy to read some of the science. Published papers are long and dense with a lot of detail and you need to have some understanding of statistics to understand the research and the results. Read this for example. Temperature and population density influence SARS-CoV-2 transmission
The Huffpost reporter argues quite well that there are many reasons to explain the spread of Covid, such as – public health policy – residential overcrowding (which is not the same as population density) – work environments which increase the frequency of face-to-face interactions
But this does not mean that population density is not an important factor. There are many factors that affect the spread of a respiratory illness.
It does seem true that there does not seem to be a connection between Covid and population density at the country level. If Covid increased with population density, the data points on this chart. would form a line rising from left to right.
But when you look at a more granular level, at smaller regions within a country, there does seem to be a very strong relationship. There have been a number of statistical studies to try and analyze this more completely. One of the better papers concludes that
Population density and temperature are drivers of R0 at state level in the United States (p<0.001), but the effect of lockdown is greater.
The additional conclusion about temperature is that as temperature increases Covid cases decrease. This has been widely noted by epidemiologists who have pointed out that in winter, people congregate indoors more than in summer and this is an important factor that gives rise to the spread of all respiratory illnesses such as seasonal flu.
It’s pretty easy to see that population density drives Covid cases yourself. Charts on the next few pages show it for the U.S. and Europe. If you look at the Covid hot spots on the first map, it is usually an area of high population density on the second map.
People reporting on TV, from politicians to public health scientists, seemed to be alarmed and a bit surprised. They shouldn’t be. Shortly after South Africa reported the new variant Omicron at the end of November, they provided statistics that showed that the number of cases was doubling every 2-3 days. This is really simple math. You don’t need a sophisticated epidemiological model, you don’t even need a calculator to see the impact of this over a few weeks. If 4 people with Omicron arrived in Canada from South Africa before the variant was identified, those 4 cases could have spread to 32,000 people by January 1, 2022, which is roughly what the latest case count is for Canada.
There were early reports from South Africa that Omicron is less severe than Delta. But the population profile in South Africa is a lot younger than the UK, Canada and the U.S. It was not so clear that this pattern of milder infections would be true for older people who have been a lot more vulnerable to the previous strains of the coronavirus.
On Dec 22, a careful study was published by Neil Ferguson and his team at the Imperial College London. He is one of the pre-eminent epidemiologists in the world. The analysis controlled for many variables such as age and sex and concluded that the reduction in the risk of hospitalisation for Omicron relative to Delta was 40-45%. This now seems to be an accepted characteristic of Omicron. https://www.imperial.ac.uk/mrc-global-infectious-disease-analysis/covid-19/report-50-severity-omicron/
But even if the probability of hospitalization is lower, when there are so many more cases than Delta, there may be an overall increase in hospitalizations. In fact, patient admissions to hospitals have now started to increase sharply.
This is what is alarming many public health officials. This trend could overrun the health care system. So, many regions are re-introducing social controls. While most governments are insisting that “lockdowns” are a thing of the past, in fact what we are seeing now is “creeping lockdowns”.
One thing that does not seem to be reported very clearly is how long this wave will last. In South Africa it seems that it peaked quite quickly and is coming down (see first graph) but that does not mean it will happen here.
To try and answer this question, I updated my coronavirus model for the Omicron variant with the following assumptions: 1. By January 9, Omicron will account for 90% of the coronavirus cases in Canada. 2. Omicron is 4 times as transmissible as Delta.
Based on this, it does look like the Omicron wave will peak more quickly and decline more quickly than the earlier waves. The peak is towards the end of January with cases returning to pre-Omicron levels at the end of February. What determines when the decline begins is when the total immunity based on both vaccinations and natural immunity from people who have had Covid reaches a critical threshold. This model is very sensitive to the assumptions, so the peak cases may be more or less than 100,000 depending on how effective the various new restrictions are in reducing social interactions and transmission of the virus.
One thing that some epidemiologists are saying is that almost everyone will get Omicron, even vaccinated people. I don’t see anything like this. The total number of people in Canada who had Covid-19 at the end of the Omicron wave in the model, both symptomatic and asymptomatic, is about 8 million people out of a total population of 37 million. So about 30 million people will not get Covid because they are being protected by the vaccine, in spite of many breakthrough cases. So it does not make sense from a health perspective to surrender, throw caution to the wind and not worry about getting infected because “everyone will get it anyway”. It’s hard to predict if you will have a mild case or not. In addition, very little is known at this point what the effect of Omicron is on “long covid”. With earlier variants, 5% of people who were infected have lingering symptoms for many months and in some cases much longer. What is my risk of getting Long Covid
The other thing some epidemiologists are saying is that this may be the last wave of the pandemic after which Covid will become endemic. It won’t disappear and will continue to infect people, but not at an epidemic rate, and will become more like a seasonal flu. However Dr. Fauci commented that most pandemics in the past have subsided after two waves, but Covid-19 has been unprecedented and has now proceeded to a fourth wave. So the most experienced experts in the field are really not able to predict what will happen. And the threat of another variant after Omicron is of course still possible.
The news has been full of reports of the Covid-19 Omicron ever since it was declared a variant of concern by the World Health Organization (WHO) on November 26, 2021. There has been a lot of new information every day and many changes to some of the earlier reports. The following is an excellent summary and assessment that is complete and up-to-date to December 18. Dr Andrew Morris is a professor of Infectious Diseases at the University of Toronto and a member of the Ontario COVID-19 Science Advisory Table. It is worth reading all of this and perhaps signing up for his regular mailings.
The early data from South Africa suggested that Omicron might be less severe than Delta because hospitalizations from Omicron were less frequent than Delta but this is not being borne out in Denmark, and probably will not be true in Canada and the U.S.
There are several other reasons why the progress of Omicron in South Africa may be very different than here.
Omicron is spreading rapidly around the world. Besides South Africa, UK, and Denmark, there are steep Covid case increases in Norway, France and Spain.
What should you do?
Besides the recommendations made by Dr Morris in the article above, you should make sure you are using an effective mask. The typical surgical mask is only about 50% effective because it is not very tight fitting and there is a lot of space where virus particles in the air can get through to your mouth and nose. An N95 mask on the other hand is 95% effective. Cloth masks shouldn’t be used at all.
One reason that Omicron may be so much more transmissible than Delta may be because it spreads more readily through the air. This could be because people who have Omicron may be expelling larger amounts of virus particles than with Delta or it could also be that the aerosol particles may be smaller, circulate more quickly and stay in the air longer. The evidence now suggests that Covid-19 is primarily spread through infectious aerosols that people breathe in. Preliminary data hint at what makes Omicron spread so readily.
The previous blog article highlighted how ventilation is a big risk because there are no standards, from small spaces like restaurants to large spaces like factories and warehouses. Ventilation is very important for removing the small aerosol particles in the air. The larger droplets that contain the virus tend to drop out of the air within 6 feet shortly after being exhaled. Social distancing in enclosed spaces is not enough to keep you safe; the virus aerosol particles which may circulate in the air for hours may be more dangerous than the droplets.
It is difficult to assess how well a space is ventilated without some measurement or getting a statement about the HVAC system from the building management. And you cannot assume that a newer building will be better ventilated than an older building. Air Circulation and Coronavirus: How to Judge a Ventilation System
You can judge if a space is small relative to the number of people in it. So a crowded restaurant with low ceilings is probably not very safe whereas a gym with high ceilings that is not very crowded may be a lot safer. On the other hand, you could get infected in an empty restaurant from aerosol particles that are still circulating from a patron who left hours before you arrived.
Finally remember that the best way to protect yourself from Covid infection is having several layers of defense. The following illustrates this well.
At the end of September the 4th coronavirus wave peaked and began to decline. With increasing vaccination rates it was widely assumed that this was the last big wave of the pandemic in Canada and the US. However, in recent weeks case counts have plateaued and started moving up. Is this the start of a 5th wave?
One thing that happened is the emergence of new variants. The Delta Plus variant AY.4.2 may be slightly more transmissible than the Delta variant. It has made headway in the UK, outcompeting the Delta variant and now accounts for about 10% of sequenced virus samples there. To date it has not been widely reported in the U.S. or Canada.
However, in Canada, some other Delta variants have been identified, AY.25 and AY.27. In Saskatchewan, AY.25 is becoming the predominant circulating strain, more than 50% of all cases. In Ontario, AY.25 accounted for 31% of confirmed cases.
This chart shows the spread of AY.25 and AY.27 in Saskatchewan.
In various parts of Europe there has been a sharp increase in Covid cases. Germany, which managed the pandemic better than most other countries (except Scandinavia) has more cases and hospital admissions than at any other time during the pandemic.
The extent of the new Delta variants in Europe is not known. The most likely causes for the spike in cases are low vaccine uptake, waning immunity among people inoculated early and growing complacency about masks and distancing after governments relaxed curbs over the summer.
Here is an assessment from a respected epidemiologist Dr. Colin Furness. He points out a number of “dumb” things that Ontario has done and how they should be corrected.
Allowing full stadium attendance was a sure way to allow further spread. This should be rolled back.
Restaurants are “one of the most dangerous places to be” because there are no regulations or standards for air filtration. The Ontario government has not officially acknowledged airborne transmission of the coronavirus. This will probably not be done by conservative governments in general because it would imply updating their health and safety standards to require many businesses from large warehouses to restaurants to incur the expense of upgrading their heating and cooling systems. However, requiring HEPA filters in spaces where large numbers of people are congregating is really fundamental to controlling the spread of the Delta virus and its variants.
What is the likely outcome?
It was not possible to update the spreadsheet model because there are too many unknowns about the rate of spread and the effect of the new Delta variants. If these new variants do not spread more than 15% more rapidly than the Delta variant and if vaccinations continue to increase, especially now that the vaccine has been approved for children, my expectation is that in Canada and most regions of the U.S. the current increase in cases will be more of a bump than a 5th wave. However in low vaccination areas such as the American South and parts of Europe, the balance could be the reverse and they will experience a full 5th Wave.
I have noted numerous times how inept Public Health has been in handling the Covid-19 pandemic and the many mistakes that they made. But I was not able to explain in more than general terms why there were so many errors and what was wrong with the system. I have just finished reading an incredible book which explains a lot of this. It documents the many things that happened behind the scenes in the pandemic in the U.S. It tells the stories of many unsung heroes who really made a difference in overcoming the shortcomings of Public Health.
The book is The Premonition by Michael Lewis, published in May 2021. Here are a few of the surprising things that Lewis explained.
The bungled response in the US to the pandemic was not due to Donald Trump. There were many more failures in the system than all the outlandish statements and directives from Trump. Chief among them was the CDC. In many cases the CDC did not act when it should have and in some cases actually hindered some people in the public health system who were trying to contain epidemics, not just for Covid-19 but also earlier public health outbreaks.
The other surprising thing is that George W. Bush was the one who first developed a pandemic plan for the U.S. In 2005 someone gave him a book called The Great Influenza about the 1918 pandemic. There was a document from the Department of Health that laid out pandemic plans to speed up the production of vaccines and stockpile antiviral drugs. Bush said “This is bullshit. We need a whole society plan.” The disaster of 9/11 was still fresh in his mind and so he created a task force to create a comprehensive strategy for dealing with a pandemic.
The task force was interested in computational models that could predict pandemic spread. There were some academic models available but they were complicated, unwieldy and slow. Through an unusual sequence of events, they came across a usable model that had been developed by a 13 year old girl for a science fair and later refined by her father who was a researcher at Sandia National Labs.
Among all the incredible individuals and stories that Lewis uncovered, one person more than any other could be considered the hero. Charity Dean was a public health nurse working in California at the county level. She had a knack for seeing public health risks and had made some bold decisions to contain several infectious disease outbreaks, such as meningitis and tuberculosis. She was noticed and promoted to assistant director of the California Department of Public Health in 2018.
When she saw the reports coming out of Wuhan in December and January 2020, she did some research and became very concerned. But when she tried to inform her boss, she was told not to use the word pandemic because it might alarm people. In the absence of direction from either the Whie House or the CDC, she continued to try to press her case but she was barred from many meetings. Eventually, at the risk of being fired, she intruded on some meetings and her analysis and concerns eventually reached Governor Gavin Newsom. It was her interventions more than anything else that led California to issue a stay-at-home order in March 2020. This was the first state to take such action and it influenced many other states to do the same.
In this short excerpt from an interview, Lewis describes what he wanted to accomplish with this book.
In a more extensive interview Lewis describes the ‘ignored characters’ of the pandemic and why their premonitions were pushed aside.
But I don’t think there is any substitute for reading the full book. Lewis is an incredible researcher and writer and there are many fascinating things that are not covered in any interview or reviews. Several previous books by Lewis have been made into blockbuster films.
The first blog article on the Delta variant, on June 18, 2021, showed an increase in cases in July but declining throughout August and beyond. This was more of a bump than a fourth wave. https://anydaynow.blog/delta-variant/
The blog on July 19 revised the model projections by recalculating herd immunity for the delta variant when 80% of the population was fully vaccinated. Then vaccination rates were projected and herd immunity was predicted in August in Canada. https://anydaynow.blog/herd-immunity-recalculated/
But here we are at the end of August and daily cases in Canada are still increasing.
What happened to herd immunity?
The big change was that at the beginning of August, the rate of vaccination decreased in Canada. On the current trajectory, 80% fully vaccinated will not be reached until October instead of August.
This change results in a fourth wave that peaks with about 6,000 new cases per day at the beginning of October, 2021. After that, cases decline to a negligible amount.
