Canadian news about Covid-19 has generally been pretty positive about the progress being made to contain the virus across Canada.
American news has been obsessed, for good reason, about the outbreaks occurring all over the country.
But you don’t see many reports about Europe. Many countries in Europe had major outbreaks before we even saw very many cases in North America. They have contained the virus far better. Our health “experts” probably could learn a lot from the Europeans, but I’ve never seen any indication that they communicate with them very much. This is doubly true for Asia. Many Asian countries have done a far better job from the beginning than Europe and certainly North America (noted in several earlier blogs). When’s the last time you saw an Asian virologist interviewed on our news?
Here’s the proof in pictures.
U.S.
Canada
Italy and Spain had the worst outbreaks in Europe, but they have brought their cases down much faster than Canada and to a much lower level.
When you signed up with an Internet Service Provider (ISP) you probably got a range of options for download speed, ranging from 10 Mbps (Megabits per second) up to 1 Gbps per second (1000 Mbps).
A byte is 8 bits, so 10 Mbps is 1.25 MB per second.
At 50 Mbps (40 MB/s), you will get good Internet access including HD (High-definition) streaming and online gaming. Plus you can share the connection with 3–4 other computers without noticing a slowdown. You can download high resolution photos in seconds and HD videos in just a few minutes.
Let’s suppose you have 50 Mbps service. Can you actually download data from the Internet this fast?
It depends on the Wi-Fi speed between your computer and the router. Here’s a typical home set up for your Internet connection. Anything using the Internet has to first send the data over the Wi-Fi network.
Wi-Fi is subject to a lot of noise interference (see the previous blog). Generally, the further your computer is from the router the slower your Wi-Fi connection is going to be because of interference from walls, ceilings and any other large objects in the path.
The Wi-Fi is network is shared among all the computers in your house so you need to run this from each device that uses the Internet. If you find that some of your Wi-Fi speeds are low, you should see if you can move the router and/or the computer so they are closer together.
Then add up all the Wi-Fi download speeds to see if your Internet connection is fast enough when all computers are streaming video. If the Wi-Fi total is greater than your Internet speed on your plan, you might want to consider upgrading to a higher speed. But if the Wi-Fi total is less than your Internet plan, you may want to change your Internet plan so you are paying for only the speed you can use.
I was happily working on my computer in my home office the other day and suddenly most of the tabs in my browser reported a network error.
Like most home Internet setups, my computer uses a Wi-Fi wireless connection to connect to the router provided by my Internet Service Provider (ISP). The router connects to a modem that sends your request to the ISP network where it gets forwarded on to the Internet.
I went into the Wi-Fi settings on my Windows computer, disconnected the Wi-Fi and then reconnected it. You can find the Wi-Fi settings by using the Search on the Taskbar (magnifying glass icon).
I went back to work and for a time everything was fine. But then I lost the Wi-Fi again. I checked on my mobile phone and it still had a Wi-Fi connection. So there was no problem with the Wi-Fi router, it was strictly a local problem on my computer.
I looked along a line of sight from my computer to the router which was downstairs in the kitchen and tried to think of what might be blocking the signal. Well right front of me I saw that the door to my room was closed. Now I often work with the door closed but this time on a hunch I got up and opened the door. Now after I reset the Wi-Fi it worked for the rest of the day without any further outages.
Why did this happen?
Wi-Fi is a radio signal. As such, it is subject to all kinds of noise disruptions. If you have ever listened to an analog radio, you know that there is often interference and you get crackle and other noises. For a digital signal such as Wi-Fi, the tiniest little noise that you wouldn’t even notice on a radio is enough to signal an error. Internet data is sent in packets typically about 1,500 bytes long. Any error in the packet means that the whole packet is discarded and the sender has to transmit the whole packet again. So a small amount of interference or noise on your Wi-Fi connection can create a lot of retransmissions that result in long delays when you are trying to use the Internet.
A major source of interference in our house is the microwave oven. Microwave uses radio signals that are in the same frequency band as our Wi-Fi, the 2.4 GHz frequency band. Our Internet router is in the kitchen and whenever the microwave is on it effectively knocks out the Internet for everybody.
Cordless phones, baby monitors and garage door openers also use the 2.4 GHz frequency band, so they can also interfere with your Wi-Fi.
Some routers support another Wi-Fi frequency band, at 5 GHz. If your router has this option, you will see another Wi-Fi network name in your device’s WiFi settings. You might want to consider using it instead of 2.4 GHz.
5 GHz is faster and less prone to interference from other devices since fewer devices use this frequency. However 5 GHz may have a smaller coverage area and is less successful at penetrating solid objects.
So computers that aren’t too far from the router should use 5 GHz. But mobile phones which move around and may be farther away from the router should use 2.4 GHz.
We were looking forward to a lovely dinner at a restaurant in Rome. I checked Google maps on my phone for the directions. It was about a 15 minute walk and looked pretty straightforward. Every few blocks I checked the map because there were a lot of turns onto small streets.
After about 15 minutes, I noticed that the street corner I was approaching looked kind of familiar. Sure enough, we had been there earlier. While I was scratching my head, my wife asked a shopkeeper for directions. Ignoring my phone, we were able to follow the directions and arrive at the restaurant.
But it was too late; it was a very popular restaurant and they had given our reservation to someone else. But in Rome this is not a problem. There are so many restaurants that we had no trouble finding one nearby on the lovely Piazza Navona and had a thoroughly enjoyable dinner.
So what in the world had caused the directions on my phone to fail so badly?
I knew that mobile phones have a radio receiver that reads signals from GPS satellites (Global Positioning System) that are continually broadcasting their position and time. The phone’s position can be calculated by solving for four unknown quantities — latitude, longitude, altitude and the time it took for the signal to travel from the satellite to your location. If you remember some high school algebra, you know that solving for four unknowns requires four equations. So your mobile phone needs to get GPS readings from four satellites.
I also knew that GPS signals could be obstructed when you were surrounded by tall buildings, such as in Manhattan, downtown New York City. But Rome, and certainly where we were, does not have very high buildings. On the other hand, the streets are extremely narrow so there is not much sky visible. This was probably the reason I did not get the right directions on my phone.
View of the sky in a narrow street in Rome
What is the lesson to be learned from this?
Simple. If you suspect that your GPS may not be accurate, look up at the sky. If you can’t see lot of sky, your GPS may not work. However, this does not necessarily mean that your map directions will fail because mobile phones also use cell phone towers to determine location, but it may not be as accurate as GPS which determines location to within 5 meters.
Historical note: The first GPS system was developed for the U.S. military during the cold war. In 1983 a passenger plane on route from New York City to Korea entered prohibited airspace because of navigational errors and was shot down by Russia (the Soviet Union). After this, the U.S. made GPS available for civilian use to try and avoid such disasters. Not long after this, Russia also made their satellite system available for civilian use. Many smartphones will use the Russian satellites as well as GPS. Europe and China are also developing navigational satellite systems.
It seems clear now that many States that opened too early at the end of May has led to an increase in Covid-19 cases in the US.
By contrast, in Canada where opening has been more gradual and is still in progress, new cases continue to decline.
Many states (red on map) are seeing increases in the daily number of cases. The three largest states in the US — California, Texas, Florida — are setting records for the highest number of new daily cases since the pandemic began. Texas has just started to reimpose some lockdown restrictions. Many other states will likely be forced to do the same.
This spike in cases does not disprove the alternate theories reviewed in the previous email, which basically held that the virus would not spread at epidemic rates because population immunity had become 50% or more. Those theories could still be true and in the US the virus is spreading because their immunity level is under 50%.
These alternate theories used UK data to arrive at the conclusion that immunity in the UK could be more than 50%. The real test of these theories will be what happens in the UK. The UK is still in various stages of lockdown, but on July 4, pubs, bars and restaurants reopen. If people do not adhere to social distancing guidelines, there could be a spike in cases, as in the US, or there could be no spike if the theories about immunity in the UK are true.
Indications are that social distancing guidelines will not be followed very well, as seen in the rush to Bournemouth Beach last weekend. This is similar to scenes from California and Florida.
In the June 3 post, I expressed a strong opinion that the health authorities have bungled dealing with face masks and that they should be strongly recommended.
It turns out there are Open Letters to Dr. Tam (Chief Public Health Officer of Canada) and the top health officials in Albert, Ontario and Quebec recommending mandatory face masks under specific conditions. To date there are about 1400 people who have signed these letters, almost all are health practitioners and it looks like more than 50% are MD’s.
In epidemiology as in most sciences, there is a prevailing conventional view and then there are other unconventional views.
In North America we are currently following the conventional view based on the research done by Neil Ferguson and his group at the Imperial College London, which I have referenced several times. According to this view, various social restrictions must be imposed to prevent the epidemic spread of Covid-19, with a primary aim to flatten the curve so that the health care system is not overwhelmed. The interpretation of where we are now, according to this view, is that as many locations in the US and Canada are opening too early, there will be another series of outbreaks that could reach epidemic proportions and will require another period of lockdown.
However, in the UK, there is a lively public debate about a number of other views. For some reason, the British media thinks its audience is intelligent enough to follow these scientific theories, whereas here in the “colonies”, we hear very little about them.
Sunetra Gupta and her group at the University of Oxford published research in March around the same time that the Imperial College of London released its report. In their view Covid-19 was circulating for quite some time before it was recognized as a pandemic. In the process, the Oxford research showed that many people had acquired immunity through these early unrecognized cases. Gupta argued that in fact the level of immunity was high enough to slow down the spread of Covid-19 without the extreme social measures and lockdowns imposed in the UK and other countries, and that the Imperial College model was an overreaction at an extremely high cost. https://unherd.com/2020/05/oxford-doubles-down-sunetra-gupta-interview/
Another theory being proposed by distinguished scientists Michael Levitt and Karl Friston, is that not all people are susceptible to Covid-19 because some have resistance. This may be due to past immune responses to other coronaviruses like the common cold. There is evidence that as much as 50% of the population has some of this resistance to Covid-19 at the T-cell level in the immune system. This means that Covid-19 will not spread as rapidly as when 100% of the population is susceptible, a typical assumption made with new viruses. https://unherd.com/2020/06/karl-friston-up-to-80-not-even-susceptible-to-covid-19/
While the UK research focuses on the UK and Europe, the same principles would apply to North America, just the numbers might be different.In our Covid-19 model for Canada, setting an initial immunity of 50% results in a rapid decline in cases that does not match actual case counts. With an initial immunity of 30%, we get a much slower increase in cases than when initial immunity is 0%, so that reimposition of lockdown is not needed until Dec 2021 instead of Sep 2020.
So if these contrary theories have merit, we may not see large outbreaks of Covid-19 in the ensuing months. In spite of increasing cases in a number of US states this week, it is too early to conclude that there will be epidemic outbreaks leading to a second wave requiring another period of lockdown.
There have been a number of good articles about countries who have been very successful in controlling the Covid-19 pandemic. Can we can learn how to improve our response by looking at what they did?
One big reason for the success of countries such as South Korea, Taiwan, Vietnam, Japan and New Zealand has been that they responded very quickly when the virus was first reported. It is too late for us to incorporate those actions, but can we learn from this for the future?
Yes, but only if there is a commitment to funding improvements for epidemic preparedness in the public health infrastructure that are long-term. Unfortunately “expenses” like this are often subject to budget cuts in the future by short-sighted governments.
There are two important lessons we can learn as we move forward and relax our current unlock down restrictions. These detailed reports are particularly good at highlighting them.
A common factor in these reports, and in fact in all Asian countries, is that almost everyone wears a face mask. Masks have limitations, especially cotton cloth masks as compared to surgical masks, but they do reduce the spread of the virus. The CDC in the US and Dr. Tam in Canada have completely bungled the recommendation to wear masks. They wavered back and forth several times so many people really don’t know what the recommendation is.
But the “authorities” also badly bungled the message and repeatedly said that the reason for wearing a mask is to protect other people from being infected by you. Relying on the altruism of others for action is never the best strategy. In Asia they do not say this is the main reason for wearing a mask. Our health authorities should have said that you should wear a mask because it will protect you when you may not be not able to keep safe social distance, such as when you are in a grocery store and someone suddenly comes around an aisle and laughs or coughs in the direction of your face. The other reasons for wearing a mask should have been mentioned only after this.
On the positive side, I notice in Toronto that a lot more people are now wearing masks, in spite of this double bungle.
The second thing to learn from these success stories is that contact tracing is critical to prevent new outbreaks of the virus. This is usually stated in Canada and the US as conditions for “opening”. But what is actually being done about contact tracing? It’s not easy to find out.
These reports are probably representative of the rest of Canada and the US. We are way behind having this critical capability in place.
By contrast, in Japan, a large network of experienced public health nurses who were in place before the pandemic do the contact tracing. In South Korea they have a sophisticated system that is automated and gets results in 10 minutes.
In North America, as different jurisdictions build up contract tracing capability, expect to see some that hire entry level people at low wages with minimal training. In fact, in Canada, there is a program to recruit volunteers for contract tracers. I wonder what kind of background and training they will have? https://emploisfp-psjobs.cfp-psc.gc.ca/psrs-srfp/applicant/page1800?toggleLanguage=en&poster=1437722
A few months from now when virus outbreaks are happening, people will wonder why contract tracing doesn’t work here the way it does in many other countries where it has been very successful.
I’m sorry if a lot of this seems pessimistic. But when governments and health authorities are making poor decisions and are not being transparent on issues that are a matter of life and death for all of us, they need to be called out.
There is an overwhelming amount of virus information published by the media, from statistics and charts to personal stories and interviews, but comparatively little well researched critical articles by experts in the field (i.e. not journalists). For example, a lot of media reports/stats/charts have given me the impression that Canada has done fairly well compared to many other countries. Here is an opposing point of view from a scientist, “How Canada is mismanaging its most significant peacetime crisis in a century”. It has a very interesting perspective — the author is a professor in Epidemiology and Law. It is pretty scathing, hold onto your hats. https://www.macleans.ca/society/health/how-canada-has-bungled-the-covid-19-endgame/
American TV news are showing many examples of people coming out of social isolation and ignoring a lot of the social distancing measures that are still recommended. https://www.youtube.com/watch?v=gomUsLLqaag If this does not lead to a large increase in Covid-19 cases in the following weeks, every epidemiologist and infectious disease expert will be completely flummoxed.
Since there is a 14-day infection period, expect to see a big increase in cases in about three weeks. In fact, a projection by the US Federal Emergency Management Agency forecasts an increase from 25,000 cases today to about 200,000 new cases by the end of May. https://www.nytimes.com/2020/05/04/us/coronavirus-live-updates.html#link-582f66ac
So now that many provinces and states are relaxing the social distancing restrictions, which in the U.S. they like to call “opening up the economy”, there seem to be many different plans. It is not at all clear how this is being done. That’s because it is trial and error, with very little science.
Here’s the science. The Imperial College London published a study in which they measured the effect on the transmission rate of different social distancing policies (interventions). They measured the following interventions: – Self isolation – Social distancing – School closing – Public events – Lockdown
When all interventions are applied, the transmission rate is 0.8. A transmission rate less than 1 decreases the rate of the virus spreading, so this is why Lockdown has been successful in controlling outbreaks. But without Lockdown, the transmission rate of all the other interventions combined is 1.6, which will result in the virus spreading. https://www.imperial.ac.uk/mrc-global-infectious-disease-analysis/covid-19/report-13-europe-npi-impact/
As Lockdown is removed, it is critical to have contact tracing and testing to isolate new cases quickly before they can infect others. The model of how this has been done successfully is South Korea. Here is the best report I’ve seen on how South Korea did this. https://www.cbc.ca/player/play/1729976899648
Neither the U.S. nor Canada currently have enough trained people working as contact tracers or enough testing capacity to achieve the success of South Korea. If new cases cannot be isolated, the virus will start to spread. It will be necessary to re-introduce Lockdown to prevent the rapid epidemic spread of the virus. This pattern results in the multi-wave model where there are alternating periods of relaxed restrictions and Lockdown, repeating every 2 to 3 months. Here is a more detailed article based on a report published by a team of epidemiologists https://www.statnews.com/2020/05/01/three-potential-futures-for-covid-19/
Health authorities are hoping that if they do not relax too many restrictions they can keep the transmission rate low enough to avoid re-introducing Lockdown. It is pie in the sky to think that any state or province will be able to find a magic combination of interventions that will allow most major parts of the economy to resume without resulting in a transmission rate that is a lot more than 1 and closer to the Imperial College threshold of 1.6.
The prediction based on our model (and others) is that there will be a second wave in October and restrictions approaching Lockdown that will need to be reimposed. This may exclude school closing for grade schools but not high schools and universities, as has been done in other countries. Lockdown will be lifted in early December, just in time for Christmas shopping.
After that the next wave requiring Lockdown will start in March. However the government and health authorities won’t say anything about this until well into the new year.
Many states are proceeding to open their economies even though they do not have control of the current virus outbreak and cases are increasing. This means their cases and death rates will get even worse. I don’t think we should be surprised that many states are ignoring recommendations of health experts and authorities. The U.S. society is a much less caring society than the rest of the western countries. There are millions of Americans who do not have coverage for basic health care let alone any kind of medical emergency. The U.S. is the only western country that has such poor health care for its citizens. So it should be no surprise that so many states are ready to tolerate very high death rates from this pandemic. While the Government of Canada has a target to limit the total number of deaths from Covid-19 to be less than 5% of the population over the next 2 years, the U.S. has no such guidelines or targets. There are many states that will have a lot more deaths than this with their current policies.
