I think the reality is that while people social distancing has greatly reduced the number of interactions between people, it hasn’t completely eliminated them, and as such any outbreaks will take some amount of time to die down. The outbreaks that occurred in the meat processing plants surely led to some amount of community-level spread. Since it’s been a couple weeks now since the start of the Cargill outbreak hopefully we’ll start to see a decline in new cases since measures taken since then should start to manifest in infection rates.
Here is a paper that suggest that the results are inconclusive, and that ACE inhibitors could have both beneficial and risk-enhancing effects.
This topic interests me because I’m on daily doses of both Plavix (clopidogrel – technically an ACE inhibitor but used as a blood thinner, along with low-dose aspirin) and a different medication entirely that is specifically for controlling blood pressure, all as a result of a cardiac episode a few years ago. Since one of the potentially deadly side effects of COVID is blood clotting, I had been thinking that it actually offered a benefit. The money quote is this: “Professional societies have navigated this uncertainty by recommending that patients receiving ACE inhibitors and ARBs should continue taking them. For example, a statement from the American College of Cardiology and American Heart Association (ACC/AHA) notes that “there are no experimental or clinical data demonstrating beneficial or adverse outcomes with background use of ACE inhibitors [or] ARBs.”3 The statement recommends continuing these drugs if they are being prescribed for valid cardiovascular indications and advises clinicians not to add or remove them “beyond actions based on standard clinical practice.”
There’s also this:
Initial data from one Chinese center on the use of angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) in patients hospitalized with COVID-19 appear to give some further reassurance about continued use of these drugs.
The report from one hospital in Wuhan found that among patients with hypertension hospitalized with the COVID-19 virus, there was no difference in disease severity or death rate in patients taking ACE inhibitors or ARBs and those not taking such medications.
The data were published online April 23 in JAMA Cardiology.
The study adds to another recent report in a larger number of COVID-19 patients from nine Chinese hospitals that suggested a beneficial effect of ACE inhibitors or ARBs on mortality.
If I wanted to play doctor (I don’t) I could switch from Plavix to Brilinta, which is not an ACE inhibitor. I have a large supply of left-over Brilinta from when my cardiologist switched me to Plavix. According to what I thought was in the cited paper but it must have been in some other paper I was recently looking at, Brilinta is a more powerful anti-platelet aggregator than Plavix, but his view is that although it’s excellent for the first year for patients receiving stents (he prescribed it when I left the hospital), there are too many risks of side effects from long-term use.
I think the moral of the story is that medicine and medical research is complicated to the point of pushing the limits of human understanding, and no one should jump to simplistic conclusions about any of it. Except for my own research conclusions that I announced in another thread, that regular daily doses of wine and rum have been 100% successful in keeping the virus away! 
Triple bad news from Fort McMurray, an oil-producing town in Alberta:
- Total collapse in oil prices, job losses, huge hit on the economy
- COVID-19
- And now, major flooding and loss of homes.
In 2016, Fort McMurray was also the population epicenter of a major forest fire that was described as the costliest disaster in Canadian history. I recall a nation-wide funding drive for the victims who had lost their homes in that one.
Yes, flooding on top of everything else. How do you social distance in a flood? It is bad news.
Most of Alberta is opening some businesses in phase one today. The two exclusions are Calgary and Brooks which I am fine with. We will wait another two weeks, based on the data. Calgary and Brooks have 75% or so of the cases in Alberta and are still getting new cases. Other parts of the provinces have almost no new cases, and the openings make sense. One of the businesses being opened is hair salons, and my wife had an appointment for today until Calgary got excluded. I could really use a haircut.
Restaurants are another business being opened with restrictions. If I lived in a city with almost no cases like Red Deer, I might consider going to a restaurant. I would have not gone to a restaurant in Calgary whether it was open or not. The one exception I might consider is a patio, if there is plenty of distance from other tables.
Alberta is following the data, so I am fairly confident we will not see a spike in cases. With recoveries, there are currently 1,100 or so active cases in Alberta.
How is re-opening where you live?
I am resigned to just waiting to catch it while I go about life trying not to.
I realize things have to open up before an effective vaccine is created, if ever. I am in the age and bad habits group that it will likely be very bad or fatal for me. My best hope in the shorter term is an effective treatment regime that lowers the fatality rate for my group. Kills the virus, even if I am not left with antibodies. Or keeps O2 in me till I can make the antibodies.
But that is just the way it is. We regularly do things that carry a certain amount of risk. We try and minimize the risk. Going forward with this, we need to minimize the risk to certain groups. That can be done quite well, because a lot of those folks are already in controlled environments. Health care, elder care. I am still working. Luckily I can control my immediate environment at work quite well.
Out and about things will continue to be risky. When things really open up a lot, I will still be wearing a mask. I have trained myself well to NOT TOUCH MY FACE! Sanitize, wash hands, don’t share stuff unless it is sanitized.
The opening is a balancing act of acceptable daily death tolls versus necessity of living life. It seems to me that a vaccine is far off, if at all. Herd immunity will sort of happen. The thing mutates, so immunity may be as fleeting as yearly flu. I realize that I may just be roadkill on the road to herd immunity for this round of it.
Such is life. And death.
Ontario has announced Phase 1 of Stage 2. Most non-malls stores can reopen as of Tuesday with extreme care and distancing in place. This included golf and racquet sports, but not indooor gyms. Doctors can reopen, personal care (spa, manicure, hair) is still on hold.
I’m working on our office reopening plan, currently everyone is working from home. I don’t expect to be back in the office before fall.
The sequestering thing wasn’t necessarily intended to prevent infections or deaths. The intention was to ensure that we didn’t overwhelm the health care system. The powers that be, in your country, state, or province are thinking that we can now slowly creep out of this without inundating the health care system.
Is this true? I don’t know, but at some point we need to start opening doors. Yes, people will continue to die. But are we now capable of dealing with that.
Bon chance, mes amies.
I agree with what you are saying, but it seems that with enough testing and contact tracing, the new infection rate (and thus deaths) can be held way down, close to a flat line on a graph. Time will tell.
Perhaps most of us will eventually get the coronavirus, just like most of us have had the flu. But I would choose to remain virus free until there is a much better understanding of it, and more treatments availalbe to mitigate the worst affects.
I listened to Cuomo speak today and he talks of the infection rate for coronavirus. He said you want a number of less than 1, and start to get into trouble about 1.1. That is what he is monitoring as their state re-opens.
Is anyone else using this metric? I know we were talking of initial infections rates of 2 to 4, and then you have exponential growth. Are there current infection rates stated for the provinces or Canada?
I was looking at the Alberta and Calgary infections - where most of the infections are. It shows that most infections are from a known exposure, but why are people getting infected from a known exposure two months into isolation?
The government still has no contact tracing plan, and very limited testing. I guess they don’t care.
We should be able to control this without testing and contact tracing, by counting new cases and extrapolating outwards on the best exponential curve estimate we have.
Take Alberta. Let’s start with the worst-case, snd use Calgary’s numbers. On April 12, Calgary had 1000 cases. By April 26, Calgary had 3,000. We never came close to overwhelming the health care system here. In fact, our ICU bed use never went over 10% of capacity.
So if we say that we can tolerate maybe 20,000 infections before we risk overwhelming the health care system (leaving a conservative margin), and if we assume that the new cases we see today represent 1/3 of cases we’ll see in two weeks, we should be able to open, but if infections hit 7,000 we lock down again. To be even more conservative, let’s make it half that number.
We have 807 active infections in Alberta right now. So we start opening up, but if infections hit 3500 we lock down again until active infections drop back to 1,000. Rinse and repeat. Each time, it shoild take longer to get back to 3500, as more and more of the population has the antibodies.
Adjust these numbers as we gain more experience. Maybe they are too conservative, or not conservative enough, But we should be able to manage re-opening without overwhelming the health care system even without testing.
Contact tracing would allow us to manage re-opening better and control outbreaks better, giving us better odds of not having to close down again. But it shouldn’t be necessary.
Trudeau decides to address the nation in a face mask. He chooses black. Black face mask. Guy really can’t help himself.
572 active cases in Alberta today, 216 active cases in the Calgary zone. 57 new cases.
I thought we might be able to get these numbers down a bit more. I think our best day has been 7 new cases. The other day it was 70 new cases, so fairly low numbers, but definitely still there is a huge threat that could quickly explode. I noticed some areas like Edmonton have had spikes in cases, again just showing that we have to keep up the effort to be safe. The park beside me had re-opened, but now it is closed again.
The reason I posted now is the youtube video above. It is obvious that the US is in real trouble with coronavirus, if they won’t or are not able to get control, maybe there only hope is a vaccine.
I was wondering why US commenters kept talking about how Asian and European countries were doing compared to the US, but were never mentioning Canada. So here we got our shout out.
Be safe.
The Atlantic bubble opened today. New Brunswick with 2 active cases (from an outbreak in the north of the province that resulted in 30 or 40 cases from one oops event), Nova Scotia with 3 active cases, I think. No active cases in PEI or NL.
We are taking a trip to NS this weekend to visit friends. I figure this is probably the safest time. Soon the mixing and cottagers coming from other areas of the country are bound to create some hot spots.
The trip sounds reasonable. We plan to drive to Saskatoon and Winnipeg which both have lower cases than we do. We have some family obligations. We will get a covid test before we go.
My city passed a mask law that takes effect on Monday. Most people are delighted. I, on the other hand, am asking why it took so goddamn long.
Most people are delighted? Where do you live? I saw grudging acceptance mostly. I wondered why we bothered when Ontario had gotten the cases so low already without masks. But I guess local health officials got a quiet heads up that the province was going to Stage 3 opening this week and wanted to be proactive. Which I grudgingly accept. Lol.
Ontario managed to get the cases so low by isolation. To maintain that, masks in public places are needed. I don’t see the confusion and like RickJay, wondered why this was taking so long to implement.
What confusion? We’ve had lots of stuff open for awhile and we didn’t see a rise in cases so clearly “we needed masks to maintain that” isn’t really true. Stage 3, maybe true.