Tag Archives: COVID-19

Some amusements in the time of COVID-19

Gold stars for everyone who recognized the loose paraphrasing of the title, Love in the Time of Cholera, for Gabrial Garcia Marquez’s 1985 novel.

I wrote my headline and first paragraph yesterday and found this in my email box this morning, from a March 25, 2020 University of British Columbia news release, which compares times, diseases, and scares of the past with today’s COVID-19 (Perhaps politicians and others could read this piece and stop using the word ‘unprecedented’ when discussing COVID-19?),

How globalization stoked fear of disease during the Romantic era

In the late 18th and early 19th centuries, the word “communication” had several meanings. People used it to talk about both media and the spread of disease, as we do today, but also to describe transport—via carriages, canals and shipping.

Miranda Burgess, an associate professor in UBC’s English department, is working on a book called Romantic Transport that covers these forms of communication in the Romantic era and invites some interesting comparisons to what the world is going through today.

We spoke with her about the project.

What is your book about?

It’s about global infrastructure at the dawn of globalization—in particular the extension of ocean navigation through man-made inland waterways like canals and ship’s canals. These canals of the late 18th and early 19th century were like today’s airline routes, in that they brought together places that were formerly understood as far apart, and shrunk time because they made it faster to get from one place to another.

This book is about that history, about the fears that ordinary people felt in response to these modernizations, and about the way early 19th-century poets and novelists expressed and responded to those fears.

What connections did those writers make between transportation and disease?

In the 1810s, they don’t have germ theory yet, so there’s all kinds of speculation about how disease happens. Works of tropical medicine, which is rising as a discipline, liken the human body to the surface of the earth. They talk about nerves as canals that convey information from the surface to the depths, and the idea that somehow disease spreads along those pathways.

When the canals were being built, some writers opposed them on the grounds that they could bring “strangers” through the heart of the city, and that standing water would become a breeding ground for disease. Now we worry about people bringing disease on airplanes. It’s very similar to that.

What was the COVID-19 of that time?

Probably epidemic cholera [emphasis mine], from about the 1820s onward. The Quarterly Review, a journal that novelist Walter Scott was involved in editing, ran long articles that sought to trace the map of cholera along rivers from South Asia, to Southeast Asia, across Europe and finally to Britain. And in the way that its spread is described, many of the same fears that people are evincing now about COVID-19 were visible then, like the fear of clothes. Is it in your clothes? Do we have to burn our clothes? People were concerned.

What other comparisons can be drawn between those times and what is going on now?

Now we worry about the internet and “fake news.” In the 19th century, they worried about what William Wordsworth called “the rapid communication of intelligence,” which was the daily newspaper. Not everybody had access to newspapers, but each newspaper was read by multiple families and newspapers were available in taverns and coffee shops. So if you were male and literate, you had access to a newspaper, and quite a lot of women did, too.

Paper was made out of rags—discarded underwear. Because of the French Revolution and Napoleonic Wars that followed, France blockaded Britain’s coast and there was a desperate shortage of rags to make paper, which had formerly come from Europe. And so Britain started to import rags from the Caribbean that had been worn by enslaved people.

Papers of the time are full of descriptions of the high cost of rags, how they’re getting their rags from prisons, from prisoners’ underwear, and fear about the kinds of sweat and germs that would have been harboured in those rags—and also discussions of scarcity, as people stole and hoarded those rags. It rings very well with what the internet is telling us now about a bunch of things around COVID-19.

Plus ça change, n’est-ce pas?

And now for something completely different

Kudos to all who recognized the Monty Python reference. Now, onto the frogfish,

Thank you to the Monterey Bay Aquarium (in California, US).

A March 22, 2020 University of Washington (state) news release features an interview with the author of a new book on frogfishes,

Any old fish can swim. But what fish can walk, scoot, clamber over rocks, change color or pattern and even fight? That would be the frogfish.

The latest book by Ted Pietsch, UW professor emeritus of aquatic and fishery sciences, explores the lives and habits of these unusual marine shorefishes. “Frogfishes: Biodiversity, Zoogeography, and Behavioral Ecology” was published in March [2020] by Johns Hopkins University Press.

Pietsch, who is also curator emeritus of fishes at the Burke Museum of Natural History and Culture, has published over 200 articles and a dozen books on the biology and behavior of marine fishes. He wrote this book with Rachel J. Arnold, a faculty member at Northwest Indian College in Bellingham and its Salish Sea Research Center.

These walking fishes have stepped into the spotlight lately, with interest growing in recent decades. And though these predatory fishes “will almost certainly devour anything else that moves in a home aquarium,” Pietsch writes, “a cadre of frogfish aficionados around the world has grown within the dive community and among aquarists.” In fact, Pietsch said, there are three frogfish public groups on Facebook, with more than 6,000 members.

First, what is a frogfish?

Ted Pietsch: A member of a family of bony fishes, containing 52 species, all of which are highly camouflaged and whose feeding strategy consists of mimicking the immobile, inert, and benign appearance of a sponge or an algae-encrusted rock, while wiggling a highly conspicuous lure to attract prey.

This is a fish that “walks” and “hops” across the sea bottom, and clambers about over rocks and coral like a four-legged terrestrial animal but, at the same time, can jet-propel itself through open water. Some lay their eggs encapsulated in a complex, floating, mucus mass, called an “egg raft,” while some employ elaborate forms of parental care, carrying their eggs around until they hatch.

They are among the most colorful of nature’s productions, existing in nearly every imaginable color and color pattern, with an ability to completely alter their color and pattern in a matter of days or seconds. All these attributes combined make them one of the most intriguing groups of aquatic vertebrates for the aquarist, diver, and underwater photographer as well as the professional zoologist.

I couldn’t resist the ‘frog’ reference and I’m glad since this is a good read with a number of fascinating photographs and illustrations.,

An illustration of the frogfish Antennarius pictus, published by George Shaw in 1794. From a new book by Ted Pietsch, UW professor of emeritus of aquatic and fishery sciences. Courtesy: University of Washington (state)

h/t phys.org March 24, 2020 news item

Building with bacteria

A block of sand particles held together by living cells. Credit: The University of Colorado Boulder College of Engineering and Applied Science

A March 24, 2020 news item on phys.org features the future of building construction as perceived by synthetic biologists,

Buildings are not unlike a human body. They have bones and skin; they breathe. Electrified, they consume energy, regulate temperature and generate waste. Buildings are organisms—albeit inanimate ones.

But what if buildings—walls, roofs, floors, windows—were actually alive—grown, maintained and healed by living materials? Imagine architects using genetic tools that encode the architecture of a building right into the DNA of organisms, which then grow buildings that self-repair, interact with their inhabitants and adapt to the environment.

A March 23, 2020 essay by Wil Srubar (Professor of Architectural Engineering and Materials Science, University of Colorado Boulder), which originated the news item, provides more insight,

Living architecture is moving from the realm of science fiction into the laboratory as interdisciplinary teams of researchers turn living cells into microscopic factories. At the University of Colorado Boulder, I lead the Living Materials Laboratory. Together with collaborators in biochemistry, microbiology, materials science and structural engineering, we use synthetic biology toolkits to engineer bacteria to create useful minerals and polymers and form them into living building blocks that could, one day, bring buildings to life.

In one study published in Scientific Reports, my colleagues and I genetically programmed E. coli to create limestone particles with different shapes, sizes, stiffnesses and toughness. In another study, we showed that E. coli can be genetically programmed to produce styrene – the chemical used to make polystyrene foam, commonly known as Styrofoam.

Green cells for green building

In our most recent work, published in Matter, we used photosynthetic cyanobacteria to help us grow a structural building material – and we kept it alive. Similar to algae, cyanobacteria are green microorganisms found throughout the environment but best known for growing on the walls in your fish tank. Instead of emitting CO2, cyanobacteria use CO2 and sunlight to grow and, in the right conditions, create a biocement, which we used to help us bind sand particles together to make a living brick.

By keeping the cyanobacteria alive, we were able to manufacture building materials exponentially. We took one living brick, split it in half and grew two full bricks from the halves. The two full bricks grew into four, and four grew into eight. Instead of creating one brick at a time, we harnessed the exponential growth of bacteria to grow many bricks at once – demonstrating a brand new method of manufacturing materials.

Researchers have only scratched the surface of the potential of engineered living materials. Other organisms could impart other living functions to material building blocks. For example, different bacteria could produce materials that heal themselves, sense and respond to external stimuli like pressure and temperature, or even light up. If nature can do it, living materials can be engineered to do it, too.

It also take less energy to produce living buildings than standard ones. Making and transporting today’s building materials uses a lot of energy and emits a lot of CO2. For example, limestone is burned to make cement for concrete. Metals and sand are mined and melted to make steel and glass. The manufacture, transport and assembly of building materials account for 11% of global CO2 emissions. Cement production alone accounts for 8%. In contrast, some living materials, like our cyanobacteria bricks, could actually sequester CO2.

The field of engineered living materials is in its infancy, and further research and development is needed to bridge the gap between laboratory research and commercial availability. Challenges include cost, testing, certification and scaling up production. Consumer acceptance is another issue. For example, the construction industry has a negative perception of living organisms. Think mold, mildew, spiders, ants and termites. We’re hoping to shift that perception. Researchers working on living materials also need to address concerns about safety and biocontamination.

The [US] National Science Foundation recently named engineered living materials one of the country’s key research priorities. Synthetic biology and engineered living materials will play a critical role in tackling the challenges humans will face in the 2020s and beyond: climate change, disaster resilience, aging and overburdened infrastructure, and space exploration.

If you have time and interest, this is fascinating. Strubar is a little exuberant and, at this point, I welcome it.

Fitness

The Lithuanians are here for us. Scientists from the Kaunas University of Technology have just published a paper on better exercises for lower back pain in our increasingly sedentary times, from a March 23, 2020 Kaunas University of Technology press release (also on EurekAlert) Note: There are a few minor grammatical issues,

With the significant part of the global population forced to work from home, the occurrence of lower back pain may increase. Lithuanian scientists have devised a spinal stabilisation exercise programme for managing lower back pain for people who perform a sedentary job. After testing the programme with 70 volunteers, the researchers have found that the exercises are not only efficient in diminishing the non-specific lower back pain, but their effect lasts 3 times longer than that of a usual muscle strengthening exercise programme.

According to the World Health Organisation, lower back pain is among the top 10 diseases and injuries that are decreasing the quality of life across the global population. It is estimated that non-specific low back pain is experienced by 60% to 70% of people in industrialised societies. Moreover, it is the leading cause of activity limitation and work absence throughout much of the world. For example, in the United Kingdom, low back pain causes more than 100 million workdays lost per year, in the United States – an estimated 149 million.

Chronic lower back pain, which starts from long-term irritation or nerve injury affects the emotions of the afflicted. Anxiety, bad mood and even depression, also the malfunctioning of the other bodily systems – nausea, tachycardia, elevated arterial blood pressure – are among the conditions, which may be caused by lower back pain.

During the coronavirus disease (COVID-19) outbreak, with a significant part of the global population working from home and not always having a properly designed office space, the occurrence of lower back pain may increase.

“Lower back pain is reaching epidemic proportions. Although it is usually clear what is causing the pain and its chronic nature, people tend to ignore these circumstances and are not willing to change their lifestyle. Lower back pain usually comes away itself, however, the chances of the recurring pain are very high”, says Dr Irina Klizienė, a researcher at Kaunas University of Technology (KTU) Faculty of Social Sciences, Humanities and Arts.

Dr Klizienė, together with colleagues from KTU and from Lithuanian Sports University has designed a set of stabilisation exercises aimed at strengthening the muscles which support the spine at the lower back, i.e. lumbar area. The exercise programme is based on Pilates methodology.

According to Dr Klizienė, the stability of lumbar segments is an essential element of body biomechanics. Previous research evidence shows that in order to avoid the lower back pain it is crucial to strengthen the deep muscles, which are stabilising the lumbar area of the spine. One of these muscles is multifidus muscle.

“Human central nervous system is using several strategies, such as preparing for keeping the posture, preliminary adjustment to the posture, correcting the mistakes of the posture, which need to be rectified by specific stabilising exercises. Our aim was to design a set of exercises for this purpose”, explains Dr Klizienė.

The programme, designed by Dr Klizienė and her colleagues is comprised of static and dynamic exercises, which train the muscle strength and endurance. The static positions are to be held from 6 to 20 seconds; each exercise to be repeated 8 to 16 times.

Caption: The static positions are to be held from 6 to 20 seconds; each exercise to be repeated 8 to 16 times. Credit: KTU

The previous set is a little puzzling but perhaps you’ll find these ones below easier to follow,

Caption: The exercises are aimed at strengthening the muscles which support the spine at the lower back. Credit: KTU

I think more pictures of intervening moves would have been useful. Now. getting back to the press release,

In order to check the efficiency of the programme, 70 female volunteers were randomly enrolled either to the lumbar stabilisation exercise programme or to a usual muscle strengthening exercise programme. Both groups were exercising twice a week for 45 minutes for 20 weeks. During the experiment, ultrasound scanning of the muscles was carried out.

As soon as 4 weeks in lumbar stabilisation programme, it was observed that the cross-section area of the multifidus muscle of the subjects of the stabilisation group has increased; after completing the programme, this increase was statistically significant (p < 0,05). This change was not observed in the strengthening group.

Moreover, although both sets of exercises were efficient in eliminating lower back pain and strengthening the muscles of the lower back area, the effect of stabilisation exercises lasted 3 times longer – 12 weeks after the completion of the stabilisation programme against 4 weeks after the completion of the muscle strengthening programme.

“There are only a handful of studies, which have directly compared the efficiency of stabilisation exercises against other exercises in eliminating lower back pain”, says Dr Klizienė, “however, there are studies proving that after a year, lower back pain returned only to 30% of people who have completed a stabilisation exercise programme, and to 84% of people who haven’t taken these exercises. After three years these proportions are 35% and 75%.”

According to her, research shows that the spine stabilisation exercises are more efficient than medical intervention or usual physical activities in curing the lower back pain and avoiding the recurrence of the symptoms in the future.

Here’s a link to and a citation for the paper,

Effect of different exercise programs on non-specific chronic low back pain and disability in people who perform sedentary work by Saule Sipavicienea, Irina Klizieneb. Clinical Biomechanics March 2020 Volume 73, Pages 17–27 DOI: https://doi.org/10.1016/j.clinbiomech.2019.12.028

This paper is behind a paywall.

COVID-19: caution and concern not panic

There’s a lot of information being pumped out about COVID-19 and not all of it is as helpful as it might be. In fact, the sheer volume can seem overwhelming despite one’s best efforts to be calm.

Here are a few things I’ve used to help relieve some fo the pressure as numbers in Canada keep rising.

Inspiration from the Italians

I was thrilled to find Emily Rumball’s March 18 ,2020 article titled, “Italians making the most of quarantine is just what the world needs right now (VIDEOS),” on the Daily Hive website. The couple dancing on the balcony while Ginger Rogers and Fred Astaire are shown dancing on the wall above is my favourite.

As the Italians practice social distancing and exercise caution, they are also demonstrating that “life goes on” even while struggling as one of the countries hit hardest by COVID-19.

Investigating viruses and the 1918/19 pandemic vs. COVID-19

There has been some mention of and comparison to the 1918/19 pandemic (also known as the Spanish flu) in articles by people who don’t seem to be particularly well informed about that earlier pandemic. Susan Baxter offers a concise and scathing explanation for why the 1918/19 situation deteriorated as much as it did in her February 8, 2010 posting. As for this latest pandemic (COVID-19), she explains what a virus actually is and suggests we all calm down in her March 17, 2020 posting. BTW, she has an interdisciplinary PhD for work largely focused on health economics. She is also a lecturer in the health sciences programme at Simon Fraser University (Vancouver, Canada). Full disclosure: She and I have a longstanding friendship.

Marilyn J. Roossinck, a professor of Plant Pathology and Environmental Microbiology at Pennsylvania State University, wrote a February 20, 2020 essay for The Conversation titled, “What are viruses anyway, and why do they make us so sick? 5 questions answered,”

4. SARS was a formidable foe, and then seemed to disappear. Why?

Measures to contain SARS started early, and they were very successful. The key is to stop the chain of transmission by isolating infected individuals. SARS had a short incubation period; people generally showed symptoms in two to seven days. There were no documented cases of anyone being a source of SARS without showing symptoms.

Stopping the chain of transmission is much more difficult when the incubation time is much longer, or when some people don’t get symptoms at all. This may be the case with the virus causing CoVID-19, so stopping it may take more time.

1918/19 pandemic vs. COVID-19

Angela Betsaida B. Laguipo, with a Bachelor of Nursing degree from the University of Baguio, Philippine is currently completing her Master’s Degree, has written a March 9, 2020 article for News Medical comparing the two pandemics,

The COVID-19 is fast spreading because traveling is an everyday necessity today, with flights from one country to another accessible to most.

Some places did manage to keep the virus at bay in 1918 with traditional and effective methods, such as closing schools, banning public gatherings, and locking down villages, which has been performed in Wuhan City, in Hubei province, China, where the coronavirus outbreak started. The same method is now being implemented in Northern Italy, where COVID-19 had killed more than 400 people.

The 1918 Spanish flu has a higher mortality rate of an estimated 10 to 20 percent, compared to 2 to 3 percent in COVID-19. The global mortality rate of the Spanish flu is unknown since many cases were not reported back then. About 500 million people or one-third of the world’s population contracted the disease, while the number of deaths was estimated to be up to 50 million.

During that time, public funds are mostly diverted to military efforts, and a public health system was still a budding priority in most countries. In most places, only the middle class or the wealthy could afford to visit a doctor. Hence, the virus has [sic] killed many people in poor urban areas where there are poor nutrition and sanitation. Many people during that time had underlying health conditions, and they can’t afford to receive health services.

I recommend reading Laguipo’s article in its entirety right down to the sources she cites at the end of her article.

Ed Yong’s March 20, 2020 article for The Atlantic, “Why the Coronavirus Has Been So Successful; We’ve known about SARS-CoV-2 for only three months, but scientists can make some educated guesses about where it came from and why it’s behaving in such an extreme way,” provides more information about what is currently know about the coronavirus, SATS-CoV-2,

One of the few mercies during this crisis is that, by their nature, individual coronaviruses are easily destroyed. Each virus particle consists of a small set of genes, enclosed by a sphere of fatty lipid molecules, and because lipid shells are easily torn apart by soap, 20 seconds of thorough hand-washing can take one down. Lipid shells are also vulnerable to the elements; a recent study shows that the new coronavirus, SARS-CoV-2, survives for no more than a day on cardboard, and about two to three days on steel and plastic. These viruses don’t endure in the world. They need bodies.

But why do some people with COVID-19 get incredibly sick, while others escape with mild or nonexistent symptoms? Age is a factor. Elderly people are at risk of more severe infections possibly because their immune system can’t mount an effective initial defense, while children are less affected because their immune system is less likely to progress to a cytokine storm. But other factors—a person’s genes, the vagaries of their immune system, the amount of virus they’re exposed to, the other microbes in their bodies—might play a role too. In general, “it’s a mystery why some people have mild disease, even within the same age group,” Iwasaki [Akiko Iwasaki of the Yale School of Medicine] says.

We still have a lot to learn about this.

Going nuts and finding balance with numbers

Generally speaking,. I find numbers help me to put this situation into perspective. It seems I’m not alone; Dr. Daniel Gillis’ (Guelph University in Ontario, Canada) March 18, 2020 blog post is titled, Statistics In A Time of Crisis.

Hearkening back in history, the Wikipedia entry for Spanish flu offers a low of 17M deaths in a 2018 estimate to a high of !00M deaths in a 2005 estimate. At this writing (Friday, March 20, 2020 at 3 pm PT), the number of coronovirus cases worldwide is 272,820 with 11, 313 deaths.

Articles like Michael Schulman’s March 16, 2020 article for the New Yorker might not be as helpful as one hope (Note: Links have been removed),

Last Wednesday night [March 11, 2020], not long after President Trump’s Oval Office address, I called my mother to check in about the, you know, unprecedented global health crisis [emphasis mine] that’s happening. She told me that she and my father were in a cab on the way home from a fun dinner at the Polo Bar, in midtown Manhattan, with another couple who were old friends.

“You went to a restaurant?!” I shrieked. This was several days after she had told me, through sniffles, that she was recovering from a cold but didn’t see any reason that she shouldn’t go to the school where she works. Also, she was still hoping to make a trip to Florida at the end of the month. My dad, a lawyer, was planning to go into the office on Thursday, but thought that he might work from home on Friday, if he could figure out how to link up his personal computer. …

… I’m thirty-eight, and my mother and father are sixty-eight and seventy-four, respectively. Neither is retired, and both are in good shape. But people sixty-five and older—more than half of the baby-boomer population—are more susceptible to COVID-19 and have a higher mortality rate, and my parents’ blithe behavior was as unsettling as the frantic warnings coming from hospitals in Italy.

Clearly, Schulman is concerned about his parents’ health and well being but the tone of near hysteria is a bit off-putting. We’re not in a crisis (exception: the Italians and, possibly, the Spanish and the French)—yet.

Tyler Dawson’s March 20, 2020 article in The Province newspaper (in Vancouver, British Columbia) offers dire consequences from COVID-19 before pivoting,

COVID-19 will leave no Canadian untouched.

Travel plans halted. First dates postponed. School semesters interrupted. Jobs lost. Retirement savings decimated. Some of us will know someone who has gotten sick, or tragically, died from the virus.

By now we know the terminology: social distancing, flatten the curve. Across the country, each province is taking measures to prepare, to plan for care, and the federal government has introduced financial measures amounting to more than three per cent of the country’s GDP to float the economy onward.

The response, says Steven Taylor, a University of British Columbia psychiatry professor and author of The Psychology of Pandemics, is a “balancing act.” [emphasis mine] Keep people alert, but neither panicked nor tuned out.

“You need to generate some degree of anxiety that gets people’s attention,” says Taylor. “If you overstate the message it could backfire.”

Prepare for uncertainty

In the same way experts still cannot come up with a definitive death rate for the 1918/19 pandemic, they are having trouble with this one too although, now, they’re trying to model the future rather than trying to establish what happened in the past. David Adam’s March 12, 2020 article forThe Scientist, provides some insight into the difficulties (Note: Links have been removed)

Like any other models, the projections of how the outbreak will unfold, how many people will become infected, and how many will die, are only as reliable as the scientific information they rest on. And most modelers’ efforts so far have focused on improving these data, rather than making premature predictions.

“Most of the work that modelers have done recently or in the first part of the epidemic hasn’t really been coming up with models and predictions, which is I think how most people think of it,” says John Edmunds, who works in the Centre for the Mathematical Modelling of Infectious Diseases at the London School of Hygiene & Tropical Medicine. “Most of the work has really been around characterizing the epidemiology, trying to estimate key parameters. I don’t really class that as modeling but it tends to be the modelers that do it.”

These variables include key numbers such as the disease incubation period, how quickly the virus spreads through the population, and, perhaps most contentiously, the case-fatality ratio. This sounds simple: it’s the proportion of infected people who die. But working it out is much trickier than it looks. “The non-specialists do this all the time and they always get it wrong,” Edmunds says. “If you just divide the total numbers of deaths by the total numbers of cases, you’re going to get the wrong answer.”

Earlier this month, Tedros Adhanom Ghebreyesus, the head of the World Health Organization, dismayed disease modelers when he said COVID-19 (the disease caused by the SARS-CoV-2 coronavirus) had killed 3.4 percent of reported cases, and that this was more severe than seasonal flu, which has a death rate of around 0.1 percent. Such a simple calculation does not account for the two to three weeks it usually takes someone who catches the virus to die, for example. And it assumes that reported cases are an accurate reflection of how many people are infected, when the true number will be much higher and the true mortality rate much lower.

Edmunds calls this kind of work “outbreak analytics” rather than true modeling, and he says the results of various specialist groups around the world are starting to converge on COVID-19’s true case-fatality ratio, which seems to be about 1 percent.[emphasis mine]

The 1% estimate in Adam’s article accords with Jeremy Samuel Faust’s (an emergency medicine physician at Brigham and Women’s Hospital in Boston, faculty in its division of health policy and public health, and an instructor at Harvard Medical School) estimates in a March 4, 2020 article (COVID-19 Isn’t As Deadly As We Think featured in my March 9, 2020 posting).

In a March 17, 2020 article by Steven Lewis (a health policy consultant formerly based in Saskatchewan, Canada; now living in Australia) for the Canadian Broadcasting Corporation’s (CBC) news online website, he covers some of the same ground and offers a somewhat higher projected death rate while refusing to commit,

Imagine you’re a chief public health officer and you’re asked the question on everyone’s mind: how deadly is the COVID-19 outbreak?

With the number of cases worldwide approaching 200,000, and 1,000 or more cases in 15 countries, you’d think there would be an answer. But the more data we see, the tougher it is to come up with a hard number.

Overall, the death rate is around four per cent — of reported cases. That’s also the death rate in China, which to date accounts for just under half the total number of global cases.

China is the only country where a) the outcome of almost all cases is known (85 per cent have recovered), and b) the spread has been stopped (numbers plateaued about a month ago). 

A four per cent death rate is pretty high — about 40 times more deadly than seasonal flu — but no experts believe that is the death rate. The latest estimate is that it is around 1.5 per cent. [emphasis mine] Other models suggest that it may be somewhat lower. 

The true rate can be known only if every case is known and confirmed by testing — including the asymptomatic or relatively benign cases, which comprise 80 per cent or more of the total — and all cases have run their course (people have either recovered or died). Aside from those in China, almost all cases identified are still active. 

Unless a jurisdiction systematically tests a large random sample of its population, we may never know the true rate of infection or the real death rate. 

Yet for all this unavoidable uncertainty, it is still odd that the rates vary so widely by country.

His description of the situation in Europe is quite interesting and worthwhile if you have the time to read it.

In the last article I’m including here, Murray Brewster offers some encouraging words in his March 20, 2020 piece about the preparations being made by the Canadian Armed Forces (CAF),

The Canadian military is preparing to respond to multiple waves of the COVID-19 pandemic which could stretch out over a year or more, the country’s top military commander said in his latest planning directive.

Gen. Jonathan Vance, chief of the defence staff, warned in a memo issued Thursday that requests for assistance can be expected “from all echelons of government and the private sector and they will likely come to the Department [of National Defence] through multiple points of entry.”

The directive notes the federal government has not yet directed the military to move into response mode, but if or when it does, a single government panel — likely a deputy-minister level inter-departmental task force — will “triage requests and co-ordinate federal responses.”

It also warns that members of the military will contract the novel coronavirus, “potentially threatening the integrity” of some units.

The notion that the virus caseload could recede and then return is a feature of federal government planning.

The Public Health Agency of Canada has put out a notice looking for people to staff its Centre for Emergency Preparedness and Response during the crisis and the secondment is expected to last between 12 and 24 months.

The Canadian military, unlike those in some other nations, has high-readiness units available. Vance said they are already set to reach out into communities to help when called.

Planners are also looking in more detail at possible missions — such as aiding remote communities in the Arctic where an outbreak could cripple critical infrastructure.

Defence analyst Dave Perry said this kind of military planning exercise is enormously challenging and complicated in normal times, let alone when most of the federal civil service has been sent home.

“The idea that they’re planning to be at this for year is absolutely bang on,” said Perry, a vice-president at the Canadian Global Affairs Institute.

In other words, concern and caution are called for not panic. I realize this post has a strongly Canada-centric focus but I’m hopeful others elsewhere will find this helpful.