Dearest Drew Dilkens, consider this an open letter, from me to you. I truly hope you read it and take it under consideration. I’m not expecting a reply, all I ask for is 10 minutes of your time.
I’m going to keep this as civil as I possibly can, but you and I need to have a little public chat regarding the situation we’re currently facing. To say that you’ve done an absolutely piss-poor job of keeping the public informed in regards to this would be an understatement, and that needs to change TODAY. The timing of this letter is ABSOLUTELY intentional. If it makes you hate me, then so be it, and for that I am sorry. However I’m not about to sit idly by like a deer in headlights and risk giving you an easy out from making quite possibly the most important decision of your life, that will have a direct impact on the future of this joint and all of its people.
I assure you, the last thing I want to do is to incite panic. Undeserved panic does no one any good. But neither does ill-informed complacency. It’s wrong to assuage the public by saying “only 2% will die.” Death’s should not be brushed off. Losing one of our elders is a travesty, losing people with pre existing conditions is a travesty. People aren’t adequately grasping the national and global systemic burden wrought by this swift-moving of a disease. Nothing in the last 6 weeks has dampened my alarm in the slightest in regards to how the general public will respond to this, and that is the direct result of a complete lack of adequate community outreach. To the contrary, we’re seeing abject refusal of many countries and our literal neighbors to adequately respond or prepare. Of course some of these estimates will be wrong, even substantially wrong. But I have no reason to think they’ll be orders-of-magnitude wrong. Even if your personal risk of death is very, very low, don’t mock decisions like canceling events or closing workplaces as undue “panic”. These measures are the bare minimum we should be doing to try to shift the peak – to slow the rise in cases so that healthcare systems are less overwhelmed. Each day that we can delay an extra case is a big win for the HC system.
We need to keep our frontline workers adequately equipped, that’s the most important thing. I have no idea what you’ve personally done, but I’ve purchased and handed out full face respirators and masks to frontline workers on my own dime. I’ve attempted to inform the public of the seriousness of this since January. I’ve gone as far as making my own android app that displays statistics and should theoretically warn people if they’re in proximity of reported cases[as long as our reporting is on par with Italy’s], I’ve began making my own Canada-focused dashboard available at www.benh.ca, I’ve even began making a semi edgy site to convey the general public information regarding this since I’ve seen a completely inadequate response to outreach from you and your constituents. That site is available at www.staythefuckhome.ca , it’s a very rough draft and nowhere near complete but, it should convey what I’m trying to get across. Apologies for the curse word but it is what it is, and I am who I am. I may be a brute, but I only have the absolute best interests of this community at heart with everything that I do. Hell, I’ve even created and trained my own tensor-flow kernel from pneumonia/covid19 entirely from scratch based on ct scans that’s been delivering somewhat reliable results in classifying Covid19 pneumonia from regular pneumonia scans in ~3 seconds, compared to the 20-40 minutes of processing time that Italy and SK has been reporting just to do everything I possibly can to help the healthcare system out. Call me crazy, I’ll wear it, but I prefer to think of it as dedication. I won’t even get into my ventilator shenanigans. With that, I ask… what have you done?
First, it’s going to hit here and it’s going to be relentless. The most important thing that needs to be done is to FLATTEN THE CURVE, staggered the infections as much as possible, and make SURE that people understand to self quarantine at home, make them aware of what to expect while getting through it, and when to contact the health unit if they develop severe symptoms. Because I can ABSOLUTELY GUARANTEE YOU, a HUGE percentage of your city’s population do not, and that’s on you to fix. I’ve tried, but the amount of ignorance and people simply pretending nothing bad is going to happen here is absolutely staggering. We are SO well prepared to take this on, from local to federal level, it’s on YOU to make the call at the right time, and proactively deal with this. Re-actively attempting to bandage things will just end with tears.
Second, this is not “a bad flu.” It kills more of its hosts, and it will spread farther unless we take aggressive steps to slow it down, because no one is yet immune to this disease. It will be quite some time before the virus runs out of new patients.
Third, we can fight it. Despite early exposure, Singapore and Hong Kong have kept their caseloads low, not by completely shutting down large swaths of their economies as China did but through aggressive personal hygiene and “social distancing.” South Korea seems to be getting its initial outbreak under control using similar measures. If we do the same, we can not only keep our hospitals from overloading but also buy researchers time to develop vaccines and therapies.
Fourth, and most important: We are all in this together. It is your responsibility to keep Windsor safe by following whatever guidelines you have, but the TIME you decide to implement those will make or break us.
If you don’t take drastic steps to inform the public at large about social distancing, and nip this in the bud right off the hop, I fear we’re going to squander away the gift of foresight almost instantly. These scenarios have played out already in Italy with arguably one of the best medical systems in the world. Also from what I’m hearing, UK awaits the same fate. It’s played out the same in Iran. We’re up against a foe that multiplies exponentially, by the time you realize that things are getting out of hand, it’s too late. We are so incredibly lucky to be in the position that we are in right now, the situation is very fluid, and keeping the public uninformed about this is the absolute worst possible way of handling this. No one is even taking the washing your hands part seriously, let alone coughing into your arm. This war on fear is detrimental. People need to be aware of the dangers they’re facing if they don’t take this seriously. I still fear many in the public do not, and that is something I directly attribute to your lack of outreach. I implore you, fix this. Today. Not tomorrow. To THIS day, I hear that same old diatribe spewed by people in positions of power in this city “the flu kills more people”, this needs to stop. This is dangerous.
Let’s go over the absolute worst case scenario here, I’m sure you’ve heard it, but this needs to be driven home. So everyone knows what’s at stake if people don’t take immediate action to socially distance, and the city doesn’t get shut down:
Covid19 is coming at us with full steam.
It’s likely a matter of a day or two.
When it starts rearing its ugly head, the healthcare system will be put under intense pressure and will be overwhelmed if we allow community transmission to take root for any amount of time.
Your fellow citizens will be treated in the hallways of the hospitals after they run out of beds.
Exhausted healthcare workers will break down.
They will have to decide which patient gets the oxygen and which one dies.
Which one gets a ventilator and which one dies.
The only way to prevent this, is social distancing the second the first case is confirmed. Even now would be a good time. Not tomorrow.
That means keeping as many people home as possible, starting now.
As a politician, community leader or business leader, you all have the power and responsibility to prevent this. This is not about money anymore, Trudeau has done an amazing thing today, as much as I disagree with quite literally everything else he does… this was a fantastic thing. It needs to be praised. No one should turn this into any kind of political BS, we’re beyond that now. We’re in this together, and we need to work together.
You, yourself, are probably freaking out… What if I’m overreacting? Will people laugh at me? Will they be angry with me? Will I look stupid? Won’t it be better to wait for others to take steps first? Will I hurt the economy?
But in 1-2 weeks, when the entire world is on lockdown, when the few precious days of social distancing you will have enabled end up saving countless lives, people won’t criticize you anymore. They will thank you for making the right decision. I assure you, I do not take anything I say here lightly, worst case scenario, blame it on the crazy fat dude. I’ll wear it, I’ve got no qualms with that. But I know I’m right, and I feel like you know I’m right also.
Alright, let’s break it down as simply as possible. This chart right here, this will be the most important chart you will lay your eyes on. It is literal gold by which you should base your actions off.
This is Tomas Pueyo’s analysis from the Journal of the American Medical Association, based on raw case data from the Chinese Center for Disease Control and Prevention.
The orange bars? Those are the daily official numbers of cases in the Hubei province… how many people were diagnosed that day.
The gray bars? Those are the TRUE daily coronaviruses cases. The Chinese CDC found these by asking patients during the diagnostic when their symptoms started.
Crucially, these true cases weren’t known at the time. We can only figure them out looking backwards: The authorities don’t know that somebody just started having symptoms. They know when somebody goes to the doctor and gets diagnosed.
What this means is that the orange bars show you what authorities knew, and the grey ones what was really happening.
On January 21st, the number of new diagnosed cases (orange) is exploding: there are around 100 new cases. In reality, there were 1,500 new cases that day, growing exponentially. But the authorities didn’t know that. What they knew was that suddenly there were 100 new cases of this new illness.
Two days later, authorities shut down Wuhan. At that point, the number of diagnosed daily new cases was ~400. Note that number: they made a decision to close the city with just 400 new cases in a day. In reality, there were 2,500 new cases that day, but they didn’t know that.
The day after, another 15 cities in Hubei shut down.
Up until Jan 23rd, when Wuhan closes, you can look at the grey graph: it’s growing exponentially. True cases were exploding. As soon as Wuhan shuts down, cases slow down. On Jan 24th, when another 15 cities shut down, the number of true cases (again, grey) grinds to a halt. Two days later, the maximum number of true cases was reached, and it has gone down ever since.
That’s the terror that we’re facing, an foe that multiplies exponentially if left to its own devices unchecked. Check. It. Immediately. Otherwise you will be throwing our insane levels of luck right in the garbage and I fear we will suffer the same fate as Italy&the rest of the world.
When a danger is growing exponentially, everything looks fine until it doesn’t.
The crisis in northern Italy is what happens when a fast doubling rate meets a “threshold effect,” where the character of an event can massively change once its size hits a certain threshold.
In this case, the threshold is things such as ICU beds, ventilators and oxygen. If the epidemic is small enough, doctors can provide respiratory support to the significant fraction of patients who develop complications, and relatively few will die. But once the number of critical patients exceeds the number of ventilators and ICU beds and other critical-care facilities, mortality rates spike.
Denmark just closed all schools and universities due to coronavirus, and ordered all public sector employees with non-critical jobs to be sent home from Friday.
Meanwhile, South Korea, Italy and Iran had a full month to learn, but didn’t. They started the same exponential growth of Hubei and passed every Chinese region before the end of February.
Italy had 20 cases two weeks ago. It now has 12,462 cases, 827 deaths. 196 new deaths in 24 hours.
The US’s ignorance has basically screwed them. The former homeland security advisor just stated this “We are 10 days away from the hospitals getting creamed”.
South Korea is probably an outlier. The coronavirus was contained for the first 30 cases. Patient 31 was a super-spreader who passed it to thousands of other people. Because the virus spreads before people show symptoms, by the time the authorities realized the issue, the virus was out there. They’re now paying the consequences of that one instance. Their containment efforts show, however: Italy has already passed it in numbers of cases, and Iran will pass it tomorrow.
We already have had two super spreader incidents in toronto almost back to back, they’re both currently incubating, and worst of all, they’re going to be doing so in a cascading fashion. I don’t want to even think about what kind of things they’re going to be dealing with shortly, if I was a man of God, this is where I would pray for them.
If you look at how many more deaths per city the Flu averages in the states, pay attention to how many more deaths per city there were depending on how fast the response was. And that’s all that matters when it comes to a virus with a r0 this high. Response time.
Italy has finally figured this out. They first locked down Lombardy on Sunday, and one day later, on Monday, they realized their mistake and decided they had to lock down the entire country.
Hopefully, we will see results in the coming days. However, it will take one to two weeks to see. Remember the Wuhan graph: there was a delay of 12 days between the moment when the lockdown was announced and the moment when official cases (orange) started going down. Italy’s got more terrible things ahead to deal with I’m afraid.
Now, let’s talk about response. Honestly, the best thing to do is follow Italy’s example and institute as many of these as fast as possible, without waiting to address the spread reactively. This needs to be done proactively.
This is what they ordered:
Nobody can enter or exit lockdown areas, unless there are proven family or work reasons.
Movement inside the areas is to be avoided, unless they are justified for urgent personal or work reasons and can’t be postponed.
People with symptoms (respiratory infection and fever) are “highly recommended” to remain home.
Standard time off for healthcare workers is suspended
Closure of all educational establishments (schools, universities…), gyms, museums, ski stations, cultural and social centers, swimming pools, and theaters.
Bars and restaurants have limited opening times from 6am to 6pm, with at least one meter (~3 feet) distance between people.
All pubs and clubs must close.
All commercial activity must keep a distance of one meter between customers. Those that can’t make it happen must close. Temples can remain open as long as they can guarantee this distance.
Family and friends hospital visits are limited
Work meetings must be postponed. Work from home must be encouraged.
All sports events and competitions, public or private, are canceled. Important events can be held under closed doors
This is the least I would order. If you want to be safe, do it Wuhan style. People might complain now, but they’ll thank you later.
It is very possible that so far you’ve agreed with everything I’ve said, and were just wondering since the beginning when to make each decision. Put in another way, what triggers should we have for each measure.
The only right answer, is the second you see a confirmed case. This is a binary thing. Again, reference that graph and extrapolate, after the first case was officially diagnosed, they had 1200 actual cases being spread and continuing transmission through the community unchecked. Taking chances here, with the current climate of ignorance that’s displayed by the general populace to this date… I don’t even dare to think about the consequences of such inaction. This is not about money anymore. This is about survival.
Also, I need to address some of the worst ignorance I’ve seen en-masse thus far. The age statistics have been severely skewed by China’s initial coverup re: numbers. The critically ill patients across the UK are in a broad age mix. Same with Italy. There are a smaller number of younger patients (30s to 40s), yes, but there are still very much present, and a larger number of older patients with comorbidities. If you’re just banking on this virus only coming down on the elderly and you’ll surely be fine, bad news friend, there is no guarantee this thing will be kind to you unless you take it seriously. Italy exceeded their critical care capacity days ago. The units are full, no operations are occurring as patients are being ventilated in theaters. Portable ventilators are being used. You will be at the mercy of surge capacity, which will be a direct result in how seriously we take this right off the hop.
I’ll leave you with a fitting quote from Tyson
Neil deGrasse Tyson: “This is an experiment on whether people will listen to scientists” – We’re incredibly lucky to be ahead of this. We were given immense support from Trudeau re: businesses. I implore you, do not piss this away.
Much love and all that jazz <3