00:00
The total number of COVID tests
done around the world as of October
was distributed
according to this graph,
on a country to country basis.
Every country does it differently.
00:12
Testing is key.
00:14
Absence a cure,
a treatment, or vaccine
testing is the best strategy
for containing the epidemic.
00:22
because if you can identify
people who are ill,
you can prevent them
from infecting others.
00:28
So, Singapore was the world leader
for a long time in doing testing.
00:33
Other countries struggled
to keep up.
00:35
So the countries that do
strategic and thorough testing
tend to have a better grasp
on the spread of the epidemic.
00:43
Singapore and Iceland
have done a good job.
00:47
The total confirmed cases
exploded quickly
in the first six months
of the disease
from the end of February
up until October.
00:56
So, we got to about
35 million cases
in those seven months,
between March and October.
01:06
And now, two months later,
we're at over 80 million cases.
01:12
So, that is a case of
exponential growth.
01:15
Number of deaths
are also increasing.
01:19
The COVID cases by country in
the first nine months of disease
are presented in this graph.
01:24
This is useful for showing where the
clustering seems to be taking place.
01:28
And not surprisingly, the most
crowded largest countries are having
the worst experience
with this disease.
01:38
Total confirmed deaths
are of course,
the most troubling statistic.
01:42
From March to October,
we saw a rapid rise in deaths
to the point
where we have a million deaths
at the end of October.
01:51
But here we are
at the beginning of January,
and we're closing in on
2 million deaths.
01:54
So, it took seven months
to reach 1 million deaths.
01:57
And just over two months to reach
another million deaths.
02:01
That is a sign of exponential
growth in death as well.
02:09
COVID-19 has a disproportionate
effect on individuals
with certain
pre-existing conditions.
02:17
And by disproportionate,
I mean
you're more likely to be
hospitalized
and more likely to die
if you have certain conditions.
02:24
Number one, is age.
02:26
The elderly are far more likely
to die of this disease.
02:31
That's why it's burning through
long-term care centers.
02:33
And that is why we must focus
so much of our attention
on preventing the disease from
entering the domain of the elderly.
02:42
Cardiovascular disease,
diabetes,
people are undergoing
steroid therapy,
the obese,
the hypertensive,
these are conditions
that predispose you
to having a very bad experience
with this disease.
02:55
In many ways,
this disease
is shortening the timeframe
of bad outcomes.
03:02
Typically experienced by those
experiencing chronic diseases,
shortening that timeframe
to make it resemble
an acute experience.
03:11
In other words,
perhaps your diabetes
or your obesity
would have killed you
in a few decades.
03:17
But now it's going to kill you
in a few weeks
because of COVID-19.
03:21
Pandemics have a way of
shortening timeframes,
and for making chronic diseases
appear acute.
03:34
So, what are the challenges
to COVID-19?
Well, we have this
very high transmission rate.
03:40
Some people argue over
the lethality of the disease,
but it is a fairly lethal disease
when compared to things
like the seasonal flu.
03:50
The infection fatality rate is
probably somewhere between
0.5 and 1%.
03:56
And for seasonal flu, it's around
0.1 or at the most 0.2%.
04:02
But even if we're
as equivalent.
04:04
The fact is COVID-19
is so much more infectious,
that it affects
a great many more people,
therefore, a larger number of people
will be hospitalized and die.
04:15
So, high transmission is troubling.
04:20
It is, in large part
an asymptomatic epidemic.
04:24
This really confounds our ability
to contain it and control it.
04:28
Because...
04:31
just because you have no symptoms
doesn't mean you're not infectious.
04:38
So, this long incubation period
is a great confounder.
04:42
The vaccines are a
scientific miracle, to be sure.
04:47
But they don't yet have
high penetration.
04:49
As a result, they cannot be
relied upon as the great panacea.
04:54
We cannot vaccinate as quickly as
the disease can spread.
04:59
If the forest is on fire,
you cannot outrun the fire.
05:03
You have to put up breaks
between you and the fire.
05:06
You have to try to put out
some of those flames.
05:08
That's why these
public health endeavors
to slow transmission
are more vital than ever,
even though
we have a vaccine
and we are doing
our best to roll it out.
05:19
The high hospitalization rate
is of course troubling.
05:22
Because when combined,
all these factors mean
COVID-19 has
a high probability,
a high potential
to rapidly overwhelm
any healthcare system.
05:35
So, this is not just about
one disease,
it's about one disease having
the downstream ability
to destabilize
an entire healthcare system.
05:45
When all of the health care workers
are focused on
combating and treating people,
struggling with COVID-19,
other care does not get done.
05:55
Cancer screening does not get done.
05:58
Mental health care
does not get done.
06:01
Proper care
for people showing up
requiring acute urgent care
is not as good
because other health care workers
have been taken off
of those roles to give critical care
elsewhere, to the COVID wings.
06:17
So, we have in many places,
cancelled, elective surgeries.
06:22
And when I say elective surgeries
that gives the impression
that these are optional
or frivolous endeavors
but they're not an elective surgery
can be someone who needs
a knee replacement,
to go back to work.
06:33
They need that knee replacement
for their economic wherewithal.
06:38
So, this disease
is an enormous threat
to the infrastructure
of many societies.
06:46
The challenge is not overwhelming
the health care system.
06:50
This is a chart
showing the projection
in the province of
Ontario and Canada
for how COVID-19
might have affected us.
07:00
So, in green, we see the actual
cases observed up until April.
07:05
In blue, we see
the best case scenario. right?
So, if we were to introduce
the strongest restrictions
on human contact
to drive transmission low,
we will still see a rise in cases
plateauing around April.
07:21
The worst case is,
we fail to enact those procedures,
and the cases explode out
of control plateauing,
at a very high level,
easily overwhelming
the healthcare system.
07:34
So, this kind of projection
was implemented
in order to know
the intensity and extent
of public health endeavors
to put into place
to slow transmission.