Canada needs a hospital capacity-based approach to guide local lifting and reintroduction of restrictive measures as necessary
The past two months have shown that with major sacrifices, the community transmission of the SARS-CoV-2 virus could be slowed down. In Canada, we can rightfully say that we were able to “flatten the curve” to avert a northern Italy or New York City scenario. Now we face the unintended consequences: delays in medical care for non-COVID-19 patients, educational impacts, the looming pandemic of mental-health issues, and massive economic repercussions. Widespread restrictions certainly cannot be sustained until an effective and safe vaccine is widely available, which may not occur for years, if ever. And the virus is unlikely to disappear from Canada or the world any time soon.
Did the lockdown achieve the desired goals? Yes and no. Success in “flattening” the outbreak curve permitted the health-care system to handle the surge in cases safely and to avoid unnecessary deaths. But, we were not successful in protecting the elderly and frail population in nursing homes, where roughly 80 per cent of Canada’s deaths occurred. It is important to point out that more than 95 per cent of COVID-19 deaths occurred in those over 60, compared with none under age 20. Protection of the former group deserves the most attention; this will be easier if limited resources are diverted from other, low-risk groups.
In Canada, the individual rate of death from COVID-19 for people under 65 years of age is six per million people, or 0.0006 per cent. This is roughly equivalent to the risk of dying from a motor vehicle accident during the same time period. In other countries where data are available, 0.6-2.6 per cent of deaths in people below age 65 have occurred in people without known underlying health conditions. Although the risk of death is small in this group, ongoing research to discover the critical risk factors for death from COVID-19 in younger age groups must remain a top priority. This will permit us to better protect those at risk, while loosening restrictions for the majority.
Neil Rau, Susan Richardson, Martha Fulford and Dominik Mertz – National Post – Maymay 21, 2020.