Large Fierce Mammal

Our title today comes from something Mrs. LFM said last night in reference to statistics in general, and the way they are being presented in daily government COVID-19 briefings specifically.

A state of emergency was announced yesterday for the Province of Nova Scotia, where we live. The details of its scope and perceived application can be read in the CBC News article here.

The measures being taken are attributed for the most part to the way members of the public are behaving while under advisement to voluntarily maintain “social distancing” and avoid gathering in groups of 50 or more. That applied until yesterday when the limit for public gatherings was shrunk under the new emergency declaration to a maximum of 5.

The government is not making this up. Over the past weekend, beaches and parks were as crowded as one would expect on Canada Day, or any other holiday weekend, as people who had been told they could go out in the fresh air as long as they maintained “social distance” decided that only applied to cities and towns, and all wide open spaces were up for grabs.

Naturally, some of those people were simply stupid, others misguided, and still others perfectly aware of the possible consequences of their actions but had no fucks they were willing to give.

Yesterday, just before the state of emergency was announced, I wrote, “… if you won’t control yourself, you’ll be controlled. Don’t give anyone that excuse.” Well folks, you did. Go now to the nearest mirror and offer up a resounding, self-congratulatory Huzzah!

I will have more to say in coming days in the matter of the state of emergency as it plays out, but from here I will limit the discussion to a point of contention that has existed since Canada began reacting to the arrival of COVID-19 on these shores, and continues to be trotted out at every daily briefing — infection statistics.

Here’s an example drawn from yesterday’s provincial state of emergency announcement:

“The province also announced seven new presumptive cases, all related to travel or close contact. So far, Nova Scotia has reported 28 confirmed and presumptive cases in total.

“Dr. Robert Strang, the province’s chief public health officer, said although there has been no community spread in Nova Scotia, he expects it will happen soon. As of Sunday’s update, more than 2,100 people in the province had been tested for COVID-19.

“Those affected in Nova Scotia range in age from late teens to mid-70s. The cases are spread throughout Nova Scotia.”

This all sounds to be a simple statement of reality intended to keep the public informed, but the value of the statistics being used to justify stating that, “… there has been no community spread in Nova Scotia …” is undermined by the way those statistics are being collected, to the point of being worthless as justification for such a statement.

It all comes from the way people are getting tested for the virus in the first place. In an article published on 17 March 2019 by CBC News under the title, What to do if you think you have COVID-19: A guide to each province and territory, the general advice is:

“If you have symptoms of COVID-19, the illness caused by the coronavirus, the first step is to contact your health-care provider or local public health agency by email or telephone.

“They’ll be able to tell you if you’re eligible for testing in your area. Most provinces and territories are restricting testing to those who have been exposed to people who have a confirmed or presumptive case, or have returned from travelling to an affected area.

“Do not show up unannounced at a clinic, hospital or pharmacy. However, if you have a sharp turn in your condition, including shortness of breath, call 911 or your local emergency number.”

Here in Nova Scotia, this falls under the guidelines published by the Provincial Government on its Novel coronavirus (COVID-19) page. In explaining what classes of asymptomatic people should self-isolate at home for 14 days (in which case no testing is done), and those under which they should pursue testing, their When to call 811 about COVID-19 page gives this advice:

Use this screening tool to find out if you should call 811 about COVID-19.

Only certain people need to call about COVID-19. Don’t call if you don’t need to.

Answer the questions on each page of this tool to find out if you should call.

If you have concerns about another health issue, you can still call 811 to speak to a health professional. We’re experiencing higher than normal call volumes, so it’ll take longer than usual to respond to your call. We’re working hard to respond to all calls as quickly as we can. Thank you for your patience.

That information ends with a button to be clicked labelled “Start now” that launches the questionnaire. The effect of this is to quell any potential flood of people who only just found themselves downwind of someone who coughed, or have a burning need “just to be sure”.

This approach is effective at streamlining the efforts of sample collection personnel, reducing the load on lab time, and reserving testing supplies for the most likely cases, and in this it has so far been effective. What it does not do is provide meaningful statistics on the actual number of people infected, nor does it provide insight into the percentage of mortality among the population known to have tested positive.

From the get go, horror stories notwithstanding, the effects of COVID-19 infection on healthy people have been generally described as mild to moderate, and in some cases (most notably children), easy to ignore as explainable for other reasons (teething for example). In Nova Scotia, anyone who doesn’t fit the template built into the government’s online screening tool as having engaged in high risk activities, or coming to know they have been exposed to someone who subsequently became ill and tested positive, will not be tested, and later development of a mild to non-existent set of symptoms won’t change that under present protocols. The virus will thus go undetected among the untested population until it inevitably brings to light an apparently unheralded transition from an imported infection to one that is “community spread”. Further, if the size of the infected population is limited to those who have tested positive, but filters in place to limit testing to likely positive cases, the actual number of infections cannot be known and must be assumed to be higher. What is known is the number of deaths which, measured against the artificially truncated positive count, will of necessity appear frighteningly elevated in the eyes of an ever more restive and tremulous populace.

Whether or not Dr. Strang is playing along with some doctrinal dictates is beyond my ken, but what lies within it is that a man of his stature and in his position should know better than to spout worthless statistics with the observation that he expects the transition to community spread to happen soon. Hopefully he’ll wise up, and until we next convene I’ll close today with the sage words of Dr. Gregory House.