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Measuring success: what metrics are used in the fight to flatten the coronavirus curve?

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For several months, health officials around the world have been touting various tools for combatting the novel coronavirus.

As cases continue to rise in Canada, the term “flattening the curve” has been advertised as a way for individuals to limit transmission to prevent the health care system from becoming overwhelmed.

Social distancing, self-isolation and travel restrictions are lauded as crucial components of reducing and preventing further spread of COVID-19, but what key metrics can be measured in the fight to flatten Canada’s curve?

READ MORE: Coronavirus: Travellers coming back to Canada now mandated to isolate, feds say

Alon Vaisman, an infectious diseases physician at Toronto General Hospital, said the main variables public health officials will be looking for are the number of new cases, deaths, recoveries and how these numbers are changing from day-to-day.

One of the main ways to measure that, he said, is by looking at the number of cases that have doubled each day.

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“If you’re seeing a doubling of the curve of increasing cases, that could be indicative of an outbreak that’s very hard to control or even lost control,” he said.

He noted that these numbers, however effective, are “not set in stone, though.” The doubling rate has to be calculated against the incubation period of the disease.

How countries have fared trying to flatten the curve
How countries have fared trying to flatten the curve

The novel coronavirus has an incubation of up to 14 days, which means the government wouldn’t see the full effects of any of their interventions, like social distancing for example, until two weeks later.

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Health Canada was unable to respond to requests for comment in time for publication.

Measuring the slope of Canada’s curve

Through measuring the rate of cases, infection control epidemiologist Colin Furness said the government can make decisions on how to best flatten the curve.

“The steeper the curve, the more cases we’re getting in … the more scared we should be,” he said. “The more horizontal, the flatter the shape of the curve, the better.”

READ MORE: How vulnerable is Latin America to a COVID-19 outbreak? Here’s what the data shows

Furness, who has been tracking the curve of Canada’s COVID-19 slope on his own EpiModel, said during the initial outbreak of the virus, cases were doubling every four days.

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Weeks later, they were doubling every three days. Shortly after that, he said cases began doubling two and a half times every three days.

The curve was getting steeper.

Social distancing becomes standard to fight COVID-19
Social distancing becomes standard to fight COVID-19

Shortly after that, Furness said the government began implementing social distancing — and the impact got his attention.

“It calmed right down,” Furness said of the curve. It went down to about 1.7 every three days, which is great. It got almost to the point of going back to doubling every four days, which is great.”

But on Monday, he said cases spiked again. The infectious disease specialist said the government will make informed decisions based on what they can deduce from the sudden increase.

The measure of success, Furness said, will be when cases stop doubling and the country stops getting new cases, thereby flattening the slope.

He added that Canadians should be mindful that just because a curve decreases, doesn’t mean they should expect the government to scale back preventative measures.

“If cases are still increasing at all and we let those up, it’s just going to skyrocket again. Just like with a fire, you don’t stop when the fire’s almost out because you know that it’ll just pick up again,” he said.

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READ MORE: China reports fewer new coronavirus cases, with all of them arriving from overseas

Subject to change

According to Furness, “these things can really change on a dime,” and urged Canadians not to panic every time they see a sudden jump in confirmed COVID-19 cases.

If health care workers get infected en masse, or if there’s an institutional outbreak in, for example, long-term care homes or prisons, spikes can occur that are based on local phenomena, he said.

READ MORE: Trudeau announces ban on non-essential Canada-U.S. travel; $82B aid package

“Whenever you see a spike, your next question should be, who, where was that, and why?” Furness said. “A spike can mean that all of our social distancing measures failed or it could mean that one person managed to infect 50 other people just ’cause.”

Asymptomatic transmission, he said, also raises concerns that the data may be skewed.

The government’s approach to doing testing is predicated on the assumption that it can identify who is at risk and who should be tested. If infected Canadians are unknowingly passing the virus to healthy people, the curve will reflect the number of people tested, rather than the number of people sick.

© 2020 Global News, a division of Corus Entertainment Inc.

Source: Global News

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Italy sees smallest increase in coronavirus infections for almost four weeks with 3,039 new cases

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Italy today recorded its smallest increase in coronavirus infections for almost four weeks, with just 3,309 new cases, in the latest sign the lockdown has been a success.

It amounts to a 2.3 percent rise in new cases, compared to a 2.8 percent rise on Monday, when 3,559 new cases were recorded.

In addition, there were 604 more COVID-19 deaths on Tuesday, lower than 636 the day before, taking the total number of fatalities to 17,127, the highest in the world.

The total number of infections recorded in Italy now stands at 135,586, but the latest numbers have again underscored growing confidence that the nationwide lockdown imposed on March 9 is bearing fruit. 

A patient suffering from coronavirus is wheeled through the Cernusco sul Naviglio hospital in Milan on Tuesday

A patient suffering from coronavirus is wheeled through the Cernusco sul Naviglio hospital in Milan on Tuesday

A patient suffering from coronavirus is wheeled through the Cernusco sul Naviglio hospital in Milan on Tuesday

Previous daily infection increases since March 17 had all been in a range of 4,050 to 6,557. And Italy has not recorded a lower daily increase than Tuesday’s since March 13.

Of those originally infected, 24,392 were declared recovered on Tuesday against 22,837 a day earlier. There were 3,792 people in intensive care against 3,898 on Monday – a fourth consecutive daily decline. 

Italy’s health ministry has sent inspectors to the country’s biggest nursing home where 70 elderly people reportedly died in March alone while management allegedly downplayed the risk of infection of coronavirus.

Italian daily Repubblica says Milan prosecutors have opened a criminal investigation into alleged homicide at the Pio Albergo Trivulzio home. 

A coronavirus patient talks with a relative using a tablet computer at a hospital in Milan on Tuesday

A coronavirus patient talks with a relative using a tablet computer at a hospital in Milan on Tuesday

A coronavirus patient talks with a relative using a tablet computer at a hospital in Milan on Tuesday

Italian soldiers patrol in front of the Selam Palace, a structure occupied by migrants, in La Romanina district, on the outskirts of Rome today

Italian soldiers patrol in front of the Selam Palace, a structure occupied by migrants, in La Romanina district, on the outskirts of Rome today

Italian soldiers patrol in front of the Selam Palace, a structure occupied by migrants, in La Romanina district, on the outskirts of Rome today

Repubblica quoted a geriatric doctor, Luigi Bergamaschini, as saying he had been removed for having insisted his staff wear masks and protective gear, while union leaders blamed managers for having listed the deaths as pneumonia.

The Health Ministry’s deputy minister, Pierpaolo Sileri, told Radio Capitale that inspectors backed by the Carabinieri’s health care squad would seize documentation from the facility as well as other nursing homes with a high death toll.

Many nursing home dead were never tested for COVID-19 and weren’t hospitalized, given their frail conditions and northern Italy’s overflowing intensive care units. 

As a result, their deaths don’t figure into Italy’s official death count, already the highest in the world.

Medics wearing protective gear take a patient thought to be suffering from coronavirus out of an ambulance at Policlinico di Tor Vergata hospital in Rome

Medics wearing protective gear take a patient thought to be suffering from coronavirus out of an ambulance at Policlinico di Tor Vergata hospital in Rome

Medics wearing protective gear take a patient thought to be suffering from coronavirus out of an ambulance at Policlinico di Tor Vergata hospital in Rome

A graph showing the total number of coronavirus cases per day that have been reported in Italy, up until April 6

A graph showing the total number of coronavirus cases per day that have been reported in Italy, up until April 6

A graph showing the total number of coronavirus cases per day that have been reported in Italy, up until April 6

A graph showing the number of coronavirus deaths reported each day in Italy, with data going up until April 6

A graph showing the number of coronavirus deaths reported each day in Italy, with data going up until April 6

A graph showing the number of coronavirus deaths reported each day in Italy, with data going up until April 6

Meanwhile Italian leaders are trying to plot a way out of lockdown and restart Europe’s fourth largest economy as the virus slowly eases.

About 150 Italian academics have published a letter in Italian financial daily Il Sole-24 Ore, owned by the Italian business lobby Confindustria, urging the government to unblock the economy.

‘The social and economic consequences would risk producing irreversible damage, probably more serious than those caused by the virus itself,’ the letter said.

Medical staff work in the Intensive Care Unit of the Bassini Hospital which is treating coronavirus patients in Italy's hard-hit north, near Milan

Medical staff work in the Intensive Care Unit of the Bassini Hospital which is treating coronavirus patients in Italy's hard-hit north, near Milan

Medical staff work in the Intensive Care Unit of the Bassini Hospital which is treating coronavirus patients in Italy’s hard-hit north, near Milan

Italy has said pressure on its hospital system is easing as the rate of infection slows, but that a nationwide lockdown will remain in place for now

Italy has said pressure on its hospital system is easing as the rate of infection slows, but that a nationwide lockdown will remain in place for now

Italy has said pressure on its hospital system is easing as the rate of infection slows, but that a nationwide lockdown will remain in place for now

Rome imposed a nationwide lockdown on March 9 when the new virus, which emerged in China, had already killed more than 460 people. 

Two weeks later, Prime Minister Giuseppe Conte announced that non-essential businesses, including car, clothing and furniture production, would have to close until April 3.

The death toll has risen relentlessly and now stands at more than 16,500. 

The government extended the restrictions last week until April 13 and is widely expected to extend them again, for another three weeks.

However the smallest daily rise in COVID-19 deaths for nearly two weeks on Saturday, and the first fall in the number of patients in intensive care, have fed hopes that the epidemic might have reached a peak in Italy and focused attention on the next phase in the crisis.

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Little boy watched as ‘killer abducted his mother before shooting her in the head ‘

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Corrie Wallace, Sam
Corrie Wallace is charged with killing Ja’Riel Sam after kidnapping her in front of her four-year-old son. (Picture: St John the Baptist Parish Sheriff’s Office/Facebook)

A little boy watched in terror as a killer kidnapped his mother who he later shot in the head, police said.

Corrie Wallace, 37, gave himself up to authorities on Monday in LaPlace, Louisiana where he is charged with killing 25-year-old Ja’Riel Sam, who was found dead on the side of a local street hours earlier.

Investigators said Sam’s four-year-old son was inside her apartment when she was abducted by Wallace, who is described as being an acquaintance of Sam Police later found the boy traumatized in his mother’s bed after Sam’s body was identified.

‘He heard his mama screaming,’ St John the Baptist Parish Sheriff Mike Tregre told Nola.com.

Police said Wallace stuffed Sam in the trunk of her own car during the violent abduction. A short time later, she jumped from the trunk of the moving vehicle – but she was unable to escape her attacker, who police say chased her down and shot her once in the forehead.

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Sam reportedly suffered road rash on her knees, legs and elbows during her failed attempt to flee.

Wallace
Corrie Wallace, known to be an acquaintance of Sam, allegedly kidnapped her, shoved her in the trunk of her own car and drove off before shooting her in the head. (Picture: Facebook)

‘She tried to run for her life,’ Tregre said.

‘We believe he shot and killed her right there on Belle Terre Boulevard.’

After Wallace allegedly killed Sam, he crashed her car into a metal guard rail in front of a car dealership and abandoned the vehicle.

Tregre said officers responded to Sam’s apartment and discovered someone had doused the home in bleach in an attempt to destroy evidence.

Wallace was later identified as a suspect after investigators used crime cameras and surveillance footage from nearby businesses. The gun believed to have been used to kill Sam was subsequently found in a nearby canal, police said.

Tregre said Wallace is facing charges including first-degree murder.

Sam’s son is reportedly staying with relatives in the wake of his mother’s death.

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Source: Metro News

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Men who ransacked bus depot told to ‘be good citizens’ amid the pandemic

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Kevin Steele and Ian Byrne
They were told to ‘be god citizens’ (Picture: NCJ)

Men who broke into a bus depot and ransacked it causing hundreds of pounds worth of damage have avoid jail sentences.

Kevin Steele and Ian Byrne were told they deserve to go to prison but that in the current pandemic, they were not ‘dangers to the community’.

Instead, they were freed and told to ‘be good citizens’ by a judge.

The pair broke into the Go North East depot, in North Shields, near Newcastle, while drunk.

Kevin Steele in his police mugshot (Picture: ncjMedia Ltd)

They stole a TV from the wall, coins and food from a vending machine.

Now burglars Steele and Byrne, who had been remanded in custody, have been freed on suspended sentences while Darren Robertson, who admitted handling stolen goods, has been given a community order at Newcastle Crown Court.

Judge Amanda Rippon told them: ‘Each of you have got bad records and deserve prison sentences but in the current situation I have decided that you are not, I don’t think, dangers to the community.

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‘The better option is to find an alternative and see whether the time has come for you to recognise you need to grow up and become responsible members of the country, rather than breaking into people’s properties and stealing from them.’

Ian Byrne broke in alongside Kevin Steele (Picture: NCJMedia Ltd)
Darren Robertson admitted handling stolen goods (Credits: NCJMedia Ltd)

The judge added: ‘It is the time to be good citizens.

‘The world is upside down at the moment and you are about to join it.

‘Make sure you join it responsibly, you don’t want to come back in front of me.’

The break-in happened at the Go North East depot on Norham Road, North Shields, around 12.45am on July 4.

Steele and Byrne took a TV from the wall and carried it out into a Ford Focus they had taken to the scene.

They then went back in and damaged vending machines in the canteen, forcing them open and removing 41 pound coins as well as food.

The court heard they caused £547 of damage during the break-in.

Steele, 35, of Dudley and Byrne, 37, of North Shields, admitted burglary and were each given 16 months suspended for two years with a three month curfew.

Robertson, 31, of Shields, admitted handling stolen goods and was given a two year community order.

John Wilkinson, for Steele, had urged the judge to take a more ‘constructive’ approach than jailing him.

Adam Birkby, for Byrne, said he had a long-standing addiction to class A drugs and had served the equivalent of a 14 month sentence on remand.

Penny Hall, for Robertson, said his involvement was limited.

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Source: Metro News

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