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Excellent post Frances. I noticed the Northwest LHIN does quite well though still low by international standards. Good to know.

Livio, Thanks! On the Northwest LHIN - yes, I would imagine that's probably something to do with smaller hospitals needing to have a bit more spare capacity because they can't take advantage of the law of large numbers like big city hospitals can? Or do you have another take on it?

It's several things. Partly they have to have a certain number of smaller hospitals outside of Thunder Bay given the region is about the size of France. Second, there is the spare capacity argument given the relative remoteness. If a small hospital in a place like Marathon serves a large geographic area for many things with more specialized cases requiring transport to Thunder Bay.

Livio, thanks, that's what I'd have figured. What's the population growth rate been like there - are the numbers consistent with the funding inertia argument (there's always been a hospital in Marathon so we keep funding a hospital in Marathon)?

Population growth has actually been positive particularly in the First Nation communities.

How can Canada do better? Maybe by taking a cue from Shakespeare? « First let’s kill all the lawyers! » In this cas MBA’s and everybody at the Treasury Board who advise us to get rid of idle capital?

Jacques René - "How can Canada do better?" is a difficult question. Rational, evidence-based decision-making in health care would be a good first step. I'm not sure that throwing money at hospitals is, in fact, the answer - there are other acute needs in the system e.g. long-term beds in nursing homes, public health. What irks me is what looks like arbitrariness in bed allocations, rather than the overall level of beds. It's also becoming increasingly clear me that pandemic response and day-to-day health care needs are quite different things, and need to be funded differently. There's also that classic Canadian tension: the federal government has all of the revenue raising capabilities, the provinces have all of the spending responsibilities. When provinces decide that they're going cut taxes in order to be open for business...well...that's what's behind the numbers in the post.

Jason Kirby, the person who does the chart round up for Macleans, is getting a bunch of people to comment on COVID19. I've written up a short paragraph which gives some of my long term thinking on this.

My first job long ago ( and I mean a longer ago than the long ago of last week) was in public health. Having trained in Industrial Organization I knew nothing about the subject but my boss told me « I once had an economist and I liked his work, so I asked HR for one ».
Let say you buy one billion N-95 masks at $0.75 a pop over 5 years. It’s a rounding error that will save you a 25% drop in GDP. We’ll leave the cost-benefits analysis as an exercise to the first-year student. I wanted to leave the calculus about the dead to my colleagues at the Treasury Board but they told me they don’t care.

A problem is you run out of nurses even with ventilator stockpiles. I've got an outline of the social distancing tradeoff; the at risk vs (near term) Q-of-Life sacrificed SD-ing:
A class of SD acts, such as all our breakfasts at a coffee chain, should be measured by the number of communicable contacts incurred. For some positions, one key immune individual makes it a low spread event. The corporate chain-of-command can work with design engineers for pop up tents kiosks. There is also low capacity in present off-peak mall hours and parks.
Marginal profitability is being lost and firms are closing whereas you may get 30% immune staffing soon in Wuhan and NYC. It is an open reflexive economic issue how to cross the gap. Utilitarian means and ends should be permitted more such un-SDing credits, likewise for expected contributors (not bloggers) towards pandemics and maybe disasters. With better sensors you may want to time in not too dense locales, a square-wave pandemic workforce (it is risky) and have some infected right away to immediately start-up a post-pandemic workforce, and then apply extra brakes to plateau the cases and health care limits.
There is a golden opportunity to do longevity research here as a long-term economic stimulus but it makes bioevents happen without decent neuro-imaging. We can remove freedoms and add some back based on these metrics, for many replicating risks.

Jacques René - yes, as a society we make some decisions about risks and how to prepare for them that end up looking really dumb in hindsight. It's not just a recent thing either - e.g. all of those magnificent forts (the citadelle in Quebec, Fort Henry in Kingston, the big fort in Halifax) that were built after the war of 1812 and then almost immediately became obsolete.

Phillip - your observation raises the vital importance of data and testing in dealing with COVID19. Trace and contain seems to make a lot of sense to me, but we're past the point where that can happen any time soon in most Western countries. Knowing who had antibodies would also be incredibly useful.

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