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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.

They are testing using cultures, say across a room, to see if a slightly desiccated airborne virus is viable. These types of tests for treatable or accessible pathogens, should be mass-produced. The vaccine model works but eventually we will transition to exporting decontamination and getting patient zero. Decontamination is also needed for partially restarting economy parts. I think our busy building standards should be upgraded to hospital standards using new technology. There should be cross flow of air circulation among rooms/tenants. This suggests better motors, filters, a new duct material, and ultimately new fireproof and optionally porous building materials. We can probably safely find a way to stop cytokine storm before it alters the steric and/or chemical environment of the lungs, but to really bear down and use gene therapy is risky while we don't have good employee screening.
Sometimes the rust belt can easily retool for a new product and sometimes the production machine needs to be bought. We can list products we will need for all sorts of disasters, and now, manufacture the production machine or at least the tool and dies required. For every future disaster we can do this and economically measure our resilience net worth even if it is a GDP carrying cost to store stuff. Many people will have a disaster job to attend to and be on reserve for such.
NYC plateauing for 13 weeks is a July 4th economic restart, ignoring health care. These "disaster parts" supply chains will fall if a GD happens. Tangential products made by the suppliers who make disaster parts and required machinery, can keep them afloat. Restarting NYC early might hurt neighbors. We clearly need smaller ships and smaller nursing homes but there is a robot with a hammer/lighter to defend from later.

...if restarting early, rust belt supply chains can be maintained that are capable of making many things to keep the surface area of the economy small (big brother picks the products). The shuttered discretionary income sectors can be socially distanced; a game or theatre at 1/12th capacity with a worker paying extra and either he or the venue is subsidized (tailing off as an immune population is built). Right now the trickle down is hurt, but paying extra for SD-ed discretionary services restores it if even 30% of the sector remains for the newly pseudo-rich to enjoy. For some factories and services positions where SD-ing isn't possible, very aggressive symptom assessing is needed. Probably the employee should be isolated while away from work and receive future spending power. Aerodynamics, microbiologists, et al., are needed to redesign workplaces, and recreation parks/malls to achieve SD-ing before part of an economy is restarted. Design engineers should learn to make surfaces decontaminatable. Paint might be all that is often needed. Immunotherapy R+D is a logical sector to buttress.

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