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A national health data infrastructure could manage pandemics with less disruption

A national health data infrastructure could manage pandemics with less disruption

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Using data to manage the spread of coronavirus means that work and everyday life could quickly resume. (Shutterstock)

If we did not know it before, we know it now: pandemics present dire threats to our lives, similar to climate change and nuclear proliferation. Confronting these threats requires social and technical innovation and the willingness to view potential solutions in entirely new ways.

As Canada struggles with calibrating its response to COVID-19, the limits of our existing crisis strategies are plain to see.

Political leaders are stuck between controlling the spread of the pandemic and resuming commercial and economic activity. How quickly should restrictions on confinement and social distancing be relaxed? And for whom? Their responses rely largely on the extensive use of personal protective equipment (notably masks), deployment of immunity tests and test-and-tracing technologies.

Prime Minister Justin Trudeau on data collection and analysis to inform pandemic response policies.

There are two problems with this approach: first, they are based on after-the-fact views of COVID-19’s spread. And second, this approach treats the pandemic as a medical problem.

Managing the unknowns

The facts of this virus are becoming clear. While it is hard to know who is infected given that many may be asymptomatic, we do know that the vast majority of those who become infected will not experience severe symptoms. Data from France show that if everyone gets infected, only approximately one per cent of the population will experience symptoms severe enough to require admission to an intensive care unit.

Instead of using the blunt instrument approach of designing public health policy for an entire population, would it make more sense to predict who would fall into that highly vulnerable one per cent group and then devote the state’s resources to protecting them. That way, those who are less vulnerable can continue about their lives, while those who are more vulnerable would be better protected.


Read more: When will we return to normal after coronavirus? The data will tell us


Different perspectives

Governments are not following this path. They see COVID-19 as primarily a medical problem when it is really an information problem. If it were to be seen as an information problem, then potential solutions are possible. These solutions use advanced information technologies that have proven successful in other contexts.

Consider personalized prediction. Machine-learning models fed with vast quantities of health data, for example, could be trained to make clinical risk predictions. Public health leaders could use these prediction models to identify those who are vulnerable and who would need to be quarantined and prioritized for access to scarce medical resources, such as personal protective equipment, dedicated health support, free delivery of groceries and other necessities.

Personalized prediction, based on machine learning and artificial intelligence, has transformed businesses over the last 20 years. Netflix evaluates consumers’ characteristics and past choices to make personalized recommendations about what they might watch next. Amazon uses the same approach to recommend future purchases based on past spending behaviour.

A similar approach could be taken to measure individuals’ clinical risk of suffering severe outcomes if infected during a pandemic such as COVID-19. What would this look like if rolled out on a country-wide scale?

Each person would receive an electronic message with their clinical risk score, which would be derived automatically from their medical records and reflect how vulnerable they are to a particular virus. Those with predicted scores above a certain threshold would be classified as “severe” or “high risk.” They would be temporarily isolated and supported. Those with scores below a threshold would be able to return to a more-or-less normal life.

Two office workers wearing surgical masks using laptop.
Identifying and protecting the more vulnerable members of a population would enable the development of herd immunity, and a quicker return to work. (Shutterstock)

Data-informed policies

A personalized approach to clinical risk during a pandemic outbreak has multiple benefits. It could protect medical systems from being overwhelmed and communities from the economic pain of indiscriminate lock-downs. It could help build herd immunity with lower mortality — and fast. It could also allow a more targeted and fairer allocation of resources, from test kits to hospital beds. Unlike medical tests that are scarce, expensive and slow to deploy, a data-driven digital personalization approach could be applied quickly and is relatively easy to scale.

An approach based on data science and machine learning could also enable safer de-confinement at a much faster rate than current best practices. In one study, my co-authors and I used COVID-19 data from France as of early May 2020 to understand the public health policies regarding the enacting and lifting of restrictions intended to control the spread of disease.

Our simulations show that isolation entry and exit policies could be substantially faster and safer using personalized prediction models. Our simulations indicated that the complete lifting of COVID-19 restrictions could be undertaken in six months, with only 30 per cent of the population being under strict isolation for longer than three months — all without overwhelming the medical system. In contrast, using conventional methods, simulations indicated that the complete exit would take 17 months, and 40 per cent of the population would be subject to strict isolation for more than one year.

This ideal scenario may seem like a moonshot, but a simple version could be designed and rolled out fairly quickly. Governments can focus on the data and models that can be deployed for COVID-19. For example, age, body mass index and hypertension and diabetes data for each person — all of which can be assessed at a community pharmacy for everyone within weeks and applied to an individual’s health card — can be used to train models. Even with just this information, public policy can be much more targeted.

National data infrastructure

What would need to happen to implement this new model on a province- or country-wide basis? For one thing, a deep data pool. Training a machine learning model for a pandemic such as COVID-19 would require data on thousands of people who tested positive and were hospitalized for the virus. It would also require medical data for everyone else in the population, akin to the information dossiers that big tech firms such as Facebook or Netflix have on consumers.

This is why government commitment to building a robust health data infrastructure is so important. Unfortunately, in Canada as elsewhere, the state of electronic health records varies widely. Depending on the jurisdiction, records may be incomplete or difficult to access, and information may not be standardized. A commitment to address these shortcomings is paramount. Privacy protections and cybersecurity provisions would need to be developed and well communicated.


Read more: Your electronic health data: Understanding the different records, systems and how they connect


As COVID-19 shows, the upside of applying advanced analytical tools used successfully elsewhere vastly outweighs the downside of staying the course. The question is not whether countries can apply artificial intelligence at a health-system scale. It is already being used at scale for commercial purposes that hardly involve life-or-death issues. The question for policy makers is: Can we afford not to go down this path?

Anton Ovchinnikov does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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New York Refuses To Give More Money For Offshore Wind Projects As Cheap “Green” Myth Implodes

New York Refuses To Give More Money For Offshore Wind Projects As Cheap "Green" Myth Implodes

By Irina Slav of OilPrice.com,

The New York…

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New York Refuses To Give More Money For Offshore Wind Projects As Cheap "Green" Myth Implodes

By Irina Slav of OilPrice.com,

The New York state authorities have rejected a request by Orsted, BP, and Equinor for raising the price of electricity in future power purchase contracts featuring offshore wind energy.

Offshore wind developers have been pressured by rising raw material and component costs, and higher borrowing costs, which has cast doubt over the viability of many projects. Indeed, Reuters reported that some projects planned for the waters off the coast of New York may need to be reconsidered in light of the authorities’ decision.

"Sunrise Wind's viability and therefore ability to be constructed are extremely challenged without this adjustment," Orsted told Reuters.

Sunrise Wind is an offshore project with a planned capacity of 924 MW that could supply electricity to 600,000 households. According to Orsted, it would also involve several hundred million dollars in investments in the state and 800 jobs.

"These projects must be financially sustainable to proceed," the president of Equinor Renewables Americas told Reuters, referring to the offshore wind projects the Norwegian energy major is leading in the U.S.

Per Reuters, Equinor is involved in three projects with BP—the 816 MW Empire Wind 1 and the 1.26 GW Empire Wind 2, as well as the Beacon Wind farm, with a projected capacity of 1.23 GW.

Indeed, rising costs have compromised the financial sustainability of many wind power projects and earlier this year led to the cancellation of a large-scale one off the coast of the UK.

Swedish Vattenfall, which led the Norfolk Boreas project, said it would quit it after it saw costs rise by 40%, which made the project unviable.

To tackle the rising cost problem, wind developers have turned to governments, asking for additional tax incentives and higher electricity prices, busting the myth of cheap wind power.

The New York Public Service Commission said that if they had agreed to do what the wind developers wanted, that would have added 6.7% to New Yorkers’ electricity bills, which are already among the highest in the State.

Tyler Durden Sat, 10/14/2023 - 10:30

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Russia Denies Talks Of A Gas Cartel

Russia Denies Talks Of A Gas Cartel

By Michael Kern of OilPrice.com

There are no plans for the creation of a natural gas cartel similar to…

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Russia Denies Talks Of A Gas Cartel

By Michael Kern of OilPrice.com

There are no plans for the creation of a natural gas cartel similar to the OPEC cartel in crude oil, Russia’s Deputy Prime Minister Alexander Novak said on Friday. 

“There are no discussions to set up a (gas) cartel,” Novak told RT Arabic TV as quoted by Reuters

The Gas Exporting Countries Forum (GECF) is an organization of gas producers and exporters but it is not coordinating supply to the market the way OPEC does. Russia is a member of the GECF and its top energy official Novak said in the televised interview that the gas organization was “mostly about exchanging views.”  

Since the Russian invasion of Ukraine and the halt of most of Russian pipeline gas supplies to Europe, the EU has turned to LNG imports and increased deliveries via offshore pipelines from Norway and North Africa to replace the Russian supply, which accounted for around one-third of all European gas imports before the war in Ukraine. 

The EU aims to ditch Russian gas by 2027. 

Having lost the European market, Russia has raised pipeline exports to China and its global LNG exports, which are neither sanctioned nor too shunned in gas-starved Europe. 

This year, the exports of Russian gas giant Gazprom to Europe have slumped and dragged its profits down. Gazprom has reported a massive drop in its first-half net profit as deliveries to Europe plunged compared to the same period in 2022 when Russia was still supplying pipeline gas to its European customers.  

The major drop in Gazprom’s gas deliveries to key customers was due to the halt of Russian pipeline gas exports to nearly all European countries.

Gazprom started to reduce supply via the Nord Stream pipeline to Germany in June 2022, claiming an inability to service gas turbine maintenance outside Russia due to the Western sanctions against Moscow for the invasion of Ukraine. This was weeks before the sabotage of the Nord Stream pipelines at the end of September 2022, which definitively closed all pipeline gas routes of Russia’s gas to Germany. 

Tyler Durden Sat, 10/14/2023 - 09:20

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Carnival Cruise Line enforces a key main dining room rule

Cruisers love to debate every aspect of eating in the main dining room, but Carnival has drawn a line in the sand on one key issue.

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For most people on a Carnival, Royal Caribbean, MSC, or Norwegian  (NCLH) - Get Free Report cruise the main dining room serves as a gathering and reset point. 

During the day families and friends may go off in different directions, but on most nights they gather in the main dining room for a multicourse dinner experience that generally takes about 90 minutes.

Cruise lines have more small tables, so in many cases you're not sitting with strangers as often as you would have been in the past, but dinners in the main dining room remain an important part of cruising. 

Dinner brings everyone on a trip together and creates shared memories even when days are spent in different places.

Related: Carnival Cruise Line CEO openly talks about adding unpopular fee

The main dining room , of course, is not the only option. You can opt for specialty dining or the buffet, or you can just grab a pizza. Still, with the capacity to serve the entire ship across multiple seatings, the main dining room dinners remain a crucial part of the cruise experience on Carnival, Royal Caribbean (RCL) - Get Free Report, MSC, and Norwegian sailings.

Cruisers, of course, love to debate any changes and rules that are enforced or not enforced in the main dining room. Thousands of social-media posts argue how and whether each cruise line enforces its dress code, with some people wanting to wear shorts, hats or flip-flops while others lament that passengers no longer wear tuxedos on formal nights.

Carnival Cruise Line (CCL) - Get Free Report Brand Ambassador John Heald recently touched off a debate, however, when he outlined on his Facebook page one rule that Carnival does enforce.

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Dinner in a cruise ship main dining room is an elaborate affair.

Image source: Nora Tam/South China Morning Post via Getty

Don't be late for your Carnival main dining room time

Heald spends most days answering questions from Carnival's customers. Sometimes he shares notes that have been sent to him and solicits public response.

BOOK YOUR CRUISE NOW: Plan a dream cruise vacation at the best possible price.

In this case, he shared what happened to one family when it arrived 40 minutes late to its designated meal time. 

On our recent Pride cruise from Rome, we had a table of 10. After long days in port, we did not always make it on time for early seating and came into the main dining room at intervals. This really threw our servers off and therefore, OUR service suffered. One evening, we were all 40 minutes late That is all.. The restaurant manager told us we had to eat at the buffet or come back to see if there was a table available at the late seating.

Carnival, like most cruise lines, offers early and late seatings as well as "anytime" dining options. People who have a specific seating will eat at the same table every night, while people with flexible time seating will eat in a different dining room.

The family that arrived late shared more info with Heald.

That is not acceptable with teenagers. If Carnival puts a cruise together with long stays in ports then expect many to be late. We were punished for being 30 mins late. Unacceptable !!! You are monsters!

Carnival's brand ambassador tried to be understanding but also backed the main dining room management's decision.

I also understand as a parent myself that getting a family ready for dinner on time is not easy, especially after a long day in port. However, the waiter has not just this table to serve but others and moving back to serving appetisers while everyone else is about to be served their main course really can cause a massive dollop of stress for the waiter. If perhaps they had Your Time Dinning or late seating it might have been manageable but early seating, nope, I support what the Maitre D did by asking them to use the Lido or come back later for a table

Heald also posted a poll asking his followers to vote on whether directing guests who were 40 minutes late to their seating to the buffet was a correct choice. 

His followers overwhelmingly agreed with the cruise line: 97% agreed with the decision and 3% said the cruise line should have tried to accommodate the family. 

SAVE MONEY ON YOUR CRUISE: Let our travel experts get you booked and sailing.

A comment from Pam Miller Downey seemed to illustrate how most people felt about the issue.

"They were late...that means not on time..that means they eat somewhere else. Most people who are 40 minutes late wouldn't even dream of going to the MDR. They would automatially go to Lido or one of the other eateries," she wrote.

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