Discover and read the best of Twitter Threads about #sk

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Latest wastewater data for #SK communities was released earlier today. It's NOT good.

Let's work through what has been going on over the last couple of weeks as BA.2 has taken complete hold across Saskatchewan.

Short 🧵 - here we go. (1/7)
Regina & Saskatoon have seen HUGE increases in wastewater viral burden since early April. It's all driven by the more contagious BA.2 Omicron variant.

@LaurenPelley tweeted last week as Saskatoon's viral burden increased an astonishing *742%*. (2/7)

As of Apr 13, Saskatoon's viral burden has increased by yet another 25%, setting a new historic record once again. Nuts.

Viral burdens are TRIPLE that of the worse levels seen with Delta last Fall. It's all BA.2 - 99.3% now. The tiny 0.7% remaining is BA.1. (3/7)
Read 7 tweets
Between February 1-26, 143 Saskatchewan citizens have died from #COVID19, despite Omicron being "less severe".

That's an INSANELY high number.

Saskatchewan's most deadly month thus far was October 2021, when 156 people died during our horrific Delta wave. /1
As highlighted by @DrKyle, Saskatchewan's death rate from #COVID19 is more than DOUBLE that of the 2nd highest province, Manitoba.

No province is even remotely close in terms of deaths per capita at this point with Omicron. So embarrassingly bad. /2

With 2 days left, February 2022 might not technically be Saskatchewan's deadliest month during this pandemic, but remember... there's only 28 days in February vs 31 days in October.

If you pro-rate 5.5 deaths per day (February 2022's deaths per day) x 31 days? *170* deaths. /3
Read 5 tweets
Hi, Saskatchewan.

Though @SKGov has now dropped all #COVID19 protections & mandates, sadly, COVID is NOT over.

#SK hospitals & ICUs remain packed.

Patients are being admitted, and dying, tragocally, eacn and every day.

A short 🧵 below for my fellow Saskatchewanians. /1
Please, be mindful of our medically vulnerable, kids under 5 who can't be vaccinated, the elderly & frail. Those who will and already face long COVID.

Respect their health and their right to live their lives as fully as possible in a manner that is safe & low-risk. /2
If your immediate response for those who are vulnerable to or anxious of COVID is, "well, just stay home"?

Remember how you felt when "others" said the same to you about mask mandates or proof-of-vaccine programs.

Let's end the divisiveness. Let's do things TOGETHER, safely. /3
Read 11 tweets
Weekly Saskatchewan COVID-19 data for Feb 13-19.

- 37 deaths over 7 days. 1 b/w 20-39, all others >= 40
- Hospitalizations & ICU admissions decreasing (phew)
- Weekly test positivity 14.4% (last wk ~20%)
- ALL Omicron (no breakdown of BA.1 vs BA.2)

Brief 🧵 /1
Let's start with key data around hospitalizations & ICU admissions.

Week-by-week hospitalizations down 9% to 372, ICU down 18% to 27. Slowly coming down, thankfully.

Of those with known COVID status, 42% in hospital/ICU "due to COVID", 58% "incidental". /2
We can see that overall hospital admissions per day definitely decreasing now across all regions of Saskatchewan, but it's a relatively slow decrease, likely driven by limited protections we have in place provincially.

Still, this is reassuring and encouraging. /3
Read 15 tweets
Saskatchewan #COVID19 wastewater data released today for 4 #SK communities.

Both Saskatoon & Regina showing significant INCREASES in viral load week over week. Discouraging.

Reasons for increase unclear at this time. BA.2 driven?

Brief 🧵 to review #SK wastewater data. /1
Let's start with Regina.

@UofRegina wastewater analysis shows rebounding viral load levels week-over-week, suggestive of ongoing high rates of viral transmission in community.

BA.1 remains dominant but 18% BA.2 reported too. We expect BA.2 to dominate in coming days. /2 Image
Also, note that @UofRegina plot is time-lagged by 13 days, as the most recent analysis comes from the time period b/w Feb 6-12 inclusive.

So presumably proportion of BA.2 in Regina is higher now, just don't know how much higher. /3
Read 11 tweets
"Hi Alex, what's BA.2? Is it a little bad or is it REALLY bad?"

BA.2 is a sub-lineage of Omicron. The 'original' lineage of Omicron is designated as BA.1 & remains the dominant strain circulating in most parts of Canada currently.

A brief 🧵 of what we know thus far. /1
BA.1 & BA.2 are both classified by @WHO as Omicron, but are distinct viruses. See the phylogenetic diagram below (thx @kallmemeg).

BA.2 has over 25 mutations that differentiate it vs BA.1.

Many questions still exist around how similar BA.1 & BA.2 are clinically. /2
Danish pre-print data comparing transmission of BA.1 vs BA.2 in household settings suggests BA.2 IS more transmissible than BA.1.

BA.2 also LIKELY possess more immune-evasive properties vs BA.1 that could reduce vaccine efficacy. /3…
Read 20 tweets
Great @SaskHealth Town Hall last PM re: #COVID19 in Saskatchewan. Key points:

- Community MAY have peaked w/ Omicron.
- Non-ICU/ICU numbers STILL rising
- #SK non-ICU system capacity MAXED OUT.
- Relaxed public health measures in #SK = LONGER & MORE SEVERE Omicron wave

🧵 /1
Let's start w/ cases, non-ICU & ICU COVID patients, & deaths.

CASES (blue line) are falling. This may be artificial to degree given limited PCR testing in #SK.

HOSPITALIZED (non-ICU) patients (light green 'shade') are at HIGHEST LEVELS of pandemic, now exceeding Delta. /2
ICU patients (dark green 'shade') are rising but nowhere near levels seen w/ Delta when #SK had to fly patients to Ontario.

DEATHS (red line) are rising gradually with Omicron but remain considerably lower than #SK's Delta peak. /3
Read 21 tweets
While Moe again declares public health measures basically over in the midst of a COVID wave, we've been approached to promote a weekly action for teachers & others starting Groundhog Day. We support this action & we'll elaborate how & why you should participate. #covid19sk 🧵/1
So Scott Moe—once again—against all medical advice, wants to declare #covid19sk over when it’s surging, & get rid of all measures to protect us, based on the flat-Earth anti-vax view of the world that vaccines do nothing to prevent Omicron infection/transmission. #covid19sk🧵/2
Moe has openly aligned himself with the anti-vax side, all so they don't run off to a new right-wing party—which will not unseat the SaskParty but cause losses in urban ridings to the NDP. That's the reason. #covid19sk 🧵/3
Read 13 tweets
Yesterday, Premier Moe said #COVID19 cases in Saskatchewan are more frequent in the vaccinated vs. those who aren't.

THUS, vaccines DON'T prevent infection with or transmission of Omicron.

The Premier's conclusions are INCORRECT. But why?

It's complicated. Here we go.

🧵 /1
The Premier's incorrect conclusion stems from a simplistic interpretation of the data. 'Base rate fallacy' is one problem, but there are MANY other factors at play.

We explained 'base rate fallacy' with cases & vax status back in August. See below. /2

For 'base rate fallacy' & #COVID19 & hospitalizations, this is the diagram EVERYONE uses (thx @MarcRummy).

MANY more people are fully vaccinated now, so even though a small proportion of them go to hospital, the absolute numbers are the same as those unvaccinated. See below. /3
Read 25 tweets
"Hi Alex. I have #COVID19 infection. Should I try to get Paxlovid? What is it? Will it help me?"

Short answer: YES, you should.

BUT, there's LOT of things to know about it, and your eligibility for it will depend on where you live + many other things, too.

Explainer 🧵. /1
Paxlovid's generic name is nermatrelvir/ritonavir. It's a combination of 3 pills taken twice daily for 5 days.

Nermatrelvir is a "protease inhibitor". It works by blocking an enzyme ("protease") that the virus needs to manufacture new copies of itself. /2
In this situation, Ritonavir acts as what we call a "booster drug".

It inactivates an enzyme in our bodies called CYP3A4 that plays an important role in metabolizing and removing many medications from our bodies.

This allows nermatrelvir to exist longer in our bodies. /3
Read 15 tweets
Earlier today, @PremierScottMoe posted a letter. In it, he stated:

- Being vaccinated DOES NOT prevent one from contracting #COVID19
- Vaccines are NOT reducing transmission of #COVID19

Both statements are FALSE & should be corrected ASAP for the record. Thank you.

🧵 (/1) ImageImage
Many studies show 3 doses of mRNA vaccine (Pfizer or Moderna) provides 60-70% protection (vaccine effectiveness, VE) vs Omicron infection.

If you don't get infected, then you don't transmit the virus. Simple.

So being vaccinated, esp. w/ 3 doses, makes a HUGE difference. (/2)
Here is a recent pre-print from Moderna showing ~68% VE against Omicron infection with 3 doses of vaccine.

Also, VE to prevent hospitalization w/ Omicron following 3 doses was >99%. That's HUGE. (/3)…
Read 13 tweets
On January 18, @PremierScottMoe posted a graphic comparing "real-time" QC / ON / MB hospitalizations / ICU admissions vs. SK.

Problem: SK is ~3 weeks behind those provinces w/ our Omicron surge.

We MUST be careful interpreting this data. We're NOT OK, Saskatchewan.

🧵👇 (1/n)
A more reasonable and appropriate comparison would be to look at where MB/QC/ON were at ~3 weeks from Jan 18 to create a more fair "apples vs apples" graphic.

For those 3 provinces, that would take us to about Dec 28. Let's see what the data shows us. (2/n)
We have #QC data from Dec 28 & Jan 18 in the graphics below courtesy @sante_qc:

Dec 28: 804 in hospital (including ICU), 128 in ICU
Jan 18: 3425 in hospital (including ICU), 285 in ICU

Read 11 tweets
"Hi Alex, I have 2 doses of vaccine & JUST recovered from COVID. I'm eligible for a 3rd dose. When should I get it?"

Great Q. You assuredly had Omicron, so while you're eligible to get your booster 'right away', I'd personally wait at least 6-8 weeks. Why?

Short 🧵 👇 (1/n)
First, getting a 3rd dose even AFTER you've recovered from Omicron makes sense. You're further bolstering your immune response from whatever the 'next' variant will be. *Big sigh.*

Better for your immune system to be ready for whatever this pandemic throws at it next. (2/n)
Second, DON'T get a booster dose when you're symptomatic.

You're putting persons at risk of exposure to Omicron, and your immune response to vaccine WON'T be as good as when you've fully recovered and your immune system has had a chance to calm down. (3/n)
Read 7 tweets
As a responsible Saskatchewan citizen I cannot remain silent in the face of what I perceive to be a dangerously irresponsible COVID communication strategy I see being followed by @PremierScottMoe at this crucial point in the protracted pandemic 🧵(1/12)
It's understandable that many citizens are experiencing a growing sense of fatigue in our struggle with COVID. We all hunger for some hopeful news about an impeding end to this pandemic. We're like a patient with a serious cancer diagnosis hoping for an imminent cure (2/12)
In communication with a patient who has a serious cancer diagnosis, responsible physicians always include messages of hope but they do not shirk their professional obligations to be truthful even when that truth is hard to hear (3/12)
Read 13 tweets
OK. #SK COVID-19 mega-thread.

NEW #SK Omicron models (via @DennisKendel) Jan 19:

- Measures implemented to SIGNIFICANTLY reduce social mixing, MAYBE we avoid disaster/triage in #SK hospitals.

- Do NOTHING, #SK hospitals crushed, triage ensues.

Get comfy - here we go.

Let's begin with history.

@SKGov was provided w/ models from WORLD-CLASS #SK modeler Dr. Nate Osgood in late August 2021 that predicted EXACTLY how #SK ICUs would be overwhelmed w/ Delta in Fall 2021.

Nothing was done. Everything left wide open.

Also August 2021, consensus letter sent by #SK MHOs (led by @CoryNeudorf) to @SKGov recommends NUMEROUS measures to stem Delta:

Universal indoor masks, proof of vaccine, gathering/capacity limits, increased contact tracing capacity.



Read 25 tweets
Many #SK families are worried re: return to school Jan 3. How safe are our kids & school staff?

Omicron in Regina and Saskatoon is surging. We'll continue to see record case numbers for weeks.

@SKGov, what's your plan? We NEED to know.

A 🧵 on safe schools, below. (1/n)
Let's begin with other provinces who are RIGHT in the storm of their Omicron surges. Quebec has delayed opening of 'everything' to Jan 17. Ontario has delayed opening till Jan 5 to try to distribute HEPA filters & N95s for staff (not students). (2/n)…
A respected colleague in Toronto, @drmwarner, reasonably argues for a 1-2 week delay IF a delay will increase booster doses for school/daycare staff, improve vaccine uptake for ages 5-11, & solidify distribution of HEPA/N95s/RATs in schools. (3/n)

Read 18 tweets
Modelling released by @SKGov predicts DRAMATIC rise in cases, hospitalizations, & ICU admits w/ #Omicron if no additional measures to reduce contacts (i.e. gathering & capacity limits).

Briefing today: NO measures to be implemented at present. Wait and see.

Here is ICU / non-ICU modelling data. Not great, as you can see. Also not being taken into account - scores of HCWs taken out of circulation as a result of widespread community transmission.

Who will look after all the patients? Many HCWs have already moved on.

Once again, there is an appeal to personal responsibility for #SK citizens to make good choices, do the right thing.

No surprises here. Get vaccinated, improve ventilation, use your best mask, etc.

Read 6 tweets
"Hi Alex. With #Omicron in Canada, what's the optimal 2nd dose interval for kids b/w 5-11 who have 1 dose?"

VERY different space w/ Omicron now vs 4 weeks ago when NACI guidance was released.

We'll try for 3-4 wk interval in #SK for our 5 year-old, NOT 8. Here's why. (1/n)
Let's start by acknowledging that we have no real clinical data in this space right now. We don't know HOW protected kids b/w 5-11 are with 1 dose vs different variants like Delta or Omicron.

Kids immune systems are ++ robust, so 1 dose definitely confers some protection. (2/n)
That said, NACI guidance on 8 week interval was developed before we knew about Omicron. Extending dose intervals makes 100% sense to optimize long-term protection and minimize risk of heart inflammation events, etc. (3/n)
Read 7 tweets
Private surgery in #saskatchewan will transfer public dollars into private pockets. It will add a layer of costs.

Increasing capacity of our public system would be more efficient. #covid19sk #skpoli @drkyle @ShellyRiffel1 🧵/ 1
Setting up private surgery within public health system is likely a step towards full privatization where patients would pay directly for for-profit surgery in contravention of the Canada Health Act. #covid19sk #skpoli @hinz_tamara / 2
This potentially explains Moe's bizarre flirtation with separation / separatists. It's not about a distinct “Western Canadian” or #SK’s “distinct culture,” it's about defying federal jurisdiction in order to advance their privatization agenda.#covid19sk #skpoli @SUNnurses / 3
Read 4 tweets
A LONG explanatory 🧵 on ICU 'capacity' & 'flow' in Saskatchewan & why we need MULTIPLE interventions to avoid compromised care for ALL #SK citizens & triage.

I'm going to use an analogy of ICU capacity = bathtub. Patients = water. Health care system = house.

Water is running into the bathtub. That's all the patients who need ICU care in Saskatchewan. Some have COVID, some don't. The patients have now overflowed our ICUs.

To cope, we've built walls up on our bathtub to hold more water. That's our 'surge' capacity.

We can only build walls up on the tub so much, because there's limits on what can be done safely w/ availability of specialized staff, especially nursing & respiratory therapists (who support ventilated persons).

We've reached that limit w/ ~120 pts in #SK ICUs.

Read 19 tweets
Summary 🧵 of last night's SHA "town hall" for MDs:

- Overall #SK test positivity ~14%
- Cases declining, but so is testing
- #SK has HIGHEST current case & death rates of all provinces
- HIGHEST ICU census per capita of ANY province at ANY point in pandemic.

Vaccine & mask mandates have helped, but not enough. #SK remains in exponential growth & cases NOT coming down at this point.

Public health experts @SaskHealth recommend gathering restrictions, including limits on household gatherings, capacity limits, etc.

As of 0730hrs yesterday AM (Oct 21), 117 persons in ICU. 57 persons on high-flow oxygen (Optiflow) normally in ICU, cared for on regular hospital wards.

ICU census now forcing out-of-province transfers, widespread service slowdowns, and informal triage.

Read 8 tweets
This is an explanatory 🧵 on ICU capacity in Saskatchewan, the different levels of ICU care & support provided across #SK, and why freeing up ICU beds in Regina & Saskatoon is SO important right now for us.

Put plainly: "not all ICU beds are equal"


Not all ICU "beds" are created equal. There's different capability levels to provide support for complex patients depending on the expertise of available doctors, nurses, respiratory therapists, and specialist support. (2/n)

Let's divide "care levels" into 3 buckets:

✅ 1. BASIC = ventilatory support, cardiac monitoring, IV blood pressure management, sedation, high-flow O2 support

✅ 2. SPECIALIZED = BASIC + continuous renal therapy, complex ventilatory support (eg. proning)


Read 11 tweets
Some data slides released today @SKGov w/ accompanying discussion via Dr. Shahab.

Short 🧵 w/ commentary.

First, being unvaccinated in #SK = 28X risk of ICU admission, 13X risk of hospitalization, and 6X risk of getting COVID vs. being fully vaccinated. (1/6)

Second, ~50% of all persons admitted to hospital in October had 1st positive COVID test on/after being admitted. This informs approach to early therapy, monoclonal Abs, etc.

Earlier testing & identification of illness clearly ideal. (2/6)

Overall #SK ICU census numbers continue to rise dramatically, shown by the graph on the right, attached. This is what's killing us right now.

We need relief through combination of public health measures, more ICU staff, and out-of-province transfers. (3/6)

Read 6 tweets
Kudos to ALL #SK MLAs who have shown support for masks, vaccines & #SK HCWs via #SKMLAchallenge.

This 🧵 CELEBRATES our #SK MLAs by compiling their posts.

It's BOTH REFRESHING & EFFECTIVE to see unified public health messaging from our elected leaders. Thank you!

Read 7 tweets

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