Thread by @awong37

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

Here is the COVID-19 non-ICU census for the province presented as 7-day rolling average.

The overall numbers (green) are clearly rising. Saskatoon (orange) and Regina (yellow) are peaking but not coming down as yet.

Northern (light blue) and Rural (purple) are rising still. /4

Currently, 74 persons are occupying ICU beds in #SK.

A little over 40% are currently (+) for COVID-19. We expect these numbers to rise in the coming days as hospitalizations continue to push higher, causing ICU strain once again like w/ Delta. /5

Point of emphasis:

COVID non-ICU cases at HIGHEST levels ever across Saskatchewan.

As result, non-ICU system capacity is MAXED OUT.

So YES, @SKGov declared an end to public health measures amidst worst non-ICU system pressures thus far in pandemic across province.

Sad. /6

In a positive sign, #SK's 7-day rolling average of PCR test positivity IS declining. Slowly.

This is a more reliable indicator of where #SK is at with Omicron compared to case numbers in light of restricted PCR testing.

Test positivity peaked ~Jan 30-31, per graphic below. /7

If #SK has peaked in community end of January, we'd expect hospital & ICU admissions to peak b/w Feb 14-21, and come down thereafter, if similar to other jurisdictions.

Caveat: very relaxed / non-existent public health measures in #SK MAY cause more prolonged peak. /8

How about BA.2, which has taken over as dominant strain in some parts of world? BA.2 = 30-40% MORE transmissible vs original Omicron.

We don't know what BA.2 will do in Canada. Will it cause second peak? If so, in face of relaxed measures in #SK, could be problematic. /9

A reminder slide on what is classified as 'priority groups' for publicly-funded PCR testing in #SK:

- Hospitalized pts
- Public Health outbreaks
- Symptomatic HCWs / essential workers w/ (-) RAT
- Symptomatic in Indigenous communities
- Symptomatic w/ high-risk conditions

/10

#SK remains second-last in 1st & 2nd dose vaccine uptake in Canada, only behind Alberta.

3rd dose uptake in those 18+ & eligible is better in #SK, the province is "middle of pack".

Still LOTS of work with regards to #SK's provincial vaccine push. /11

For #SK tweens/teens b/w 12-17, 3rd doses are NOW available.

Pfizer preferentially offered over Moderna (decreased risk of myocarditis), Moderna available on request.

Must be >5 months from 2nd dose. If your teens are eligible, please GO! /12

The Critical Care Resource Allocation Framework (CCRAF) was developed in Spring 2020 amidst COVID.

Goal = save most lives possible.

During Delta, criteria MET to escalate triage stage, but MAJOR barriers occurred including "reluctance to triage", operationalization. /13

This confirms the following:

When #SK was at Delta peak & transferring #SK ICU pts to Ontario, there was CCRAF formal request to escalate triage stage.

For political reasons, this didn't "officially" occur.

Result? Bedside triage, deaths, HUGE moral distress for #SK HCWs. /14

An update on early therapies in #SK.

To date? 156 persons rec'd sotrovimab, 26 rec'd Paxlovid.

Given number needed to treat of 16 (sotrovimab) & 17 (Paxlovid) to prevent 1 hospitalization, that's ~12 hospitalizations prevented so far.

Modest impact. Can do better, IMO. /15

Summary points:

- Community transmission appears to have peaked in urban settings, rural settings unclear.
- Hospitalizations / ICU admissions still rising. Expect trend to continue in coming days.
- Impact of early therapies has been modest.

/16

Everything is where we expected them to be with modelling, except KEY difference = we have not seen anywhere near HORRIBLE numbers predicted by modelling thus far (i.e. 750-1500 in hospital).

Case peak end of Jan means hospitals/ICUs should hopefully turn around 'soon'. /17

Unknowns?

Given #SK's relaxed protection measures & revocation of ALL of measures by March 1, what impact will this have?

Will Omicron drop quickly, will BA.2 cause a resurgence?

Regardless, dropping ALL protections WAS early by any medical or public health metric. /18

I don't think anyone is debating this point any longer, but for the record, the decisions announced earlier this week to remove all public health measures WAS motivated by political ideology, NOT public health guidance or a desire to save lives & minimize suffering. /19

Sorry, short rant.

The lack of meaningful #COVID19 data @SKGov is, IMO, shameful.

If you're going to give us a weekly update, AT LEAST give us better than yesterday's garbage.

LOOK at Town Hall data. Use same approach.

Inform your citizenry to make good decisions.

/20

Take-home?

- STILL lots of community transmission. Take care, be careful.
- #SK hospital capacity is MAXED OUT.
- Don't expect #SK hospitals to turn around for 7-10 days.
- Removing public health measures WILL prolong #SK's painful Omicron wave.

Stay safe #SK.

/end