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Irfan Dhalla Profile picture
@IrfanDhalla
Sep 16, 2020 • 3 tweets • 2 min read • Read on X
Thread: I've tweeted before that I find this the most worrying graph in Ontario.

This figure shows that we are contact tracing less successfully in September than we were in June.
This is of course because people have more contacts. But we must invest in #TestTraceIsolate so that we can continually improve the effectiveness of contact tracing even while we increase the number of contacts we have.
Given that #TestTraceIsolate isn't good enough right now, we need blunter instruments in many areas while we improve #TestTraceIsolate.

Some blunter instruments:
-stop indoor dining
-encourage work from home
-lower social gathering limits
-travel advisories
-universities online

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More from @IrfanDhalla

Irfan Dhalla Profile picture
Aug 27, 2021
Thread: The new @CDCMMWR paper about a Delta outbreak in a California elementary school shows the value of a layered approach to keeping kids in schools and keeping outbreaks small.

I counted 14 relevant factors. (And I'm sure I missed some.)
1. Lower community incidence - if the teacher didn't get infected in the first place, no outbreak at all.

2. Mandatory vaccination of staff - all teachers but two were vaccinated.

3. Better education re: staying home when sick - teacher worked for 2 days despite symptoms.
4. Better adherence to masking - teacher read to children while unmasked.

5. Test-based screening - what if the teacher had been testing every day or every two days?

6. Easy access to diagnostic testing - what if the teacher could have had a sample collected at school?
Read 6 tweets
Irfan Dhalla Profile picture
Dec 23, 2020
A thread on travel, Covid-19 and 🇨🇦.

1. International travel is likely playing a very small role right now. Community transmission is raging, and international travelers are required to quarantine for 14 days.

Interprovincial and regional travel may be a different story.
2. Lab-based PCR testing capacity is severely constrained in the public system. Using it for asymptomatic travelers is not a great idea.

3. Using rapid antigen tests to shorten the 14-day quarantine period might seem to make sense. But...
4. We'll miss some cases for sure if we do that. Might be OK, but...

5. As we vaccinate more people, and as winter turns to spring (or, less optimistically, spring turns to summer), travel-related cases will start to form a greater proportion of a smaller number of total cases.
Read 6 tweets
Irfan Dhalla Profile picture
Nov 26, 2020
Thread: We all know we need to keep improving #TestTraceIsolateSupport to get us out of the lockdown, and to save lives.

The chapter on testing, case management and contact tracing in the Auditor General's report is a GREAT blueprint for improvement.

auditor.on.ca/en/content/spe…
Recommendation #1 is about lab testing capacity and adequate funding for hospitals.
Recommendation #2 is about making sure @PublicHealthON is properly funded and that the behind the scenes work is being properly coordinated.
Read 10 tweets
Irfan Dhalla Profile picture
Nov 3, 2020
Thread: 6 things I'd suggest we do differently.
1. Every day, in every way, emphasize the core behaviours we want to encourage:
-stay home except for essential purposes, school, health care and healthy outdoor activity
-get tested and self-isolate if symptomatic, even mildly
-get tested if exposed
-emphasize work from home
2. Improve our #TestTraceIsolate strategy.

Don't let perfection be the enemy of the good.

Keep making testing more accessible.

Restart contact tracing.
Calling 50% of contacts is better than calling no contacts.

Keep improving and tweaking.
Read 8 tweets
Irfan Dhalla Profile picture
Oct 11, 2020
Thread: I've exchanged views about Covid-19 with someone from the business world over the last 48 hours. I thought I'd share what I think is an emerging consensus.

The goal is to help bring us closer to a "whole of society" approach to dealing with the virus.
First, the impact of the virus - and muddled responses to the virus - on investors, businesses and employees has been absolutely massive. In some ways this is stating the obvious, but it's important for those of us with secure jobs to keep reminding ourselves.
Second, investors and business owners need to be able to plan. More transparency, and continuing to strive for agreements across partisan lines, would be helpful. For example, transparent, pre-defined targets for re-opening or closing would allow businesses to plan.
Read 10 tweets
Irfan Dhalla Profile picture
Jul 9, 2020
Thread: I know and admire many authors (e.g., @drbobbell, @OnyeActiveMD, @vg_to, @UofTMedDean, @trclosson, etc.) of the "balanced response" letter re: Covid-19.

But I worry about the overall tone of the letter, and I also have three specific concerns...
1. The letter says that "with ready access to health services, severe outcomes can be averted in those who do not have pre-existing risk factors."

This is misleading. Covid-19 does occasionally kill healthy people who are in the prime of their lives. nytimes.com/2020/07/06/hea…
2. The letter says that the "consequences of the public health measures" are being borne disproportionately by "those in lower income groups, Black and other racialized groups, recent immigrants and Indigenous people."

I agree. But...
Read 9 tweets

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