Cannot emphasize this enough. Our wait times were often terrible before the pandemic, anyone can review the data here:

hqontario.ca/System-Perform…

The wave 1 shutdown was an added burden in a system with heavily rationed OR availability to surgeons. #covidontario #waittimes 1/n
As noted in the editorial, “elective” is often a misnomer. I saw a neighbour go from walking dogs kilometres at when referred to ortho for a joint replacement to essentially immobile by the time of surgery nearly 2 years later. This is in the GTA. Haven’t seen him out since. 2/n
The BC Supreme Court in the Day case acknowledged that Charter rights to security of person can be infringed when health worsens due to wait list delays. So what is an “elective surgery”? 3/n
This document from @OntarioHealthOH has an interesting definition: ontariohealth.ca/sites/ontarioh…

4/n
Note that this definition comes from a paper written by staff at the University of Chicago. Surgeons in the US typically do not face the barriers to surgical scheduling that exist in Canada. “Without neg impact” is 🔑 wording here. 5/n
Given our baseline “accepted” wait for arthroplasty of about a year, it’s not clear to me that using a definition out of a publication based on the American experience, which contemplates delays of 2-6 weeks, is appropriate. 6/n
I have no idea how the government plans to succeed in maintaining access to usual surgical care and fixing added backlogs but it’s great to see that there are many intelligent people in Ontario working on this vital issue. It simply needs to happen. 7/n
Hopefully it sparks an ongoing discussion on matters such as rationed OR time and the impact on both patient care and the surgical workforce i.e. hiring of newly trained surgeons, which has been a huge issue across the country. 8/n

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More from @WinstonBharatMD

23 Oct
It seems Air Canada has managed to convince the federal government to employ rapid testing as an opt out of quarantine on the basis of preliminary results from a massively flawed study.

Seems like a bad idea. @BillBlair @marcomendicino @celliottability @IrfanDhalla

1/n
First, Australia and New Zealand remain the gold standards for the “Western world” in regards to COVID response. Both had mandatory hotel (not home w/relatives) quarantine at port of arrival, before going anywhere, mandatory testing AND drastically reduced int’l flights. 2/n
Australia diverted ALL international flights out of Victoria when Melbourne’s numbers skyrocketed in 2nd wave and cut total international arrivals by 40% concurrent with other restrictions. This is what happened after. 3/n Image
Read 18 tweets
25 Sep
Somehow nobody is talking about acute bed capacity.

Unlike the first wave, Ottaw public health is now reporting 100% of acute beds occupied despite only 14 COVID admissions. Image
Peel public health is reporting 92% acute beds full and 82% of ICU beds full Image
Toronto public health is doing a bit better at 89% acute bed occupancy and “only” 60% of ICU capacity full. Image
Read 5 tweets
11 Sep
Anybody trumpeting their Cambie decision as some sort of victory needs to read this.

“ I have also found...provisions have the effect of limiting the right to security of the person individuals who are suffering from degenerative/deteriorating conditions and waiting for... Image
...elective surgery in the public system beyond their wait time benchmarks associated with their diagnostic priority codes, even though the patients are available for surgery...
Specifically, some of these patients will experience prolonging and exacerbation of pain and diminished functionality as well as increased risk of not gaining full benefit from surgery.
Read 17 tweets
13 Jul
Disappointed to see the continued racist depictions of BIPOC victims of crime in the mainstream Canadian media after @CTVToronto @CP24 and @CBCNews used a mugshot in stories of a murder victim in Toronto meanwhile this is how white suspects of murder were depicted last year. ImageImage
Yet this is how someone who killed a cyclist while driving impaired is depicted after allegedly violating parole while speeding up a major highway impaired again. Has anyone seen Marco Muzzo’s mugshot? ImageImage
Here’s CP24’s depiction of a smiling serial killer Bruce McArthur.

The author of this piece is listed as the author of the (now edited) Mohamed Sow piece linked from the @CP24 tweet:

Image
Read 4 tweets
11 Jul
While Canada continues to import cases via the dozens of international arrivals daily, perhaps if we’re lucky by October the CBSA will catch onto the whole asymptomatic/presymptomatic thing.

Take the UP express, subway then 3 buses, what could go wrong?
The CBSA website and actions in relation to travellers arriving from out of Canada by air is a joke compared to what can be found in New Zealand.

Canada: “Please answer these honestly then be on your way”

NZ: mandatory direct managed isolation/quarantine AND COVID test 4 all.
health.govt.nz/our-work/disea…

The transparency and data release is foreign to what we could expect here.

Yes, NZ is a small country. It’s also done this better than pretty much any other country in the world.

@Travisdhanraj here’s something to ask about at those pressers! ImageImage
Read 6 tweets
6 Jul
This might be the single most asinine thing I’ve seen written by an individual with *some* subject matter expertise in the last 3 months. It’s in relation to the #sickkids report on school opening precautions. Image
It’s comically hypocritical as the author of this statement appears to have absolutely no background in child health or education whatsoever, but claims to be able to weigh the impact of months on end better than report authors who are ID docs AND paediatricians.
Nothing to see here folks, totally inconsequential.

(>20% of kids in Toronto love below the poverty line, nearing 50% in some wards)
Read 4 tweets

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