Thread by @NathanStall

Yesterday, despite rising #COVID19 cases, hospitalizations, and deaths in LTC, Ontario released a framework to "keep the province safe and open": news.ontario.ca/en/release/590…

This is nothing more than an ageist, ableist & unethical "shielding" or "focused protection" strategy.

1/12

A "shielding" or "focused protection" strategy (the latter was popularized by the Great Barrington Declaration: gbdeclaration.org) segments the oldest and most vulnerable to #COVID19, while allowing everyone else to resume life as normal with simple hygiene measures.

2/12

As many have already highlighted, the #Ontario framework establishes a very high threshold for closures and lockdowns: cbc.ca/news/canada/to…

Specifically, the 10% test positivity and incidence rate ≥100/100,000 thresholds for return to a modified stage 2 are very high.

3/12

Allowing this level of transmission will have catastrophic consequences for our #LTC population, where >2000 residents have already died of COVID19.

Our research clearly shows that the strongest risk factor for #LTC outbreaks is community incidence: cmaj.ca/content/192/33…

4/12

Ontario's "framework" says they will "put measures in place to protect those most vulnerable to COVID19", but as the Jon Snow Memorandum states, "prolonged isolation of large swathes of the population is practically impossible and highly unethical": johnsnowmemo.com

5/12

First, the "practically impossible".

@DFisman and colleagues showed us how lagged staff #COVID19 infections are a strong risk factor for #LTC resident deaths: jamanetwork.com/journals/jaman…

Shielding LTC residents from #COVID19, would also require shielding >100,000 LTC workers.

6/12

As the Jon Snow Memorandum also emphasizes, "empirical evidence from many countries shows that it is not feasible to restrict uncontrolled outbreaks to particular sections of society": johnsnowmemo.com

Why does #Ontario believe we are any different?

7/12

Second, the "highly unethical".

As @GanguliMitra and colleagues wrote, segmenting communities as a public health strategy "erases decades of work in disability activism" and institutionalizes ageism & ableism by "normalising exclusion from society": wellcomeopenresearch.org/articles/5-104…

8/12

Of course, locking down #LTC homes has had and continues to have catastrophic consequences on the wellbeing of residents.

There is now a new diagnosis called the "confinement syndrome" to describe the physical, mental, cognitive and functional adverse impacts of lockdowns.

9/12

Without a strategy to suppress community transmission and strive for elimination of #COVID19, we will be committing #LTC residents and many other older adults (and vulnerable individuals) to indefinite, harmful and deadly confinement.

This is ageist, amoral & unethical.

10/12

As David Cayley wrote in @reviewcanada, "there are fates worse than death, and one of them is the bullying of the old into the self-serving belief that we have incarcerated and abandoned them for their own good": reviewcanada.ca/magazine/2020/…

11/12

So let's be clear about the path that @fordnation and #Ontario has chosen.

They're choosing a not-so-covert "shielding" or "focused protection" strategy, and prioritizing the wellbeing of our businesses and our economy over the lives and wellbeing of our most vulnerable.

12/12