Very reasonable adjustments to the #COVID19 response in Ontario.

Message:
-Limit trips
-Work remotely
-Stay within your household

Significant adjustments to the colour-coded framework:

*Red Zone thresholds lowered* from 10% positivity to 2.5%; 100 new cases/100k to 40/100k. Image
It took a while, it took some pushing (translation: it took a lot of pushing), but the province moved on this. Phew. Good move.
Here is the updated framework.

ontario.ca/page/covid-19-… Image
Last point...always important to consider public health measures & how these may impact virus transmission, but also negatively impact marginalized groups/businesses. How do we best support the mental health & financial well-being of those impacted?
pp(p?)s: These measures may still not be enough given high rates of community transmission in Peel and Toronto, but they are certainly steps in the right direction. @IrfanDhalla

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More from @BogochIsaac

16 Nov
Wow - More positive #COVID19 vaccine news.

Moderna's interim analysis shows ~95% efficacy in their Phase 3 trial!

Yes, lots of unanswered questions & more science by press release, but very positive news none the less.

bit.ly/3fbsMdm
Other very helpful points:

"Of 11 participants who developed severe Covid while on the trial, all were in the placebo group."

"The results also suggest the vaccine is effective in older people and those from diverse ethnic backgrounds."

Nice.
From a logistical standpoint - MUCH easier to transport.

"the vaccine can be kept in a conventional freezer at -20C for up to 6 months and that once thawed the vaccine can be kept for up to 30 days at standard refrigerator temperatures of 2 to 8C."
Read 6 tweets
9 Nov
"A vaccine against #COVID19 is in sight, with the announcement of the first interim results in large-scale trials showing the Pfizer/BioNTech candidate is 90% effective"

Pro: Amazing- if this holds true.
Con: Science by press release, let's see the data.

bit.ly/36e4gUK
ps: Canada has access to this one.

pps: While clearly very promising and exciting, best to see the final data on safety and efficacy.

ppps: "People from black and minority ethnic backgrounds appear to have been as well protected as everyone else, the company says."
Additional helpful details:

-Trial is enrolling 43000 people
-They've had 94 cases of #COVID19
-Much more covid in non-vaccinated group...less than 10% of those vaccinated diagnosed with covid
-Protection seen 7 days after 2nd dose of vaccine
-Goal is to enroll up to 164 cases
Read 6 tweets
11 Oct
Fomite transmission (from inanimate objects) of SARS-CoV-2 is much less of an issue than previously thought.

Some recent data:
bit.ly/3nEtDH9
bit.ly/2FnTeD4

Hand hygiene is still important & I hope better hand hygiene is a lasting legacy of this pandemic.
Policy is keeping up with emerging data...

For example the CDC acknowledges that one can get infected from touching contaminated surfaces, but adds...

"Spread from touching surfaces is not thought to be the main way the virus spreads."

bit.ly/2SMi0Q8
Also, in a recent Lancet letter:

"Our findings suggest that environmental contamination leading to SARS-CoV-2 transmission is unlikely to occur in real-life conditions, provided that standard cleaning procedures and precautions are enforced."

bit.ly/3jVCsu8
Read 4 tweets
19 Sep
1/

More data demonstrating the low (but not 0%) risk of acquiring #COVID19 on flights.

2 business class passengers likely transmitted virus to 2 flight attendants on this 15 hour flight in early March, 2020.

No mention of masks.

bit.ly/3iKYMGf
2/

2nd example: On a 10 hour flight, 1 person (also reported in business class) likely transmitted to 16 others, out of 217 passenger & crew. Proximity a risk.

Once again: "Face masks were neither recommended nor widely used on airplanes in early March"

bit.ly/2ZTwT7c
3/

Could there be something about business class that facilitates transmission (e.g. seating arrangement/air flow, lax mask use)? Is this a real issue vs reporting bias? Not sure.

Other examples of rather limited #COVID19 transmission on planes here 👇

Read 4 tweets
30 Jul
1/

#COVID19 transmission on a train:

This study quantified the risk of infection based on duration and proximity to an infected person.

"Overall attack rate of COVID-19 in train passengers with close contact with index patients was 0.32%"

bit.ly/3hRhH1e
2/

TIME on train:
-Attack rate with 1-hour co-travel time is 0.25%, and with 7 hours 0.38%

PROXIMITY to case:
-Closer to index case = higher risk (shocker).
-3.5% attack rate if sitting next to case
-Attack rate drops significantly if >2 rows apart
3/

Take home points:

-Spread apart as much as possible
-Wear a mask
Read 4 tweets
10 Jul
The incredible S. Korean #COVID19 nightclub outbreak response:

>40k tests revealed 246 confirmed cases: 39% primary & 61% secondary

This is the gold standard of how to effectively conduct contact tracing, especially in stigmatized populations (see below) bit.ly/2ZQpnJC
"...prejudice against homosexuality, gay men in South Korea...discrimination & stigmatization...often unwilling to reveal their sexual identity. Thus, the Seoul Metropolitan Government consulted sexual-minority groups to discuss ways to encourage testing among gay men."👍👍👍👍
"To conduct contact tracing for this outbreak, we used multiple forms of advanced information technology, including location data from mobile devices, credit card payment history,...
Read 5 tweets

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