The #COVIDzero approach recognizes that there is a disjointed approach to #COVID19 in Canada that is causing uncertainty, unnecessary suffering, economic hardship, and preventable deaths.
#COVIDzero is based on a goal of 0 cases with 0 tolerance for community transmission.
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The "moderate" or "balanced" camp scoffs at this aspirational strategy, minimizing it to "hashtags and platitudes...on social media", highlighting its impossibility, and contends that we need to focus on "improving our ability to live with #COVID19": nationalpost.com/opinion/opinio…
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The "live with COVID19" approach also argues to "focus on preventing transmission amongst our most vulnerable and within congregate living settings", despite the known failings and questionable ethics of "shielding" or "focused protection" strategies:
Most proponents of a #COVIDzero strategy understand that absolute elimination of #COVID19 is an aspirational strategy, but we also understand the need for a common objective to reinvigorate Canada's pandemic response.
As @DFisman says "don’t put the goal ahead of the task".
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Remarkably, many of the core strategies underpinning a #COVIDzero and a "balanced" approach are similar:
New @medrxivpreprint (not yet peer-reviewed) with @KevinAnBrown and colleagues examining temporal variations in the intensity of care provided to the 2,000 Ontario #LTC home residents who died of #COVID19 between March 11th and October 28th, 2020: medrxiv.org/content/10.110…
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While there was no official policy denying hospitalizations media reports (cbc.ca/news/health/co…) & testimony from Ontario's LTC COVID19 commission (ltccommission-commissionsld.ca/transcripts/pd…) suggest that resident transfers to hospital were strongly discouraged at the onset of the pandemic.
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To investigate this, we measured monthly variations in hospitalizations among community and #LTC-dwelling Ontarians who died of #COVID19 between March-October, 2020.
We found that monthly hospitalization rates were relatively stable among community-dwelling individuals.
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.
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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.
Let's review the escalating #COVID19 catastrophe in the province's care homes.
There are 14 active #LTC home outbreaks and 38 cumulative resident deaths. Today the @redcrosscanada was called into Parkview Place and Maples, the two hardest hit homes: cbc.ca/news/canada/ma…
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Earlier this year, @LTCcovid published international examples of measures to prevent and manage #COVID19 outbreaks in residential care and nursing home settings: ltccovid.org/wp-content/upl…
#Manitoba is failing miserably on almost every key measure.
There remain 22 active Ontario #LTC home outbreaks (see figure).
@ASPphysician has challenged me to say what must be done to get this under control.
Here it is (a thread).
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We need swift action to control community transmission of #COVID19 which is getting out of control.
In our @CMAJ study, the prevalence of #COVID19 in the community surrounding a home was strongly associated with the odds of an outbreak (aOR = 1.91): cmaj.ca/content/192/33…
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Controlling community transmission is imperative, as staff neighborhood characteristics are also significant predictors of outbreaks: medrxiv.org/content/medrxi…
The nonsensical requirement for potential visitors to test negative for #COVID19 within the previous two weeks holds visitors to a higher testing standard than healthcare workers!
As @drlesleybarron writes "I'm a HCW but my first #COVID19 test will be so I can visit my mom"
2/8
The biweekly testing requirement for a weekly visit is ridiculously onerous.
Many visitors will themselves be frail older adults with mobility issues, they're being asked to travel to and from #COVID19 assessment centres, often standing outside in the heat to await testing.
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