I found this discussion illuminating and stressful (because it was hard to know even where to start unpacking the somewhat strange takes on the current realities) - I can’t watch it because I can’t watch myself (cringey!!) but I learned a lot...
People really seem hung up on ??misrepresentations of health care capacity (why should your mismanagement make us lock down) rather than
1) it’s all us - health care is people and for all of the people, and uncontrolled COVID 19 hurts people and businesses simultaneously
2) the initial health care need projections were for an apocalyptic event and we assumed every able bodied HCW would just do what they could. We didn’t think we’d PLAN for that scenario, keep everything open, and watch it coming.
3) Many seem to think hospital and ICU capacity are the security blanket but really, treatments and support are pretty limited for this virus. Steroid reduce the very high death rate of people needing ventilation to still very high. All of the chat about high tech treatments-
Obscures that these are modest effects, and there is limited availability.
4) around a 1/100 chance of dying (1/10 if older) sounds less good than “99% recover”.
1/20 hospitalization also no cakewalk, and possible long term symptoms.
5) We can’t manage huge COVID surges without HAVING to compromise care for other people. We run a very lean system and staff are sick, leaving, stressed.
That has always been clear. Maybe people didn’t want to believe that but it’s the truth.
6) Businesses struggle while we are “open” because consumers are avoidant in uncontrolled COVID -without benefits of lockdown supports or lockdown control of cases.
7) Finding loopholes in restrictions benefits only the virus. Biology is not a lawyers game. We all lose.
7) We need to look ahead and strategize together. We have seen how this goes elsewhere and doing the right things now will save more pain later.
-Fewer contacts. -#DistanceHandwashMask

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More from @AntibioticDoc

22 Nov
To date AB has had better COVID19 stats than average:

3.5% hospitalized, 1.1% ICU, 1% deaths - because we identified a large number of nonsevere cases. Now with almost one in 10 tests positive we know there’s significant undercounting.
Low balling: if we keep going at this rate (not even increasing, although it is increasing) - infecting “only” 0.2% of the population weekly (say 1250 x7 days) with previous rates, we’d have about
90 deaths
90 ICU admissions
300 hospital admissions a week. (full facilities)
Moderate estimate:
If we are undercounting and 1% pop infected weekly, using modest rates as above again
440 deaths
440 ICU admissions
1540 hospital admissions a week.
Read 7 tweets
20 Nov
Med student started a thread on vertebral artery dissection ( causing stroke, sometimes severe) after chiropractic manipulationon #MedTwitter and my goodness so many people chiming in with terrible stories. Say no to neck adjustments-I have seen one case and it was tragic.
Headache, neck pain, and later neurological issues-dizziness, sensation symptoms one side face-other side body, balance, vision, swallowing, taste can be affected... lots of stuff can go wrong if your artery lining tears a little.
I’m a hospital based doc not a neurologist and saw this in training, but remember it VERY well because the patient had no symptoms before the adjustment (routine visit apparently) but refused to believe the adjustment caused it when we admitted them. (These can happen from...
Read 4 tweets
14 Nov
Apropos of...well, COVID19, I’m sharing a few of my favourite Dr. Who quotes. These are barely a start...

“Of course we should interfere. Always do what you’re good at.” – The Fourth Doctor, Nightmare of Eden (1979)
“Never give up. Never give in.” – The War Doctor, The Day of the Doctor (2013)

“Always try to be nice, but never fail to be kind.” – The Twelfth Doctor, Twice Upon a Time (2017)

“Anybody remotely interesting is mad in some way or another.” – The Seventh Doctor, THSITG (1988)
“There are some corners of the universe which have bred the most terrible things. They must be fought.” – The Second Doctor, The Moonbase (1967)

Read 8 tweets
11 Nov
I fear we have lost perspective on the measurable risk of the pandemic for both lives and livelihoods, and while we debate the worst harm, we are losing an opportunity to protect both. This is the worse we've seen so far.
A thread.
@ByMatthewBlack visualizations:
No plateau in hospitalizations, or ICU and we WILL be tight in ICU very soon. Image
Look at the heatmap coming up - more cases in older people, more deaths....although younger adults may still die or have serious complications too. Image
Read 6 tweets
24 Oct
...about COVID numbers.
(Note -I’m often up for a reasonable look at varied viewpoints, and can get along with people that I also violently disagree with. )

The 2 broad takes (with lots in between are

1) Not a big deal calm down girlie

2) holy #%*^ better do better

So for the “no big deal” crowd-
Let’s say case# and percent positivity and hospitalizations are all increasing because of increased testing, or maybe numbers are right but it’s less lethal

(both of those are *very unlikely*)#
First, the “no changes” thought experiment - we do nothing different, ride it out. Heck. Open up more. Infect the healthy - get it over with.
If you are right, everything is fine.
If you are wrong, densely populated areas see overcapacity hospitals excess preventable deaths
Read 6 tweets
22 Oct
So... Alberta COVID-
Record setting new cases is profoundly concerning.

Overall in Alberta so far, 5% of cases hospitalized, 1-2% go to ICU and 1% die. (The improvement in COVID outcomes from the use of dexamethasone would reduces the risk of death by up to 25%.)
Right now the ICU proportion in Edmonton and Calgary is actually high, in the 4-7% range. Very sick people.

Percent positivity is 3.15%
- rate is 4.2% in Edmonton since October 8. Part may be reduction of low likelihood asymptomatic testing

BUT the numbers and % both ⬆️
>30 cases daily in people over the age of 60 and climbing over last days*

The daily case rate NOW is six times higher than it was in April.

The number of new outbreaks over last 10 days (of voluntary restriction) is about the same as previous 10 d (40-45/ 10 d)

Read 12 tweets

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