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Kashif Pirzada, MD Profile picture
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15 Dec, 5 tweets, 5 min read
Thanks to @MLInstitute for publishing our editorial on Canada's failure to approve and use rapid testing effectively in this pandemic. Many reasons we outline in the paper, but they need to be overcome if we want to beat this.
Thread ->
macdonaldlaurier.ca/failure-use-ra…
Even with vaccinations starting now, no one should assume the pandemic is over; it will take until late summer/early fall before normal life can resume. Rapid tests, done properly can help stop the cycle of lockdowns and reopenings we find ourselves caught in.
Halifax, Slovakia, Liverpool and other examples show that it can be done to suppress numbers, we just need to find the political will and logistical moxie to pull it off. This is something I wrote a few weeks ago:
We should always remember, rapid tests are not a replacement for PCR tests; they are meant to be used as mass screening tools, used frequently and regularly. They offer one of the best tools we have to prevent further waves of Covid-19 #nomorewaves

@michaelmina_lab @VicLeungIDdoc @TestandTraceCa @DFisman @IrfanDhalla @BMC_Patients @jkwan_md @MaryFernando_ @imgrund @SharkawyMD @ASPphysician @Samir_Grover @NightShiftMD

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More from @KashPrime

Kashif Pirzada, MD Profile picture
24 Nov
Lots of attention (finally) on rapid tests today, but it is important that they be used properly and in the right setting. They have limits, they are best at picking up people who are acutely contagious, they won't pick up those who are exposed and incubating the virus.
They need to be done frequently on a large population, perhaps twice a week. Someone testing negative one day, could very well test positive the next day. They are not a replacement for PCR testing.
They need to be coupled with supports; lots of the hotspots are in workplaces where people live paycheck to paycheck. We need to support these workers so that they keep their families fed while keeping their co-workers safe. Federal sick leave benefits should kick in seamlessly
Read 12 tweets
Kashif Pirzada, MD Profile picture
17 Nov
To get to #COVIDzero we need to look at Slovakia. Over two weekends, they brought their numbers crashing down, from an R0 of 1.47 to 0.62 in just two weeks Thread ->
How did they do it?
- They used two rapid tests from South Korea (Rapigen and SD Biosensor)
- They tested everyone between 10-65 twice over Oct 30-Nov 1, and Nov 6-8.
- Positive tests were isolated for 10 days.
- Untested citizens isolated for 10 days
Impressively, they mobilized 5000 eight-person teams, composed of health care workers, military medics and others.
They used polling stations as makeshift testing centres.
Results were available in 15 minutes
This way, they were able to test 3.6m out of 5.4m total population.
Read 8 tweets
Kashif Pirzada, MD Profile picture
15 Nov
I and #Masks4Canada are joining with many across the country in advocating for #CovidZero, the elimination of Covid-19 from our communities. I once thought this idea impossible, but watching Melbourne, Halifax and the rest of the Atlantic do it has been inspiring. Thread ->
This is likely the only way we’ll be able to save many lives, businesses and to return to some semblance of a normal life before vaccines are rolled out. Watching the US and Europe go through wrenching spikes and lockdowns is instructive. We can avoid their fate.
First, we need to aim for zero. Lockdowns are coming in parts of the country, which are futile until leaks in our system are plugged. Including:
- Locking down the US border (for real this time)
- Setting regional bubbles
- Bring in the Australian mandatory quarantine system
Read 11 tweets
Kashif Pirzada, MD Profile picture
4 Nov
How do we prevent US style polarization from wrecking Canada?

Already here we are seeing signs of populist echo chambers, fueled by new right-wing news sources and through private Facebook groups.
Like it or not, the US election was far closer than expected, especially given Trump’s missteps on Covid19 and ethical and many other lapses. Exit polls of his voters consistently showed that law and order as well as economic issues were their main concerns.
Hidden Tribes breaks the electorate into a number of camps. What’s interesting is the centre-left and centre-right folks form a silent majority. It’s extremists on the fringes who drive polarization, and the same is happening here.
hiddentribes.us
Read 9 tweets
Kashif Pirzada, MD Profile picture
4 Nov
Many of you are undoubtedly shocked by the election outcome tonight. Our American neighbours will endure 4 more years of brash, incompetent populism.

Can it happen in Canada?

I couldn't sleep, so here I’ll list reasons how I think we can avoid a similar outcome
The rot that takes place with the loss of democratic norms requires a society to be in great distress, like hyperinflation in Germany in the 1930s. A well functioning government anticipates and cares for its citizens and heads off these crises through shared action.
Firstly, our government is much better run. A strong civil service was able to roll out funding during the Corona lockdown in record time. We have non partisan judges, who issue perfectly bland rulings. Hardly anyone here would be able to name a judge on the supreme court
Read 10 tweets
Kashif Pirzada, MD Profile picture
3 Nov
Great to hear that the Ontario government is going to adopt clear metrics on when to open and close regions. This will keep politics to a minimum, especially now that things may have started to turn around in parts of the province.
R = 1.04, but growth is still happening in some of the restricted regions, particularly in Peel region
And Ontario has the lowest active case count per capita outside of the Atlantic bubble

Read 5 tweets

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