1/ Many are talking about gradually lifting public health measures as #COVID19 cases are dropping in Canadian settings.
What is needed to avoid undoing our collective efforts & sacrifices as we reopen? And how do we account for more transmissible variants (eg B.1.1.7)? 👇👇👇
2/ We often hear people say that because of the more transmissible variants we need to "double down" on control efforts & vaccinate.
What exactly does doubling down mean?
It most likely means keeping R at (or preferably below) 0.8 to account for greater transmissibility.
3/
Maintaining R at/below 0.8 would likely allow for a continued decline in cases as we see more B.1.1.7 circulate.
So what questions do we need to address to gradually & safely reopen in the context of community #COVID19 transmission & growing burden of B.1.1.7?
A few Q's👇
4/
-Can we slow down importing more variants of concern? We have pretty stringent border measures already, so, yes.
-Is the capacity for Test-Trace-Isolate-Support in place to keep up with the existing #COVID19 burden? Can this stretch to accommodate some degree of growth?
5/
-Are "wrap around" services available to ensure equitable access to support & protection?
"...making sure that people who are disproportionately impacted by this virus have access to the supports and protections they need..." Thank you, @joe_cressy
-Is the school environment safer? Smaller class sizes, ventilation, masks, etc?
-Are there policies to create safer work environments for essential workers & those returning to work? Paid sick leave, masking indoors, ventilation, screening with rapid tests, etc.?
7/
-Can the healthcare system accommodate potential surges in #COVID19 cases yet still function reasonably well? (e.g. not cancelling scheduled surgeries).
-Is there a framework in place that allows for rapid policy changes if there appears to be a dangerous growth in cases?
8/ There are probably a lot of other questions to highlight, but these are ones that struck me as being important & addressable.
#COVID19 vaccines will certainly help, but more widespread vaccine rollout is months away (late March/April?).
9/
If we haven't addressed upstream drivers of community infection (e.g. many equity related issues) and mobilized infrastructure/programs for community #COVID19 control, then we may see another cycle of lockdowns when restrictions are lifted.
3/ Long Term Care - a significant black eye for Canada, is also improving. We failed to protect our most vulnerable (twice!), but cases are rapidly declining, perhaps mirroring reduced community transmission, widespread vaccination, or both.
"85% effective overall in preventing severe disease & demonstrated complete protection against #COVID19 related hospitalization and death as of Day 28"
If this can keep people from getting very sick/prevent hospitalization/death then this is an obvious win.
3/ This is a single dose vaccine, requires conventional refrigeration for storage & would be much easier to administer to populations.
60% efficacy against B1351 is decent, but not amazing.
Important to point out that the numbers are still very small in this trial & this could change with more data. Also if the vaccine prevents severe #COVID19 disease (which it likely does), it would still be extremely helpful.
Just to clarify, in the South Africa study, efficacy is ~60% in those who were HIV negative, ~50% in entire trial including HIV+ individuals.
Still, no severe disease seen in #COVID19 cases confirmed to have B1351 (variant discovered from South Africa) in those vaccinated.
"Vaccination with the Moderna #COVID19 Vaccine produced neutralizing titers against all key emerging variants tested, including B.1.1.7 and B.1.351, first identified in the UK and Republic of South Africa, respectively."
(Also, yes this is science by press release, but see how they included valuable information/data here?)
There may still is an attenuated response to the variant discovered in South Africa, but it appears the vaccine will still provide some protection - and there is a lot more to an immune response than these antibodies.
1/ Colchicine may be an effective treatment for #COVID19.
In a well designed trial (prospective, randomized, >4000 people) colchicine "resulted in a 25% decrease in hospitalizations, a 50% decrease in the use of ventilation & a decrease in deaths by 44%.“ bit.ly/39Vwpls
2/ This was in non-hospitalized patients with confirmed infection.
Standard caveats: Press release, no preprint data, etc.
Colchicine is a cheap, widely available pill.
If this pans out it will be very helpful - works via anti-inflammatory (& immunomodulatory?) mechanism.
Also, I'm still baffled that a pre-print (with actual data/analyses) could not be made available at the time of press release. That should be standard.