1/#COVID19 the path forward:
Last week @sdbaral@HeidiTworek@zchagla@kwadwo777 put together recommendations on how we get through this pandemic with the least collateral damage. We focused on:
Essential workers
Rapid testing
Schools
LTC
Communication
Vaccine hesitancy
2/ Essential workers:
-Invest in infection control and prevention (IPAC) in settings like plants, factories and warehouses.
-Use occupational health specialists in these settings to help navigate this.
3/ Essential workers cont.
-Introduce Paid Leave when there are outbreaks in LTC, hospitals, homeless shelters, and offer housing supports.
-Must have a plan for everyone we test (ie. provide an isolation site). theglobeandmail.com/opinion/articl…
4/Rapid tests
-Introduce In Clinics:
-Identify people at the testing centers and link them directly with public health to avoid not being able to reach them if they have a positive test.
-Offer isolation centers if needed for the vulnerable or those in multigenerational homes.
5/Rt cont
Introduce in LTC:
-Implement rapid tests into every LTC facility.
- Identify positive cases at the door before someone enters the facility.
-Recruit volunteers from the community and add new hires into LTC so that everyone has a resolved test by the time they come in
6/ Introduce in Factories/Warehouses:
-Must tie in rapid tests in these settings with social supports to provide an incentive to take the test and to take time off if required through Paid Leave.
7/Integrate a simple assessment using the following questions: “Do you have a place in your household to isolate?” (ie. no) and “Do you live in a multigenerational household?” (ie. yes).
-Provide an isolation site (ie. a hotel)for the employee to wait before getting their results
8/SCHOOL REOPENINGS :
Childhood development is incredibly important, and closing all of our schools to solve all of our problems is an oversimplification.
9/we suggest:
-Use our public health resources to re-open schools and consider Rapid Testing to track transmission in schools.
-Put public health in charge: use public health resources to track schools effectively and look at what happens to community transmission.
10/Other provinces have managed a balanced approach, with schools remaining open despite hard lockdown measures (ie. BC, Manitoba).
*Areas in Europe have prioritized schools reopening and have performed much more testing (ie. random testing weekly in schools).
11/Communication:
- Connect public health officials with civil society by choosing 1 main communicator in Ontario. This person must be an excellent communicator that people can trust, and who speaks in a clear manner that people can understand.
12/ -Meet people where they’re at: use social media platforms (ie. Snapchat, Facebook, Twitter) for efficient and effective communication and use interactive materials (ie. graphics, videos).
-Use diverse languages and cultures in messaging.
13/ -Advocate for approaches that lower risk but allow us to be human.
*In the middle of a Canadian winter why aren’t we talking about ways to do things safely outside?
14/ADDRESSING VACCINE HESITANCY:
-Communication must be proactive. In countries where governments released good guidelines rapidly, less of the public bought into misinformation.
-Provide simple messaging.
15/ -Better explain the meta-narrative of science in an accessible way (ie. what are mRNA vaccines, clinical trials, address concerns about allergies).
-Avoid vilification and welcome questions.
17/These principles apply to the new variants.
The main thing is to focus on the major sources of spread. This will allow for more focused/strategic interventions with less collateral damage.
This thread is about steps/ideas that can be done to make healthcare more sustainable. Evidence for these will vary, but Im hoping this will increase awareness and start the dialogue. This will also help guide the direction of future shows.
Early goals of care discussions.
We shouldnt be having these conversations after putting our loved ones on life support. Lets have honest conversations with our loved ones. Lets respect their values.
Furthermore, the cost of taking of ICU pts is crazy.
-$3000/day
-1% of GDP
-Population is aging
We really need to think about who is actually going to BENEFIT from an ICU admission