Thread by @TorontoIDDoc

With respect to COVID, many of us have been on about hospitalizations and death, and how the vaccines relate. This is very important because it takes us back to why we are doing all of this in the first place THREAD: 1/

At the present time, SARSCOV2 is spreading in a pandemic fashion all over the world. It's a respiratory virus, but that has significant differences than others (e.g. influenza etc.) my goal here is not to dwell on these differences 2/

As we saw in Northern Italy and NYC, the big problem with COVID and unchecked community spread, is that you get a massive expansion of cases and from those, a large number of hospitalizations all at the same time. 3/

This renders the hospitals barely able to deal with the COVID patients let alone patients with other non-COVID issues. Before we had treatments, a large proportion of these sick patients were being put on ventilators, which also are a limited commodity. 4/

Based on this, and the knowledge we had at the time, it was clear that we had to do what we could to slow community transmission so that this overwhelming of regional hospital systems didn't happen, and of course saving lives/decreasing morbidity in the process. 5/

It's important to note that while in some places they were able to drive cases down (close to) zero, in most places, for a number of reasons, this was not possible and the virus remains in circulation. 6/

Lockdowns / restrictions are thus an imperfect way to try to keep community transmission low with the end goal of decreasing the burden on local hospitalizations. It's not meant to try to prevent every case. 7/

Why are so many of us excited about all the current vaccines even if one is 95% effective and one is 60something% effective? It's because those numbers are not reflective of a very important fact: they are ALL nearly 100% effective at preventing hospitalization/death 8/

Going back to tweet 7: if you now have a vaccine that's able to effectively and significantly reduce hospitalizations, you can eventually lift the very restrictions that have been such a weight on us over the last year 9/

Some important things come out of this. If you are almost eliminating hospitalization through vaccine, then the raw number of cases of COVID does not matter. If you have 350 people get a viral illness that is a mild cold, you don't need community restrictions 10/

Another big thing: if there is an increase in community cases in fall/winter (which we expect) the relatively low number of hospitalizations is something we can deal with WITHOUT having to restrict the community (we deal with flu every winter without lockdowns) 11/

What about the variants? Well all the vaccines are close to 100% effective in preventing hospitalization and death with those too! The vaccine can also be altered to better address these. We may require booster shots in the future, but won't have to restrict the community 12/

Finally we are seeing that the vaccines significantly reduce transmission as well! What does this mean? We have multiple vaccines which prevent people from getting severely ill from COVID, and also reduce transmission to to others. THIS IS OUR TICKET OUT THE PANDEMIC. 13/

In the very near future, because of vaccines, we won't have to worry about case counts. We won't have to worry about the threat of a lockdown or restrictions hanging over us. Most importantly, we don't have to worry about getting severely ill from COVID19. 14/

Taking the longview: normal life is once again actually conceivable and it's close! We will once again be with our friends and family. We will once again be enjoying restaurants, bars, sports, museums and whatever else you can imagine with company 15/

THIS is why I am so optimistic after a year of great difficulty, and despite case counts and variants and waves. It is within our reach. See you in a restaurant soon! 16/16

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