Thread by @KashPrime

We should consider #oneshot vaccinating as many people as quickly as possible, and that means delaying a second dose of the vaccine. We have enough doses coming in by the end of June, that would cover nearly the entire adult population. Why? We are ignoring two thing:

Firstly, there is natural fatigue with Covid measures. I can feel it talking to patients. Better weather is coming, the euphoria around vaccination drives is palpable, and people will let their guard down. It’s only natural, but contagious variants will rip through the public

Secondly, now that we’re quickly vaccinating elders at risk, deaths will become rarer, but we will be ignoring one very important factor - disability. ‘Long Covid syndrome’ can cause issues long after acute infection. And it can wreak havoc:
pharmaceutical-journal.com/article/featur…

I work in a chronic pain clinic and have seen similar conditions before, labeled as Chronic Fatigue Syndrome or Fibromyalgia. Truth is, no one knows what causes these, and no one knows how to fix it. If Long Covid is similar, folks are in for a lifetime of pain and disability.

What’s scary is these patient’s will often have completely normal labwork and imaging tests, and will often by gaslit into believing that it’s a mental health issue. Many patients in my chronic pain practice who tell me, they would not wish their lives on their worse enemy.

Imaging how many promising lives are upended by long term symptoms such as fatigue, memory loss, chronic pain. What’s scary is, according to UK data, ~ 20% of people who recover may have some of these symptoms more than 5 weeks after their diagnosis.
ons.gov.uk/peoplepopulati…

How fair is it that the generations that had their economic future destroyed in the Great Recession, will now be asked to sacrifice the one thing they had left, their good health?
It is an outcome we can prevent by altering our approach.

Is it safe? @CIDRAP recommends altering strategy in their recent report With more transmissible variants will make changing course even more urgent. A summary thread:

https://twitter.com/OmanReagan/status/1365080498414837761?s=20

CIDRAP's recommendations go even further, with an idea of splitting Moderna's dose up into multiple doses, and delaying second doses for those who've already had Covid:

Public Health England found 72% effectiveness after one dose.
papers.ssrn.com/sol3/papers.cf…

an Israeli group estimates 90% at Day 21
medrxiv.org/content/10.110…

A survey of Quebec health workers estimates 79% at 21 days:
inspq.qc.ca/publications/3…

There are a lot of unknowns, another study from Israel shows big boosts in immunity after the 2nd dose, so we could give 2nd doses to elderly who have a weaker response to the first dose. And we should ensure that everyone gets their 2nd within 12 weeks

https://twitter.com/KashPrime/status/1364932190295982080?s=20

But I suspect we'll start to see more news like this one, where one dose may be enough to ward off the worst outcomes and save folks of all ages from a summer of misery and long term consequences.
dailymail.co.uk/news/article-9…

@DFisman @IrfanDhalla @FourWinns298 @PHealthGnome @BogochIsaac @zchagla @TorontoIDDoc @BrooksFallis @DrZoeHyde
@deonandan @JPSoucy

Looks like BC is already doing it:
H/t @LadyScorcher

https://twitter.com/richardzussman/status/1366457284482670594

Good to see Ontario actively considering it:

https://twitter.com/robferguson1/status/1366509066017767430