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Kashif Pirzada, MD Profile picture
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30 Mar, 4 tweets, 2 min read
Canada is having its wave ahead of America... something we haven't seen before. Usually we benefit from 2-4 weeks of warning from the US, now roles are reversed: we're the under performers, the canaries in the coal mine. h/t @jkwan_md for the figures.
And we we're the first in North America to see the new variants absolutely ravage younger and younger people:
And we are steadily seeing our ICU system fill up. We have far fewer critical care beds per capita than in the US
Hopefully this will be the final wave, let's aim to eliminate community transmission through some common sense measures:

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More from @KashPrime

Kashif Pirzada, MD Profile picture
31 Mar
We are facing our 3rd lockdown in parts of Canada. It sucks, could have been prevented, but here we are. How can we make sure this is the last time this happens? With vaccines and summer weather coming, we have a golden opportunity to eliminate Covid completely... Image
We should adopt common sense measures used by Nova Scotia, Newfoundland, Australia etc. to hammer case numbers down. Life in these places is mostly normal, with brief lockdowns whenever an outbreak happens. Schools are safe, businesses are thriving, and no one is dying Image
Why is it important to do this? Although most adults will be vaccinated, children will be left unprotected. Most don't get seriously ill with Covid, but they can get disabling long-term symptoms. No one knows for how long, but can we take that risk with 10% of all children? Image
Read 10 tweets
Kashif Pirzada, MD Profile picture
21 Mar
This is thread of cases to get the point across that variant Covid is brutalizing young people. Please post your own cases in the replies.

35 year old teacher with no medical problems got severe Covid from a student. 65% sat on room air, went straight to our ICU. UK variant.
A colleague's case, 30 year old man admitted with Crohn's flare, deteriorated over night, required high flow oxygen and is now in the ICU
What it should look like:
Read 8 tweets
Kashif Pirzada, MD Profile picture
20 Mar
With the province opening up indoor dining to more people, I've decided to go into the restaurant business. Ventilators for every patron. Come for the steak, stay for our in-house ICU team!
But seriously, going out to a crowded restaurant is a really bad idea. Even if the government allows something doesn't mean it's wise to do it. Order lots of take-out to support businesses, but please, don't expose yourself right when vaccinations are kicking into high gear.
My colleagues and I are seeing many, many younger people with severe Covid, down to their 30s. These variants are a different beast, and even if you're young it may not spare you and loved ones from a lot of grief. What was safe to do before is simply not so anymore.
Read 5 tweets
Kashif Pirzada, MD Profile picture
28 Feb
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…
Read 15 tweets
Kashif Pirzada, MD Profile picture
8 Feb
Quebec is seeing school cases increase exponentially about 1 month after opening schools. They have limited capacity to test for variants, but this pattern is very similar to what we saw in the UK, Ireland and others with the B117 variant.
Sadly so much could have been done to make schools safer, but Quebec did absolutely nothing.
They needed to:
- improve ventilation
- install HEPA filters
- mask everyone from JK
- create small class sizes
- use rapid testing
And of course, the South African and Brazilian variants, along with the UK variant, are on there way to becoming fully established here. No surprise given the volume of flights still coming in and out.
Read 8 tweets
Kashif Pirzada, MD Profile picture
20 Jan
Happy to see more support for rapid testing, now finally being endorsed by prominent experts in Canada. However, this should have happened 6 months ago when their value was first recognized by @michaelmina_lab

theglobeandmail.com/opinion/articl…
There is a global supply crunch for the most accurate tests, and we will need tens of millions of them to really be effective. It takes months to spool up a production line; we could have done so, and easily tested our way out of this lockdown. But we didn't.
The same reticence slowed adoption of mask laws in the summer, and now is slowing recognition of the airborne nature of Covid-19. Is it inertia? Listening to the wrong experts? A culture of just following what America does? Would love to hear any other ideas.
Read 6 tweets

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