Thread by @Tommy_Slick

The Calgary and Edmonton medical staff associations are currently holding a briefing about the third wave of COVID-19. Going to tweet any interesting details in this thread. #yyc #yeg #ableg

They say the numbers look grim, as modeling data shows that in a week from now, the number of COVID variant cases per day will double. They say this means hospitals and ICUs could become overwhelmed before the end of April.

President of the Calgary Medical Staff Society, Dr. Scott Beach, says he hopes recommended actions being proposed here can help finally bend the curve downward.

Dr. James Talbot, an adjunct professor at the U of C, details some Calgary numbers, starting with the chart I included up above. Next, the positivity rate graph is very important he adds. We are on pace for the worst rate in the past year, means we need harsher measures.

On hospitalizations and ICU admittance, Talbot says this is a very indicative graph. Shows how variants clearly cause worse outcomes due to the jump in people going to ICU.

Dr. Malgorzata Gasperowicz, a developmental biologist at the U of C, is up next. These graphs shows some more specific numbers on infection growth. Pay special attention to that red line in the second graph.

Here's where we could be with stricter measures.

She says we need, at the very least, the closures we had last spring in order to significantly bring down cases. What we're doing right now is not enough.

Infectious disease expert Dr. Craig Jenne speaking now. He says stricter measures are the only option, and the models shown before are being conservative. They don't take the P1 variant into account either, which is even more infectious.

Dr. Daniel Niven, an intensive care physician at Peter Lougheed Centre speaking now. First, he says this third wave involving variants should be very concerning to all of us. Massive increases in hospitalizations and death rates for the B117 variant.

Of particular concern is the fact the variants are being more troublesome for younger, healthier people. Many people are going to the ICU without comorbidities. Those who survive may still have long term health problems.

Final speaker of the morning is Dr. Shazma Mithani, an emergency physician and assistant professor in Edmonton. Talking about variants, she says a main challenge is how they have to segregate all patients. Cannot have someone with a variant in the same room as others who do not.

In the prior waves, they could put four COVID-positive patients in one room. But they can't do that now in order to prevent variants spreading further. So, this is effectively reducing hospital capacity even more.

She says staff are burnt out and exhausted, and now they are experiencing more shortages and they are forced to close beds. This all means that if you go to hospital with a non-COVID problem, you will be waiting longer.

She has a call to action. She says all levels of government need to take further action to stem the wave. They are calling for a strict lockdown, like what we saw in Ontario. Also wants the government to give more enforcement powers to inspectors.

She adds vaccinations need to be expanded to everyone in the healthcare field, along with all frontline and essential workers. They are disproportionately affected by the variants and protection is needed.

Questions now, @audreyneva on vaccinations and if the focus on vaccination rates is a good thing.

Dr. Talbot says it is good to look at the rates, and we can beat the virus once we have widespread immunity. But the lesson of the variants is that herd immunity is a "bad idea."

(Herd immunity in terms of people just getting infected, to be absolutely clear, the key is vaccinations)

Followup, what's a good target for herd immunity in terms of vaccinations, is 70 per cent a good target.

Talbot says it's reasonable, and it's in the right ballpark. But there needs to be major ground made in the next couple of months.

Dr. Gasperowicz adds on, that we also don't really know what the ideal target is for immunity. We have to think about vaccinations in terms of just reducing infections as much as possible, rather than reaching a figurative target.

.@cderworiz asks what is enough to bring down the third wave, what types of restrictions.

Gasperowicz says we need the restrictions from last spring, at least. Limiting all gatherings will be key, but also mostly the closure of non-essential businesses and schools.

But she adds we also need to consider the P1 variant, and we have to be extremely proactive to ensure that does not spread more. With P1 considered, the spring measures may not be enough.

Talbot adds that the restrictions from yesterday are a good thing and could help buy us some time, but again it's not enough to bring the numbers down. Numbers will just continue to rise, but at a slower rate.

Talbot says people can help themselves by going into a sort of self-imposed lockdown. Best we can do is help ourselves and the people we care about.

.@alanna_smithh asks about the lockdown and how the Premier is dismissive of this, what can be done to make sure politicians are listening?

Dr. Mithani says this has been a huge challenge throughout the pandemic, they've been asking for stronger measures for a long time.

She thinks Dr. Hinshaw has been a good advocate, but the decisions still come down to politicians. Reaching out on social media, and doing any form of advocacy, will continue to help. Again the answer is clearly we need stronger restrictions.

.@ashleyjoannou asks, since we don't know how yesterday's announcement will affect the numbers, what do you expect to see as a result?

Dr. Mithani says one concerning thing is that outdoor dining is still allowed. Many examples of patios being overcrowded.

We also know there's outdoor transmission on patios with the variants. We could still see major issues, and we know people are not following cohort rules. This is why they also ask for increased enforcement powers.

Dr. Gasperowicz adds we could see a slower rate of growth as a result, but we won't see the curve bending downward.

.@SKomadinaGlobal asks about schools and how they may fare through this wave.

Dr. Talbot says one issue with schools is the shutdown does have a wider impact to parents, workplaces etc. But the variants have a good ability to infect school sport settings, so could start there.

He says schools should be the last to close until we can be sure parents are there for the kids. He says vaccinating teachers would also help a lot to keep people safe.

Also, in looking at Ontario, they are already at a point of overcapacity in some hospitals. We could easily hit that point in Alberta if cases continue to rise.

Dr. Mithani says we end up mirroring Ontario, and it's inevitable we would be in their situation. We have the highest proportion of variants of concern in Alberta, so we know the direction we are heading. Strict measures needed now before the health care system struggles more.

.@cderworiz mentions the Grace Life Church shutdown in her next question.

Dr. Talbot says the enforcement measures have a couple of effects, including sending a message that we're serious about the policy.

If you don't give out the tickets to people breaking the rules, it amounts to an encouragement to their bad behaviours. Talbot says that should be unacceptable to most Albertans.

Followup on the capacity limits in places of worship. Dr. Mithani points out that in large places, you could still see hundreds of people even with the limits. Still major potential for spread.

Dr. Jenne says compliance is a big issue. Every instance of non-compliance puts the progress against the virus at risk. Enforcement is needed to ensure more compliance.

Dr. Noel Gibney says when we keep taking half and quarter measures, we are delaying the recovery. "Let's do it quickly...let's get it over with."

.@ashleyjoannou asks some more on the proposed lockdown, how long would it have to be in place?

Dr. Gasperowicz says after ten days to two or three weeks, curve would bend down quite quickly. But then we need to sustain that point. In ten to 12 weeks, we would be at zero.

Dr. Mithani says the longer we wait, the longer the lockdown will have to last. Better to get it done now.

In closing, Dr. Beach hopes this information can help promote some positive change. Wants people to continue pushing for safe measures.

That wraps it up. Thanks for following along everyone. This was the best health information on COVID-19 I have seen in Alberta in probably over a year.