I’ve spent my whole life being a rules follower. Imagine my surprise when one of my tweets from earlier today turned out, at 5 pm, to be a call for civil disobedience in Ontario, where unsafe nonessential work is okay but safer outdoor socializing isn’t. 1/n
As a WOC, my advocacy has had to be subtle, and my voice has had to be quiet. Burning it all down, leaving the table, throwing a tantrum and getting my way… these are privileges I actually don’t have if I want to have any impact. 2/n
BUT: I am aware that many other members of equity seeking groups don’t have a voice at all. And don’t have a seat at any table. I do. (Privilege is a relative thing.) So I’ll tell it to you straight: 3/n
This province’s pandemic response is inequitable, ineffective, and both scientifically and economically unsound. It will harm our most vulnerable. But make no mistake, it will harm ALL OF US, too. 4/n
Small business owner? Elderly person? Young person? First responder? Stay at home worker? New immigrant? Suburban parent? Bay Street financier? Nobody's actually winning, in the long game (or even the short one), with what's happening now. 5/n
Like many “model minorities.” I have also been forced into being not JUST a rules follower, but a solutions finder. (Who do you think calms down the tantrum throwers?) But luckily, this has made being on the province’s Science Table such an eye opening experience. 6/n
The advice from the province's independent Science Advisors (and the MANY experts in this province who have used their platforms to inform and educate) is actually really solutions oriented. It would have empowered our government, and empowered Ontarians. 7/n
This is why having it cast aside hurt. It didn’t hurt my professional ego. It hurt me as a mom, who was hoping her kids could go back to school safely. And a daughter who hasn’t hugged her own mom and dad in 13 months. A wife who's husband has done a lot of emotional labour. 8/n
My best friend had a baby less than a year ago - I can’t fly out to see him. And of course - my heart is broken as a HCW, seeing my colleagues not okay, seeing myself not okay. My patients are so scared, and many of them are at such high risk. Worry for them steals my sleep. 9/n
The hurt comes because these policies will cost us our summer. It will prolong the pain. Don’t like masking? Miss your freedoms? Guess what - ME TOO. I’d love to kiss my dearest friends on the cheeks, hug my mom, and go for a walk with my neighbour. 10/n
I don’t even know what to say about the state of the healthcare system. Or our most vulnerable. People have said it better than I could. @DrKaliBarrett @NathanStall @drandrewb @jkwan_md @DrKateJMiller @jddneary 11/n
The government of Ontario will not heed evidence based advice to truly limit essential work, make all workplaces safe, support people AND businesses with sick leave, and allow people to safely meet outdoors - wearing masks, with six feet distance. 12/n
They won't do the math - so simple my 5 year old could manage it - that the money to pay for these essential supports is pennies compared to the healthcare costs of an out of control pandemic, and prolonged depression of business activity and consumer confidence. 13/n
So I’m standing by my earlier thread. Take your power back, Ontario. Take your health AND your economy back (since they're not mutually exclusive). Protect yourself (mask, distance, safely socialize, get your vaxx). We really ARE in this together, and we're strong. 14/14

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More from @MPaiMD

16 Apr
Hey Ontario. Our healthcare system (and all the good things that flow from it, including the economy) is about to collapse. It's about powerful people not making hard choices that ultimately benefit everyone they are supposed to serve. What can YOU do? Empower YOURSELF. Read on:
1. Don’t spend time with people indoors if they're not in your household. If you have the privilege to follow this rule, follow it! Cosy up with your hunny bunny. Cuddle your kids. Facetime with all the people you love who are ?NOT in your household.
2. If you have to be indoors for essential tasks, keep 6 ft away + mask. Essential tasks = your job (though ask yourself... is it REALLY essential that you work indoors?) or life and death stuff. LCBO does curbside pickup, FYI.
Read 7 tweets
7 Apr
The UK vaccine advisory group, the JCVI, recommends that people aged 18 to 29 be offered an alternative vaccine where available. This graphic (UK risks) illustrates why. Note the importance of balancing harms.
What about if your exposure risk isn't low, but MEDIUM? Frontline workers, HCWs... The harms are static, but now COVID causes more harms. Vaccine benefit becomes more pronounced.
Now what if we're in a wave (which we are, in Canada). If all you have available is AZ vaccine, check out these risk/benefit numbers. (Also note that Canada has more than AZ available - our vaccine portfolio is impressive, when compared to other countries.)
Read 6 tweets
7 Apr
62 cerebral sinus (brain) clots, 24 splanchnic (abdominal) clots out of ~25 million AZ vaccine recipients. Serious clots, but rare. Europe's @EMA_News says benefits of AZ vaccines outweigh risks - pertinent for 🇨🇦 as we struggle with wave 3. Waiting for @MHRAgovuk to weigh in now
Above cases came from EU and UK reporting in March. However as of April 4th there were reports of 169 CSVT, 53 splanchnic clots out of 34 million AZ vaccine. @EMA_News states these updated numbers did not change their appraisal of risk:benefit.
@EMA_News felt parallels to HIT were a plausible explanation of pathophysiology.
Read 4 tweets
26 Mar
🚨🚨🚨 @COVIDSciOntario Science Brief and layperson’s guide for vaccine-induced prothrombotic immune thrombocytopenia (aka. VIPIT) following AstraZeneca #COVID19 #vaccination. Read the 🧵! 1/n
AZ #COVID19 #vaccine appears to be associated with immune thrombosis that mimics heparin induced thrombocytopenia. It’s rare: 1/125K to 1/1 mill @EMA_News @uni_greifswald @PEI_Germany 2/n
@COVIDSciOntario brief helps clinicians identify, diagnose / rule out, and treat rare serious clots of VIPIT. Please read - and check out the figures for easy clinical reference. covid19-sciencetable.ca/sciencebrief/v… 3/n
Read 11 tweets
19 Mar
Long 🧵 on vaccines and blood clots (from somebody who spends an inordinate amount of time thinking about, preventing & treating blood clots). #COVID19 #COVID19vaccine #hemetwitter #thrombosis 1/n
Yesterday @GovCanHealth, @MHRAgovuk, @EMA_News and my profession's organization @ThrombosisCan made clear statements that risks posed by AZ vaccine are far outweighed by its benefits. Does that square with media reports? Should we really get the first shot available to us? 2/n
I love my job as a blood and blood clot specialist. (LOVE IT!) So much of it focuses on talking to people about risks & how to stay safe DESPITE those risks. A lot of common medical procedures, drugs & life experiences [aging, pregnancy] increase your blood clot risk. BUT... 3/n
Read 13 tweets

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