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Dr. Alexander Wong

17 Apr, 4 tweets, 3 min read

My colleagues Lori & Jeff explain the SUPER BAD situation in #YQR ICUs. 2 COVID+ pts / room to maximize nursing & RTs. All ICU beds full in #YQR, city now on ICU/CCU bypass (including cardiac pts). Staff @ breaking point.😢 (1/4) #COVID19SK

cbc.ca/news/canada/sa…

I have tried to maintain equipoise but feel I need to say this again: we CANNOT vaccinate our way out of this without losing many lives & overwhelming our ICUs, forcing triage. We NEED definitive & immediate mandated measures to help bend our #SK curve quickly. (2/4) #COVID19SK

We are vaccinating 'easy' folks quickly in #SK. Soon, we will hit road blocks: persons who need improved access & hesitant persons who will need their concerns addressed / questions answered. Nobody can be left behind if we are going to achieve herd protection. (3/4) #COVID19SK

Everything we are seeing now in #YQR is unprecedented yet sadly predictable. Same story 'soon' in #YXE. Forget "rules". Everyone MUST do their part. Tightest bubbles, no non-essential travel, test/isolate if symptoms, stay 🏠, vaccinate! Be safe, everyone. (4/4) #COVID19SK

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Dr. Alexander Wong

@awong37

9 Apr

Hi everyone. I thought I would try to explain what all these 'variants' of COVID-19 are, and are they really that bad? I feel this has relevance to #SK & Canada because we are seeing growth of all three key VoCs at once. Start w/ graphic below. (1/n) #COVID19SK

All viruses mutate (change) over time. Most of these mutations are meaningless, but sometimes the virus changes in ways that allow it infect cells or reproduce itself more effectively. This confers a "fitness advantage", and over time more "fit" viruses become dominant. (2/n)

When certain mutations confer advantages such that the virus can grow and spread within populations & infect people more quickly and/or make people sicker, these are termed "variants of concern". Several are well-described now. We'll focus on the 3 relevant in Canada. (3/n)

Read 14 tweets

Dr. Alexander Wong

@awong37

8 Apr

We don't think guidance around AZ vaccine will change soon, if at all. Evidence is mounting to suggest association b/w AZ vaccine & VIPIT is real. VIPIT occurs mostly in younger persons. It is rare but often fatal - it can't be ignored. (1/n) #covid19sk

leaderpost.com/news/saskatche…

The risk-benefit calculation of administering AZ vaccine still strongly favors its use in older persons, because such persons are far more likely to die from COVID-19 infection. We need to administer it as much as possible in populations who remain eligible. (2/n)

Even with VoCs circulating which are more dangerous, the risk-benefit calculation of AZ vaccine in younger persons remains unclear. This is not a decision that Trudeau or Dr. Tam have the jurisdiction or expertise to make on their own. (3/n)

Read 6 tweets

Dr. Alexander Wong

@awong37

5 Apr

Hi everyone. Coming off 2 weeks of call tomorrow AM. So sorry to be #debbiedowner but holy cats, #YQR hospitals are full of #COVID19 patients either intubated or requiring high-flow O2. Frontline providers are worried, anxious, and scared. (1/n) #COVID19SK

Hypothetically, if 1/3rd of current ward patients in #YQR requiring high-flow O2 deteriorate tomorrow AM and need ICU support, there would not be an obvious place for them to go. ICU beds in #YQR, including surge as of today, would be completely full. Yikes. (2/n)

One challenge we face with these critically ill #COVID19 patients is that they are so sick for so long, there's just no turnover of ICU beds where people improve and can be moved to the wards quickly to make room for new patients. (3/n)

Read 7 tweets

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