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Kashif Pirzada, MD Profile picture
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18 Apr, 6 tweets, 3 min read
Our travel precaution system in Canada is a joke. We need to stop international travel, especially from hotspot countries with lots of variants. We could have prevented or slowed the spread of the UK and P1 variants in Canada, but chose not to.
Passengers from India are the number one source of travel related Covid cases, and the country is nursing a huge surge of cases with its own new variant, the B.1.617 or 'Amravati' variant. Fake negative Covid tests can be easily bought prior to travel.
The second highest source of Covid cases is the UAE, which will soon return their double-decker superjumbo jet into service on the Dubai-Toronto route
torontosun.com/news/local-new…
Even our system of quarantine hotels is flawed; travelers are at risk of catching covid in them since there are no mitigations against airborne spread. This is what the Australians learned the hard way:
3 days is far too short. Some travelers to Hong Kong were found to test positive on day 12 of their quarantine. A broader infectious period could be a new aspect of this new Indian variant:
Hopefully vaccines will work against this variant, but the more we allow unfettered international travel (until the entire world gets vaccinated), the more we risk the emergence of a variant that is vaccine-resistant. Then we start this pandemic all over again!

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More from @KashPrime

Kashif Pirzada, MD Profile picture
10 Apr
Hard to believe the chair of the infection control committee at the @WHO is spouting misinformation about N95 masks to argue against their widespread use to save lives. This kind of thinking is why the WHO has been almost entirely useless in this fight.
Acne vs Death from Covid. Not much of a choice!

This is the event where this took place, where you can watch the full video:
To some of my infectious disease colleagues:
You were wrong about:
- how serious this pandemic was early on
- the utility of masks
- the early use of therapeutics (steroids, IL-6 inhibitors, monoclonals)
and you are wrong about airborne spread.
Read 5 tweets
Kashif Pirzada, MD Profile picture
9 Apr
Really looking forward to this event later today. Heavyweights in the field discussing how Covid is transmitted. Implications are huge, if we agree its airborne, we can protect billions of people with better masks and ventilation strategies. Register here: events.ucalgary.ca/obrien/#!view/… Image
Dr. John Conly is chair of a WHO expert group responsible for much of their current infection control policy
The WHO is hugely influential in setting policies for 194 member countries; any movement by them on this issue will have a huge impact on the lives of billions.
Advocates have been arguing that SARS2, like SARS1 has significant airborne spread, proven by superspreader events... now only worsened with the new variants. @zeynep's work has been a huge help to us front-liners trying to advocate for this.
Read 8 tweets
Kashif Pirzada, MD Profile picture
6 Apr
I want to shed some light on why we are up in arms about our ICU numbers. The ICU is basically the backstop of a hospital, where the sickest patients go to get 'intensive' therapy to get stabilized and hopefully discharged home or to rehabilitation facilities.
This is where incredible resources, expertise and equipment are used to do what would have been impossible even 20 years ago. Beds are scarce as a result. The CCU is a similar unit but meant for heart attack and other cardiac patients. Staff are full time 1:1 and highly trained
This is the situation now in Ontario. Roughly half of ICU beds are occupied by Covid patients, surgeries are getting cancelled, and the wards are filling up. In Toronto, most of the ICUs are already full with Covid and other patients.
Read 7 tweets
Kashif Pirzada, MD Profile picture
4 Apr
Rapid tests need to be used ASAP to get workplace outbreaks under control. Many are sitting unused in warehouses across the country. You can combine the rapid strips (like the Abbott Panbio) with much more accurate molecular tests onsite to recheck positive results (Abbott IDNOW) Image
These were used in Nova Scotia to get their outbreaks under control. @michaelmina_lab has been a tireless advocate of these tests, and they can now be accessed in the US without prescription. Businesses and individuals can't easily get them in Canada.
One possible success story in Canada is Manitoba, which has been using rapid molecular testing in its schools since January.
gov.mb.ca/covid19/testin…
Read 7 tweets
Kashif Pirzada, MD Profile picture
4 Apr
We are facing a reckoning in Canada, a highly contagious, deadly variant is firmly rooted in BC and spreading eastwards. We were shocked when UK variant Covid starting targeting young people, this will make it much worse. We need action now!
What's happened to the Vancouver Canucks is just the beginning. More young people will get very sick until we take decisive action to contain this threat.
We need to address these underlying issues with at-risk populations. These measures will protect all of us:
Read 8 tweets
Kashif Pirzada, MD Profile picture
2 Apr
Let's go over some simple reasons why this new 'lockdown' won't work and what we can do about it:

Essential workers 30s-50s are the bulk of new ICU admissions. There's been no change in working conditions to protect them from an airborne virus. They are at huge risk right now
1) This virus is airborne, like SARS1 before it. That's why these new variants are more contagious. Distancing won't cut it, being in closed, poorly ventilated spaces is hugely dangerous. As @AndrewChangCBC describes, we need to up our game on masks:
2) Wear a better mask, like a tightly fitting N95 or equivalent. All workers should be provided with these now. Wear one to your grocery run, or switch to pickup or delivery if you can't. They are plentiful now.

Here's a list of Canadian suppliers:
docs.google.com/document/d/1ma…
Read 10 tweets

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