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Kashif Pirzada, MD Profile picture
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26 Apr, 6 tweets, 2 min read
Yet another missed opportunity in this pandemic. A drug developed in Canada, and is used all over the US... only to languish on shelves here. Used early enough it can spare many from severe Covid-19. Many of my patients here could have benefited...
Early trials with just the single antibody showed a tepid response, but combined with etesevimab, both together showed really promising results with no real downside to the patient. 70% reduction in hospitalization and death.
investor.lilly.com/news-releases/…
This represents multiple failures

1) Gatekeeping by our public health and infectious disease experts who are far too conservative and refuse to consider a novel treatment at a critical time, and used the initial issues with the single drug to write off the entire drug category
2) Our regulators who didn't expedite the review of the new combined cocktail, even with good real wold evidence coming from the US

3) Our health care system that didn't push to set up infusion clinics. Instead we've filled every hospital bed in Ontario with covid cases.
It can be given anywhere, any clinical setting. It's been deployed rapidly by clinics in the US, including by @DanielGriffinMD at clinics in NYC.
usatoday.com/story/news/hea…
This pandemic has shown that we are incapable in Canada of reacting quickly, effectively and safely to bring new effective treatments to patients. We have the know-how and production capacity, but getting it through that last mile is literally killing us!

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More from @KashPrime

Kashif Pirzada, MD Profile picture
27 Apr
Nova Scotia is giving everyone a masterclass on how to crush an outbreak. With a test positive rate of just 1% they are
- closing schools, non-essential businesses
- limiting essential retail to 25% capacity
- rapid testing 2% of the population daily - a huge undertaking
They long ago limited entry into the province, non resident visitors are being turned back at the border and airport. A far cry from the tepid restrictions at the national border.
cbc.ca/news/canada/no…
Their premier even posts his itinerary everyday! You can just tell every minute is being spent making things safer for his people. A very sharp contrast to the rest of the country.
Read 5 tweets
Kashif Pirzada, MD Profile picture
18 Apr
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…
Read 6 tweets
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

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