From some reason, this @BusinessInsider article from Feb 23rd is making the rounds today on social media: businessinsider.com/new-data-calls…

The sensationalist headline "Scotland's vaccine rollout suggests delaying the 2nd #COVID19 shot is a bad idea" requires some serious nuance.

1/6
The news article references a Feb 19th pre-print: papers.ssrn.com/sol3/papers.cf…

This means that the study was neither peer-reviewed nor finalized when posted.

The pre-print reported a combined 58% vaccine effectiveness for #Pfizer and #AstraZeneca starting 42 days after 1 dose.

2/6
This pre-print went on to be peer-reviewed and published last week in @TheLancet: thelancet.com/journals/lance…

@TheLancet study reported a combined 74% vaccine effectiveness for #Pfizer and #AstraZeneca starting 42 days after the first dose (77% for the #Pfizer vaccine alone).

3/6
The U.K. has seen remarkable control of the pandemic with a strategy maximizing first vaccine doses for as many as possible.

Modelling work led by @BeateSander shows that such an extended dose interval strategy will also save more lives in Canada: medrxiv.org/content/10.110…

4/6
Sharing this article without proper context and fear-mongering statements are harmful.

Of course it is important to continuously evaluate and update Canada's vaccine strategy as new data emerges—@cdavidnaylor and @BogochIsaac have written about this: theglobeandmail.com/opinion/articl…

5/6
This includes determining which populations:

1. Require two doses following the same interval as the clinical trials
2. Should be prioritized for earlier second doses

#NACI has compiled and reviewed the existing evidence on extended dose intervals: canada.ca/en/public-heal…

6/6

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More from @NathanStall

1 May
The final report of #Ontario’s Long-Term Care #COVID19 Commission is now available: ltccommission-commissionsld.ca/report/pdf/Ont…

The 322 page report released today details 85 recommendations focusing on:

1. Pandemic Preparedness

2. Addressing the Aftermath of COVID-19 for Residents and Staff

1/4
3. Infection Prevention and Control

4. Strengthen Health Care System Integration

5. Improve Resident-Focused Care and Quality of Life

6. French-Language Services

7. Address the Human Resources Challenges

8. Operational and #LTC Home Development Funding

2/4
9. Increase Accountability and Transparency in Long-Term Care

10. Comprehensive and Transparent Compliance and Enforcement

11. Health Protection and Promotion Act Investigations

12. Responding to the Commission’s Report

3/4
Read 4 tweets
28 Apr
Today #Ontario enacted a new emergency measure providing hospitals with the authority to transfer patients who no longer require acute care (so-called "alternate level of care" or ALC patients) to #LTC and retirement homes without their consent.

news.ontario.ca/en/release/100…

1/15
This action is being taken to create additional room in #Ontario's acute care sector for the 3rd wave of #COVID19.

There are currently 4,288 ALC patients in hospital, and 1,854 are waiting for #LTC beds.

There are also 5,401 vacant #LTC beds available for new admissions.

2/15
The reality is that many of the #LTC homes with large vacancies are those that had the deadliest #COVID19 outbreaks (e.g., Tendercare, St. George's, Orchard Villa).

Residents (and their families and caregivers) will be justifiably hesitant to move into these #LTC homes.

3/15
Read 15 tweets
28 Apr
Today #Ontario's Auditor General released a scathing report on pandemic readiness and response in long-term care: auditor.on.ca/en/content/spe…

The report details the many factors resulting in 3,919 residents dying of #COVID19 and countless others suffering during the pandemic.

1/7
1. Residents were living in rooms with 3 or 4 occupants

2. The transfer of patients designated as alternate level of care (ALC) from hospitals to #LTC homes contributed to crowding in homes

3. #LTC homes had insufficient staff and staff training to provide appropriate care

2/7
4. Restricting families from visiting homes consequently eliminated a valuable source of resident care providers.

5. Infection prevention and control (IPAC) were not consistently practised in homes even prior to the #COVID19 pandemic.

3/7
Read 7 tweets
9 Apr
One population I fear is being overlooked (yet again) during #Ontario's 3rd wave is community-dwelling older adults.

There is no doubt that the new variants of concern make #COVID19 a different disease, with increased risk for younger populations: covid19-sciencetable.ca/sciencebrief/c…

1/8
With this changing disease come more tragedies of younger adults—especially essential workers—being hospitalized and dying from #COVID19.

These stories must be told and Ontario must enact supports like paid sick leave.

But sometimes missing are the stories of older adults.

2/8
In #Ontario, 21.1% of people 60+ and 77.2% of people 80+ have received at least 1 dose of a #CovidVaccine: publichealthontario.ca/-/media/docume…

Yet in the last 14 days, older adults still accounted for 76/85 (89%) of deaths and 715/1171 (61%) of hospitalizations: publichealthontario.ca/en/data-and-an…

3/8
Read 8 tweets
8 Apr
ICMYI—Dr. @iPreetBrar on why the Canada Recovery Sickness Benefit (CRSB) is NOT paid sick leave: thestar.com/opinion/contri…

#CRSB is limited to those workers who miss at least 50% of their work week because they are unwell or isolating from #COVID19: canada.ca/en/revenue-age…

1/5
This means that #CRSB doesn't cover shorter absences, thereby excluding:

-Worker time off to get tested or vaccinated

-Workers who stay home due to symptoms or exposure, subsequently test negative for #COVID19, and are cleared for return to work within <50% of a work week.

2/5
#CRSB is limited to a 1-week period, is not renewable and can only be used 4 times/year.

This may not be enough for workers in high exposure occupations.

These limitations may discourage testing and isolation of workers, thereby hindering mitigation of workplace outbreaks.

3/5
Read 5 tweets
16 Feb
With #COVID19 vaccine supply ramping up, there is lots of discussion about #Ontario's vaccine distribution plan and how individuals are being prioritized.

Ontario's ethical framework is clear that prevention of illness/death is not the only priority: ontario.ca/page/ethical-f…

1/8
These multiple and divergent priorities (reduce illness/death vs. promote economic/social wellbeing) aren't clearly ranked.

e.g., 1.5 million essential workers have similar priority to 3.5 million older adults (who account for 96% of COVID19 deaths): files.ontario.ca/moh-covid-19-v…

2/8
This leads to frustration, anger and fear for older adults who are at highest risk of death and see other vaccination programs like the UK's focus on age and have the singular goal of "prevention of mortality and supporting the [healthcare system]": gov.uk/government/pub…

3/8
Read 8 tweets

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