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Darren Markland

@drdagly

27 Apr

We relish working with the sickest patients & are privileged to walk the most agonizing paths with their families. It’s the impending sense of being overwhelmed at any moment that is grinding us down. It’s that we are here again, as though we have not learned that’s demoralizing.

I am constantly amazed by the heavy lifting our administrators do to adapt and keep things running. They must be feeling this weight as much as we do. The added pressure of being in a leadership role must be immense. I hope they have support too.

You won’t hear it from them. That job doesn’t allow a lot of disclosure, but they are fine people, doing their absolute best in really difficult situations. It’s a job I could never hack, and it is essential to keeping our hospitals running.

Read 7 tweets

Darren Markland

@drdagly

23 Apr

@CMOH_Alberta

As we speak our @CMOH_Alberta and health minister are betting on vaccinations to temper hospital and ICU admissions despite our exponential case numbers. That is a high risk wager if they get it wrong. Based on current hospitalizations and past experiences we should lock down.

This is a similar situation to last wave. Though I hold optimism that vaccines will save lives, using lagging indicators just means we wait for young people to start overwhelming the system. Even though they tend to have better disease outcomes, this remains a percentage game.

This is predictable math. To make infection control an all or nothing game is naive and irresponsible. Lock down now. Continue aggressive vaccination. Open up at 80% vaccine uptake, regardless of how low case counts are. Better yet push for #CovidZero.

Read 4 tweets

Darren Markland

@drdagly

22 Apr

The Covid situation in Ontario is making people pretty jumpy, so let’s focus on some positives.
- GenX showed up like crazy for their vaccination
- Our elderly are vaccinated
- We have had a 2 week head start
- Our population is younger
- We have lower population density.

Now let’s focus on what we can do about it in the short term.
- don’t let your mask slip.
- support and advocate for racialized and essential workers
- enjoy spring while following the rules
- push for #covidzero
- help curb vaccine hesitancy (be nice about it)
- take the jab.

When your brain isn’t overloaded, in those quite moments, think about long term solutions.
- wage disparity
- marginalized populations
- health and social equity
- socialized healthcare and health prevention
- mental health and addictions stigma
- political polarization

Read 4 tweets

Darren Markland

@drdagly

18 Apr

Everyone keeps telling you that the side effects from AstraZeneca and Jansen vaccines are rare and you should get the vaccine. I totally 100% agree with this, but trust is only part of the equation. So here’s what I know about #VITT or vaccine induced thrombotic thrombocytopenia.

Let’s start with the name, because it tells us a bit about the problem. Thrombocytopenia means a low platelet count, which can happen for many reasons, and thrombotic refers to the generation of blood clots. When you understand that platelets are what start most clots ....

You really are a leaky meat bag. No offence. Platelets are constantly plugging tiny holes in blood vessels and maintaining vascular health. They are kind of like clotting grenades. Super effective at what they do, but you don’t want them going off in the wrong place.

Read 14 tweets

Darren Markland

@drdagly

1 Apr

As #COVID19 escalates, & predictably hospital and ICU admissions follow, I am being asked to do more interviews. Please, let me be clear, physicians are not saying, “I told you so”. We have been here before, and this is all so predictable. It’s hard not to sound frustrated.

We want the best for our patients. We’ve advocated for plans that would have avoided this situation. We’ve seen other provinces do this the right way. We are left pleading with people to do the right things at great personal cost, but they are fatiguing from this harassment.

Most of us will make it through this alive, but we all will have scars from it. Physical, mental, social, financial, we will all be marked by these half hearted measures. Death is only one marker of this pandemic, but right now it’s the one I’m most focused on.

Read 5 tweets

Darren Markland

@drdagly

13 Jan

Ok. Educational thread. #COVID19 #vaccine #strains #Mutation

First a caveat. Until we have good data most of this thread is theoretical, but to keep you out of suspense, I believe that our current vaccines will protect us from evolving strains of coronavirus.

The reason for this is that the target chosen for these vaccines was its virulence factor, the thing that makes this normally annoying old virus deadly. The capsid spike protein that interacts with our bodies ACE2 receptor.

Viruses need a way to get into cells to infect them. Previous generations had spike proteins that opened doors on tissues of the throat and nose. The ensuing infection and inflammation is the stuffiness that we associate with a cold. You can survive a sore throat.

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