Menaka Pai, MSc MD FRCPC Profile picture
Jun 11, 2021 11 tweets 7 min read Read on X
A word on #AstraZeneca (making the decision about your 2nd shot, and when the 🤬 you can get your 2nd shot)... 1/x
The frustration of Ontarians who got AZ for dose #1, and now feel hung out to dry since their 2nd dose hasn't been accelerated, is palpable. Think the insistence on a 12 week gap isn't science based? You're right. It sucks, and it's scary (esp if you're in a hotspot!) 2/x
I have yet to meet a scientist or health care professional who thinks that a 12 week gap between AZ and mRNA is carved in stone. And NACI - the TRUE vaccine experts - have already said 4-12 weeks is fine. Their recommendations should hold a lot of weight. 3/x
If you received AZ, know that many of these knowledgeable experts are advocating for narrowing the window between shots, ESPECIALLY in hotspots, where we know that getting 2 doses in fast is most important. We need a nimble vaccine strategy in the face of the delta variant. 4/x
So hang tight. People are working hard to encourage the government to make the right decision ASAP, and help get us to a better place, faster. While you wait for dose 2, continue to follow PH guidance re: masks, distance. Avoid the indoors. Enjoy the outdoors safely. 5/x
Use your time to reflect on how this pandemic has been handled. Frustrated about decisions that weren't science based, that made inequity worse, that harmed the people that any humane society should protect and prioritize? Bookmark that. There's an election next year. 6/x
Maybe call @fordnation at 416-325-1941 and add your voice to the chorus that's demanding a vaccine rollout (and a pandemic recovery) that protects ALL Ontarians. #GenXZeneca is the last generation that grew up phoning, not emailing or texting. Let's use our telephonic skills. 7/x
And if you're on the fence about what vaccine to pick, check out this decision aid! Another team effort from docs, scientists, pharmacists, and patient partners. We'll walk you through the AZ vs mRNA decision so you can decide what's right for you. uwaterloo.ca/pharmacy/sites… 8/x
Big ❤️ to @AndreaChittle, @SabiVM, @heysciencesam, @NoahIvers, @DrSamiraJeimy, @PharmacistMama, @tara_kiran, @hwitteman, @DrKateJMiller & our super efficient UWaterloo contingent, @kgrindrod and @adrianwpoon. You guys are my pandemic silver lining. 9/x
Have a good weekend, Ontario. Stay safe. Get vaccinated. Better days ahead. 10/10
Okay, just one more. It's a privilege to be in the same orbit as Dr @Tania_WattsUofT, one of this country's foremost immunologists. People like to hand wave about "science," but Dr. Watts' thoughts on this issue are the SCIENCE (+ expertise + experience).

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More from @MPaiMD

Jun 25, 2023
Trauma induced coagulopathy is the leading cause of death in young people. EVERYTHING gets messed up. Such a cool talk by Dr. Dante Disharoon at #ISTH2023 on dielectric coagulometry micro sensors to sort out this hot mess… 1/n
10 microL of blood in a microfluidic sensor - run current through it - and determine the type of clotting dysfunction (platelets, factors, fibrinolytics. Overcomes a lot of the practical challenges to using ROTEM (size, vibration sensitivity, not near-patient). 2/n
Dr. Disharoon’s group coated electrodes with thrombin receptor activating peptide 6 (TRAP-6), which could detect platelet activity. Imagine getting rapid functional results - and targeting your patient’s resuscitation to platelets (versus other aspects of coagulation)! 3/n
Read 5 tweets
Nov 12, 2022
Dr Bruce is one of our incredible anaesthetists at McMaster Children’s Hospital, and a former Med school classmate. Please read her tweet carefully. What would it take for you to wear a mask? Would you do it if there was a chance it could save a child’s life? 1/n 🧵
Mac Children’s serves not just Hamilton, but kids from across our region. It is overflowing. Urgent cases are being sent to Hamilton’s adult hospitals. Staff are struggling to take care of frightening patient loads, and very sick children. 2/n
When adult hospitals were suffering this plight, we did all we could to stop the spread. Now we are dealing with a storm of respiratory illness in little ones, yet there seems to be no societal appetite to do hard things. Or even easy things. And trust me - masking is easy. 3/n
Read 6 tweets
Mar 27, 2022
A thread about about paxlovid - the “early treatment” pill for COVID-19 that’s been all over the news. Who is eligible? Who decided who is eligible?. Why aren’t more people eligible? (Are YOU eligible?) 🧵1/n
This thread is inspired by one from my friend & colleague Dr @kgrindrod, whose expertise in pharmacy and knowledge translation (getting science out to people who need to know about it) is superb. Read the whole thing! (Then come back 😉) 2/n
Paxlovid is an antiviral drug. It stops the SARS-CoV-2 virus from multiplying in your body’s cells. It works if it’s taken EARLY - within five days of the start of symptoms. It reduces the chance of your COVID getting worse. 3/n
Read 25 tweets
Mar 9, 2022
Hastily dropping masks in schools - an easy thing that helps protect staff and kids (inc JKs who can’t get vaxxed, and many eligible kids who aren’t vaxxed) - seems like such a callous, thoughtless “end” to the pandemic. Here’s what my 6 year old said when we discussed it: 1/n🧵
This morning at breakfast, while my husband wrangled the preschooler, I told my 6 year old that on Mar 21, there likely would NOT be a mask rule in his school. I asked him how he felt about it, and what he wanted to do. Because now he had a choice. 2/n
This kid has seen his mommy come home with bruises on her face after 12+ hours in an N95. Two years of this. Our narrative on masks, from the start, has been: “My mask protects me, your mask protects you, our masks protect each other.” 3/n
Read 14 tweets
Jan 18, 2022
News today of shortages of life-saving Covid drugs & HC approval of paxlovid (which will initially be in v short supply too). As a methodologist & a clinician, I wonder… how do you follow evidence-based guidance on drugs when you don’t have any drugs? 🧵 thestar.com/news/gta/2022/…
As Co-Chairs of @COVIDSciOntario’s clinical practice guideline working group, @ASPphysician and I have been thinking a lot about this. Here are our practical suggestions on how to treat COVID-19 patients during periods of drug shortage. 2/n
But first: a recap of how we use evidence to inform recommendations. Think of clinical decision making as a treacherous river. To take care of your patients you MUST cross that river. Clinical practice guidelines can help. 3/n
Read 27 tweets
Aug 22, 2021
Going to take a Twitter break for the next 6 weeks, to conserve energy for myself and the people I love! Most of my life happens OFF SoMe, and that’s where I’d like to focus my attention right now. Here’s some parting thoughts: 🧵
1. Please mask up and get your vaccine. We are in wave 4. After a week on call, I don’t even need modeling to tell you - the unvaccinated are getting sick, intubated, dying. COVID is unrelenting and cruel.
2. Show gratitude. I am grateful for my little family, the privilege of my job, and friends near & far who check in on me, make me laugh, inspire me to work hard, remind me to rest, send me spa recs & coffee invites & funny texts & so. many. silly. tiktoks. My cup is full.
Read 10 tweets

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