Read 'em for you. There are a number of not-surprising facts that these documents make clear. Our Public Health response was not guided by the best evidence available. Curious as to whether political interference and the interest of certain lobby groups played a role. (1/31)
https://twitter.com/crystalmundypsy/status/1406251215999041537
"Monetary compensation for lost wages, trust in public health regulations and worry about infection was linked to increased intent to adhere to quarantine. However, stricter sanctions, higher fines and penalties for violators did not impact adherence." AB chose the former 2/31
The incubation period across all meta-analyses was an average or median of 5-7 days with the longest reported to be 32 days. There was some evidence the average incubation period may be longer for children and older adults. IMP: the 3 day isolation hotel is nonsensical. 3/31
We knew in Aug 2020, "body of evidence and mathematical models, consistently report that increasing the flow of outside fresh air into built environments (e.g. open windows) and reducing occupancy within enclosed indoor settings" yet we consistently ignored ventilation. 4/31
In July 2020, knowing "face shields that wrap further around the face, fully shielding the cheek area, wrap under the chin and any enhancements that minimize bioaerosol leakage/entry around the edges of the mask were more protective," gaping medical masks were promoted. 5/31
"Minimizing time to identify a case and notify the high risk contacts of the case is an important factor in contact tracing to minimize the potential infectious days a person is not in quarantine or isolation" but AB exceeded available tracing resources when cases mounted. 6/31
"Across all COVID-19 cases, there was an increased risk of mortality among BAME, Blacks, South Asians and Asians compared to Whites… No Canadian data on ethnicity and hospitalizations, severity or mortality was identified" BECAUSE we lack necessary race-based data. 7/31
"An individual’s adherence to public health interventions such as social distancing, wearing face masks and washing hands, plays an important role in how effective these interventions will be at controlling the epidemic." In AB, leaders disregarded these recommendations. 8/31
"Factors positively correlated to adherence in adults include: risk perception, higher COVID-19 knowledge, trust in science and government, increased anxiety levels, perceived self-efficacy to adopt protective measures, and Black / Asian ethnicity." We needed to build trust. 9/31
In July 2020, we knew “allowing younger children (< primary) to return to school would have the smaller impact on R0, whereas the return of secondary school grades will have greatest impact.” Children transmit virus at same levels as adults, more often while asymptomatic. 10/31
There was an assumption that VOC don’t transmit in schools in a relevant way, while acknowledging “a key knowledge gap in this research is the lack of high-quality studies of transmission of VOCs in children and transmission patterns in schools,” so we flew blind(ish). 11/31
In Aug 2020, Re transmission, “Random mixing events as public transit, restaurants/bars and sporting events were high-risk events because people from many small networks mixed and could then take the virus back to their network.” In HK, bars accounted for 30% of spread. 12/31
Two reports addressed sports. “Hockey provides favourable conditions for SARS-CoV-2 transmission.” Also, “one should avoid running or walking directly behind another person.” Nothing to suggest why we stopped outdoor activities for children. 13/31
In August 2020, we knew “the cumulative rate of COVID-19 hospitalization among children was low compared with that in adults), the hospitalization rates among Hispanic was 8x higher, and among black children was 5x higher, than the rate in white children.” COVID is racist. 14/31
"Masks that do not fit tightly against the skin were shown to significantly reduce the mask effectiveness and in some studies the reduction was more than 50% in filtration effectiveness… Loosely folded face masks, bandana-style face masks... offer little protection." 15/31
"Early in an infection viral load may be very low and there's a high likelihood of false negative result - a meta-analysis indicates false negative results are ~100% on days 1-3, 67% on day 4, 38% on day 5 and 20% on day 8 post exposure." IMP: Most tests done at wrong time. 16/31
Masks work. But also “Implementing a community mask policy instead of only recommending people wear masks has a significant impact on adherence to mask use in public settings.” So - consistent and enforced policy works even more. 17/31
There is a clear evidence-based path for exemptions, “Mask wearers should be cognizant of their exertion and heart rate given the studies show an increased cardio-respiratory burden of wearing any face mask and the impact increases with exercise.” Oh, but acne… SMH 18/31
Regarding global vaccine distribution, “results show that the public favors prioritizing the vaccine to HCWs, those at high risk, those in lower income brackets, and older populations.” Well, apart from late community HCW and late targeted campaigns... hmmm. #VaccineRodeo 19/31
"Studies report previous infection resulting in antibodies seems to be associated with protection from reinfection for up to 7 mo… Older age, duration of symptoms, and # of symptoms were correlated with higher IgG response (less reinfection)" - so everyone needs vaccines. 20/31
"Some patients will retest positive more than once. Upon retesting positive, patients were re-hospitalized until discharged again following two consecutive negative PCR tests, only to retest positive a 2nd, 3rd and even 4th time." Explains some of my long-COVID re-admits. 21/31
"Occupations most at risk of infection are drivers/transport workers, service/sales workers, food industry, personal care occupations, food production workers, preschool occupations, community/social services occupations (social work/counselors)." #PaidSickLeave was key. 22/31
"Risk factors for infection identified in the workplace include difficulties adhering to physical distancing, lack of hand hygiene, poor ventilation/air circulation design, + crowded working, transportation +/- accommodation condition," this is on OHS for factories/schools. 23/31
"Being female, a visible minority, and in a low-income bracket were associated with employment in occupations associated with significantly higher risk of exposure / do not allow working from home and involves working in close proximity to other people." COVID is elitist. 24/31
"Variants of concern ( B.1.1.7, B.1.351, P.1) may have different transmission dynamics and virulence than wild-type strains… Even if vaccines do not fully prevent infection, reducing viral load during infection will likely reduce transmission." So it's a new pandemic. 25/31
"Vit D deficiency was high among COVID-19 cases, and mean vitamin D levels were lower with severity of COVID-19...Vit D treatment in COVID-19 patients may reduce the risk of severe disease progression (RR 0.04)” These reports were seen as biased though. That's a cheap pill? 26/31
"Air samples collected from hospital care settings treating COVID cases have demonstrated RNA contamination, likely from aerosols and small respiratory droplets. SARS-CoV-2 is found to remain viable in aerosols for up to 4 hours." #aerosols 27/31
"Viral load in aerosols emitted by patients... exhibiting respiratory symptoms were much higher... An individual spending time in a room with a person breathing normally (not exhibiting respiratory symptoms) was likely to inhale tens to hundreds of copies of the virus." 28/31
In June 2020, we knew “respiratory droplets and aerosols expelled from infectious individuals may travel distances greater than 2m… and aerosols can travel distances as far as 10m when generated by coughs or sneezes,” making the whole 2m recommendation suspect. Elevators? 29/31
In June 2020, we knew “computer simulations to demonstrate SARS-CoV-2 aerosols can travel distances up to 10m, and the inhalation of sufficient concentrations of #aerosols (100 virus laden particles was assumed to be infectious) is possible within one second to one hour." 30/31
A Mar 2021 “update identified 46 new studies… Based on these findings the investigators suggest differences in air exchanges and ventilation to be a key difference that is more important than disease acuity, with respect to environmental air contamination." #ventilation 31/31
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