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Kashif Pirzada, MD Profile picture
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2 Jul, 15 tweets, 5 min read
I outline here why BC and Alberta lifting mask mandates is reckless:
- Only 35% are fully vaxxed
- Kids <12 are unprotected
- Indoor spaces are dangerous without masks with an airborne virus
- Places that lifted mandates are backtracking ...
- It places the onus on small business owners to enforce mandates which will lead to conflict
- leaders really want to show that somehow its over, when it clearly is not, and is worsening in large parts of the world

Thanks to @AnitaSharma for the chance to speak.
Fully vaccinated people can transmit the virus to unvaccinated or partially vaccinated people, including children. Masks can help prevent this. This is from Singapore:
With an airborne virus, all it can take is 'fleeting' contact for a few seconds from someone unmasked who is heavily shedding virus, as they found in a shopping mall in Australia.

abc.net.au/news/2021-06-2…
Israel has reimposed mask mandates after a spike in cases there:
bbc.com/news/world-mid…
Many experts in Canada believe that it is too soon to remove these mandates:
theglobeandmail.com/canada/article…
Hospitalizations are also increasing in the UK; which is 1-2m ahead of us. Against the Delta variant vaccines are not 100% effective, 2x mRNA is 96% against severe disease, ~80% against getting infected at all. 1/25 infected will still end up in hospital.
Hospitals in Missouri, which has an abysmal vaccination rate (only 45% had one shot, 35% fully vaxxed) are filling up and transferring patients hundreds of miles away
What's more reasonable is the phased approach Ontario and the Atlantic provinces are taking:
- Keep the mask mandate indoors
- Let the vaccine rollout take place, 75% will be fully vaxxed in a few weeks
- A gradual reopening of more dangerous spaces with an eye on case counts
Why shouldn't we just let this virus just rip through the population? It only causes mild illness in kids and the vaccinated right?
Long Covid is real, affects 1/7, and for many, it will be a lifelong affliction just like ME/CFS and Fibromyalgia
ons.gov.uk/peoplepopulati…
When do I see these mandates going away?
- Once children have their chance at being vaccinated in September, 3rd shots for immunocompromised
- When case counts are under control
- When we have the ability to screen, test, trace, isolate and stamp out outbreaks when they happen
If the plan in BC and elsewhere is for kids to be infected and aim for natural immunity, there at least should be a conversation and debate about it. There are far too many unknowns at this point for this to be a safe strategy.
An example of the incoherent messaging in BC. Masks aren’t required but they are encouraged. What does this actually mean?

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More from @KashPrime

Kashif Pirzada, MD Profile picture
21 Jun
A lot of concern about mixing the two mRNA vaccines. Due to the vagaries of global supply, most people who got Pfizer will be offered Moderna in the coming weeks. I'll show you why this is a great thing, and why its important to get your second shot as quickly as possible
A research group sequenced both vaccines from discarded vials, and found that the important spike protein encoding sections were almost exact matches to each other. Some minor differences in the 5' and 3' untranslated areas, used by cells for formatting

github.com/NAalytics/Asse…
If you look at the sequence between the start and stop codons (which tells cells where to start and stop encoding), its off by just one base pair at the end! Both match the spike protein sequence identified early on in the pandemic.
Read 11 tweets
Kashif Pirzada, MD Profile picture
14 Jun
With the Delta variant, we'll likely need ~90% vaccinated to get to herd immunity.
It's possible we'll get close to this, 89% of Canadians want to get vaccinated. This is out of the question in most of Europe and the US, where vaccine skepticism is much higher. Vaccine checks on arrival for travelers will be needed
Certain provinces will probably never get to herd immunity:
Read 6 tweets
Kashif Pirzada, MD Profile picture
8 Jun
It’s been a hard day for members of my family and broader community, seeing 3 generations of a whole family wiped out... who look very much like us, and did everything right. They were highly educated, loved this country, worked hard, the Canadian dream in every respect...
My family has been here 51 years, my father came in 1970 (after a harrowing stopover in Moscow, a story for another day) to join his siblings building a life here. He came to a young country full of promise, but blighted by attacks against South Asians.
ftp.issuu.com/uw_imprint/doc…
He and representatives of the community met with the editorial board of a tabloid newspaper in the 70s to get them to stop pushing race-baiting stories targeting the South Asian community. The response: 'We will print whatever sells newspapers.' Thankfully things are better now
Read 16 tweets
Kashif Pirzada, MD Profile picture
2 Jun
We've created this guide on how to protect yourself from an airborne virus using HEPA filters in offices and schools. A simple solution that needs to be used especially in the fall/winter when opening windows and doors will be less practical:
docs.google.com/document/d/17t…
CO2 monitors are an important component to this, and can roughly tell you how much of the air is fresh in a given room. Higher than 700 is risky, and the higher the number, the more you get 'rebreathed' air from another person possibly containing infectious virus.
The goal is to get to 6 ACH (air changes an hour), which is the minimum in most hospital settings. We describe how to calculate this, and what types of filters you should be buying.
Read 7 tweets
Kashif Pirzada, MD Profile picture
6 May
Data from @GovCanHealth which was obtained by @kellygrant1 at @globeandmail with some astonishing stats on effectiveness of the vaccines, even after a single dose. The calculations behind these numbers are here:
This matches roughly with similar stats published by Ontario Public Health. You can download it here: publichealthontario.ca/-/media/docume…
Also discussed here:
Much discussion about the new study from Qatar showing the second dose is more effective, but our situations are not comparable. They stuck to the 3w schedule, so could not study how immunity evolves after more time.
cp24.com/news/early-eff…
Read 7 tweets
Kashif Pirzada, MD Profile picture
6 May
Feeling great today on my ER shift:
- hardly any new critically ill COVID cases
- almost every patient I’ve seen is vaccinated with at least one shot

And the good news keeps coming:
It looks like vaccines will work for all of the variants of concern:
By Sept-Oct almost every child will have access to them as well:
Read 7 tweets

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