Ahmed Al-Jaishi, PhD Profile picture
Jul 5, 2021 15 tweets 9 min read Read on X
1/14

Do we need to remain in lockdown (forever) if #COVID19 herd immunity is not reached? **NO**

We have many measures to *control* the spread of infectious diseases.

Please read and consider sharing.

#epitwitter #onpoli #AcademicTwitter
2/14

Herd immunity is when a significant proportion of the population becomes immune (through vaccines and prev. infection) to an infectious agent (e.g., virus), making the spread of the disease unlikely. As a result, the whole community becomes protected.
3/14

While herd immunity may never be achieved, we still see significant *herd protection* through vaccine and natural immunity.

👇👇Excellent thread here👇👇
4/14

In order to control the spread of SARS-CoV2, we must control the transmission pathways between the:

1. virus
2. host (i.e., us)
3. environment

These three components are called the “Epidemiological Triad.”
5/14
So, what tools do we have to *control* spread of infectious diseases?

1. Changing our behavior to minimize the risk of exposure.

This includes handwashing, physical distancing, gathering in small groups / small social bubbles, etc. Continue to follow PH guidance!
6/14

2. Vaccinating against #sarscov2

Vaccines are one of this pandemic’s biggest success stories. We significantly reduced case counts, COVID-related hospitalizations, and deaths through direct vaccine effects and herd effects.

Image from: @Billius27
7/14
3. Surveillance systems to help monitor spread, characterize patterns, and detect outbreaks

With this information, PH can prioritize disease control programs and provide vaccine programs/education (where applicable).
8/14
Surveillance also gives PH the ability to detect cases early to **Test, contact trace, and isolate** affected individuals.
9/14

4. Modifying our environment

Treating #COVID as #Airborne is one of this pandemic's biggest response failures. Changes to the environment may include upgrading ventilation (e.g., in schools.), reducing classroom sizes or the number of people in indoor spaces, etc
10/14

5. Put in place infection control measures in health care facilities (e.g., LTC).

This might include vaccine programs for staff and patients/clients, providing *appropriate* PPE, isolating infected individuals, improve hand hygiene, put in place a surveillance system.
11/14
6. *Other* broad measures that can be used to control virus transmission.

For example, improving social determinants of health, improving working conditions (e.g., paid sick days and parental support), and supporting businesses.
12/14

There are also things like:
- supporting other countries to vaccinate their populations
- having a robust international surveillance system
- border infection control measures (#TestTraceIsolate travelers)
- border closure rules to reduce importation of new variants
13/14

7. Improving the way we treat COVID19

Improving treatments does not help control spread; however, we can manage those who become ill, and hopefully, reduce hospital stays and avoid ICU admissions and death. The goal is to limit #COVID19's impact on the healthcare system.
14/14

These are just a few things public health can do to control the spread of infectious diseases. Happy to address concerns or provide additional resources for those interested 😊

Please add things that I missed.

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More from @AALJaishi

Jul 5, 2021
July 05: #COVID19 in #Ontario
- Cases: +170
- Deaths: 9215 (+1)
- Hospital: 155 (-3)
- ICU: 228 (-7)
- Ventilated: 157 (-2)
- Active cases: 1967 (-64)
💉 Vaccines administered yesterday: 144,795
- Rt: 0.86 (CI: 0.68, 1.06)

Dashboard: covid19inontario.com
The top 3 public health units reported 79 of today's 170 cases (46%):
- Waterloo Region, PH: 34 cases (20%) or 58 cases per million
- Toronto PH: 27 cases (16%) or 9 cases per million
- Grey Bruce HU: 18 cases (11%) or 106 cases per million

covid19inontario.com
#COVID19 in Long-term care (LTC) homes (last updated: July 04)
- Number of homes with an active outbreak: 3 (change from yesterday: +0)
- Number active cases among residents: 22 (+1)
- Number of active cases among healthcare workers: 6 (+1)
Read 5 tweets
Jul 4, 2021
July 04: #COVID19 in #Ontario
- Cases: +213
- Deaths: 9214 (+9)
- Hospital: 158 (-48)
- ICU: 235 (-8)
- Ventilated: 159 (-6)
- Active cases: 2031 (-82)
💉 Vaccines administered yesterday: 196,068
- Rt: 0.88 (CI: 0.7, 1.07)

Dashboard: covid19inontario.com
The top 3 public health units reported 116 of today's 213 cases (54%):
- Waterloo Region, PH: 49 cases (23%) or 84 cases per million
- Toronto PH: 42 cases (20%) or 13 cases per million
- Grey Bruce HU: 25 cases (12%) or 147 cases per million

covid19inontario.com
#COVID19 in Long-term care (LTC) homes (last updated: July 02)
- Number of homes with an active outbreak: 3 (change from yesterday: +0)
- Number active cases among residents: 21 (+12)
- Number of active cases among healthcare workers: 5 (+1)
Read 5 tweets
Jul 3, 2021
July 03: #COVID19 in #Ontario
- Cases: +209
- Deaths: 9205 (+9)
- Hospital: 206 (+27)
- ICU: 243 (-9)
- Ventilated: 165 (+5)
- Active cases: 2113 (-62)
💉 Vaccines administered yesterday: 210,504
- Rt: 0.91 (CI: 0.73, 1.1)

Dashboard: covid19inontario.com ImageImage
The top 3 public health units reported 89 of today's 209 cases (43%):
- Waterloo Region, PH: 47 cases (22%) or 80 cases per million
- Halton Region HD: 22 cases (11%) or 36 cases per million
- Grey Bruce HU: 20 cases (10%) or 118 cases per million

covid19inontario.com ImageImage
#COVID19 in Long-term care (LTC) homes (last updated: July 02)
- Number of homes with an active outbreak: 3 (change from yesterday: +0)
- Number active cases among residents: 21 (+12)
- Number of active cases among healthcare workers: 5 (+1) Image
Read 6 tweets
Jul 3, 2021
Every patient should demand "safe, appropriate, and timely care." But, there is no reason to believe that unvaccinated HCWs are unable to provide such care; which, they've been doing since the pandemic started

Demanding to know whether an HCW is vaccinated is a slippery slope
🧵
First, I fully support pushing for health care *policies* (e.g. at the employer level) that require proof of vaccinations or put in place additional precautions for unvaccinated HCWs.

However, patients have no right to demand and know that information directly from their HCWs.
If at any point, patients feel unsafe or the HCW is unable to provide appropriate care, of course, they have the right to refuse care. But, that comes at a cost. For example, in a LTC setting, a person refusing care from an HCW might mean missed or delayed delivery of needed care
Read 5 tweets
Oct 22, 2020
Oct 22: There are 567 (-6 change) schools with 1+ #COVID19 cases in Ontario schools. There are also:

- 200 schools with 2+ cases
- 369 (1 in 11) elementary and 192 (1 in 5) secondary schools with 1+ cases
- 912 people with an infection

Live map/charts: covid19inontario.com/school-tracker
The top five municipalities contribute 413 (72%) of the 567 schools with active cases:

- Toronto: 194 (1 in 4 schools)
- Ottawa: 93 (1 in 4 schools)
- Mississauga: 54 (1 in 4 schools)
- Brampton: 48 (1 in 4 schools)
- Hamilton: 24 (1 in 7 schools)
- 200 schools have 2+ and 80 schools have 3+ active cases
In total, there are 4828 public schools
Read 6 tweets
Oct 22, 2020
October 22: #COVID19 in #Ontario
- Cases: 67,527 (+841 new)
- Deaths: 3071 (+9)
- In hospital: 270 (+10)
- In ICU: 74 (+3)
- On a ventilator: 48 (-1)
- Active cases: 6390 (+91)
- Reproduction rate: 0.99 (Credible interval: 0.88, 1.1)

covid19inontario.com
The top 3 public health units reported 603 of today's 841 cases (72%):
- Toronto PH: 335 cases (40%) or 107 cases per million
- Peel PH: 162 cases (19%) or 101 cases per million
- York Region PH: 106 cases (13%) or 86 cases per million

covid19inontario.com
Regional #COVID19 cases in #Ontario:
- 9 of 34 PHUs reported having fewer than 5 cases active cases
- 10 of 34 PHUs reported fewer than 5 new cases in the last 7 days

covid19inontario.com
Read 8 tweets

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