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Kashif Pirzada, MD Profile picture
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11 Jul, 7 tweets, 4 min read
Key questions we need to know the answers to asap:
1) Do fully vaccinated people get #LongCovid?
2) We know severe illness is less likely in kids, but how likely is it they get Long Covid? #longcovidkids

I’m going to try to dig through some studies in this 🧵
It seems getting long Covid post vaccination is possible if there is breakthrough symptomatic infection. It’s important to collect data on this because we’ve seen similar post-viral symptoms cause a lifetime of disability in many patients
businessinsider.com/nurse-coronavi…
Interesting study out of the UK that's collecting data from >4m contributors using an app called Zoe (@Join_ZOE). With that country facing a massive surge in cases, they are estimating 50k cases a day, and with that, 1k cases of Long Covid a day.
The study lead @timspector goes into more detail here:

They released a preprint (with @KingsCollegeLon and @ucl) showing that
1.2% of 20 year olds
4.8% for those in their 60s
can get debilitating Long-Covid symptoms that lasts beyond 12 weeks
medrxiv.org/content/10.110…
Another study based on Zoe data found 1.8% of children had symptoms beyond 8 weeks
medrxiv.org/content/10.110…
Which is similar to a cohort study in Switzerland:
medrxiv.org/content/10.110…
This highlights the need to keep case counts as low as possible, and to keep NPIs like masking in place. Condemning 2% of the population, 1 in every 50 individuals, many of them children, to a lifetime of preventable disability is a terrible option, in my opinion.

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More from @KashPrime

Kashif Pirzada, MD Profile picture
8 Jul
There is a divide now in the vaccinated world; governments and experts (mostly conservative leaning) who want to 'let it rip' through the population, and those who are more cautious and want to keep case counts low. It's so secret that I favour keeping the lid on infections...
...Given how close to zero cases we are, and given how little we know of long term effects. If any government wants to run a population-wide experiment, it behooves them to have a public debate about the issue at least
cbc.ca/news/politics/…
We are spitting distance to herd immunity in Canada, the level where most activities will be extremely safe. We have the highest vax rates in the world. In a few weeks, 75% of adults will be fully vaccinated. There's no need to run crazy experiments here.
Read 5 tweets
Kashif Pirzada, MD Profile picture
6 Jul
Watching the UK, BC and elsewhere give up on containing Covid is frankly depressing. There is another way, herd immunity is achievable in most of Canada once kids <12 get their shots in Sept/Oct. We need to hold the line on masking, testing, tracing and isolating until then.
Why is it important to do this? Yes, vaccines likely lead to a mild illness in most vaccinated people, kids mostly get mild illness also, but just by the law of large numbers, many will still get seriously ill. Long Covid is also another big wildcard. scientificamerican.com/article/a-tsun…
The mathematics behind the herd immunity calculation by @dfisman is here:
Read 7 tweets
Kashif Pirzada, MD Profile picture
2 Jul
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:
Read 15 tweets
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

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