Thread by @TRexMD780

Hey Twitter of #Alberta. Doctors just finished a town hall with Dr.Hinshaw about the new policy changes. I tried my best to take notes on as much as I could. So here's what I have.

*Pls note: I am NOT endorsing anything, this is what was said from Dr.Hinshaw ONLY*

Thread🧵

She recognizes that communication last week was not sufficient or complete and they are going to try to send us more info. They are working on a document with cited evidence to explain their decisions that is coming end of this week or next. 2/x

Her bottom line that was said many times: We need to learn to live with COVID, we can not eradicate it and that is the basis of these decisions/policy changes. 3/x

More specifically: COVID is not an extraordinary disease like Measles that we can expect to eradicate. So we shouldn't continue "extraordinary measures" to continue to try to manage it like as what we are doing now. 4/x

Although we are the first province to do this, she is under the impression from other public health officers in other provinces that they are going to do the same. She has no timeline on when anyone else will follow. 5/x

She wants to move to a regional/local outbreak approach as it happens in real time instead of pre-emptive blanket mandates for the province. 6/x

There are contingency plans to go back to quarantining/isolating/tracing if there is a variant that can escape vaccines or if acute care facilities become overwhelmed again. 7/x

The Delta variant was considered in making these recommendations (and it's not considered an escape variant). They used data from UK's experience with Delta to make these policy changes. I think we will see that in the document coming this week. 8/x

They will provide modelling for what we expect in COVID spread & mortality with these new policy changes. COVID cases will increase but they do not expect impact on acute hospital care to be significant (maybe this will be in the document too?) 9/x

They won't continue to mandate masking/distancing/isolating when sick in "respiratory illness season" because she's hoping that COVID has taught the public to wear masks when appropriate & not going to work/school when sick. But she says this shouldn't be legally mandatory. 10/x

Let's talk kids, this was asked A LOT. Please recognize your medical community is super concerned about your kids, lots and lots of questions on this but it boils down to these 2 concepts from Dr.Hinshaw: 11/x

#1: She states they have cited studies from UK/Germany that show that young kids have less long COVID than older kids and so exposing young children to COVID is not as risky as it is for adults & older kids 12/x

#2: She states they have many studies showing that young kids have less severe short-term COVID outcomes/mortality than older kids/adults, and so again, exposing them COVID is not as risky 13/x

Masking in schools: She has concerns around masking of kids in school affecting speech/social development. Masks are also "polarizing". So apparently we will need to do "local" recommendations on this. This was very vague, I can't explain this more 14/x

Let's talk primary care/family doctor involvement in policy changes. This was also asked repetitively and I think she might have conceded at the end that they did a very poor job of involving primary care providers in this discussion 15/x

She states they worked w/PCNs and the ACFP about these policies. She admits primary care offices will need a referral pathway for doctors to send patients for testing if the doc can't do it in office. There should be locations around the province for this 16/x

GPs are apparently going to have access to COVID testing kits and rapid on-site testing. We have no idea what a "COVID testing kit" is. She has no answer to PPE costs for community clinics or if GPs will be reimbursed for this added cost. 17/x

She does not want Primary Care offices to test every person with mild symptoms. We need to use our "clinical judgment" on who needs testing. She does not explain how we will stop employers, schools or daycares from requiring swabs for people to return to work/school. 18/x

She states that GPs have managed other respiratory illness seasons for years & she expects we will manage this Fall with COVID just like we would manage it for prior years. This includes work volumes, swabbing, cleaning/sanitizing, etc. - these should be equivalent to before 19/x

She cited again that other public health issues like congenital syphilis and opioid deaths should be a new focus. Did not explain what this "new focus" will look like or how we will improve these public health issues w/our new resources redirected from COVID 20/x

For immunocompromised individuals, they will be expected to follow recommendations they always used to receive about other infectious diseases prior to COVID. "This was one of those really tough decisions [we had to make]". They may also be getting extra booster vaccines. 21/x

THAT'S IT EVERYONE. Those are all the notes I have and I know it is woefully inadequate to answer all questions. Again, I am **NOT** endorsing anything that she said above, I just felt the public should know what we were told. 22/x

Feel free to ask me Qs to clarify as I am limited for characters in tweets. I might be able to expand on this as these are just brief notes. And pls - for any of my doctor colleagues who were also there, add on what you heard.

#abhealth #abpoli #ableg #COVIDAB 24/fin

*ha sorry, the last one is 23/fin. There is not a missing #23 tweet.

@threadreaderapp Please unroll this tweet. (Yes I'm actually doing this for my own tweet, but its 23 tweets long!)

Response from the ACFP about Tweet # 16: No they were not involved in these policy changes.

https://twitter.com/TRexMD780/status/1423452006606417927

Okay the clock has struck midnight & I did my best to answer questions. Will try to answer others later but there are lots, may not be possibmd. Keep pushing those tough questions to our government ✊