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Kashif Pirzada, MD Profile picture
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14 Sep, 8 tweets, 4 min read
Really strong case for 3rd doses, especially for those over age 60:
This should be the biggest priority for decision makers in the coming weeks.
I'll go over why in this thread ->
Waning immunity is being observed in multiple studies, in elderly populations, and needs to be addressed. It's too bad our federal authorities are paralyzed by the election, a decision needs to be made soon.
Vaccine equity is an issue, but:
- the world is swiftly catching up
- Median age in Africa is 19.7 years, its 45+ in most Western countries, and death/ICU risk increases exponentially with age
A frequent argument used is that 2 shots are enough to prevent hospital/ICU illness. We should aim to prevent ANY infection; even mild infection exposes you to 2-3% risk of Long Covid/Chronic Fatigue. That's a devastating, potentially life long affliction.
Expanding production is the best way to fight disease. Covid will be with us for a long time, variants resistant to 1st gen vaccines will come and the world needs to be ready for them:
In Canada we are fortunate to have federal investment in
- an mRNA production facility in Ontario by @IncResilience
- antibody production in Vancouver by @AbCelleraBio
and @PrecisionNano
- vaccine production in Montreal by @Novavax
Every region and country needs to do the same
Localizing production, like this project, is the best way to fight future variants/outbreaks as they arise. And not just for Covid, but for any new pathogen or bioterror threat that will arise in the turbulent years to come.
who.int/news/item/30-0…
Can’t argue with these numbers.
Fact is, no one knows yet what ‘fully vaccinated’ means. It’s a work in progress. Polio takes 5 shots, Hep B takes 3. Maybe COVID takes 3, maybe 4. Until we know, no need to let thousands become chronically ill with Long COVID.

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More from @KashPrime

Kashif Pirzada, MD Profile picture
5 Sep
How is it that 18m after the first mRNA vaccine was developed we still don’t have an approved vaccine for kids?
This will be one of the greatest preventable public health failures in history, and it is happening in real time right before our eyes
What can we do? Some ideas: Image
The stakes are massive; cases in children in the US are rising exponentially. Given how infectious Delta is, and the lack of mitigations in most schools, we can expect many, perhaps most, children to be infected in the next few months. aap.org/en/pages/2019-… Image
And it must be emphasized, as seen above, children can get seriously ill from this virus; 1/100 will need hospital admission, 1/10000 will die. 24 died in the US last week out of 200k new infections
1/50 will get Long Covid:
covid.joinzoe.com/post/long-covi…
Read 21 tweets
Kashif Pirzada, MD Profile picture
18 Aug
Listening to this phenomenal seminar by @kprather88 and others on what's at stake on the return of kids back to school this month.

@denise_dewald explains that the ICU system for kids if fragile and not designed for big shocks

Letting children get infected (and 1% of them will need hospitalization) will overwhelm this system quickly, and opens the prospect of triaging which child gets life-saving care.
@kprather88 explains that aerosol spread is the primary mode of spread of SARS2, and can float and linger in a room. Indoor spaces need to be filtered, masks need to be worn.
Read 16 tweets
Kashif Pirzada, MD Profile picture
18 Aug
Going through US data on children and Covid from @AmerAcadPeds is pretty alarming reading. Cases and hospitalizations are accelerating quickly.
aap.org/en/pages/2019-…
It looks like a pediatric hospitalization rate of 0.9% is consistent across 23 US states (Texas, Florida, Arkansas and many others are refusing to report this data)
If you extrapolate roughly from the rate of new pediatric cases every week, which is at 120K children last week (and accelerating), that's >1000 kids needing admission this week alone.
Read 5 tweets
Kashif Pirzada, MD Profile picture
17 Aug
Happy to see that teachers will be required to vaccinate (or get rapid tests). Ontario's plan is probably the best in the country now, but there's still some big gaps:
- Require masks from JK up
- Eliminate unmasked indoor activities
- Come up with a safe plan for lunch-time
Some great ideas on making lunch-time safer, especially when the weather gets colder:
Overall our children need a circle of protection around them. Vaccinated parents, teachers, rapid tests, ventilation upgrades. We have the resources and time to get this right.
Read 7 tweets
Kashif Pirzada, MD Profile picture
3 Aug
Here is a checklist you can show your local school administrators on protecting kids <12 before school starts. Will post supporting documents and explainers later this week, but we have no time to waste... we have a month to get this right.
The stakes are high. As @DanielGriffinMD likes to say, kids are at low risk, but they are not at no risk. Perhaps 1/25 will get long-term symptoms, 1/140 may need to be hospitalized, 1/3000 may develop MIS-C.
An even more exhaustive list:
Read 5 tweets
Kashif Pirzada, MD Profile picture
13 Jul
If I had to summarize what I think are the most basic things to keep everyone safe and the economy humming, it boils down to these elements:

1) Keep public masking
2) Push vaccination rates higher
3) Vaccine requirements in sensitive areas like borders, hospitals, schools
Basic measures have kept us safe so far, and the results are dramatic; we are performing much better than many of our closest, and less careful, neighbours and allies. More can be done, but we should be proud of what we've accomplished.
And it builds on another idea, that we are very close to herd immunity, that we can eliminate circulation of this virus when enough are vaccinated. We have to hold the line until younger kids can get the vaccine this fall
Read 7 tweets

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