Thread by @a_longhurst

Researchers are confident that majority unvaxxed pop likely to be infected this fall/winter, esp in unvaxxed settings with few/no NPIs (eg child care & primary school). Yesterday, @CDCofBC head was on @CBCOnTheCoast. My concerns in this 🧵 cbc.ca/listen/live-ra… #bcpoli #bced

Delta is ~2x more transmissible than original COVID. Emerging evidence also shows that it is more severe in the unvaccinated. Fully vaxxed with breakthrough infections can spread to others, but vaxxed appear to spread the virus for a shorter time. cdc.gov/coronavirus/20…

Since COVID began, BC officials have routinely stated that kids are less likely to become infected and spread to others. Just last week Health Min stated this. Until recently, @CDCofBC "COVID-19 & children" webpage stated this. Thankfully this misinformation has been removed.

Might it have been removed following my recent op-ed with @Raffi_RC in which we called out this misinformation? We'll never know. If you're looking for a good scientific evidence review about children and COVID-19, I recommend this US @CDCgov brief. cdc.gov/coronavirus/20…

To return to my main point, in settings with low immunity and little testing (BC continues to discourage testing in kids & no rapid tests in schools), Delta will spread rapidly in child care and school settings (particularly primary schools w/ under 12s). washingtonpost.com/health/2021/08…

Instead of *increasing* non-pharmaceutical interventions (NPIs) in ed settings, we have *fewer* NPIs. No distancing, cohorts, remote options (w/out risking loss of in-person spot), mandatory vaxx for 12+, masks for kids 2+ (as per @AmerAcadPeds), BC-wide ventilation standards.

In fact, officials still unwilling to clearly state that the #COVIDisAirborne & primary mode of COVID-19 transmission is aerosols (not droplets, certainly not fomites). Just this week, officials were spreading misinformation to BC family physicians.

https://twitter.com/MicMcCulloch/status/1438057095035686912?s=20

Why does this really worry me? Family physicians have very important long-term, trusted relationships with their patients. Family docs are fundamental to efforts to increase literacy about COVID-19 and how to prevent its transmission. Instead, officials spread misinformation.

Leading journals have published consensus articles that #COVIDisAirborne. From this, we must embrace high-efficiency masks & ventilation as fundamental prevention tools. @trishgreenhalgh, @jljcolorado, @kprather88 among many others across disciplines have been at the forefront.

Here's a fantastic (short) read in @TheLancet from @trishgreenhalgh @jljcolorado @kprather88 et al:

"Ten scientific reasons in support of airborne transmission of SARS-CoV-2"

Read it, share it. And as, @trishgreenhalgh says, it might just save a life.

https://twitter.com/trishgreenhalgh/status/1391488944852905986?s=20

Okay, back to kids and COVID.

3 problems with BC's policy approach & messaging from top officials.

1) To achieve high population immunity and exit the pandemic, we need under 12s vaxxed. @TallPupper @CarolineColijn told us this back in April. sfu.ca/magpie/blog/af…

As @TallPupper @CarolineColijn state, this can be achieved either through vaxx or infection. In BCCDC head's comments (see bold), she says it's very likely that unvaxxed could become infected in the weeks ahead. Don't forget that 617,000 unvaxxed British Columbians are under 12s.

As we've seen with this #DeltaWave, transitioning to "endemic" COVID is elusive because we don't have high enough population immunity. We have very full hospitals and ICUs & hundreds of people accessing acute care services. That's not a virus that we can declare "endemic".

But the issue here, which leads me to problem #2, is that officials seem to be okay with –– and through policy decisions –– inviting infection in those under 12. Ethically, this is wrong. While Dr Gustafson says otherwise, BC's policy decisions downplay Long COVID in kids.

2) Kids suffer severe illness & #LongCOVID, & can die. In practice, absence of policies that employ precautionary principle & highest level of prevention invites mass infection (even if officials say otherwise). Re Dr Gustafson's new "re-assuring" UK data:

https://twitter.com/dgurdasani1/status/1438780287958257664?s=20

Here are the comments from Dr Gustafson's re "re-assuring" UK data and the importance of "monitoring" Long COVID. Note that she doesn't say "prevent". Also, BC collects no data on Long COVID in kids (or adults), so it's a bit rich to say we're "monitoring" it because we're not.

As @KatharineSmart thoughtfully put it, we are only starting to understand Long COVID in kids (& we may not fully for years). Hospitalization and death aren't the only severe and deadly outcomes. The US @CDCgov guidance is important to keep in mind. cdc.gov/coronavirus/20…

Dismantling test/trace/isolate in BC means that Delta will spread in more unvaxxed ppl, incl kids, more rapidly. Refusing to isolate classes/close schools to prevent further spread will hasten spread. More transmission, more severe/deadly outcomes & Long COVID in kids. It's math.

More on outcomes in children. Sorry, Delta isn't different in BC. It's the same virus. We don't have "our own pandemic".

https://twitter.com/jljcolorado/status/1437789024610029568?s=20

It's very troubling that Dr Gustafson is back-pedalling on their comments about potentially not recommending vaxx for under 12s (listen for yourself when they compare COVID to a "cold" in kids

https://twitter.com/MicMcCulloch/status/1438048779941265408?s=20

). Trials are underway, but if safe, why wouldn't we recommend?

3) Exposure notices in childcare/schools must be provided. W/ widespread cmmty transmission, isn't PH's place to determine what information is "effective" or important for families to assess their own risk. PH's duty is to report not withhold, but that's what they're doing.

Nvm how Dr Gustafson wants to spin it, it's not okay to withhold this. In a un/masked class, any respected aerosol scientist would tell you that everyone in that class is a "direct" contact. Enough rhetorical gymnastics. Delta is highly infectious. nytimes.com/2021/08/28/hea…

And regardless of justification that b/c BC is transitioning to "communicable disease control" Public Health can report even less information publicly. Nah, that's not okay. Most places report way more than BC. Here's Seattle's dashboard w/ school-level reporting, for example.

So what's my point? We need to honour kids as we did for unvaxxed elders. If the absence of policies to prevent infection & spread among unvaxxed kids leads to mass infection, then the policy approach is about encouraging immunity through infection.

https://twitter.com/drajm/status/1438860819584880641?s=20

What's needed? We're already seeing lots of exposures & +cases reported by the volunteer @BCschoolCovid. If we want to avoid mass infection (& consequences), we can't only rely on vaxx for 12+. @Raffi_RC & I put forward ideas to both honour kids & science. thetyee.ca/Opinion/2021/0…

Existential concern moving forward is about policy learning & health sector governance. BC's policy actions belie the rhetoric. In some cases, we're not in fact doing what PH says we're doing. In others, PH/govt stubbornly refuse to embrace science & the precuationary principle.