"Hi Alex. If vaccinated folks can transmit #COVID19 like unvaccinated folks, why get vaccinated? Negative testing is good enough!"

Fully vaxxed persons transmit #COVID19 at FAR LOWER LEVELS than unvaxxed persons. Rapid antigen testing has limitations.

🧵 below to explain

(1/7)
If you're fully vaccinated, your chances of getting #COVID19 infection are MUCH lower, so your chances of transmitting are ALSO much lower too.

If you're fully vaccinated but still get #COVID19, you clear the virus MORE quickly, so you're less contagious overall.

(2/7)
This is why being fully vaccinated & PREVENTING #COVID19 infection is BETTER than just doing negative lateral flow testing (LFT, "rapid" tests).

Persons who are fully vaccinated protect themselves from infection as well as those around them MUCH BETTER.

(3/7)
The sensitivity of lateral flow tests in asymptomatic persons with #COVID19 is ~60%. So 4 times out of 10, the LFT doesn't identify you correctly - it "misses" you.

If it's positive, then you've got #COVID19. But it misses a good # of infections, especially early on.

(4/7)
Suppose you're unvaccinated. You do an LFT w/ no symptoms but you're actually infected. It's negative.

72 hours later, you attend @ericchurch concert. Presumably at that point you're pretty contagious. If you're not wearing a mask, shouting, chanting, singing... uh oh.

(5/7)
That's why being fully vaccinated IS BETTER than a negative LFT for non-essential activities.

Being fully vaccinated protects yourself & those around you FAR BETTER than negative LFT every 72 hours.

PCR testing has far better sensitivity than LFT but is ++ expensive.

(6/7)
In summary, this is why we should consider removing the negative test option for some/all non-essential activities.

Requiring full vaccination for these activities is FAR safer from public health perspective & will push vaccine uptake as high as it possibly can be.

(7/7)

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More from @awong37

27 Oct
"Hi Alex. Do #COVID19 vaccines affect fertility? Should I get it if I'm pregnant?"

There's SO MUCH misinformation about how COVID-19 vaccines aren't safe in pregnancy or can affect fertility. THIS IS NOT TRUE.

Excellent link 👇 & short 🧵.

(1/4)

pregnancyinfo.ca/covid/
All the information we have with billions of doses of #COVID19 vaccine given is that there's NO EVIDENCE that COVID-19 vaccines affect fertility at all.

Every person, whether actively trying to conceive or just thinking about conceiving, SHOULD be vaccinated.

(2/4)
Acquiring #COVID19 while pregnant means a woman is at HIGHER RISK of needing hospitalization & ICU care versus not being pregnant. Being very sick with #COVID19 could be dangerous for baby.

All pregnant woman SHOULD be vaccinated to prevent serious illness from #COVID19.

(3/4)
Read 4 tweets
27 Oct
The benefits of vaccinating ALL children b/w ages 5-11 with Pfizer #COVID19 vaccine OUTWEIGHS known or potential risks.

A long-ish 🧵 on data & risk/benefits thus far.

As an ID physician, I'll vaccinate my 5 year-old w/ confidence, and recommend to others to do the same.

(1/n)
#COVID19 is a serious infection for all kids.

Although kids who acquire COVID are at much lower risk of death than adults, other complications can occur after recovery from acute infection, including Multisystem Inflammatory Syndrome (MIS-C), and Long #COVID.

(2/n)
Much higher rates of infection, hospitalizations, and deaths have been reported in children in last several months in the USA & Canada as a result of widespread transmission of the more contagious Delta variant.

(3/n)
Read 15 tweets
24 Oct
A LONG explanatory 🧵 on ICU 'capacity' & 'flow' in Saskatchewan & why we need MULTIPLE interventions to avoid compromised care for ALL #SK citizens & triage.

I'm going to use an analogy of ICU capacity = bathtub. Patients = water. Health care system = house.

1/ #COVID19SK
Water is running into the bathtub. That's all the patients who need ICU care in Saskatchewan. Some have COVID, some don't. The patients have now overflowed our ICUs.

To cope, we've built walls up on our bathtub to hold more water. That's our 'surge' capacity.

2/ #COVID19SK
We can only build walls up on the tub so much, because there's limits on what can be done safely w/ availability of specialized staff, especially nursing & respiratory therapists (who support ventilated persons).

We've reached that limit w/ ~120 pts in #SK ICUs.

3/ #COVID19SK
Read 19 tweets
22 Oct
Summary 🧵 of last night's SHA "town hall" for MDs:

- Overall #SK test positivity ~14%
- Cases declining, but so is testing
- #SK has HIGHEST current case & death rates of all provinces
- HIGHEST ICU census per capita of ANY province at ANY point in pandemic.

1/ #COVID19SK
Vaccine & mask mandates have helped, but not enough. #SK remains in exponential growth & cases NOT coming down at this point.

Public health experts @SaskHealth recommend gathering restrictions, including limits on household gatherings, capacity limits, etc.

2/ #COVID19SK
As of 0730hrs yesterday AM (Oct 21), 117 persons in ICU. 57 persons on high-flow oxygen (Optiflow) normally in ICU, cared for on regular hospital wards.

ICU census now forcing out-of-province transfers, widespread service slowdowns, and informal triage.

3/ #COVID19SK
Read 8 tweets
21 Oct
This is an explanatory 🧵 on ICU capacity in Saskatchewan, the different levels of ICU care & support provided across #SK, and why freeing up ICU beds in Regina & Saskatoon is SO important right now for us.

Put plainly: "not all ICU beds are equal"

(1/n)

#COVID19SK
Not all ICU "beds" are created equal. There's different capability levels to provide support for complex patients depending on the expertise of available doctors, nurses, respiratory therapists, and specialist support. (2/n)

#COVID19SK
Let's divide "care levels" into 3 buckets:

✅ 1. BASIC = ventilatory support, cardiac monitoring, IV blood pressure management, sedation, high-flow O2 support

✅ 2. SPECIALIZED = BASIC + continuous renal therapy, complex ventilatory support (eg. proning)

(3/n)

#COVID19SK
Read 11 tweets
20 Oct
Some data slides released today @SKGov w/ accompanying discussion via Dr. Shahab.

Short 🧵 w/ commentary.

First, being unvaccinated in #SK = 28X risk of ICU admission, 13X risk of hospitalization, and 6X risk of getting COVID vs. being fully vaccinated. (1/6)

#COVID19SK
Second, ~50% of all persons admitted to hospital in October had 1st positive COVID test on/after being admitted. This informs approach to early therapy, monoclonal Abs, etc.

Earlier testing & identification of illness clearly ideal. (2/6)

#COVID19SK
Overall #SK ICU census numbers continue to rise dramatically, shown by the graph on the right, attached. This is what's killing us right now.

We need relief through combination of public health measures, more ICU staff, and out-of-province transfers. (3/6)

#COVID19SK
Read 6 tweets

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