We can't live with Covid any more than we can live with measles, polio, smallpox, malaria, chemical, biological and nuclear weapons. These are all things that have been controlled with sustained effort over multiple generations.
There's no evidence that the virus is evolving to a more benign state. It is not being 'defanged' - it has only gotten more infectious with time.
There is ample evidence that the virus persists in many parts of the body, replicating at a low level for months after infection.
Long Covid is still a risk even with breakthrough infection. With vaccines that is less likely, but its not something that we want to test with high community viral load. medrxiv.org/content/10.110…
SARS2 has a number of features that lead it to cause massive damage across the body. It has a 'superantigen' - which overstimulates T-cells. It has a furin cleavage site- enhancing transmissibility.
This was covered in a recent episode of TWIV:
There are still too many unvaccinated adults out there. If we let the virus run rampant, we risk their health and everyone else as hospitals get overwhelmed again.
This is the only logical conclusion:
Use common sense, ratchet up interventions when things go bad, relax when things are better.
So far in Ontario we are doing quite well with this approach, though cases are starting to track upwards today. Shops and restaurants are open, life is proceeding normally, and hospitals are not falling apart (no more than usual!).
What to do if cases start tracking up?
Right now, clusters are starting out in children and schools, the largest unvaccinated pool we have.
We need to deploy rapid testing in regions that are spiking up ASAP.
We need to roll 5-11 vaccinations quickly.
A true 'living with Covid' strategy should aim to keep cases low permanently. Have testing available at home; deploy antivirals when they are available; permanently fix ventilation - cleaner air is better for everyone. With case numbers low, we can carry on without fear.
What's the end game? A true sterilizing vaccine that prevents onward transmission. With the promising numbers that we're seeing with 3rd doses, maybe we'll get there sooner than we think.
In the end, policy choices matter. Leaders that can convince their societies to endure short-term hardship for long term gain will prosper. This is the choice before every society on the planet now.
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Wanted to share with you something near and dear to my heart.
Today my colleagues and I are proud to launch the Canadian Covid Society. @CanCovSoc
Covid-19 is thankfully not the threat it once was, but there are still significant issues with having a new disease roughly 4x as bad as Flu (and much more contagious) floating around, which also disables a lot of people as well.
In Canada it was the 3rd leading cause of death 2020, 2021 and 2022. We have the Canadian Cancer Society, and Heart and Stroke foundation for the 1st and 2nd causes, it's time we have one for the 3rd leading cause of death.
It is perfectly natural to not want to deal with this issue anymore. But that's part of the problem isn't it?
Many of us have a visceral aversion to discussing it, perhaps a natural reaction to memories of the most traumatizing days of the pandemic. But the fact remains that it's still out there, that it will continue to cause strain on our health systems, disable people, and shorten life for many of us.
We need a national body that will keep advocating for things like updated vaccines and therapies, as well as common-sense fixes that prevent the spread of disease, like cleaner indoor air (which could have been very useful stopping this nasty measles outbreak we're having).
We need a national strategy to support and improve access to care for Long Covid sufferers, many of whom are simply unable to access any care for a devastatingly disabling condition. 2 out of the 3 Long Covid advocates we approached for our launch event were not able to attend due to illness, which should tell you something! There's no way to predict who will get it, when they'll get it, and there is no cure, yet.
We are organizing a virtual press conference for 1pm (ET) today, Wednesday March 6, 2024. A video stream will begin on Youtube, and this url will forward you there: . Journalists who wish to ask questions please send me a DM and I will send you instructions to join.
Our website is up at
You'll hear more from us as we grow the range of activities offered by the Society. We would love to share resources and help like-minded groups start national societies in their own countries. Would love to see and collaborate with an American Covid Society, a British Covid Society etc.
It is time that we create a permanent effort to fight this disease, and not have these efforts subject to political whims or a societal wish to indulge in denial.covidsociety.com covidsociety.ca
C19 is the third leading cause of death, behind heart disease and cancer, ahead of accidents/trauma.
Mortality overall is up 13% across all age groups compared to 2019, and increasing every year
This should be a huge scandal!
We are being robbed of precious life years, for no good reason except to maintain an unsustainable status quo. We are losing time with our loved ones, the economy is losing out on workers in their prime years, and there must be a better way.
Media article:
Statscan source:
and
Does this look like a trend that's slowing down?
Not to me
So much truth in this one graphic.
True story, on a recent shift, I had to run and help a patient who had collapsed on our waiting room floor, short of breath. Hypoxemic. The family was diligent, and tested before coming, and lo-and-behold, they were positive. With some help, got… twitter.com/i/web/status/1…
I asked ChatGPT to summarize my feelings in verse, and it did an astonishing job:
In sorrow do I witness suffering's reign,
The public's decline, inflicted by this bane,
The young struck by blood clots, strokes untold,
Life's flame grows dimmer, as the years unfold.
Alas,… twitter.com/i/web/status/1…
Today wore an N95 mask outside for the first time ever, and found it really helpful for throat irritation and that annoying choking feeling. Doesn't help for eye irritation though. Would highly recommend.
If you've upgraded your home, workplace or school with enhanced ventilation and filtration to fight airborne illnesses, you're in luck: staying indoors will protect you. If not, you can jerry-rig some filters using commonly available parts:
If you've spent time in any congested Asian or African city, the feeling is both routine and hard to forget. Even more reason to push hard the energy transition away from polluting and global-warming contributing fuels around the world.
This post really speaks to the incoherence of national policy. As doctors we have to hold two very different ideas in our heads. Covid is 'over' and 'just a flu' has to live in the same meatspace as 'omg why is this young person with zero risk factors having a stroke', or 'why… twitter.com/i/web/status/1…
The unprovoked death of an innocent 16 year old boy in Toronto's subway system needs to lead to radical changes to the way in which we handle criminal behaviour, and address the chronic neglect of the most vulnerable in our society.
The homeless population roughly breaks into 4 groups, which often overlap with each other. We often lump it all together, but each individual requires targeted supports depending on what factor is keeping them homeless.
Poverty is the 'easiest' to fix, just build more housing… twitter.com/i/web/status/1…
Mental health - the vast vast majority of mentally ill patients are non violent and do very well with treatment. They live, work and contribute positively to their communities. There is a subset of those who suffer severe psychotic illnesses, like cbc.ca/news/canada/ma…… twitter.com/i/web/status/1…