Thread by @Lidsville

This briefing by @Protect_BC starts NOW.

I'm going to try to live-tweet it, or at least the highlights. Do you have questions for Dr. David Fisman or Dr. Amy Tan? Attach them to the tweet quoted here (don't reply to my tweet or they won't see it) #bcpoli fb.me/e/1tgbo68Fb

https://twitter.com/Protect_BC/status/1465856650800099333

@Protect_BC Here are the livestream links to todays's @Protect_BC briefing #bcpoli #covid19BC protectbc.ca/Livestream/

Dr. @DFisman talking about the fact that he seems to be able to speak more freely about BC #covid19BC issues than many scientists, doctors and others in BC can. @AmyTanMD saying we're going to chat about #Omicron and other issues today. Starting with the new variant:

Dr. Fisman, joking: "they leapfrogged over calling it "Nu" probably because they wanted to avoid an Abbott & Costello routine (who's on first style: it's Nu, I know, but what's it called?) and Xi is the name of China's president...

Dr. Fisman on what we know of #omicron: 'It does look as if it's more infectious, but an explosion in cases can also mean immune evasion (evading immunity either acquired from prior infection or vaccination) so we have yet to find out...

Fisman: #omicron has been circulating for a long time for it to have appeared in such distant locations in Africa - SA is very far from Nigeria and even further from Egypt. And it's transmitting in the community already in the UK

Fisman saying early signs are that Omicron may be more severe than Delta, and it seems to be highly contagious across distances (the isolation hotel in Hong Kong, transmitted past masks down a hallway). "It's airborne, as all #Covid19 is."

Fisman: Europe has been doing very badly the last few weeks, and we've been attributing this to getting rid of proactive measures like masks, but now we must ask if Omicron cases have been flying under the radar.' We'll find out...

Fisman: signals are that vaccination is still working, so get vaccinated.

@AmyTanMD "Yesterday there was chatter because Bonnie Henry declared Covid-19 as "endemic" in yesterday's BC presser. Thoughts?

@AmyTanMD Fisman: what makes a pandemic a pandemic is widespread susceptibility (new virus). At baseline *everybody* is susceptible. Over time, the reproduction number gets pulled down & you get below exponential growth.

@AmyTanMD Fisman: we are not at endemicity yet.

Amy Tan: is there any place in Canada where Covid has hit an endemic state.

Fisman: No

#bcpoli

@AmyTanMD Fisman: it's not fair if you're a Canadian citizen that you should suffer under terrible public health leadership (as with this summer in SK and AB) tho it's hard for the feds to step in. How do you allow the floor to be that low?

@AmyTanMD Fisman: talking about social inequality in BC which makes things much harder, and fuels social division.

But political leadership needs to act before hospitals get overwhelmed, whether it's convenient for them or not, whether the public thinks it's too early or not

@AmyTanMD Now we're hearing from Dr. Forrest via pre-recorded video - talking about the severe overwhelm at Nanaimo Regional General Hospital. "My fear is that once this wave settles down, many nurses will look for other work. They are exhausted."

@AmyTanMD Forrest: "patients trickle in but with #Covid1- don't leave for walks and it just sucks up resources, so a trickle quickly becomes a reservoir' and can overwhelm ICUs.

It's not workable.

@AmyTanMD Dr. Amy Tan: we have 300 in hospital in BC - they have 300 in hospital in Ontario, with 3x our population and more hospitals.

We are not asking for lockdowns - those are a sign of failure. We're asking for other measures on top of vaccines: #vaccinesPLUS

@AmyTanMD Dr. Amy Tan laying out what a #vaccinesPLUS approach would look like. We don't want shutdowns; we want better management and for people to be safer. #bcpoli #covid19BC

@AmyTanMD Now we're in the Q&A. First Q is from @npescod:

Fisman: It's bad public health practice and this is a bigger theme for BC. The people are the team; public health authorities are the captain. The team can't do the work if it doesn't have the info about where infections are

@AmyTanMD @npescod Fisman: it's like with aerosol - Canadians understand aerosols - we can see our breath five months from the year! Give people the information about where Covid is - and we pay for this data, it's not acceptable to keep this information hidden from the public.

@AmyTanMD @npescod Q from @PennyDaflos:

how much advantage would Omicron need to have over Delta to start getting us into trouble?

Fisman: the problem is that Omicron wouldn't have to be much worse to create problems. But there are different moving parts...

@AmyTanMD @npescod @PennyDaflos Fisman: with exponential growth, even small percentage increases can create increases overall. Dr. Sarah Otto in BC has been following this and tracking potential small changes but they can make a big difference.

@AmyTanMD @npescod @PennyDaflos Penny: will this be a 3-dose series for the vaccine? People should exercise caution until they've had a 3rd dose?

Fisman: Vaccines work well between 4-6 months. But Canada has to realize that it doesn't have its own pandemic - we are seeing other vaxxed nations still get waves

@AmyTanMD @npescod @PennyDaflos Amy Tan: Canada IS throwing out vaccines which is pretty hard to justify morally given vaccine inequity, and we need to do our part and get the vaccines out at least and throw them in the garbage! We're throwing out 3rd doses.. why? Fisman agrees

@AmyTanMD @npescod @PennyDaflos Q from @moirawyton of the Tyee:

Fisman: the Covid 6 are the provinces dealing less well w Covid (ON, QC, MB, SK, AB, BC). It's been a big fight to get ON to admit #COVIDisAirborne

But ON did put hepafilters into schools & did better than BC...and kids had masks

@AmyTanMD @npescod @PennyDaflos @moirawyton Fisman: ON has also been good at situating vaccine clinics where people are at, with a decent vaccine equity response.

We need honest, open science-based communication with the public. Tell people Covid air is like smoke. It's not droplets, it's all aerosol. Get the kids vaxxed

@AmyTanMD @npescod @PennyDaflos @moirawyton Amy Tan: I'd add that we need rapid tests for BC. On the whole we don't supply them, and this becomes an equity issue: those who can afford them can buy them privately.

@AmyTanMD @npescod @PennyDaflos @moirawyton Next Q from @moirawyton:

Fisman: Vaccines work awfully well, even when they fail - if they get infected they're less sick & they shorten the shedding period. Vaccines do a ton. In a majority vaxxed popn you'll see lots of vaxxed infections sure & that gets spun in incorrect ways

@AmyTanMD @npescod @PennyDaflos @moirawyton Fisman: 'Yes ppl are tired. But you don't unilaterally declare a pandemic over. Doesn't mean lockdowns. Lockdowns represent policy failures; means you've crashed your health system into a tree.'

But you still have to stop that crash.

@AmyTanMD @npescod @PennyDaflos @moirawyton Fisman: "we have to follow the science where it leads. We can't just say silly things. We can't say Covid is droplet spread just because we don't have enough negative pressure rooms in our hospitals"

@AmyTanMD @npescod @PennyDaflos @moirawyton One last Q from Twitter, from the public:

What extra measures can the public take right now, esp the vulnerable?

Fisman: public health has focused more on not admitting error than on protecting patients. This has to stop. Well-fitted masks are very helpful...getting vaxxed..

@AmyTanMD @npescod @PennyDaflos @moirawyton Fisman: one problem is that the people who need protection most often have the least good antibody response to vaccines, which is why the rest of us have to work together to protect them

@AmyTanMD @npescod @PennyDaflos @moirawyton Amy Tan: As you said, there isn't much more an immunocompromised person can do; it has to be a collective effort, led by public health.

That's it! Amy Tan thanking Dr. Fisman & asking audience to tune in to @Protect_BC social media for tips over the holidays.

@AmyTanMD @npescod @PennyDaflos @moirawyton @Protect_BC Dr. Amy Tan: Remember #COVIDisAirborne!

Dr. Fisman: Stay safe, everyone

/end

argh *weeks, not walks