1/ #COVID19BC - @CDCofBC Data Update

This data is up until Nov 23rd (posted yesterday).

Important to go through to give a reference point of where we are at & where we can look at the potential #Omicron impact over next few weeks.

Cases/Hospitalizations dropping.

#BCPoli
2/ #COVID19BC - Vaccines + Kids

Will come back to this.

Slight uptick in cases from 9-11 yo recently.

Only ~35% of kids from age 5-11 yo are registered for #COVIDVaccine right now.

Recent data in 12-18 yo from @CDCgov showed Pfizer 93% effective.

Expect similar in 5-11 yo.
3/ #COVID19BC - Hospital Admissions

New hospitalizations declining.

Deaths continue to be in >age 60.

@WHO has said that if over 60 yo they are recommending against international travel

W/ risk of reinfection + #Omicron unknown, this is reasonable.

who.int/news-room/arti…
4/ #COVID19BC - Outcomes Over Last Month

Over the past month, unvaccinated individuals accounted for:
- 19% of the population but,
- 57% of cases
- 69% of hospitalizations
- 81% of critical care admissions

Again, power of vaccination is strong in preventing severe disease.
5/ #COVID19BC - Vaccine Outcomes

Over the last 4 weeks, compared w/ fully vax individuals & after adjusting for age, unvax individuals:

•≈ 8x more likely to become a case
•≈ 34x more likely to be hospitalized
•≈ 61x more likely to be admitted to critical care (NEW)
6/ #COVID19BC - Percent Positivity

Slowly declining provincially
- Lowest in @VCHhealthcare 3%
- @Fraserhealth low as well - 4.1%
- Highest in NH 18% (down from 21.5)

Also note differences by vaccination status (slide 44). Testing rates are declining across the province.
7/ #COVID19BC - Delta

Delta sublineages AY.25 & AY.27 most prevalent Variants in BC across all ages throughout province.

AY.4.2 & AY.4.2.1 are Delta sub-lineages that are slowly increasing in prevalence in the UK since mid-October, 2021.

12 cases of AY.4.2/AY.4.2.1 in BC.
8/ #COVID19BC - Dynamic Modeling

Rt is <1 in most regions (Reproductive number)

Highest on Vancouver Island at 1.3 (small numbers though)

Lowest in Northern Health - hopefully this continues, as we see cases dropping there.

Hopefully, Omicron doesn't disrupt this trend.
9/ #COVID19BC - Adolescents & Vaccines

Highlighting from the Pediatric section.

Lower case rate in 0-11 vs 12-17.

Yet to see a single hospitalization among fully vaccinated 12-17 year olds.

We will keep an eye on this as the numbers start coming in for age 5-11 population.
10/ #COVID19BC - Percent Positivity - Kids

Testing rates among 5-17 yo continue to decrease but remain elevated and stable among 0-4 yo.

Test positivity highest among 9-11 yo (>10%) and lowest in the 0-4 yo (<3%).

W/ positivity >10% in 9-11, good reason to get your kids vax.

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More from @BirinderNarang

24 Nov
1/ #COVID19BC - Age 5-11 Vax Rollout

Vax program announced today.

Some background:
Cases down w/ 457 new cases in past week, 15,917 total since beginning.

~20% new cases now in under 12 yo.

Most kids mild illness, but CAN get #MISC (19 in BC so far, average age 9)

#BCPoli
2/ Age & Vaccination

This graph shows that children under 12 years‐old are
generally at lower risk of infection than other age groups, even after returning to school in September.

Lower # of cases among fully vax individuals compared to unvaxxed across all age groups & time.
3/ Clusters & Schools

2975 exposure notifications, in 830 schools.
45% of schools had one (until Nov 13)
382 clusters (>2 cases w/in 14 days) in 217 schools.
Clusters identified in 12% of schools, so 88% of schools have had NO transmission events.
Median cluster size is 3 cases.
Read 10 tweets
9 Nov
1/ Last week there was a @UBCCPD Webinar "Addressing Anti-Indigenous Racism in the B.C. Health Care System"

I found it super insightful.

The summary will be available soon on the CPD website, but want to share a few highlights/takeaways.

Photo from Dr. James Liu.

#BCPoli
2/ Avoid Pathologizing Indigenous Peoples

This was a theme that came up a few times.

Dr. Evelyn Voyageur shared this thought:

“The lifestyle they have chosen is a defence mechanism to the trauma they experienced” as a reflection to residential school survivors.
3/ Pitfalls

One of the most enlightening pearls were pitfalls people who have seemingly good intentions may encounter while doing Anti-Racism Work and promoting Indigenous Cultural Safety & Humility

This was presented by @LenPierre2 - an Indigenous Cultural Safety Consultant
Read 9 tweets
4 Nov
1/ Wishing everyone who celebrates a Happy Diwali & Bandi Chhor Divas.

To those who do not know the historical significance, I will briefly share what I have learned about it through the years.

As per @SikhRI, Bandi Chhor Divas represents "Emancipation Day" Image
2/ Sikh Gurus

Sikhi is guided by the teachings of 11 Gurus (leaders who guide us from darkness to light) from Guru Nanak Sahib to the Guru Granth Sahib (our scriptures in homes/Gurduaras).

Guru Hargobind Sahib was our 6th Guru; Bandi Chhor Divas remembers his imprisonment.
3/ What Happened?

Guru Sahib was imprisoned by Emperor Jahangir at the Gwalior Fort for months-years (uncertain how long exactly)

Alongside Guruji, were 52 imprisoned political prisoners, the Hindu Rajahs (Kings/Princes)
Read 10 tweets
2 Nov
1/ New Opportunities

For the new people here, a brief bio/background.

A Sikh Family Doc, grandson of a 2x refugee Physician.

To be a Sikh is not only an articulation of Faith, but also to me means one who is always learning/unlearning.

Same applies to medicine.

#BCPoli
2/ Training

I grew up in the UK, Halifax & BC.

Completed undergraduate at @SFU, Medicine at @Sydney_Uni in Australia.

Returned to Canada as an #IMG completing my residency in @umanitoba

Now work in Long Term Care & Longitudinal Family Medicine at @REACHCHC inc. Addictions.
3/ Academic

I am a Clinical Assistant Professor with @UBCFamPractice

This involves mainly teaching 1st year med students & precepting residents, OSCE evaluating, interviewing

With @UBCCPD I help summarize #COVID19 Webinars & have facilitated Cannabis Education Sessions
Read 10 tweets
31 Oct
1/ Booster Doses - 9/12 later

Worth it? Rationale?
With global vaccine inequity - should we feel guilty?
Why I chose to mix...

Also co-incidentally this is my Halloween costume:

"Government Agent"
"Big Pharma Shill"

Take your pick.

Some thoughts ahead.

#COVID19BC
#BCPoli Image
2/ Why Now?

First dose Dec 20 & second dose Jan 31st.
At the time we weren't sure what optimal dosing interval was & had ongoing supply issues, so many got 2 doses at varying shorter intervals.

Now we know ~12 weeks is a good interval, but also are seeing waning immunity.
3/ Waning Immunity

Data is showing our antibody levels to #COVID19 are decreasing, but that doesn't mean our overall immunity is, as we are seeing by our vaccine effectiveness data in BC.

But, in BC we still are losing too many ppl, almost 50 have passed in last week.
Read 14 tweets
10 Oct
1/ #COVID19BC - Vaccines in 5-11 year old - Thoughts

This morning it was announced (by media) that 5-11 yo can now be registered.

A friend asked me if I had a child in that age range, would I be getting them vaccinated?

I said probably, but that isn't good enough...

#BCPoli
2/ #COVID19BC - Questions

Before we get into whether it makes sense yet, why do we keep hearing this stuff from anywhere but Public Health?

Another "soft launch" of systems? Like vax bookings, card registration & now this kid vax reg system, @BCGovNews announces after launch.
3/ #COVID19BC - Questions

This may be done intentionally, but why do it on a long weekend, when people aren't available to answer questions about it officially?

Communication from PH has been my biggest issue throughout the entire pandemic & it seems to continue.
Read 14 tweets

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