Thread by @drdagly

So, I’ve given myself 24 hours to process our provincial government’s approach to the #OmicronVarient. No, they do not come as a surprise to me, and yes I needed this time to grieve a bit.

Time to open some wounds.

Clearly there is a disconnect between public health policy and political will. We’ve seen wavering alliances here before, but even our hamstrung @CMOH_Alberta is worried about what is coming.

As more data becomes available, it is clear that this virus is fast, highly infectious and just as morbid as delta. Initial thoughts about decreased severity were likely due to partial immunity from high endemic infection rates in the South African population.

The good news is that vaccination will protect you from severe illness, but you need to update your antiviral software. Boosters will be essential, and so far Moderna is looking like the better option. The bad news, we will be seeing more breakthrough infections.

These will be mild for the most part, but it’s a numbers game, and a percentage will still get pneumonia, some will require hospitalization and some of those will require ICU. The unvaccinated will be at higher risk than ever.

No matter how remotely someone lives, or how isolated they are, with the current infection data we have, they will be at risk and need to be vaccinated fully. And with the current state of @ahs_ems, being remote carries increased risk.

Given how fast #Omicron reproduces, we will also see significant increases in asymptomatic spread. Yes, the person who is vaping watermelon infused #SARSCoV2 around the Christmas tree will look perfectly fine, well except for that ugly sweater.

And just as polarized as our political climate is, the airborn vs droplet crowd will being going at it. That’s energy poorly spent. Just like you upgrade your phone, upgrade your mask. N95s should be the standard. Fresh air is good for you so is good ventilation.

Am I concerned. Yes. Hospitals are not functioning well, neither are staff. Everyone I know, like you, was looking forward to family time over the holidays. Now, morally we need to scale it back, despite what the health regulations say.

Both the hospital and ICUs remain well above capacity as we strain under the backlog of almost two years of poorly managed chronic physical and mental health problems.

A 5th wave will come at significant cost, but not the one we will have to agree upon. If we collectively go down this path, this is the wave I foresee triage as a becoming real. With breakthrough infections, airborn spread and significant numbers of unvaccinated Albertans.

I know ICU is the choke point for hospitals and hence society. If we gamble on #OMI then we must accept the consequences if we get it wrong. The initial triage protocols were very restrictive. They will need to be liberalized. Vaccine status was never part of the algorithm.

And though it’s controversial I can tell you prognostically, if I have two patients of similar demographics and initial disease severity and limited capacity, the risk of ICU prolonged stay will be higher in the unvaxed patient.

So let’s choose not to go down this dark road, by just ignoring our premiere. Keep your gatherings small, get your booster, get your flu shot, wear an N95, invest in a CO2 monitor, and let’s continue to look out for each other.

I wish you the best of the season. ❤️