Modelling released by @SKGov predicts DRAMATIC rise in cases, hospitalizations, & ICU admits w/ #Omicron if no additional measures to reduce contacts (i.e. gathering & capacity limits).

Briefing today: NO measures to be implemented at present. Wait and see.

1/ #COVID19SK
Here is ICU / non-ICU modelling data. Not great, as you can see. Also not being taken into account - scores of HCWs taken out of circulation as a result of widespread community transmission.

Who will look after all the patients? Many HCWs have already moved on.

2/ #COVID19SK
Once again, there is an appeal to personal responsibility for #SK citizens to make good choices, do the right thing.

No surprises here. Get vaccinated, improve ventilation, use your best mask, etc.

3/ #COVID19SK
Given the history & approach of @SKGov thus far in 2021 with our 3rd & 4th waves, none of this is a real surprise for those who have been following closely.

The #SK Omicron plan is boosters, rapid test, personal responsibility, and pray for lessened severity.

4/ #COVID19SK
HCWs who are left in #SK who have been busting their asses from day 1 of pandemic are completely burnt out & exhausted.

The idea of having to face a 5th wave with no real support other than a pat on the back from @SKGov is, for me at least, soul-crushing.

5/ #COVID19SK
I pray that Omicron is significantly less severe. It's #SK's only hope at this point. Other places experiencing Omicron before us will tell the story.

It's a massive gamble. Many lives, and the well-being of #SK's remaining HCWs, are all on the line.

end/ #COVID19SK

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More from @awong37

15 Dec
"Hi Alex. With #Omicron in Canada, what's the optimal 2nd dose interval for kids b/w 5-11 who have 1 dose?"

VERY different space w/ Omicron now vs 4 weeks ago when NACI guidance was released.

We'll try for 3-4 wk interval in #SK for our 5 year-old, NOT 8. Here's why. (1/n)
Let's start by acknowledging that we have no real clinical data in this space right now. We don't know HOW protected kids b/w 5-11 are with 1 dose vs different variants like Delta or Omicron.

Kids immune systems are ++ robust, so 1 dose definitely confers some protection. (2/n)
That said, NACI guidance on 8 week interval was developed before we knew about Omicron. Extending dose intervals makes 100% sense to optimize long-term protection and minimize risk of heart inflammation events, etc. (3/n)
Read 7 tweets
15 Dec
"Hi Alex, how do I keep my holiday gatherings safe? Do I have to cancel everything?"

Depends on your risk tolerance. If your bubble has persons who are medically vulnerable, elderly, maybe reconsider.

Otherwise, use ALL measures to keep things safe as able.

Brief 🧵. (1/n)
We all know that seeing & reconnecting with friends & loved ones over the holidays is SO critically important. But with the transmissibility of #Omicron, the risk-benefit calculus has changed dramatically again. What do we do now? (2/n)
For starters, MINIMIZE indoor group gatherings where persons are unmasked. At holiday gatherings everyone will be eating & drinking, so keeping these bubbles tight as possible is optimal. Like 5-10 persons max, if you're able. (3/n)
Read 10 tweets
23 Nov
"Hi Alex. My (5 to 11) year old just got their 1st #COVID19 vaccine dose. Yay! Should we wait 8 weeks for the 2nd dose as recommended, or should we just get a 2nd dose ASAP at 3 weeks?"

No clear answer, but my wife & I WILL WAIT 8 WEEKS for our 5 year-old son.

Brief 🧵. (1/9)
A longer duration between 1st and 2nd doses of Pfizer-BioNTech vaccine has been shown to increase antibody levels and makes COMPLETE SENSE from the immunological perspective given our experience with all other vaccines in both kids and adults. (2/9)

cell.com/cell/fulltext/…
Lots of clinical data now available suggesting extended-interval dosing for #COVID19 vaccines improves overall protection against COVID-19 infection versus shorter manufacturer recommended dosing intervals. Here's an example from Quebec. (3/9)

cbc.ca/news/canada/mo…
Read 9 tweets
8 Nov
"Hi Alex. What is this Western Canadian variant? Is it something to be worried about?"

Yes, there's a new Canadian AY.25 clade which originated from Idaho. This AY sublineage appears to have become dominant in Alberta and Saskatchewan. (1/9)

#COVID19AB
#COVID19SK
This is a bit technical, but as you can see in the phylogenetic analysis below, the strain appears to have originated from Idaho and then spread quickly throughout all of Western Canada. (2/9)

#COVID19AB
#COVID19SK
The same phylogenetic analysis is now color coded by province, so you can see how the strain has spread widely through BC (sea green), Alberta (yellow), and Saskatchewan (lime green). There's smatterings of cases in Ontario, too. (3/9)

#COVID19AB
#COVID19SK
Read 9 tweets
7 Nov
"Hi Alex. My 11 year-old is ready to get vaccinated. BUT, he/she turns 12 in less than a month. Should I wait and get the higher 30 μg dose of vaccine at age 12, or just go ahead & give the lower 10 μg dose right away?"

Answer: DON'T wait, go right away.

🧵 below. (1/7)
The appropriate dosing of vaccine ISN'T dependent on weight, but rather their age. The immune system of a 'small' 11 year-old is functionally the same as a 'large' 11 year-old. The immune response isn't weight-dependent, per se. (2/7)
Younger children in general have very active immune systems, another reason why lower dosing makes sense and leads them to produce the same degree of antibody response as those ages 16-25 who received a higher dose of vaccine. (3/7)
Read 7 tweets
27 Oct
"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)
Read 7 tweets

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