Let's begin with other provinces who are RIGHT in the storm of their Omicron surges. Quebec has delayed opening of 'everything' to Jan 17. Ontario has delayed opening till Jan 5 to try to distribute HEPA filters & N95s for staff (not students). (2/n)
A respected colleague in Toronto, @drmwarner, reasonably argues for a 1-2 week delay IF a delay will increase booster doses for school/daycare staff, improve vaccine uptake for ages 5-11, & solidify distribution of HEPA/N95s/RATs in schools. (3/n)
We know ALL the measures that can help keep schools & daycares safe.
✅ High-quality universal masking (N95s)
✅ High vaccine uptake for staff & kids
✅ Optimized ventilation & filtration
✅ Liberal use of RATs
✅ Timely outbreak communication & management
What about supporting #SK families who want to keep their kids home from school?
What about helping @SK families who need to isolate b/c they're close contacts / COVID+? Paid sick leave?
That's not infringing on personal freedoms. That's SUPPORTING your people. (9/n)
#SK parents can't make the best possible decisions for their children when we're not informed. Every family's situation and risk tolerance is going to be different.
If there's no plan and you're leaving everything to the local school divisions to sort, tell us, @SKGov. (10/n)
If there's a plan to optimize safety for kids & staff such that a delay in opening would give us time to accomplish these tasks, tell us & make it happen.
If you want to delay opening to mitigate community transmission of Omicron in #SK, tell us. (11/n)
BUT: if there's NO plan except to watch hospital & ICU numbers & let Omicron flood #SK in a rush to "endemicity", tell us.
Complications of COVID like MIS-C (kids) & long COVID (adults & kids) are NOT trivial.
Let #SK families make informed decisions, please (12/n)
Finally, a personal note. As parents of 3 children, 2 of whom are too young to get jabbed + a 5 year-old who is fortunate enough to be fully vaccinated, we're STRUGGLING to know what best to do.
Our kids attend a newer facility where ventilation is likely better. (13/n)
They have been home all holidays and DESPERATELY want to go back to school & daycare to see their friends, interact socially, etc.
We have the means to keep our kids home, but many others do not. We recognize the huge impact of our kids missing in-person activities. (14/n)
We also recognize the absolute risk of MIS-C and long COVID for our kids is very low, but what if it happens to one of them and impacts them forever? That's a scary thought.
How to balance all these competing risks & benefits? It's SO tough. No clear right answer. (15/n)
We KNOW @RegPublicSchool has done so much already to help keep schools safe and consult regularly with our public health officials. Thank you!
While I'm there, thanks to ALL #SK school divisions who have prioritized the safety of kids & their staff. (16/n)
It's FRUSTRATING as a parent to know that @SKGov squandered ALL this time where they could have done SOMETHING to make schools safer. Now Omicron's here. We're out of time.
We'll optimize our kids masks and monitor day-by-day. It's all we can really do as parents. (17/n)
To conclude, we NEED to hear SOMETHING from @SKGov regarding plans for safe schools. NO plan? Tell us. Offloading everything to school boards? Tell us.
No communication? That means there's no plan. Not to mention SUPER lame.
Trends w/ Omicron & RAPID INCREASES in hospitalizations are now clear.
'Leading indicator' jurisdictions w/ advanced Omicron waves (e.g. Ontario, Quebec, NYC, UK) are ALL showing BIG increases in adult hospitalizations.
All are strained further by HCW shortages. Brief 🧵 (1/n)
Let's start with the UK. Hospitalizations are rising quickly, as evidenced by the graph below.
Yes, not as bad as January surge w/ Alpha - yet. But additional challenges including system & HCW burnout, significant staff absences due to COVID, etc. (2/n)
Excellent description of pressures that National Health Service (NHS) currently faces via @ChrisCEOHopson.
Hospitalization challenges now DIFFERENT w/ Omicron. It's a "sheer numbers" issue of persons needing ward/medicine beds, less ICU capacity. (3/n)
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.
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.
"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)
"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)
"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)
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)
"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)
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)
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)