Just finished my call. Here are my handover notes.

#Omicron #COVID19 @HRHospital
/1
First, an observation. If you want to see what's actually going on in front of you, it's probably best to look through your eyes and not through your smart phone.

Social media tends to sensationalize the mundane and amplify voices with a particular point of view or agenda.

/2
The ER docs I talked to last night felt the department was manageable. Comments ranged from 'steady but not crazy', to 'we're pretty good, not too bad at all'.

This kind of optimism from an ER doc is reassuring.

/3
From an imaging point of view, there's been another shift.

The volume of imagining for COVID related illness is ticking down.

Not only are we seeing fewer chest X-rays, but we're seeing fewer CT scans to rule out COVID related strokes and pulmonary emboli.

/4
I did an analysis of all chest X-rays over an 8 hour period. Of the 40 patients, 75% were completely normal or had disease unrelated to COVID, such as congestive heart failure.

/5
Another 20% had mild pneumonias that were reasonably attributable to COVID-19.

/6
The last 5% had moderate COVID-19 pneumonias. There were no severe pneumonias in the sample group.

/7
The age breakdown was also very interesting.

Of the 40 patients, there were no school age children.

Among those with pneumonias, the vast majority were 60 yrs old or older.

Young adults comprised 20% of those with pneumonias, so they are not invulnerable to Omicron.

/8
The take home message is that, at least in our small corner of Ontario, things are calming down.

There is no longer the sense of urgency that we had 2 weeks ago.

We are not through this wave yet, but we can certainly see the shore, and it's in reach.

#Omicron @HRHospital
/9

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More from @DrJacobsRad

8 Jan
These would be terrifying numbers if this was the Delta wave, but this is Omicron and that does make a difference.

So what's changed?

/1

#Omicron #COVID19
nationalpost.com/news/canada/on…
Omicron is less severe. It tends to present as an upper respiratory tract infection as opposed to a pneumonia. The reason is related to the change in the spike protein and its ability to enter lung cells.

/2

upi.com/Top_News/US/20…
Does this mean that it's safe to be unvaccinated? Unfortunately not.

While the unvaccinated population will not have as many deaths per infection as in the Delta wave, they are at massively increased risk of serious disease and death compared to their vaccinated peers.

/3
Read 8 tweets
5 Jan
It's 5:45 in the morning and I'm coming up to the final few hours of my afternoon/evening/overnight shift. Things have changed since last week, and here's where we're at.

/1

#Omicron #COVID19 @HRHospital
The first observation is that the ER team at my hospital are absolute heroes, and I don't say that lightly. They are taking the brunt of the Omicron wave both in terms of patient volume and exposure to the virus. They do all of this with calm professionalism.

/2
This takes me directly to the real crisis that's been brewing this wave. Due to the highly contagious nature of Omicron, we're slowly losing frontline staff. The stress for those remaining is not from fear of catching the virus, but fear of being stretched too thin.

/3
Read 13 tweets
4 Jan
Thanks for looping me into the conversation @DFisman.

Trepidation by those who lobbied for school closures and further lockdowns, that their interpretation of the data may not be a true reflection of the clinical burden of the #Omicron variant, is understandable.

#Cdnpoli
/1
So, let's review the situation locally, and see what the experts in the US and the UK are saying and doing.

/2
Currently, at my 722 bed urban hospital, we have 80 patients with COVID. Of those, 35 have been identified as having COVID unrelated to their diagnosis. That's 44% of patients and includes some in the ICU.

/3
Read 13 tweets
26 Dec 21
I've just finished up my afternoon, evening, and overnight call. Here are my observations.

My apologies, but this is going to be a long thread.

/1

#Omicron #OmicronVariant #COVID19
My heart dropped when I opened my 1st case yesterday. It was a covid pneumonia and I thought to myself, here we go again. The next case that I opened was completely normal, and the next one, and the next one, and so on. Occasionally another COVID pneumonia would pop up.

/2
In all, I tallied no more than four suspected covid pneumonias. At the worst of the Delta wave, I could tally as many as 60 a shift.

/3
Read 13 tweets

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