Dr. Alexander Wong Profile picture
Jan 20 25 tweets 17 min read
OK. #SK COVID-19 mega-thread.

NEW #SK Omicron models (via @DennisKendel) Jan 19:

- Measures implemented to SIGNIFICANTLY reduce social mixing, MAYBE we avoid disaster/triage in #SK hospitals.

- Do NOTHING, #SK hospitals crushed, triage ensues.

Get comfy - here we go.

(1/25)
Let's begin with history.

@SKGov was provided w/ models from WORLD-CLASS #SK modeler Dr. Nate Osgood in late August 2021 that predicted EXACTLY how #SK ICUs would be overwhelmed w/ Delta in Fall 2021.

Nothing was done. Everything left wide open.

(2/n)

thestarphoenix.com/news/local-new…
Also August 2021, consensus letter sent by #SK MHOs (led by @CoryNeudorf) to @SKGov recommends NUMEROUS measures to stem Delta:

Universal indoor masks, proof of vaccine, gathering/capacity limits, increased contact tracing capacity.

Nothing.

(3/25)

Delta surges. @SKGov implements indoor mask mandates Sept 16, LAST province in Canada to do so. Proof of vaccine mandates announced for Oct 1.

Mandates had been left to businesses, organizations, football teams (!), school divisions. Mass chaos.

(4/25)

cbc.ca/news/canada/sa…
On Oct 18, @SaskHealth begins transferring critically ill #SK pts to Ontario to relieve overwhelmed #SK ICUs.

Transfers cancelled, restarted. Clinical, communications, PR DISASTER.

In the end, 27 #SK pts transferred. 6 die in #ON. Devastating.

(5/25)

cbc.ca/news/canada/sa…
*348* #SK citizens die of #COVID19 during #SK's Delta surge (Sep 1 - Dec 31).

Comparatively, that's *4350* people dead in #ON!

Not all deaths preventable, but MANY could have been with good policy.

MODELLING was RIGHT THERE. Yet, no action.

(6/25)

Now, amazingly, here we are again.

Dr. Osgood's WORLD-CLASS models say #SK hospitals & ICUs overwhelmed FOR SURE if no additional measures to limit social gatherings.

Yet, Premier Moe says Jan 18 measures "cause significant harm for no clear benefit".

Cites #QC crisis.

(7/25)
Excellent thread @MoriartyLab. #QC reports deaths QUICKLY & ACCURATELY. Better than anyone else in Canada.

Hence, #SK death counts are likely huge UNDERESTIMATE.

If you're going to compare numbers, please know & EXPLAIN caveats of data.

(8/25)

Also, was Premier Moe comparing #SK's death rates per capita vs. others during Delta's surge in Fall 2021 in any public forum?

No. Why?

Because #SK had WORST per capita death rates in Canada with Delta BY FAR.

~3X excess deaths in #SK vs Canada

(9/25)

ctvnews.ca/health/coronav…
In summary, @SKGov CHOSE to be MAJOR OUTLIER with Delta. #SK citizens pay a HEAVY price.

No measures except masks & proof of vaccine. Implemented those FAR TOO LATE.

ICUs overwhelmed. Triage occurs. #ON ICUs save us.

So much PREVENTABLE death & suffering.

(10/25)
The Premier's approval ratings over management of #COVID19 continue to fall. Close to 60% disapprove of @SKGov decisions Jan 17.

Yet, @SKGov shows NO learning from past experience. They keep ignoring Dr. Shahab's advice.

"Carry on, #SK!"

(11/25)

cbc.ca/news/canada/sa…
Let's go back to new/updated Omicron modeling now and see the price of "carrying on" with NO additional measures put in place.

The models make it clear.

Here it is again for reference. Let's work through the various scenarios one-by-one.

(12/25)
The blue line models with a 6.1 day doubling time (likely underestimate) for Omicron, and 60% "less severity" vs. Delta. No changes in social mixing.

Our Omicron wave is long, protracted, and painful. It peaks in late-Feb with over 1,500 admitted to hospital.

Horrible.

(13/25)
The yellow lines model a 4.6 day doubling time (more reasonable) for Omicron, but also assumes even further lessened severity for certain age groups and decreased length of stays for those admitted to hospital.

Lots of assumptions there, many VERY optimistic.

(14/25)
Even WITH 'best case' assumptions, if no additional measures we peak in mid-Feb with nearly *1500* in hospital. Absolutely nuts.

*If* we put measures in place to reduce mixing by 2/3rds, curve IS significantly blunted. Peak early Feb, ~1,100 hospitalized. Still nuts.

(15/25)
The green lines are the MOST optimistic scenarios. 4.6 day doubling time, further lessened severity for Omicron for certain age groups, even further decreased lengths of stay for hospitalized patients.

Many assumptions. Likely FAR TOO optimistic, IMO.

(16/25)
Even WITH "best-case" assumptions, we peak in mid-Feb at ~750 in hospital. It drags, painfully, to end of Feb.

With additional measures to reduce mixing by 2/3rds, we peak early Feb at ~650 in hospital and come down fast.

*Maybe* we avoid triage if chips fall right.

(17/25)
To be clear, NO scenario avoids cancellation of ALL "non-life-saving" procedures and surgeries again. That's INEVITABLE at this point.

EVERYONE who has been waiting months/years will be pushed down yet again.

Let's call it for what it is: MASS triage of #SK citizens.

(18/25)
#SK is in a HORRIBLE place right now.

We have the LOWEST 1st/2nd dose uptake across all provinces except #AB.

We're the ONLY province with NO capacity/gathering limits.

Not even immunity from all our Delta recoveries will help, as Omicron's basically a new virus.

(19/25)
Worst of all, @SKGov REFUSES to acknowledge impending #Omicron surge.

Do they REALLY believe it's not going to happen?

They publicly say Saskatchewan will be fine, they're "monitoring the situation". They continue to gaslight the electorate:

"We're good, no sweat."

(20/25)
Dr. Shahab issues CLEAR instructions. DON'T GATHER unless for work/school.

Premier Moe? No measures needed. They're "not helpful". They're "damaging".

When the Premier is asked who #SK public should trust?

"They should trust themselves."

🙄🧐

(21/25)

cbc.ca/news/canada/sa…
Since @SKGov is monitoring the situation, they'll see that cases / hospitalizations are all surging, as we would expect. Here's Jan 19 data.

Hospitalizations are following the EXACT timeline as predicted by Dr. Osgood's modeling

It's all there, in plain sight.

(22/25)
So we'll see, THIS WEEK, whether @SKGov chooses to put additional measures in place to give #SK hospitals a fighting chance.

If they do nothing, that's implicit endorsement they're *OK* with letting #SKs smoldering healthcare system burn down yet again.

#SK HCWs? 😢😢

(23/25)
Letting COVID run unchecked as @SKGov has, sacrifices the health of ALL #SK citizens, destroys the publicly-funded healthcare system, and results in immeasurable health consequences (kids!! the vulnerable!!), suffering, & deaths.

It's complete misery. So preventable.

(24/25)
It ISN'T too late for CRITICAL policy measures to save #SK hospitals.

NOT LOCKDOWN. Appropriate measures. ASAP.

PLEASE, stop pretending, blaming, gaslighting.

PLEASE, lead. Show courage & integrity. CARE about the lives of your electorate.

We CAN do it. TOGETHER.

(/end)

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Dr. Alexander Wong

Dr. Alexander Wong Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @awong37

Jan 21
On January 18, @PremierScottMoe posted a graphic comparing "real-time" QC / ON / MB hospitalizations / ICU admissions vs. SK.

Problem: SK is ~3 weeks behind those provinces w/ our Omicron surge.

We MUST be careful interpreting this data. We're NOT OK, Saskatchewan.

🧵👇 (1/n) Image
A more reasonable and appropriate comparison would be to look at where MB/QC/ON were at ~3 weeks from Jan 18 to create a more fair "apples vs apples" graphic.

For those 3 provinces, that would take us to about Dec 28. Let's see what the data shows us. (2/n)
We have #QC data from Dec 28 & Jan 18 in the graphics below courtesy @sante_qc:

Dec 28: 804 in hospital (including ICU), 128 in ICU
Jan 18: 3425 in hospital (including ICU), 285 in ICU

(3/n) ImageImage
Read 11 tweets
Jan 21
"Hi Alex, I have 2 doses of vaccine & JUST recovered from COVID. I'm eligible for a 3rd dose. When should I get it?"

Great Q. You assuredly had Omicron, so while you're eligible to get your booster 'right away', I'd personally wait at least 6-8 weeks. Why?

Short 🧵 👇 (1/n)
First, getting a 3rd dose even AFTER you've recovered from Omicron makes sense. You're further bolstering your immune response from whatever the 'next' variant will be. *Big sigh.*

Better for your immune system to be ready for whatever this pandemic throws at it next. (2/n)
Second, DON'T get a booster dose when you're symptomatic.

You're putting persons at risk of exposure to Omicron, and your immune response to vaccine WON'T be as good as when you've fully recovered and your immune system has had a chance to calm down. (3/n)
Read 7 tweets
Jan 9
NO doubt now. BOTH Quebec & Ontario are in huge pain now w/ #Omicron. The GTA now is being hit hard.

It's a numbers game. Too many patients, not enough staff or beds.

Many HCWs & first responders out, too.

It's ALL bad. Everyone's reality is in plain sight.

🧵 below. (1/n)
The number of ICU admissions & ventilated patients in Ontario continues to rise VERTICALLY.

The primary risk for ICU admission remains being unvaccinated, but more elderly persons now with comorbidities & waning immunity also. (2/n)

Multiple physicians in Scarborough, a suburb of the GTA, have noted a surge of critically ill patients with COVID in the last 2 days.

For reference, Scarborough has ~70 ICU beds. EVERY single bed is now taken. They have NO ventilators left. (3/n)

Read 13 tweets
Jan 2
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)

Read 10 tweets
Jan 1
Many #SK families are worried re: return to school Jan 3. How safe are our kids & school staff?

Omicron in Regina and Saskatoon is surging. We'll continue to see record case numbers for weeks.

@SKGov, what's your plan? We NEED to know.

A 🧵 on safe schools, below. (1/n)
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)

cbc.ca/news/canada/to…
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)

Read 18 tweets
Dec 21, 2021
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
Read 6 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us on Twitter!

:(