Thanks to the 1000's of people who have powered our 3rd dose effort. We've made amazing progress in a short time—and still have further to go.
A thread on why 3+ doses continues to be important and where we need to focus 🧵
We now have more real world data showing that 3 doses is better than 2 at preventing infection and serious illness with Omicron
These two slides were shared by Dr. Allison McGeer and summarize data on infection and hospitalization with 3 v 2 doses in the UK
Older adults are most at risk of COVID complications and thankfully we've done a pretty good job at getting vaccines to those 70+
But some regions are lagging behind. What can we learn from regions where vaccination rates are higher?
This slide illustrates that the variation in 3rd dose vaccination rates by public health unit is not about which delivery channels are used—the factors are likely more complex and worth unpacking
We need to increase uptake now for those <70
And in particular we need to focus on priority populations
Pregnant people are at high risk of complications if they get COVID, yet only 17% have received a 3rd dose
People who are immunocompromised need 3rd AND 4th doses
Who is eligible for a 4th dose?
4th doses can be given 3 months after a 3rd dose for people with very weak immune systems, for example, b/c of dialysis, cancer treatment, or meds that weaken the immune system including high-dose steroids 👇🏽
Our experience with previous variants tell us that even after infection with COVID, vaccines add stronger and longer lasting protection. This means less chance of re-infection or transmission to others
If you got COVID, when should you get your 3rd dose?
You can receive it as soon as your symptoms are gone but most infectious disease experts recommend waiting 4-8 weeks to get stronger longer-lasting immunity
Finally, either Moderna or Pfizer are good choices for your 3rd dose if you are age 30+. Both are mRNA vaccines and have pretty much the same ingredients. Mixing and matching is just fine.
We need continue to use many layers of protection to keep ourselves and more vulnerable people in the community safe and reduce our risk of serious outcomes from COVID-19.
Vaccination with a 1st/2nd/3rd/4th dose is one of the most important layers of protection we have
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Fun fact: nearly every person in Denmark 🇩🇰 has the name of their GP (or group of GPs) on their healthcard
It's an organized system where 98+% have access to primary care.
How do they do it? One key lies in how GPs are organized. 🧵
(photos of Christian Folsach's practice)
GPs in Denmark are small business owners, similar to family doctors in Canada. They rent or own the office space, hire staff who work in the office, and pay for everything from internet to paper. Most practices in Denmark are small with b/w 1 to 3 GPs working together.
In order to get paid by government for the services they provide, GPs need a supplier number. These supplier numbers are issued by the region based on projected population demand.
How is that >98% of Danes have a GP? Part of the answer lies in their approach to training physicians.
Here's a summary of some of what I've learned on my trip to Denmark 🇩🇰 🧵
(the photo here is a wall of some of the 170+ residents trained at the practice I visited)
After high school, most Danes take a gap year where they typically work and travel (the average is 2 gap years but several take even more). They would then apply and gain admission to medical school which is 6 years in total.
After graduating from medical school, every new doctor does a one year "internship" of sorts, 6 months of which is in a GP practice and the other 6 months in a hospital.
Today we concluded the #OurCare Manitoba Priority Panel, our 5th & final reference panel on primary care in Canada
30 members of the public, randomly selected, spent >30 hrs since the start of Sept, learning, deliberating & coming to consensus on recommendations for better 🧵
These members of the public, roughly represented the demographics of the province — with one exception. We deliberately overrepresented people who identified as First Nations, Métis or Inuit.
They heard from over a dozen experts on primary care on a range of topics from the basics to in-depth sessions on accountability, rural and remote care and tradeoffs
Let's start by going back to fall 2021. Most people had been vaccinated and we thought we were heading out of the pandemic. We were starting to try and clear the backlog of care.
EDs were overcrowded and some people blamed it on family docs.
In the spring, we had just experienced a brutal COVID wave. At that time most of us were appropriately taking a virtual-first approach, seeing patients by phone or video first and then bringing them to the office if needed in an effort to minimize COVID spread.