Nathan Stall Profile picture
Feb 15 10 tweets 6 min read
On the advice of the CMOH, yesterday the Ford government lifted Ontario’s proof of #COVID19 vaccination requirements effective March 1st.

While some have simply dismissed this as capitulation to the "Freedom Convoy," it's actually much more complex.

1/10
thestar.com/politics/provi…
In evaluating their decision, we must 1st consider whether a 2-dose vaccine certificate remains justified by a compelling purpose.

In July 2021 when Delta was dominant, our @COVIDSciOntario brief outlined key considerations for vaccine certificates.

2/10
covid19-sciencetable.ca/sciencebrief/c…
At the time, we found proof of vaccination requirements were effective in:

1. Increasing vaccine uptake

2. Reducing transmission in higher-risk settings (e.g. bars & restaurants)

3. Protecting our health care system by excluding the unvaccinated from higher-risk settings

3/10 Image
There's now growing scientific doubt in the benefit of keeping a 2-dose vaccine requirement.

Doing so is unlikely to substantially further increase 2-dose uptake, and with Omicron, it’s far less likely to reduce transmission in higher-risk settings.

4/10
cbc.ca/news/health/ca…
Given these changes, experts advised #Ontario should either expand or end proof of vaccination requirements.

Expanding them would mean requiring 3 vaccine doses, something we know is our best protection against the #Omicron variant.

5/10
medrxiv.org/content/10.110…
Adding a 3rd dose was something the @OntLiberal party and I supported.

The scientific rationale changed on February 4th when #NACI recommended that those infected with #COVID19 wait at least 3 months before getting their 3rd dose.

6/10
cbc.ca/news/health/na…
During the Omicron surge, testing was restricted.

Symptomatic Ontarians were told by Public Health they should consider themselves infected, and isolate at home without needing to get tested.

This largely renders any 3-dose requirements infeasible.

7/10
thestar.com/news/canada/20…
The @COVIDSciOntario estimates that as many as 4-million Ontarians have been infected with #Omicron since December 1, 2021: covid19-sciencetable.ca/sciencebrief/u…

There is no public health benefit in excluding them from areas where proof of vaccination is required for the next 3 months.

8/10
.@StevenDelDuca and the @OntLiberal party have always said we would follow the advice of medical and scientific experts.

We are accepting Dr. Moore and Dr. Jüni’s guidance on the lifting of proof of vaccination requirements announced yesterday.

9/10
cbc.ca/news/canada/to…
Finally, proof of vaccine requirements was just 1 public health tool.

We must reinvest in public health and vaccination efforts to ensure that future waves are managed with less restrictive measures and without overburdening our health care system.

10/10
thestar.com/opinion/contri…

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More from @NathanStall

Jun 8, 2021
To date, 23.5-million Canadians (71%) aged ≥12 years have received 1 dose of a #COVID19 vaccine and 3-million (9%) are fully vaccinated.

Incredibly, we still don't have guidance for the fully vaccinated.

Us Canadians seem to be experiencing Fear of Normalization (FONO).

1/10
The @CDCgov released its first guidance for the fully immunized on March 8.

@RobynUrback wrote about the need for similar Canadian guidance on April 16: theglobeandmail.com/opinion/articl…

Months later, all Canadians are still given the same guidance regardless of vaccination status.

2/10
The absence of guidance is highly problematic for several reasons:

-We might be able to motivate even more people to get vaccinated: tvo.org/article/we-nee…

-People will make up their own rules based on what @jm_mcgrath calls their "best guesses": tvo.org/article/we-nee…

3/10
Read 11 tweets
May 1, 2021
The final report of #Ontario’s Long-Term Care #COVID19 Commission is now available: ltccommission-commissionsld.ca/report/pdf/Ont…

The 322 page report released today details 85 recommendations focusing on:

1. Pandemic Preparedness

2. Addressing the Aftermath of COVID-19 for Residents and Staff

1/4
3. Infection Prevention and Control

4. Strengthen Health Care System Integration

5. Improve Resident-Focused Care and Quality of Life

6. French-Language Services

7. Address the Human Resources Challenges

8. Operational and #LTC Home Development Funding

2/4
9. Increase Accountability and Transparency in Long-Term Care

10. Comprehensive and Transparent Compliance and Enforcement

11. Health Protection and Promotion Act Investigations

12. Responding to the Commission’s Report

3/4
Read 4 tweets
Apr 30, 2021
From some reason, this @BusinessInsider article from Feb 23rd is making the rounds today on social media: businessinsider.com/new-data-calls…

The sensationalist headline "Scotland's vaccine rollout suggests delaying the 2nd #COVID19 shot is a bad idea" requires some serious nuance.

1/6
The news article references a Feb 19th pre-print: papers.ssrn.com/sol3/papers.cf…

This means that the study was neither peer-reviewed nor finalized when posted.

The pre-print reported a combined 58% vaccine effectiveness for #Pfizer and #AstraZeneca starting 42 days after 1 dose.

2/6
This pre-print went on to be peer-reviewed and published last week in @TheLancet: thelancet.com/journals/lance…

@TheLancet study reported a combined 74% vaccine effectiveness for #Pfizer and #AstraZeneca starting 42 days after the first dose (77% for the #Pfizer vaccine alone).

3/6
Read 6 tweets
Apr 28, 2021
Today #Ontario enacted a new emergency measure providing hospitals with the authority to transfer patients who no longer require acute care (so-called "alternate level of care" or ALC patients) to #LTC and retirement homes without their consent.

news.ontario.ca/en/release/100…

1/15
This action is being taken to create additional room in #Ontario's acute care sector for the 3rd wave of #COVID19.

There are currently 4,288 ALC patients in hospital, and 1,854 are waiting for #LTC beds.

There are also 5,401 vacant #LTC beds available for new admissions.

2/15
The reality is that many of the #LTC homes with large vacancies are those that had the deadliest #COVID19 outbreaks (e.g., Tendercare, St. George's, Orchard Villa).

Residents (and their families and caregivers) will be justifiably hesitant to move into these #LTC homes.

3/15
Read 15 tweets
Apr 28, 2021
Today #Ontario's Auditor General released a scathing report on pandemic readiness and response in long-term care: auditor.on.ca/en/content/spe…

The report details the many factors resulting in 3,919 residents dying of #COVID19 and countless others suffering during the pandemic.

1/7
1. Residents were living in rooms with 3 or 4 occupants

2. The transfer of patients designated as alternate level of care (ALC) from hospitals to #LTC homes contributed to crowding in homes

3. #LTC homes had insufficient staff and staff training to provide appropriate care

2/7
4. Restricting families from visiting homes consequently eliminated a valuable source of resident care providers.

5. Infection prevention and control (IPAC) were not consistently practised in homes even prior to the #COVID19 pandemic.

3/7
Read 7 tweets
Apr 9, 2021
One population I fear is being overlooked (yet again) during #Ontario's 3rd wave is community-dwelling older adults.

There is no doubt that the new variants of concern make #COVID19 a different disease, with increased risk for younger populations: covid19-sciencetable.ca/sciencebrief/c…

1/8
With this changing disease come more tragedies of younger adults—especially essential workers—being hospitalized and dying from #COVID19.

These stories must be told and Ontario must enact supports like paid sick leave.

But sometimes missing are the stories of older adults.

2/8
In #Ontario, 21.1% of people 60+ and 77.2% of people 80+ have received at least 1 dose of a #CovidVaccine: publichealthontario.ca/-/media/docume…

Yet in the last 14 days, older adults still accounted for 76/85 (89%) of deaths and 715/1171 (61%) of hospitalizations: publichealthontario.ca/en/data-and-an…

3/8
Read 8 tweets

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