Dr. Alexander Wong Profile picture
Feb 28 11 tweets 4 min read
Hi, Saskatchewan.

Though @SKGov has now dropped all #COVID19 protections & mandates, sadly, COVID is NOT over.

#SK hospitals & ICUs remain packed.

Patients are being admitted, and dying, tragocally, eacn and every day.

A short 🧵 below for my fellow Saskatchewanians. /1
Please, be mindful of our medically vulnerable, kids under 5 who can't be vaccinated, the elderly & frail. Those who will and already face long COVID.

Respect their health and their right to live their lives as fully as possible in a manner that is safe & low-risk. /2
If your immediate response for those who are vulnerable to or anxious of COVID is, "well, just stay home"?

Remember how you felt when "others" said the same to you about mask mandates or proof-of-vaccine programs.

Let's end the divisiveness. Let's do things TOGETHER, safely. /3
For those wanting to "return to normal", unfortunately, we're NEVER going back to pre-COVID days.

Sorry.

We have yet to find our new normal.

Hopefully it will be a place where we can be respectful to one another, and where we keep each other safe from #COVID19. /4
If you're anxious about or vulnerable to #COVID19, then my best advice to you to protect yourself and loved ones, is to optimize your vaccine protection with as many doses as you're eligible for, and wear a well-fit respirator in indoor public spaces. /5
If you can do those two things, regardless of those around you, your chances of getting #COVID19 (and really, ANY respiratory virus at all) is very very low.

Go and live your life. Go to work. Play, laugh, love, and enjoy the company of others. /6
If you're symptomatic, PLEASE stay home. Protect others. Use your rapid tests. Isolate for 5 days at least, and be symptom-free before getting back out into the world. Mask.

Big indoor group gathering? Do a rapid test before.

Let's ALL be responsible & protect each other. /7
Vaccines for #COVID19 will continue to evolve. Yes, there will likely be recommendations for additional doses. New vaccine formulations like Novavax will become available.

Being fully vaccinated & boosted is your BEST protection from becoming severely ill from #COVID19. /8
Masking remains critical to protect both ourselves and those around us from infection.

Please consider masking on an ongoing basis in indoor public spaces.

It's safe, simple, and respectful of others. I will keep masking indefinitely. So will our family. /9
The last 2 years have been very hard for Saskatchewan.

Despite what we all want, COVID won't go away. Ever.

Learning to live with it and adapting to protect each other is the way we can move forward, safely and responsibly.

I know we CAN do it.

Be safe, everyone. /end
Ack! Mortified at not just one, but TWO typos on this post. *Tragically*. *Each*.

Sorry, proof-reading skills not good in the morning when rushing to get kiddos out the door along with rest of family.

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More from @awong37

Feb 24
Weekly Saskatchewan COVID-19 data for Feb 13-19.

KEY POINTS:
- 37 deaths over 7 days. 1 b/w 20-39, all others >= 40
- Hospitalizations & ICU admissions decreasing (phew)
- Weekly test positivity 14.4% (last wk ~20%)
- ALL Omicron (no breakdown of BA.1 vs BA.2)

Brief 🧵 /1
Let's start with key data around hospitalizations & ICU admissions.

Week-by-week hospitalizations down 9% to 372, ICU down 18% to 27. Slowly coming down, thankfully.

Of those with known COVID status, 42% in hospital/ICU "due to COVID", 58% "incidental". /2
We can see that overall hospital admissions per day definitely decreasing now across all regions of Saskatchewan, but it's a relatively slow decrease, likely driven by limited protections we have in place provincially.

Still, this is reassuring and encouraging. /3
Read 15 tweets
Feb 22
Saskatchewan #COVID19 wastewater data released today for 4 #SK communities.

Both Saskatoon & Regina showing significant INCREASES in viral load week over week. Discouraging.

Reasons for increase unclear at this time. BA.2 driven?

Brief 🧵 to review #SK wastewater data. /1
Let's start with Regina.

@UofRegina wastewater analysis shows rebounding viral load levels week-over-week, suggestive of ongoing high rates of viral transmission in community.

BA.1 remains dominant but 18% BA.2 reported too. We expect BA.2 to dominate in coming days. /2 Image
Also, note that @UofRegina plot is time-lagged by 13 days, as the most recent analysis comes from the time period b/w Feb 6-12 inclusive.

So presumably proportion of BA.2 in Regina is higher now, just don't know how much higher. /3
Read 11 tweets
Feb 20
"Hi Alex, what's BA.2? Is it a little bad or is it REALLY bad?"

BA.2 is a sub-lineage of Omicron. The 'original' lineage of Omicron is designated as BA.1 & remains the dominant strain circulating in most parts of Canada currently.

A brief 🧵 of what we know thus far. /1
BA.1 & BA.2 are both classified by @WHO as Omicron, but are distinct viruses. See the phylogenetic diagram below (thx @kallmemeg).

BA.2 has over 25 mutations that differentiate it vs BA.1.

Many questions still exist around how similar BA.1 & BA.2 are clinically. /2
Danish pre-print data comparing transmission of BA.1 vs BA.2 in household settings suggests BA.2 IS more transmissible than BA.1.

BA.2 also LIKELY possess more immune-evasive properties vs BA.1 that could reduce vaccine efficacy. /3

medrxiv.org/content/10.110…
Read 20 tweets
Feb 11
Great @SaskHealth Town Hall last PM re: #COVID19 in Saskatchewan. Key points:

- Community MAY have peaked w/ Omicron.
- Non-ICU/ICU numbers STILL rising
- #SK non-ICU system capacity MAXED OUT.
- Relaxed public health measures in #SK = LONGER & MORE SEVERE Omicron wave

🧵 /1
Let's start w/ cases, non-ICU & ICU COVID patients, & deaths.

CASES (blue line) are falling. This may be artificial to degree given limited PCR testing in #SK.

HOSPITALIZED (non-ICU) patients (light green 'shade') are at HIGHEST LEVELS of pandemic, now exceeding Delta. /2
ICU patients (dark green 'shade') are rising but nowhere near levels seen w/ Delta when #SK had to fly patients to Ontario.

DEATHS (red line) are rising gradually with Omicron but remain considerably lower than #SK's Delta peak. /3
Read 21 tweets
Feb 1
Yesterday, Premier Moe said #COVID19 cases in Saskatchewan are more frequent in the vaccinated vs. those who aren't.

THUS, vaccines DON'T prevent infection with or transmission of Omicron.

The Premier's conclusions are INCORRECT. But why?

It's complicated. Here we go.

🧵 /1
The Premier's incorrect conclusion stems from a simplistic interpretation of the data. 'Base rate fallacy' is one problem, but there are MANY other factors at play.

We explained 'base rate fallacy' with cases & vax status back in August. See below. /2

For 'base rate fallacy' & #COVID19 & hospitalizations, this is the diagram EVERYONE uses (thx @MarcRummy).

MANY more people are fully vaccinated now, so even though a small proportion of them go to hospital, the absolute numbers are the same as those unvaccinated. See below. /3
Read 25 tweets
Jan 30
"Hi Alex. I have #COVID19 infection. Should I try to get Paxlovid? What is it? Will it help me?"

Short answer: YES, you should.

BUT, there's LOT of things to know about it, and your eligibility for it will depend on where you live + many other things, too.

Explainer 🧵. /1
Paxlovid's generic name is nermatrelvir/ritonavir. It's a combination of 3 pills taken twice daily for 5 days.

Nermatrelvir is a "protease inhibitor". It works by blocking an enzyme ("protease") that the virus needs to manufacture new copies of itself. /2
In this situation, Ritonavir acts as what we call a "booster drug".

It inactivates an enzyme in our bodies called CYP3A4 that plays an important role in metabolizing and removing many medications from our bodies.

This allows nermatrelvir to exist longer in our bodies. /3
Read 15 tweets

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