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Kashif Pirzada, MD Profile picture
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Mar 9 • 22 tweets • 8 min read
Mask mandates should not end. We are going to sacrifice the lives and good health of a large portion of the population for a temporary election-driven 'feel-good' moment. Covid is still a danger, even to young healthy people and I will outline why in this thread: Image
Summarizing the main reasons:
1) Long Covid is a big threat, even to vaccinated
2) Kids are at risk, especially unvaccinated
3) Boosters given in Dec-Jan will start to wane very shortly
4) the BA.2 variant is starting to spread and will get those who didn't get Omicron.
Firstly, Long Covid, even in vaccinated people, is still a huge threat. It affects ~ 10% of infected even in those double vaccinated (its too soon to know for triple vaccinated). This can completely upend your life, end your career, severely disable you.
Another recent study confirming the same:
It's true you can wear a good quality N95 mask in public spaces, but protection is not absolute and will not protect you for long in a poorly ventilated space:
Nearly every day and week there are good quality studies documenting the harm that Covid does, even in vaccinated people. This one shows significant brain shrinkage and cognitive decline. This is a hard blow for an economy that depends on knowledge workers
This one shows a massive increase in heart disease post Covid. You are already hearing about famous celebrities and athletes dying suddenly in their 50s and 60s post Covid. This will only get worse and affect your own circle of family and friends.
Secondly, kids are at risk. Pediatric societies are staunchly opposed to lifting mask mandates. Interestingly enough, many were on the fence before, but the evidence of masks' protective effect has become clear:
In the US, where there are few if any Covid precautions, nearly 20 children are dying weekly, mostly unvaccinated. 521 in the first 10 weeks of 2022 along:
In Canada 33 children have died of Covid total, vs 1567 in the US, a rate per capita nearly 5x more. We saved children's lives thanks to our public health precautions in schools and elsewhere.
health-infobase.canada.ca/covid-19/epide…
covid.cdc.gov/covid-data-tra… Image
Worryingly, we have stalled at 56% of kids 5-11 who have received a single dose of vaccine in Canada. And none less than 5 have are eligible for a vaccine.
health-infobase.canada.ca/covid-19/vacci… Image
Thirdly, many of those vulnerable (i.e. anyone above 60) will start to have waning immunity following their boosters in Dec-Jan. This effect is already starting to be seen in the UK:
inews.co.uk/news/politics/…
I go over some possible reasons why waning immunity (especially in those over 60) happens in this video and thread:
Fourth, we are probably entering a new wave thanks to BA.2, a subvariant of Omicron. This time without the benefit of boosters, and masks. Anyone who didn't get Omicron the first time will likely get it now, but without booster protection.
What is a possible solution?

'Smart' masking

Until we get better vaccines/treatments, we should make the common spaces we share as safe as possible.

Shopping/groceries
Medical settings
Academic/schools
Religious gatherings
Transit/Uber/Air travel

Image
'Test to Treat' is something we need before we drop mandates. Easy and quick access to antivirals, that should theoretically reduce the risk of severe Covid and (hopefully) its complications to nearly zero:
The pandemic is not over; we had a nice, temporary reprieve thanks to vaccines, boosters, and public health measures. Dropping masks now, before antivirals are available in quantity, when immunity is waning, and when a new variant is coming is a very, very bad idea.
Great discussion here:
Yup
An excellent thread describing brain findings in Long Covid in more detail:

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More from @KashPrime

Kashif Pirzada, MD Profile picture
Feb 27
Let's embrace a new concept: 'Smart Masking'
The Omicron wave is receding, but Covid hasn't vanished and is still a potent risk to a huge portion of the population. Until we get better vaccines/treatments, we should make the common spaces we share as safe as possible.
The new CDC approach of focused protection (which is being mirrored around the world) has been tried multiple times before and failed. It will result in the death or disability of massive numbers of people.
Let's create safe common spaces with the tools we know that work well against Covid: clean air, rapid tests, better masks. Some who deem themselves at low risk will return to pre-pandemic activities, which is fine... but does not mean we abandon those who simply can't do the same
Read 6 tweets
Kashif Pirzada, MD Profile picture
Feb 20
Why isn’t the pandemic over yet? Why did we require boosters? Authorities including the CDC are finally acknowledging that our vaccines provide protection for only 3-4 months at a time. I interview @fitterhappierAJ to go over possible reasons why.
I’ve been closely following @fitterhappierAJ’s takes on Covid and immunology. Initially I didn’t want to believe his predictions regarding T-cells, but they have stood the test of time and are now being confirmed by multiple lab studies
This is part of a lecture series by @masks4canada, to chart future directions of this pandemic. What can we do to change course, or at least ameliorate ill effects? Many of our political leaders want this to be over now, is this realistic? This is what we hope to address.
Read 33 tweets
Kashif Pirzada, MD Profile picture
Feb 19
Thankfully Covid hasn't touched my family yet. In the absence of any advice from the authorities, these are some tips on how you can minimize your exposure while living a life as close to normal as possible. I'll expand in more detail in this 🧵
The Omicron surge is ending, a huge portion of the population has fresh immunity from boosters or from getting infected. Many have gotten Long Covid via the infection route unfortunately. Hopefully immunity will stand up in the face of the BA.2 variant, but time will tell.
I have two children under 5 who are not eligible for vaccination, and those of us in a similar bind, like the immune compromised and elderly, are being left to fend for ourselves as our governments rush recklessly to remove protections.
Read 15 tweets
Kashif Pirzada, MD Profile picture
Jan 21
What I imagine a chief public health officer would write, but can't:
“Dear citizens, I write to explain some difficult realities. We are tired of fighting Covid-19. Our strategy was entirely based on vaccines, and though they are amazing, their benefits are proving fleeting...
"We could have built a strategy to supplement our vaccines with multiple mitigations, but we did not spend the time or the effort to do so despite having two years to plan and implement this...
"We ignored compelling evidence that the virus was airborne and highly dangerous in poorly ventilated indoor spaces. Instead, to avoid offending powerful personalities within our ranks, we stonewalled and now are completely unprepared to contain this virus...
Read 19 tweets
Kashif Pirzada, MD Profile picture
Jan 10
It is NOT inevitable that our kids will get Covid. The tools exist, including comfortable kid-sized N95 masks, HEPA filters, to prevent this.
Some opine that kids N95 masks are too hard to wear, are harmful, etc.
Let me ask you: do these kids look like they're uncomfortable?
This table from @masknerd shows excellent filtration from well-fitting masks; many are KF94 (N95 equivalent) masks from South Korea, where their use is routine and expected.
It is unfortunate that national media is platforming physicians who push the inevitability narrative. One of the key lessons I learned in medical school: you do not shrink from a problem because it is hard and difficult!
Read 8 tweets
Kashif Pirzada, MD Profile picture
Dec 28, 2021
It must be bewildering to sort through the conflicting messaging out there now. Problem is everyone is:
- in a frenzy preparing for an Omicron wave, getting boosters out etc
- in deep shock about the rapidity of spread and what that implies
No one knows what lies next...
So part of the messaging you're seeing is accepting reality that it will be very difficult to avoid getting infected this round. Had we spent the last 2 years preparing to fight an airborne pathogen with ventilation, filtration and N95 masks, maybe most would have had a chance...
But this is likely one of many future rounds with this virus. SARS2 will win this one, and most cases will be mild; boosters will limit the damage, buy us 3-4 months of relative protection for most. The elderly, small children and of course the unvaxxed will be hit hard...
Read 9 tweets

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