When we exhale 🌬️, we add CO2 to the air. In fact, each breath from an average adult contains 35,000 parts per million (ppm) of CO2. More people in a room & poorer ventilation = higher CO2. Poor ventilation can cause a # of health effects, incl⬆️risk of COVID-19 transmission.
What else can increase CO2 levels?
-Age of a building/HVAC;
-Design of a building;
-Function of the building (may not have windows that open);
-Size of the building;
-Number of ppl in the building;
-Other CO2 sources, (smoking, stoves, furnaces, water heaters, & pets)
What can be done about high CO2?
-Engineers are experts in ventilation systems! Get their input...
-Reduce the # of people in the building;
-Avoid strenuous activities like singing, dancing, & shouting
-Servicing or upgrading your HVAC system;
-Consider HEPA filters in your HVAC system to reduce particles that may have viruses/bacteria;
-Increase the amount of outdoor air being drawn into your HVAC system, to decrease the recirculation of ‘stale’ air;
-Place portable air filtration systems throughout the building;
-Open windows and doors where the safety of occupants won’t be jeopardized, & the function HVAC system won’t be affected;
-Install screens so that windows and doors can be opened without the risk of pests (e.g. flies) coming in;
Finally to stop the spread of COVID-19, ventilation is only 1 tool (but an important one!). Vaccination, masking up, staying home when you're sick & testing/treatment are also other important tools in the ongoing pandemic.
A multilayer approach to the ongoing COVID-19 pandemic is still critical, but there's ONE intervention we all need to stick with for the time being: MASKING 😷
That's why I'm still strongly recommending for all
Here's a quick recap on the science of just how impactful it is. 🧵
Before we get started on the evidence. A quick recall, that in public health decisions, NET balance is critical. For the teeter totter of masks 😷 benefits vs harms: all the weight is on the benefits side & NO harms have been demonstrated.
People ask. Will we *have to wear masks the rest of our lives*. No, no. In the future, as the transmission risk in the community settles down 🤞, the benefits of masking will also go down 📉. At times it may go up. Some may still choose to continue to wear more often than others.
With provincial changes, and ongoing high levels of COVID transmission (though fortunately decreased from the omicron peak), I strongly recommend individuals who haven’t been vaccinated to do so as soon as possible, including their 3rd dose (or 4th if immunocompromised).
I also strongly recommend individuals continue to wear their mask indoors around others beyond the 21st of March.
I have written advice to various sectors around measures, including consideration of continued vaccine/masking requirements to create safer spaces for all including those more vulnerable to severe covid, though I realize that may have many considerations and require legal input.
I’ve lived through SARS in 2003, we quickly forgot.
I’ve lived through H5N1 in 2005 & since, we quickly forgot.
I’ve lived through H1N1 in 2009, we quickly forgot.
I’ve lived through MERS in 2012, we quickly forgot.
I’ve lived through Ebola in 2014, we quickly forgot.
I’ve lived through Zika in 2015, we quickly forgot.
I’ve lived through Ebola again in 2018, 2019, 2020, we quickly forgot.
I’ve lived & continue to live through the ongoing COVID-19 pandemic & all of its new variant waves.
We can’t forget this one.
All parts of society need to learn from this experience. We need to build in continued precaution and preparations. We need continued investments to ensure our public health system can continue to be prepared & respond to pandemics.
Through incredible science & collaboration, our two year old pandemic toolbox is pretty impressive. We've learned so much about this virus & how to protect ourselves. Our task now is to pick the best tools going forward, using the most effective & least harmful strategically.🧵
Before we begin, a fundamental misunderstanding in medicine & public health is Hippocrates good ol' words: "First Do No Harm". As my mentor @schunemann_mac always says, in the teeter totter of interventions, we need to focus on the balance to get NET benefit & not NET harm.
So that means, for any intervention, in medicine or this pandemic both the benefits and harms need to be considered.
Some interventions, like lockdowns, have been very beneficial having saved tens of thousands if not hundreds of thousands of lives through the pandemic in Canada.
We are beginning a game of strip poker with the COVID-19 pandemic. But instead of getting naked on the first hand, we need to strategically maintain all of the layers we can, for as long as we can, to save lives of those more vulnerable to the virus in our communities.
With effective rollout of the vaccine & a more mild omicron, the pandemic now disproportionately impacts vulnerable Canadians: elderly, immunocompromised, medically-at-risk, unvaccinated. But omicron has also meant more transmission than ever before and its death toll is enormous
Lockdowns have certainly had important negative impacts. But they have been necessary to save countless lives. They are only one layer of precaution & should be a last resort on a go-forward as we continue to deal with the pandemic & new variants that may come.
Happy 2022 New Year! It has been 1 month since I started with @Ptbohealth! It has been a whirlwind of a month – challenging, but a lot of fun with this great team. Like many of you I feel the weight of omicron going into the New Year. A long thread 🧵stay with me to 🔚for my hope
We now know a lot more about this omicron than we did 1 month ago when I started, but much remains unclear. We know that it is highly transmissible, but that it appears less severe than Delta (54% dec risk of hospitalizations from the PHO study).
We know our vaccines are not as protective, especially with only 2 doses, and that 3rd doses for the general public and 4th in long-term care (due to weaker immune systems in the elderly and risks of outbreaks in those settings) are needed.