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Thomas Piggott MD PhD Profile picture
@twpiggott
Apr 8, 2022 • 9 tweets • 4 min read • Read on X
I'm concerned the discussion now in pandemic, & the 6th wave we are into in #Peterborough & #Ontario is just focused on preventing hospitalizations & death. Maintaining hospital capacity & preventing severe disease are important, but even 'mild' illness impacts are concerning.
As the number of people infected increases, the number of people impacted by the effects of Long COVID is growing. This is a complex multisystem disease we are still learning the extent of...
We've known for some time that COVID-19 was as much a vascular disease as respiratory disease. This recent @bmj_latest Swedish studies quantifies 5X DVT, 33X Pulmonary Embolism
20% of those affected with Long COVID have evidence of cardiac impairment persisting beyond 6 months.
Long COVID-19 neurocognitive effects (fatigue, brain fog, dec concentration) are also very concerning, long lasting and are implicated in the majority of people w/ long COVID
frontiersin.org/articles/10.33…
Post COVID-19 people have a 40% increased risk of diabetes.
If there was nothing we could do to prevent mass population infection, it would be understandable and we'd need to shift to dealing with these tragic consequences, but we're 2++ years into the pandemic and we've learned so much.
There are in fact more than 4600 evidence-based things we can do in this pandemic (recommendations) many focused on prevention [last count from the @eCOVID19RecMap]
Emphasizing preventions that WILL help, are LOW cost & are NOT harmful is critical now:
- Wear your mask
- Stay home if sick, test & if eligible 💊
- Improve ventilation (home, schools, work, public spaces)
- Keep up to date with COVID-19 vaccinations (3 for most, 4 for some)

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More from @twpiggott

Thomas Piggott MD PhD Profile picture
Aug 20
The mpox situation is concerning, but the identification of a case in Europe doesn’t change the concern we’ve had in public health tracking this global pandemic for two years.
We’ve been tracking clade 1 in particular for a number of months. Public health is paying close attention.
canada.ca/content/dam/ph…
I’ll do a deeper dive soon, but my concerns with mpox are not immediate cases in 🇨🇦 and I would agree with @WHO that this is unlikely to be the ‘new COVID’.
bbc.com/news/articles/…
However, what the situation and last week’s declaration of a PHEIC should highlight is:
1) our health is global: inequities in countries including DRC should not be overlooked;
2) we still haven’t ‘learned from COVID’ by reviewing the response and ensuring we implement lessons learned to strengthen public health.
Read 6 tweets
Thomas Piggott MD PhD Profile picture
Jun 15
Please have a read.
A great detailed article delving deep into prescribed alternatives to toxic street drugs (aka safer supply).
I had a chance to visit the program & hear the results of their evaluation this week, the work from the NPLC & @kathyhardill is impressive & lifesaving
This eval adds to a growing literature on safer supply as an effective harm reduction intervention and counters misguided narratives that this is “just keeping people alive” (although that also sounds like a good thing from my medical perspective) - 86% ppl used less/no fentanyl Image
Is this intervention a silver bullet for the drug poisoning crisis?
No.
But nothing is.
Which is why we need escalation in a continuum of responses, prevention, harm reduction, & treatment. These aren’t alternate approaches but complementary.
Read 4 tweets
Thomas Piggott MD PhD Profile picture
May 2
The first @CochraneCanada CAN-PCC Prevention Guideline recommendation is out:
*We suggest masking for asymptomatic adults in community settings be used for the prevention of COVID-19 infection to prevent COVID-19 condition.* (Cond Rec, Low Cert Evidence) Image
Here's what we found. No surprise, masks work. Their effectiveness at prevention of COVID-19 infection and therefore Post COVID Condition increase at higher risks of transmission. With 100 people infected per 1000, masks could prevent *17 cases per 1,000*. Image
An additional *12 cases per 1,000* could be prevented with use of a respirator style masks vs medical/surgical mask. Image
Read 12 tweets
Thomas Piggott MD PhD Profile picture
Mar 9, 2023
🚨It's Time to Improve the Air We Breath 🫁: Peterborough Public Health @Ptbohealth advocates for improved indoor air quality where we live, learn, work, and play
peterboroughpublichealth.ca/its-time-to-im…
Scientific thinking on airborne transmission of #COVID19 has heightened the importance of improving & assuring optimal indoor air quality, which also comes with other health benefits.
@Nature asks if countries will clean it up, and we advocate they must!
nature.com/articles/d4158…
@Ptbohealth Board of Health recently resolved to advocate to all levels of government to make investments and use all possible strategies to improve IAQ:
🇨🇦: make investments to fund IAQ improvements
Read 8 tweets
Thomas Piggott MD PhD Profile picture
Mar 8, 2023
Did you know Canada is the ONLY country in the world that has universal health care, but🚫access to covered contraception⁉️
Contraception is a gender health equity issue & 1:5 have insufficient drug coverage.
#InternationalWomensDay @Ptbohealth actioncanadashr.org/resources/poli…
BC recently announced that contraception would be free for everyone, and all provinces in 🇨🇦, including @ONThealth should follow suit.
cbc.ca/news/canada/br…
Unfair access to menstrual products means an inability to afford tampons, pads & liners fuels stigma & shame while creating health risks for people who struggle to afford them.
@ONThealth has recently made important progress but gaps remain.
news.ontario.ca/en/release/100…
Read 6 tweets
Thomas Piggott MD PhD Profile picture
Nov 14, 2022
The immune system is a fascinating, complicated thing. Here's a story to show, but spoiler alert. You don't owe it any debts and preventing infection is always better than it learning "the hard way" through acquired immunity from infection.
When I was on a 6 mo mission @MSF, the project where I was based was in the middle of a jungle. We had no reliable electricity, just intermittent generators therefore refrigeration.
Combined with poor food prep safety meant the food made me sick. I had repeat gastro infections my whole time there. Violent explosive gastro. We're talking often both ends. Every month or more often. One time typhoid, others unknown viral and bacterial adversaries.
Read 7 tweets

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