Thread by @strauss_matt

1/ My thanks to @TheAgenda, @spaikin, and @harrisonlowman for hosting me yesterday.

I had been looking forward to a serious discussion, grounded in the medical literature and ethical reasoning.

2/ We can disagree without being disagreeable.

Here is a smattering of the medical evidence base I was hoping to discuss:

3/ The majority of Ontarians had been infected with Covid-19 after last winter:

covid19immunitytaskforce.ca/wp-content/upl…

4/ Natural immunity following Covid recovery provides protection from infection and does not seem to wane much:

cdc.gov/mmwr/volumes/7…

5/ "Among the two cohorts with a previous COVID-19 diagnosis, no consistent incidence gradient by time since the previous diagnosis was observed "

6/ See also:

sciencedirect.com/science/articl…

7/ and also:

nature.com/articles/s4146…

8/ Data is sparse, but largest sets seem to show that covid reinfections tend to be less severe than primary infections:

sciencedirect.com/science/articl…

9/ See also:

nejm.org/doi/full/10.10…

10/ One of the only RCTs of a community-based masking intervention showed a small reduction in transmission.

science.org/doi/10.1126/sc…

11/ A non-randomized, but unlikely to be biased, study from Spain showed no reduction in transmission from masking young schoolchildren.

adc.bmj.com/content/early/…

12/ These findings are roughly in line with this study of older children by the Department for Education in the UK:

assets.publishing.service.gov.uk/government/upl…

13/ It would be very hard to show that Ontario's vaccine mandate changed mortality or hospitalizations. But it doesn't even seem to have increased the vaccination rate much (est. 0-4%) , so hard to imagine that it would have.

nature.com/articles/s4156…

14/ It does not seem that non-pharmaceutical interventions did much to blunt case-growth in Canada after the first wave:

ijidonline.com/article/S1201-…

15/ Re: Western's mandate. Booster doses are important for preventing hospitalization and death! But it does not seem that they do much to prevent transmission ~4 months after taking them.

nature.com/articles/s4146…

16/ See also:

jamanetwork.com/journals/jaman…

"More than 4 months after receipt of a third dose, homologous BNT162b2 boosting had the lowest estimated booster effectiveness against confirmed infection" (−2.8%; 95% CI, −5.4% to 0.3%).

17/ Long Covid seems to be rare in children (<1%), and when it does occur, tends to resolve within six months:

link.springer.com/article/10.100…

18/ In adults, long covid seems to be more associated with believing that you had Covid than with having a positive covid test:

jamanetwork.com/journals/jamai…

19/ There are other environmental health threats of urgent and grave concern to children:

journals.plos.org/plosmedicine/a…

20/ Preliminary data shows Evusheld to be amazingly effective at saving the lives of immunosuppressed individuals. Thank God!

academic.oup.com/cid/advance-ar…

21/ Sotrivomab also very helpful for such patients. I am proud of, and grateful for, my friend @zchagla who built Canada's largest Sotrivomab clinic @hamhealthsci.

academic.oup.com/cid/advance-ar…

22/ Reasonable people can disagree in their interpretation of the medical literature, and I am always interested to have good faith discussions about what I have posted here.

23/ It was great to see @maxwellsmith again. We don't agree on everything but I am looking forward to chatting further over a beer.