Thread by @littleann4ever

🧵“It's incredible the learnings & support that we're providing BCians struggling w/Long term effects of Covid. Plus, in time, we'll all benefit from data gathered by our researchers to address this in the future” Tim Manning,PHSA Chair, Apr/22
Oh, they ALL know about #LongCovid

2/ For context, this quote was spoken immediately following this special presentation about BC’s Post Covid-19 Interdisciplinary Clinical Care Network (PC-ICCN) at the PHSA’s April 28/22 Open Board Meeting. mediasite.phsa.ca/Mediasite/Play…

3/ Okay, 1st just who is the PHSA? Well, they work w/ the BC Health Ministry, 5 regional & FN HAs "to bring health care closer to where BC residents live, to promote health, manage chronic illness...& improve access to evidence-informed practice...” phsa.ca/about/who-we-a…

4/ What's PHSA's role? Well, they oversee 28 prog/serv. Incl. is the BCCDC, the Prov Infection Control Network (PICNet) & the post-COVID-19 Interdisciplinary Clinical Care Network. A perfect trifecta of Cause, Cause & Effect, all under one roof! #bcpoli phsa.ca/our-services

5/ Who oversees the PHSA? Re: Foundational Mandate Letter, the PHSA reports to Ministry thru MoH & is “directed to develop, review & update evidence informed prov clinical policy *in alignment w/policy direction set by Ministry*" phsa.ca/about-site/Doc…

6/ Okay, now that the chain of command & relevant accountabilities h/b defined, let’s keep them on top of mind while reviewing this PHSA PC-ICCN presentation & further disseminating behind-the-scenes knowledge of BC’s decision-makers. My full transcript: docs.google.com/document/d/1zU…

7/ This answer to q from member of public about demographics is truth-telling:"it's about 60% women & interestingly, persistence of symptoms seems not t/b present in 30% of hosp patients, just non-hosp patients…so, it doesn’t correlate w/severity of disease” (see transcript Q&A)

8/ So, just how many top decision makers heard this stmt? Well, a total of 27 incl. David Byres, PHSA Pres/CEO, Alexandra Flatt, VP of Pandemic Response & Chief Data Governance & Analytics Officer AND none other than, Reka Gustafson, VP of PH & Wellness & DPHO (at the time)

9/ Manning asks how widely the network h/b communicated across divisions/fam practice & how the public can access it. 1st answer: “communication is always difficult” & 2nd: “that they should speak to GPs about their symptomatology & ensure GPs know about the resource.”(see Q&A)

10/ But all this info, incl patient clinical care & evidence-based best practices for primary care providers & much more is all posted on the PHSA site, since PC-ICCN is part of the PHSA. In fact, here are all the talking points from the presentation: phsa.ca/health-info/po…

11/ The PHSA asks: “Are you a BC resident struggling w/post-COVID symptoms & looking for help?" AKA now that you’ve been unable to escape (repeated) Covid infections & are suffering long-term as result of pro-infection policies, here’s some info that we never share mainstream.

12/ & how long has the PC-ICCN been under the PHSA umbrella & under the radar of all BC’s HAs? Well, they were all formally tasked w/overseeing it back on July26/21. This is not a random date either but indisputable one on multiple mandate letters for 2021-22 fiscal yr.#bcpoli

13/ This from Dix’s 2021-22 mandate letter to PHSA: “As a board, you will ensure that you focus on the following areas for health service improvement: Provide oversight to the PC-ICCN thru collaborative efforts w/regional partners & academic partners...” phsa.ca/about-site/Doc…

14/ & Dix’s letter to Penny Ballem, VCH Chair (w/copies to all HAs):“As a board, you will...work w/the Ministry to focus on the following areas for health service improv: Provide oversight to PC-ICCN thru collaborative efforts w/reg & academic partners...” vch.ca/Documents/Mand…

15/ How about Henry? Well, according to BC govt & PH Act re: Office of PHO, in addition to her independent advisory role, part of her duties incl working w/ “BCCDC & BC’s MHOs to fulfil their legislated mandates on disease control & health protection.” www2.gov.bc.ca/gov/content/he…

16/ So, just to reiterate, the PHSA (their programs incl BCCDC & PICNet), the MHOs in all regional HAs w/help from PHO as part of her duties, have all had & continue to have mandated directives from Minister Dix to “provide oversight” to the PC-ICCN since July/21. #bcpoli

17/ But WHEN did they all KNOW & what did they KNOW? As it turns out they all had access to real time & growing evidenced-based LC info as far back as May 2020 & yet h/b complicit in downplaying life-altering long-term impacts thru policies & PH messages. @LongCovidCanada

18/ Yes, May/2020! It’s all laid bare 2 yrs later in May25/22 BC journal article re: PC-ICCN: "Creating a prov post COVID‐19 interdisciplinary clinical care network as a learning health system during the pandemic: Integrating clinical care & research." ncbi.nlm.nih.gov/pmc/articles/P…

19/ *When they knew* from article: “PC‐ICCN was conceived in May 2020 in recognition of an emerging need for specialized coordinated care for a subset of post COVID‐19 patients w/persistent symptoms (now recognized as long‐haul COVID, long COVID, or PASC).”

20/ Next, *what they’ve known*: “international estimates indicate 10%-20% of indiv recovering from COVID‐19 exp long‐term complications” & “given multiplicity of organ systems affected & susceptibility of indiv w/substantial comorbidity...impacts are likely significant.”Con't

21/ "…Based on known physiology of whole‐body distribution of angiotensin converting enzyme‐2 receptor & virus binding to receptor, the possibility of multisystem involvement became apparent early on in the pandemic, fostering urgent need for interdisciplinary collaboration."

22/ OK, now who’s been funding it all? Well, according to article’s abstract, the PC-ICCN “is a provincially funded resource that is modelled as a Learning Health System (LHS), focused on those people w/persistent symptoms post COVID‐19 infection.” @adriandix @bcndp

23/ So, now might be a good time to circle back to PHSA Board Chair, Tim Manning’s words at the conclusion of the April 2022 Open Board Meeting, that “we will all benefit from the data gathered by our researchers to address this in the future.”

24/ His words are echoed in this published article in that a main objective of the PC-ICCN is “to embed research infrastructure w/i clinical care to facilitate learning & evidence generation to support patient care, advance clinical guideline development & support HC policy.”

25/ So, an E.g. of Post Covid-19 research data being used to inform better clinical practice is best demonstrated by PC-ICCN’s own 12-session virtual learning series: BC ECHO for Post-Covid-19 Recovery meant to aid family practitioners support LC patients: phsa.ca/health-profess…

26/ For E.g, this May/22 session re:Long Haulers presents comprehensive summary w/symptomatology incl debilitating PEM as well as multi-system complications, namely lung disease, thrombosis, heart damage, stroke, neurological disease & kidney disease:

27/ The notion this info was helping family practitioners identify & properly refer patients for testing & Post COVID‐19 Recovery Clinics (PCRCs) is encouraging, isn’t it? And since this was already the 10th session in a series of 12, surely most info was getting thru, right?

28/ Wrong. As of this session, medical #Gaslighting was still alive & well, as Dr. Arseneau affirms: “given all the info that’s out there about Long Covid, the vast majority of patients still report being dismissed, being told to push thru symptoms, that it’s due to anxiety.”

29/ Re: real-time research data identifying Post Covid-19 cardiac manifestations, this Jun/22 session provides complete overview to help practitioners better assess, treat & advise patients. Whole thing needs amplifying but esp these 2 stmts...Con't

30/ 1st stmt:“3 mths after Covid-19 infection, it was predominantly young people, 45 yrs & under, complaining of common cardiac symptoms, incl shortness of breath, chest pain & palpitations” & 2nd: “predominantly these symptoms came from non-hosp versus hosp patients”(35min mark)

31/ & finally this July/22 Respirology session is jam-packed w/updated world-wide & local research data. Many studies cited further confirm the predominance of young people affected & the wide-spread impact on non-hosp patients:

32/ The whole thing is imp to watch, but pls listen at 50 min mark & try not to cry. Patients themselves, suffering from life-altering respiratory symptoms are asking for help. A disparaging sign that all this Long Covid info is not getting thru & that care is insufficient.

33/ & btw, this whole ECHO virtual learning 12 session series is posted on the PHSA website & was “fully funded by the Shared Care Committee, one of the Joint Collaborative Committees of Doctors of BC & the BC Government.” #bcpoli

34/ OK, let's talk the elephant in the room, BC Covid-19 PH Policies. While all the evidence re:long term effects, is, at best, trickling down to HC providers, the vast majority of public are still being kept in the dark. It’s not just being omitted either; it’s being re-written.

35/ Case in point, the current message from PHSA’s BCCDC re:Priority Populations AKA those most at risk for “increased chance of developing severe illness or complications from COVID-19” still says “older people & those w/chronic health conditions": bccdc.ca/health-info/di…

36/ Then there's Henry's rebuttal to HRC justifying rescinding masks: “thankfully the data tells us the risk is no longer elevated...even in people w/underlying med conditions, who're fully vaccinated” & “leading risk factor...continues t/b older age”: www2.gov.bc.ca/assets/gov/hea…

37/ Suffice to say, all BC’s decision-makers are either overtly or silently complicit in PH narrative, from MoH, PHSA, BCCDC to all HAs & MHOs despite fact that they've all been involved in PC-ICCN & have had access to 1st hand knowledge of #LongCovid research data for years.

38/ So, if not to ramp up LC patient care by improving HC provider communication, or shouting findings from rooftops to inform public, what's PC-ICCN's main focus? Well, the PHSA has whole sec informing patients about research participant opportunities: phsa.ca/our-services/p…

39/ But when BCians are still largely uninformed & PH safety policies are non-existent, this reads more like: “Hey, now that you’re suffering after being misled & unprotected, we would love to study you to get out in front of other jurisdictions w/ground-breaking research."

40/ Because in BC, it always comes back to the research, doesn’t it?
#LongCovid #BringBackMasks #CovidIsNotOver

(Btw, this took me almost 4wks & was the hardest thing I've ever researched/written)

My full document here: docs.google.com/document/d/1HX…

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