Thread by @Protect_BC

Please join us Friday, Feb. 3 at 1:30 pm for for
"Covid Reality Check"
An online conversation about the pandemic with @SKGandhiMD, former BC Children's Hospital paediatric cardiac surgeon & new Deputy Leader of @BCGreens. Free!
Livestream link: #bcpoli

@SKGandhiMD @BCGreens We will be live-tweeting our "Covid Reality Check" with Dr. @SKGandhiMD here on this thread starting at 1:30 pm today. Please follow along! #bcpoli

@Lidsville Here we go! We begin with a welcome and land acknowledgement by today's @Protect_BC host Dr Susan Kuo. Introducing Dr. @SKGandhiMD.

@Lidsville @SKGandhiMD Q: Is the pandemic over?
Dr. @SKGandhiMD: we are still in the thick of it, despite the fact that emotionally, that's not where the BC public is. People believe the pandemic is over, and government has not corrected that impression sufficiently.

@Lidsville @SKGandhiMD Q: why have you decided to speak out?
A: @SKGandhiMD saying that he stayed silent for years but was finally unable to refrain from speaking out, and left his job and joined the @BCGreens in an effort to get the word out and make a difference.

@Lidsville @SKGandhiMD @BCGreens Q: What is your position on masks?
A: We don't put seatbelts on after a crash; we need masks to prevent Covid
The Green party's position is follow the science and adapt policy accordingly. We could have used a mask mandate indoors /transit this past winter to improve air quality

@Lidsville @SKGandhiMD @BCGreens A by Dr. Gandhi to this Q: we need to follow the science - the efficiency of masks at preventing infection is not even debatable. The @BCGreens need to ensure that people and staff are given the right equipment to prevent infection

@Lidsville @SKGandhiMD @BCGreens A: We know that schools are sites of transmission

@Lidsville @SKGandhiMD @BCGreens Dr Gandhi: "you're trying to get me riled up, aren't you!" (laughs)
Immunity debt has been debunked.
You don't need to get sick to get healthy; that's not a thing. Covid is serious - it has long term and possibly permanent effects on multiple systems in the body.

@Lidsville @SKGandhiMD @BCGreens There is no reason to keep Paxlovid from those who are eligible - it's an effective drug. it's easy to avoid prescribing it to those it may harm (drug interactions etc). If the cost is the reason BC is withholding Paxlovid, then prevention is FAR cheaper than cure for BC.

@Lidsville @SKGandhiMD @BCGreens Q: On Long Covid:
A: Dr Gandhi:
A significant # of LC cases in BC now. We need clinics for Long Covid; we have clinics for conditions far less prevalent than Long Covid, and we need them, and treatments, for LC too

@Lidsville @SKGandhiMD @BCGreens Question#11: Dr. Gandhi, what do you think were the biggest mistakes in the pandemic management in BC?
Dr Gandhi: we should have instituted proper public health and individual protective measures

@Lidsville @SKGandhiMD @BCGreens Question #12: f the Green Party came to power, what would be the top 3 things it would do to change or start doing to manage the pandemic in BC?
A: We tell people to assess their own risk, but we give them none of the info and tools they need in order to do that. Give BCers tools

@Lidsville @SKGandhiMD @BCGreens 2. Clean the air - the BC govt must become proactive on ventilation and filtration

@Lidsville @SKGandhiMD @BCGreens Dr Gandhi - what else would you like to add?

Dr G: Covid isn't about the acute illness anymore. It's like with smoking: a pack today won't kill you tomorrow. But your risk is steadily going up. If you keep getting reinfected with Covid, chance of long term damage is signif.

People aren't to blame for not knowing this; we simply haven't told them.
People say we are "obsessed with Covid." I'm not obsessed with Covid. I'm in the business of caring for people. We've done a disservice to people in not telling them what a mess this situation has become.

Now we go to Q&A:
1. When public health & prov health & Min of Health gives you guidance, it puts people in very difficult situations at work when they want to do better (masking, hepafilters) but their workplace isn't allowing them. "I've often been the only person in a mask"

"I think you have to take it upon yourself to do the best you can at work, and try to convince your employer that protective measures are going to be best for their financial well-being, since public health won't upgrade their recommendations"

A: Without a major overhaul of the system it's going to be very difficult to prevent people like me from leaving the system. I loved what I did for a living; best job on the planet bar none. But the toxicity & politics in workplace can even drive a heart surgeon out of that job.

Cont'd
The move by the BC Govt to further remunerate doctors is a good step but it's not nearly enough. To really fix the problem, we really have to listen to actual frontline HCWs. Policy has been made by adminstrators at a remove.

Sanjiv: good Q. Schools were empty this winter, absenteeism from 20-70%. I can do nothing more than agree with you on this Q, but will say main motive of govt has been to preserve a narrative, which has overtaken the wellbeing of people as top priority. They just want to be right

A: The pandemic is not over, it's been well-advertised how many have been sick. Due to the immune damage caused by Covid, HCWs like the gen pop have become more susceptible to disease. HCWs are human beings too, and will get as much or more infected due to their jobs.

How does Covid indirectly impact the health system in BC. Long Covid will be one impact, but can you comment on other impacts in BC over the next few years?
Gandhi: Impacts of Covid are on the whole body. One of the big fallacies is that Covid is a respiratory disease. it's not.

"Covid hits receptors - like hooks on your organs - all over the body, not just the lungs. We know that Covid for eg. affects heart function. Children who've had mild Covid vs kids who have never been infected, the former group show their hearts are in worse shape. Clots.

Covid is a thrombogenic disease; it creates clots. Covid also has neurological effects. People commonly call it brain fog - it sometimes recedes tho not in Long Covid. All these impacts are going to burden the healthcare system.

Q: what will working on ventilation/filtration look like, concretely and cost wise
A: This is not hard. I'm not an expert on which system is best for each room; there are experts who know that. I do know that waterborne illness is prevented by clean water. We must do this w/ air

We have to stop worrying about "cost" - the cost of illness trumps the cost of preventative medicine, and it's probably lower than that cost in pure economic terms. It is in everyone's interests to prevent illness, individually and at the pop'n level for our HC system

Protecting seniors is really no diff than protection everybody, except seniors are likely to have worse outcomes and age matters, as does having other conditions. We have to just do a better job of instituting all the things I've mentioned. Esp in schools and LTC, but everywhere

Gandhi: Well, my thoughts are that's wrong. We have put all our emphasis on vaccination tho vaccines along aren't enough; I'm all for vaccinations. But esp if you're going to rely ONLY on vaccines that we know wane at 3 months, i don't see why any prov would withhold boosters.

Tho vaxes aren't the panacaea we had hoped they would be, they are still important and should be encouraged.

A: Racialised and minoritized communities have worse outcomes on everything, not just from Covid, and we have to address that.

Immunity means you can't get it anymore; for Covid, vaccines don't give that type of immunity. It's similar to the flu vaccine; Covid and flu mutate, so we won't get absolute immunity. However these vaccines mitigate against more severe disease, vs unvaxxed.

This type of vaccine is still a very good treatment - RSV vaccines are also similar.

There's also a difference between immunity from vaccines vs from infection. The latter isn't as good. ALSO you don't want to get the disease because the disease causes other types of damage.

"Saying you need to get covid to prevent covid is like saying you need to get in a car crash to prevent future car accidents" - @SKGandhiMD

@SKGandhiMD Dr Gandhi: they get their direction from public health and Min of Health, which haven't been emphatic on need for clean air and masking, it's all "let's move on, we're done w the pandemic." Many of us know that most people wonder why we are still talking about Covid! It's sad...

@SKGandhiMD "Worksafe BC should step up to the plate, but they're being given direction by people who haven't." - @SKGandhiMD #bcpoli

@SKGandhiMD Gandhi: I'm speechless on that one. Why would anyone be prevented from using PPE that is most effective?
Dr Kuo: it's most common in LTC homes where care aids /nurses are not allowed.
Gandhi: I don't get that at all! Like stopping a skateboarding kid from wearing kneepads

@SKGandhiMD Gandhi: "Anyone being asked to remove an N95 to put on a baggy blue surgical mask should push back hard. They should make the hospital PROVE it's better practice. Show me the data, and I will. I'd encourage the courage to push back against so-called hospital leaders. "

@SKGandhiMD Gandhi: Health and Hospital administration is a serious problem in BC, there are too many of them and the layers of them are far too thick. If I were Min of Health I know what I would do with all those layers.

@SKGandhiMD Gandhi: I can't compare mRNA to Novavax but I have seen good data on Novavax and don't think they should be withdrawing it, but I acknowledge what I'm not an expert on and I'm not qualified to answer this.

@SKGandhiMD That's a wrap. Thanks Dr Gandhi!

Dr. Gandhi: I applaud @Protect_BC for trying to keep the people of BC safe and protected. Today it's Covid, tomorrow it might be something else, but I and many others appreciate your work. Thanks for letting me share what I know. /

@SKGandhiMD We would again like to thank Dr. Gandhi for speaking with us.

And thanks to all of you for following along!

Our next briefing will be on Paxlovid and we'll announce the date soon here and on Facebook. /end

@SKGandhiMD Note: if you missed this broadcast it will remain up on YouTube for you to watch at your leisure. Please watch and share! Thank you as always. Permanent link: