This wave I have been talking to multiple individuals admitted to hospital with severe COVID. Here are some of my observations so far: 🧵 There is not a single hard anti-vaccine person SO FAR. In fact many have said as much. What they tell me is eerily similar. 2/

I am concerned about this waning immunity narrative that has been saturating the airwaves for the last several weeks. Antibodies naturally wane with time, but the immune response still prevents you from getting extremely sick. This was true even before the pandemic. 1/ The implication of these waning immunity stories is that the vaccine is not working. This can’t be further from the truth. 2/

There are a lot of stories circulating in the news about people who have been vaccinated testing positive for COVID-19. The first thing you should ask is: how sick was the person? Overwhelmingly, these people are very mildly symptomatic, and have not required hospitalization 1/ Vaccinated individuals with COVID are often picked up when a group of people are mass tested in an outbreak investigation, for example in a hospital. The vast majority either have no symptoms or minimal symptoms and would otherwise not have been found. 2/

I am really concerned with how much we have undersold the amazing efficacy of COVID vaccines in Canada. 1/ At the current time we are about to reach the target of 75% of eligible adults vaccinated with a single dose, and 20% fully vaccinated. Despite this, the prevailing sentiment is still of fear of re-opening. 2/

Testing positive for COVID, even after full vaccination, is not unique to the delta variant. We saw this in the third wave as well with B117. Oftentimes it was in the context of an outbreak investigation. 1/ Fully vaccinated people who tested positive for COVID were overwhelmingly mild cases or completely asymptomatic. 2/

Agree with Mayor Brown. Where the delta variant will affect people is no mystery, as it will be the same areas that were affected with B.1.1.7.

Important to note that one dose of vaccine still offers significant protection--this 33% figure does not tell the whole story. 1/

https://twitter.com/patrickbrownont/status/1400118552888238080

There will undoubtedly be more cases because of the delta, but let's remember we are in an entirely different situation compared to even 3 months ago. One vaccine dose still provides protection. A 4th wave will look much less severe most notably because... 2/

Anecdotal observations from COVID in hosp:
1. Notable absence of LTC admissions (vaccines work!)
2. Not many community dwelling people >70y (vaccines work!)
3. No doubt that average age is younger
4. Younger people are almost all essential workers or their family members.
1/ 5. Younger people admitted have a history of not just exposure but heavy, prolonged exposure.
6. Obesity and/or metabolic syndrome are common themes (including in younger pop'n)
7. A few older people with 1 dose vaccine. Most within 2w. Over 2w, seem not to be as sick
2/

With respect to COVID, many of us have been on about hospitalizations and death, and how the vaccines relate. This is very important because it takes us back to why we are doing all of this in the first place THREAD: 1/ At the present time, SARSCOV2 is spreading in a pandemic fashion all over the world. It's a respiratory virus, but that has significant differences than others (e.g. influenza etc.) my goal here is not to dwell on these differences 2/

There was a lot of concern over a video of a lineup at HomeSense last weekend. Truth be told, I think the risk of people lining up in a large building for a fleeting time with masks, is not risk-free, but it's low risk. @zchagla @BogochIsaac @DocDominik @MikeHaddadMD 1/ These "viral" videos are obviously visible and garner a reaction, but take attention away from the much higher risk and (much) less visible high risk settings where COVID is spreading (i.e. the essential workplace - household transmission chain). 2/

I've been wanting to write this thread for a while. It has been inspired by hearing a common thought: why can't people just "listen"? If people just followed the rules, we wouldn't be in this mess. I think this is oversimplification of the problem with COVID: 1/ It is true, there are people who haven't been following guidelines (by definition that happened a LOT at Christmas/NYE in my region), but even before, we know transmission in private gatherings happens. 2/

The South Asian community I am part of has a number of overlapping risk factors that increases the risk of both acquisition of COVID and also at risk for having a more severe outcome 1/

https://twitter.com/TorontoIDDoc/status/1327936723725193216

First many work in ESSENTIAL, public-facing jobs (including in health care) as well as crowded workplaces where it is difficult to physically distance (e.g. factories, food processing plants etc.) 2/

COVID increasing significantly across Canada, a couple of notes:

1. Need intervention now: likely be seeing significant regional restrictions soon.

2. Young people make up large # cases not just because partying. School, wider social networks, work in service industry 1/ 3. Testing needs to be stratified, prioritization of those with new sx and high risk exposures etc.

4. Comms experts to target pop'n 20-39--can't rely on docs to do this @BogochIsaac

5. Don't compare daily numbers to earlier. 400 cases in May was likely more like 2000 2/