My latest on @Medscape makes the case that no, diet and and exercise are not better than medications for obesity. As in literally not better. Idealistically maybe there's room for argument (though I don't think so tbh), but the data on drugs' superiority is unequivocal 🧵 Simply put, there has never been a study demonstrating a diet and exercise approach that reproducibly leads to the sustained average weight losses we see with the newer generations of GLP1 drugs (semaglutide and tirzepatide). Not one. Regardless of your favourite diet or guru.

Weird that not releasing more hostages and then firing rockets during a ceasefire while saying you'll never stop trying to murder Israelis and that October 7th was just a rehearsal led to the resumption of war. The ceasefire people are really angry at Hamas for breaking the ceasefire and restarting the war, right?

Canadian COVID Twitter is going to be lit Monday evening and Tuesday morning. Yes this is a cryptic tweet. No I can't tell you more. Embargo lifted. The @bmj_latest has just published a special issue highlighting the failures of Canada's COVID response and calls for a public inquiry. I will link to each of the issue's 7 articles in coming tweets, but here is executive summary

FYI @LeslynLewis doesn't like being tagged on tweets that accurately report she hangs out with modern day Nazis. She immediately untags herself from the conversation. While I totally get that move, maybe some journalists could get her on the record talking about her new pal? Also, can someone tag the other MPs in the photo - happily other than Ms. Lewis, I don't recognize them.

A brief thread on being a media MD & the latest COVID gaslighting. During the pandemic I’ve done my share of interviews, I’ve turned down more requests than I’ve taken choosing instead to steer reporters to those whose training and expertise are more COVID suited than mine /1 PreCOVID bet I’d done between 700-1,000 interviews on topics related to nutrition, obesity, weight loss, & public policy therein. I don’t kid myself about kept getting invited back. It was consequent to my ability to speak in soundbites more than to my expertise or knowledge /2

Definitely useful to ask the question, "but what if I'm wrong" when considering your advocacy. If I'm wrong about mandatory masking in all essential spaces, indoor clean air regulation and monitoring, readily accessible COVID testing, test to return requirements, robust /1 ongoing booster campaigns, and only plain transparent talk from public health around local challenges, we'd see marked reductions in all airborne communicable diseases, breathing room afforded to our broken healthcare system, a better air infrastructure for the next variant /2

There have been so very many times where I've been tempted to smugly tweet that I was not starting a Substack. Glad I didn't because now contemplating. Because holy hannah I'm going to have a ton of free time when this bird gulag dies. Please don't pay anything, I have no idea if I'm going to use it, but who knows how this will all shake out. I've started a @SubstackInc. Subscribe to me there. yonifreedhoffmd.substack.com

It's 6:35am on Saturday morning. Yesterday afternoon, at 3:57pm, a parent, after waiting in line likely for an hour or two, registered their sick child at CHEO's ER. They have yet to be seen by an MD. 7:18am. Still not seen

Here's another broken transmission chain story, this time from my house, where recently 2 of us had COVID while the other 2 of us, using protocols we had considered in advance, managed to avoid it. How did COVID find us? We'll never truly know but we had a rare small get together. 5 kids total. Testing before hand. Open windows. Corsi-Rosenthal boxes scattered throughout the house. Notably though, we did not ask the kids to mask (which almost certainly was our downfall).

This question is constant and I can't understand it and not knocking Dr. Foley but figured might as well highlight for thread. The notion that municipalities can affect zero change to the health of their regions? Where does that come from? Many things municipal governments can do They could address clean air by way of proper ventilation and filtration in all city facilities - from libraries, to offices, to recreation centres, to buses. Speaking to lawyers they may even be able to affect by-law changes for at least for new construction to ensure same

#Ottawa Jan 24 COVID 🧵: School was open for 4 days last week and I put a call out (offer's still good) to school staff/students/parents to describe their experiences going back. Hundreds of responses. Some themes and thoughts follow

https://twitter.com/YoniFreedhoff/status/1483501246204071939

1. It's chaotic. Between staff absences, confusion around policies, and between board disparities the school environment does not sound like one conducive to learning, mental health, or physical health.

#Ottawa Jan 19 COVID 🧵: I wonder how many cases of COVID were contracted in our schools yesterday? 10s? 100s? 1,000s? Given DMs I received in thread below, those #s sound feasible. And the reports? So predictable. Will our MOH step in to improve anything?

https://twitter.com/YoniFreedhoff/status/1483501246204071939

Don't count on it. This despite that in a nutshell, even the wholly insufficient and greatly diluted school safety protocols that were announced as part of what our MOH described as a "changing approach" aren't being followed, & also despite @CPHO_Canada's announcement yesterday

#Ontario teachers and students, if you'd like to share your back to school at peak Omicron experiences, but feel uncomfortable or unable to do so publicly, my DMs are open and am happy to share them while protecting your anonymity. Still symptomatic with COVID EA working 1:1 with kids with special needs being asked to return to work after 5 days. No RAT necessary.

#Ottawa Jan 16th COVID 🧵: Tomorrow is Ontario's back to school day. Without a doubt, many kids will contract Omicron because somehow we've decided it's essential for children to go to school during the peak surge of the most contagious virus in history. Will mine be going back? No (and I recognize our privilege deeply), but maybe in a few weeks. Because that's likely what we're talking about. Not closed schools forever, but rather closed when they're especially unsafe. Might have been moot had we chosen these past 18mo to make them safer, but we didn't.

#Ottawa Jan 14th COVID 🧵: Hospital numbers (the actual ones, not just "Ottawans with active COVID requiring treatment" continue to rise, while wastewater appears to be starting to fall🤞. Schools set to reopen on Monday. I just can't wrap my head around the school piece. Not so much that they're opening (though I don't think they should be, many others do), but rather with the comfort of our MOHs with reopening policies that are absolutely geared to enabling rapid in school spread of what's in running for being most contagious virus in history

#Ottawa Jan 13 COVID 🧵: Back to school policies announced. In a nutshell, the government, with the support of their public health staff, have decided not to try to slow the spread of Omicron among our children in our schools. That part isn't a judgement call on whether schools should or shouldn't be opened, it's just a fact. The new policies see testing as limited at best, no mandatory reporting (as many have pointed out, Ontario school policies are stricter on reporting lice than COVID), kids being allowed to return to school even if still symptomatic

The gaslighting really gets to me. Pretending there's rationale behind their policies, or that they care for our kids' well being, or that they're not simply sending our children once more unto the breach but with even fewer safety measures to face markedly increased contagion And the silence, or worse, the collaborative gaslighting from people whose duty is supposed to be to public health? What happened to you?

#Ottawa Jan 12th COVID 🧵: Yesterday the news broke that TOH has become so overwhelmed (6 days ago they were at 115% capacity and there have been many admissions since) that patients are being housed in their rehab centre's gymnasium ottawa.ctvnews.ca/mobile/some-ot… Yet despite the crush on our hospitals, @OttawaHealth and @VeraEtches continue their practice of only reporting on "Ottawans with active COVID requiring treatment" which according to our city's COVID dashboard numbers 52, with 6 in the ICU.

#Ottawa Jan 11th COVID 🧵: Regardless of whether you support or oppose kids going back to school, yesterday it was announced they would be on the 17th. Assuming this happens (7 days can see many things change), there's no denying a huge number of our kids will catch Omicron There just isn't any way around that fact. There's also no way around the fact that some kids will have truly terrible outcomes, including deaths (from both COVID and MIS-C), and that somewhere there's been some calculus that sees those deaths as acceptable

#Ottawa January 10th COVID 🧵: Go get vaxxed! OPH announced on Saturday that there were 50,000 new vaccine appointments available. On Sunday they reported that they still had 40,000. That uptake isn't better in part due to their comms being stifled

https://twitter.com/OttawaHealth/status/1479833228764659715

I'm told frustration within OPH is high. And well it should be. Even if our MOH and Mayor aren't willing to do anything more than limit toboggan run capacity for masked kids, someone is stifling OPH's basic ability to inform our city.

#Ottawa COVID update: This will be a short thread. PCR testing restricted to essential workers, rapid tests non-existent. People with symptoms and no rapid tests are being told to assume they're positive and isolate and do their own contact tracing. If you've tested positive on a rapid test, but you're not an essential worker, there simply isn't a means for you to get a timely PCR test. Nor is there a means for you to enter your positive test data to the city for tracking purposes. And it's up to you to contact trace.