Dr. Alexander Wong Profile picture
ID/HIV/Addictions Physician & Researcher | Father to Three | Husband | Assoc Prof @USask | all views my own; he/him/his; proud to call #YQR home
Jan 21 11 tweets 6 min read
On January 18, @PremierScottMoe posted a graphic comparing "real-time" QC / ON / MB hospitalizations / ICU admissions vs. SK.

Problem: SK is ~3 weeks behind those provinces w/ our Omicron surge.

We MUST be careful interpreting this data. We're NOT OK, Saskatchewan.

🧵👇 (1/n) A more reasonable and appropriate comparison would be to look at where MB/QC/ON were at ~3 weeks from Jan 18 to create a more fair "apples vs apples" graphic.

For those 3 provinces, that would take us to about Dec 28. Let's see what the data shows us. (2/n)
Jan 21 7 tweets 3 min read
"Hi Alex, I have 2 doses of vaccine & JUST recovered from COVID. I'm eligible for a 3rd dose. When should I get it?"

Great Q. You assuredly had Omicron, so while you're eligible to get your booster 'right away', I'd personally wait at least 6-8 weeks. Why?

Short 🧵 👇 (1/n) First, getting a 3rd dose even AFTER you've recovered from Omicron makes sense. You're further bolstering your immune response from whatever the 'next' variant will be. *Big sigh.*

Better for your immune system to be ready for whatever this pandemic throws at it next. (2/n)
Jan 20 25 tweets 17 min read
OK. #SK COVID-19 mega-thread.

NEW #SK Omicron models (via @DennisKendel) Jan 19:

- Measures implemented to SIGNIFICANTLY reduce social mixing, MAYBE we avoid disaster/triage in #SK hospitals.

- Do NOTHING, #SK hospitals crushed, triage ensues.

Get comfy - here we go.

(1/25) Let's begin with history.

@SKGov was provided w/ models from WORLD-CLASS #SK modeler Dr. Nate Osgood in late August 2021 that predicted EXACTLY how #SK ICUs would be overwhelmed w/ Delta in Fall 2021.

Nothing was done. Everything left wide open.

(2/n)

thestarphoenix.com/news/local-new…
Jan 9 13 tweets 5 min read
NO doubt now. BOTH Quebec & Ontario are in huge pain now w/ #Omicron. The GTA now is being hit hard.

It's a numbers game. Too many patients, not enough staff or beds.

Many HCWs & first responders out, too.

It's ALL bad. Everyone's reality is in plain sight.

🧵 below. (1/n) The number of ICU admissions & ventilated patients in Ontario continues to rise VERTICALLY.

The primary risk for ICU admission remains being unvaccinated, but more elderly persons now with comorbidities & waning immunity also. (2/n)

Jan 2 10 tweets 4 min read
Trends w/ Omicron & RAPID INCREASES in hospitalizations are now clear.

'Leading indicator' jurisdictions w/ advanced Omicron waves (e.g. Ontario, Quebec, NYC, UK) are ALL showing BIG increases in adult hospitalizations.

All are strained further by HCW shortages. Brief 🧵 (1/n) Let's start with the UK. Hospitalizations are rising quickly, as evidenced by the graph below.

Yes, not as bad as January surge w/ Alpha - yet. But additional challenges including system & HCW burnout, significant staff absences due to COVID, etc. (2/n)
Jan 1 18 tweets 9 min read
Many #SK families are worried re: return to school Jan 3. How safe are our kids & school staff?

Omicron in Regina and Saskatoon is surging. We'll continue to see record case numbers for weeks.

@SKGov, what's your plan? We NEED to know.

A 🧵 on safe schools, below. (1/n) Let's begin with other provinces who are RIGHT in the storm of their Omicron surges. Quebec has delayed opening of 'everything' to Jan 17. Ontario has delayed opening till Jan 5 to try to distribute HEPA filters & N95s for staff (not students). (2/n)

cbc.ca/news/canada/to…
Dec 21, 2021 6 tweets 5 min read
Modelling released by @SKGov predicts DRAMATIC rise in cases, hospitalizations, & ICU admits w/ #Omicron if no additional measures to reduce contacts (i.e. gathering & capacity limits).

Briefing today: NO measures to be implemented at present. Wait and see.

1/ #COVID19SK Here is ICU / non-ICU modelling data. Not great, as you can see. Also not being taken into account - scores of HCWs taken out of circulation as a result of widespread community transmission.

Who will look after all the patients? Many HCWs have already moved on.

2/ #COVID19SK
Dec 15, 2021 7 tweets 2 min read
"Hi Alex. With #Omicron in Canada, what's the optimal 2nd dose interval for kids b/w 5-11 who have 1 dose?"

VERY different space w/ Omicron now vs 4 weeks ago when NACI guidance was released.

We'll try for 3-4 wk interval in #SK for our 5 year-old, NOT 8. Here's why. (1/n) Let's start by acknowledging that we have no real clinical data in this space right now. We don't know HOW protected kids b/w 5-11 are with 1 dose vs different variants like Delta or Omicron.

Kids immune systems are ++ robust, so 1 dose definitely confers some protection. (2/n)
Dec 15, 2021 10 tweets 2 min read
"Hi Alex, how do I keep my holiday gatherings safe? Do I have to cancel everything?"

Depends on your risk tolerance. If your bubble has persons who are medically vulnerable, elderly, maybe reconsider.

Otherwise, use ALL measures to keep things safe as able.

Brief 🧵. (1/n) We all know that seeing & reconnecting with friends & loved ones over the holidays is SO critically important. But with the transmissibility of #Omicron, the risk-benefit calculus has changed dramatically again. What do we do now? (2/n)
Nov 23, 2021 9 tweets 3 min read
"Hi Alex. My (5 to 11) year old just got their 1st #COVID19 vaccine dose. Yay! Should we wait 8 weeks for the 2nd dose as recommended, or should we just get a 2nd dose ASAP at 3 weeks?"

No clear answer, but my wife & I WILL WAIT 8 WEEKS for our 5 year-old son.

Brief 🧵. (1/9) A longer duration between 1st and 2nd doses of Pfizer-BioNTech vaccine has been shown to increase antibody levels and makes COMPLETE SENSE from the immunological perspective given our experience with all other vaccines in both kids and adults. (2/9)

cell.com/cell/fulltext/…
Nov 8, 2021 9 tweets 7 min read
"Hi Alex. What is this Western Canadian variant? Is it something to be worried about?"

Yes, there's a new Canadian AY.25 clade which originated from Idaho. This AY sublineage appears to have become dominant in Alberta and Saskatchewan. (1/9)

#COVID19AB
#COVID19SK This is a bit technical, but as you can see in the phylogenetic analysis below, the strain appears to have originated from Idaho and then spread quickly throughout all of Western Canada. (2/9)

#COVID19AB
#COVID19SK
Nov 7, 2021 7 tweets 2 min read
"Hi Alex. My 11 year-old is ready to get vaccinated. BUT, he/she turns 12 in less than a month. Should I wait and get the higher 30 μg dose of vaccine at age 12, or just go ahead & give the lower 10 μg dose right away?"

Answer: DON'T wait, go right away.

🧵 below. (1/7) The appropriate dosing of vaccine ISN'T dependent on weight, but rather their age. The immune system of a 'small' 11 year-old is functionally the same as a 'large' 11 year-old. The immune response isn't weight-dependent, per se. (2/7)
Oct 27, 2021 7 tweets 3 min read
"Hi Alex. If vaccinated folks can transmit #COVID19 like unvaccinated folks, why get vaccinated? Negative testing is good enough!"

Fully vaxxed persons transmit #COVID19 at FAR LOWER LEVELS than unvaxxed persons. Rapid antigen testing has limitations.

🧵 below to explain

(1/7) If you're fully vaccinated, your chances of getting #COVID19 infection are MUCH lower, so your chances of transmitting are ALSO much lower too.

If you're fully vaccinated but still get #COVID19, you clear the virus MORE quickly, so you're less contagious overall.

(2/7)
Oct 27, 2021 4 tweets 3 min read
"Hi Alex. Do #COVID19 vaccines affect fertility? Should I get it if I'm pregnant?"

There's SO MUCH misinformation about how COVID-19 vaccines aren't safe in pregnancy or can affect fertility. THIS IS NOT TRUE.

Excellent link 👇 & short 🧵.

(1/4)

pregnancyinfo.ca/covid/ All the information we have with billions of doses of #COVID19 vaccine given is that there's NO EVIDENCE that COVID-19 vaccines affect fertility at all.

Every person, whether actively trying to conceive or just thinking about conceiving, SHOULD be vaccinated.

(2/4)
Oct 27, 2021 15 tweets 4 min read
The benefits of vaccinating ALL children b/w ages 5-11 with Pfizer #COVID19 vaccine OUTWEIGHS known or potential risks.

A long-ish 🧵 on data & risk/benefits thus far.

As an ID physician, I'll vaccinate my 5 year-old w/ confidence, and recommend to others to do the same.

(1/n) #COVID19 is a serious infection for all kids.

Although kids who acquire COVID are at much lower risk of death than adults, other complications can occur after recovery from acute infection, including Multisystem Inflammatory Syndrome (MIS-C), and Long #COVID.

(2/n)
Oct 24, 2021 19 tweets 9 min read
A LONG explanatory 🧵 on ICU 'capacity' & 'flow' in Saskatchewan & why we need MULTIPLE interventions to avoid compromised care for ALL #SK citizens & triage.

I'm going to use an analogy of ICU capacity = bathtub. Patients = water. Health care system = house.

1/ #COVID19SK Water is running into the bathtub. That's all the patients who need ICU care in Saskatchewan. Some have COVID, some don't. The patients have now overflowed our ICUs.

To cope, we've built walls up on our bathtub to hold more water. That's our 'surge' capacity.

2/ #COVID19SK
Oct 22, 2021 8 tweets 7 min read
Summary 🧵 of last night's SHA "town hall" for MDs:

- Overall #SK test positivity ~14%
- Cases declining, but so is testing
- #SK has HIGHEST current case & death rates of all provinces
- HIGHEST ICU census per capita of ANY province at ANY point in pandemic.

1/ #COVID19SK Vaccine & mask mandates have helped, but not enough. #SK remains in exponential growth & cases NOT coming down at this point.

Public health experts @SaskHealth recommend gathering restrictions, including limits on household gatherings, capacity limits, etc.

2/ #COVID19SK
Oct 21, 2021 11 tweets 6 min read
This is an explanatory 🧵 on ICU capacity in Saskatchewan, the different levels of ICU care & support provided across #SK, and why freeing up ICU beds in Regina & Saskatoon is SO important right now for us.

Put plainly: "not all ICU beds are equal"

(1/n)

#COVID19SK Not all ICU "beds" are created equal. There's different capability levels to provide support for complex patients depending on the expertise of available doctors, nurses, respiratory therapists, and specialist support. (2/n)

#COVID19SK
Oct 20, 2021 6 tweets 5 min read
Some data slides released today @SKGov w/ accompanying discussion via Dr. Shahab.

Short 🧵 w/ commentary.

First, being unvaccinated in #SK = 28X risk of ICU admission, 13X risk of hospitalization, and 6X risk of getting COVID vs. being fully vaccinated. (1/6)

#COVID19SK Second, ~50% of all persons admitted to hospital in October had 1st positive COVID test on/after being admitted. This informs approach to early therapy, monoclonal Abs, etc.

Earlier testing & identification of illness clearly ideal. (2/6)

#COVID19SK
Oct 2, 2021 13 tweets 11 min read
Oct 2, 2021 7 tweets 6 min read
Kudos to ALL #SK MLAs who have shown support for masks, vaccines & #SK HCWs via #SKMLAchallenge.

This 🧵 CELEBRATES our #SK MLAs by compiling their posts.

It's BOTH REFRESHING & EFFECTIVE to see unified public health messaging from our elected leaders. Thank you!

#COVID19SK Hon. Warren Kaeding (@wkaeding), MLA Melville-Saltcoats

#SKMLAChallenge
#COVID19SK