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Dec 10, 2022

Thread of science and data-focused articles and threads on #covid19. 1. The case for temporary and targeted mask mandates

The Case for Mask Mandates

A review of Canada's current post-mandate status, evidence supporting temporary and targeted mask mandates, and critical success factors.

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Update: Upon reflection, I will not be locking the account today. If I did, people would not be able to access and share info, including past 🧵's. I will leave it open but dormant. If I do lock it later, it will be because of excessive glomming of disinformation to past tweets.

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16. I think things will get better but we need to work at it, not assume it will happen or that someone else will do it for us. Remember, every infected person got infected by someone else. Try not to be that someone else who did less than they could have. At least wear a mask.

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14. Do not minimize bad news. Do not minimize good news. Maximize facts and real news and let people absorb it. You owe them that. 15. Look after yourself and others.

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12. Remain objective. When sharing advice, data, or science, keep it separate from politics and other agendas. 13. Use bookmarks and create a list on twitter with your experts and sources; use it regularly to share and inform.

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10. Do not stop using rapid tests (properly) until things improve dramatically from where they are right now, especially if you are 60+ or are in contact with those 60+. 11. Fight for indoor air quality. It's the future but is needed now.

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9. Do not trust any source that naively relies on faulty or incomplete data, such as cases or underreported recent trends, eg PHO data on deaths and hospital admissions.

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8. Learn to manage your risk in a way that is not extreme in either direction. Live your life but do it smartly based on a situation assessment. Continue to rely on data and consensus science over politics and appointees. Rely on your critical thinking.

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7. Recognize that the political version of public health in 2022/2023 is mainly ableist and driven by a majority that perceive lower risk. PH and govts are less inclined to do much to protect those who are more vulnerable. Act accordingly.

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6. Keep your vaccinations up to date. When infection levels are high (or hospitalizations or deaths if no data), shorten your dose interval below 6 months if you are at higher risk.

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3. Follow the deaths. Question any attempts to underreport, distort, or hide them. 4. Follow expert accounts on every covid topic, from stats, to hospitals, long covid, and variants. 5. Wear an N95 mask or better in public indoor spaces when transmission remains high.

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1/16 🧵Last day reporting on covid here. Some final notes: 1. Don't accept the takeover of social media by those who encourage covid disinformation and pay-for-influence. 2. Don't allow public health and govs to escape scrutiny for their 2022 abdication of responsibilities.

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With only a handful still showing interest in the weekly Ontario charts, I will stop producing them. I will also be leaving this Twitter account locked and dormant at year end. Thanks for following and take care of yourselves. ♥️

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Enjoy your holidays and take care. ❤️

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7. Note: I'm no longer reporting official gov death counts since they changed the reporting to date of death. As you might guess, that means the numbers are underreported since if Joe died on Tue, it's very unlikely the Ontario death process has Joe in the system now.

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6. Note: The above level of estimated infections, if accurate, should sustain 500+ Omicron deaths per month.

IHME model estimates approximately 55,000 Omicon infections today in Ontario. They estimate that 80% masking would have brought that down to under 32,000. #onhealth #COVID19 covid19.healthdata.org/canada/ontario

Ontario pediatric ICU patients currently at 106 (80.9% of capacity). #onhealth

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4. Vaccine uptake, from Ontario open data files.

3. This sort of rise in PCR test positivity would normally lead to a rise in hospitalizations. We are not seeing that yet.

2. 7 day PCR test positivity for those eligible* continues to climb, now 13.5%. * eg high risk groups like seniors, HCW's, LTC's.

Ontario weekly #covid update. #onhealth 1. Hospitalizations remain flat, only up 10 from previous Tuesday.

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What is going on with our immune cells after COVID-19 infection? This thread will explore some of the impacts of COVID infection on our immune system even after people are recovered including: - Missing naive T-cells - Exhausted T-cells - Loss of B-cell maturation 🧵1/

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Update: When I wrote this thread flu was low incidence, now it's high. But if you have flu-like symptoms, do NOT assume it's the flu. Take a covid rapid test. If it's positive for covid-19 and you are eligible, look into getting Paxlovid pills asap and isolate.

*10 times) More on RAT's:

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Oct 14, 2022

I see anecdotal "rapid tests don't work anymore". I have seen no scientific evidence to support the statement. You need to know that: 1) With Omicron and vaccinations, RATs may not test positive until ~day 5 after exposure or symptoms. 2) Need to swab throat and nose

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Five tips that could save someone's life this holiday season.

Five safety tips for the holidays

How to reduce your risk of an Omicron or respiratory virus infection when gathering with family and friends.

Questions about masks? Is everybody an expert? This might help clear the air.

The science behind masks and their use

Evidence for masks, why they work, which work best, how to use them, and when and where they are most needed.

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Angus Reid Institute finds more than half of Canadians supportive of re-implementing mask mandates if #COVID19 rises this winter." #BringBackMasks #WearAMask Survey: angusreid.org/covid-unmasked My write up on why mask mandates will help:

The Case for Mask Mandates

A review of Canada's current post-mandate status, evidence supporting temporary and targeted mask mandates, and critical success factors.

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I used IHME daily infection estimates, Ontario open datafiles on daily total vaccination doses, and UKHSA expert consensus on vaccine protection by time interval after a classic Pfizer booster. So waning assumptions are approximate.

Estimated Omicron infection levels in Canada. Short summary: between 100K and 200K newly infected per day. Over a million currently infectious. Smart idea to take proper rapid tests (oral and nasal swabbing 10 before gatherings, whether feeling symptoms or not. #CovidIsntOver

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2/ to your personal immunity level by getting a timely bivalent booster update and wear an N95 mask in indoor settings. Rapid tests, ventilation and filtration can all make home gatherings less risky as well.

This is something I was thinking about and have made a first attempt to approximate the relative level of immunity the Ontario population has vs Omicron after factoring in vaccination and infection timing and waning of last doses/infections. You can add ⤵️ #onhealth #covid19

Ontario respiratory virus hospital admissions. While the current trend in younger ages is welcome, let me point out that deaths for covid, flu, +++, are greatest among seniors and their admit trend has been extraordinarily high for months. #Maskup

Immunological dysfunction persists for 8 months following initial mild-to-moderate SARS-CoV-2...

As for evidence on covid affecting immunity for extended periods in at least some portion of the popn, I personally attach weight to this evidence. Dysregulation of our immune systems is not something to be ignored. #onhealth #covid19

nature.com

Nature Immunology - Phetsouphanh and colleagues show that individuals with long COVID have persistent activation of the innate and adaptive immune system at 8 months after infection and define a...

From my Mastodon: repeating and adding to what some others have said re so-called "immunity debt" and inaccurately blaming masks. It is, in polite terms, evidence-challenged. Look at Sweden, masking, and RSV surges. #onhealth #WearAMask mstdn.ca/@Billius27/109

While ON PCR testing by age is lagged in gov reporting and is only for those eligible, it does help predict where hospitalizations may head next. The 65+ trend is the one you need to pay most attention to. Wider pharmacy paxlovid availability may also affect this trend in future.