Physician-epidemiologist, inactive account

Toronto, Canada
Ford owns this disaster. He has repeatedly refused to do what he needs to do. Elect a clown, expect a circus. I'm fucking done.
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The mild disease that causes a 1900% increase in risk of heart attack, stroke or pulmonary embolism in the week after infection. Don’t worry, after a year your risk is only increased by 30%.
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Yes I did just get told to remove an N95 and replace it with a flimsy surgical mask on entering a hospital. No, I did not do so. But wow, we have some educating to do.
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Masks for airborne disease are like boil water advisories for waterborne disease. Measures that you use to keep people safe while you build infrastructure and change regulations…let’s get going.
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We need to believe what other countries tell us, for the most part. When India says watch out, delta plus is more infectious, believe them When Scotland says delta has higher morbidity: believe them When Israel says we wanted to drop the masks, it didn’t work out: believe them
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I had the opportunity to reconnect last evening with a colleague who now runs a long covid clinic. He is busy. He told horror stories. Avoid infection if you can.
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One of the most impressive things about @JustinTrudeau ’s leadership: his ability to use the talents of his team to the full, and stand back as others get praise for their excellent work. Not sure people understand how unusual that is.
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I have no confidence in the government of Ontario to make good decisions that keep Ontarians safe. No confidence whatsoever.
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It is with mixed emotions that I have decided to resign from Ontario’s science and modeling tables. I wish every success to the colleagues who remain on these tables. Ontario needs a public health system that is arm’s length from politics.
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Per a colleague who wishes to remain anonymous: 300 kids in the pediatric ER at Sickkids yesterday. The word they chose: “chaos”.
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If you didn’t ask whether being a high school dropout made one underqualified to be premier of Ontario, then kindly fuck off about whether a Rhodes Scholars who edited the Financial Times can cut it as finance minister. You blatantly sexist idiot.
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Feel free to send nasty emails but I remain unapologetic in my belief that patients admitted to hospital deserve protection against acquiring new, virulent infectious diseases as a result of hospitalization. I thought this was foundational and uncontroversial.
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Waiting for critical illness or death in children before you change course runs directly counter to the mission of public health, which is prevention.
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I have no security or military background whatsoever, but the fact that people have been able to stockpile large quantities of gasoline and propane in proximity to government buildings strikes me as, self-evidently, bananas.
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Again, your immune system didn't go all flabby because there's was no flu season in 2021. Your immune system works hard, all day, every day, because you don't live in a sterile bubble.
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Honestly, my only constructive suggestion for people in Ontario: next time, vote.
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It’s not anecdotal anymore. We have the science now. Sars-2 is causing a surge in cardiovascular deaths in young and middle aged people onlinelibrary.wiley.com/doi/…
The anecdotes of sudden death in young- mid age adults is like nothing I’ve seen in my career as a cardiologist. At what point does “anecdotal” evidence translate into urgent investigation & consensus documents to empower us to prevent these terrible outcomes? #MedTwitter
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That we're headed for a humanitarian catastrophe and Cabinet doesn't want to shut down construction sites tells you everything you need to know about who calls the shots in Ontario right now.
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I will do everything I can to help Ontario get rid of @fordnation ’s government in 2022. They are just a travesty.
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If you think wait times at airports are long, you obviously haven't been to an emergency room lately.
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More good news on sars-2 vaccines: they appear to prevent long covid (we've been waiting for answers to this question). A propensity matched cohort from the UK found that 2+ doses of vaccine decreased adjusted long covid risk by 41% (95% CI 31%-50%).
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Perfect. Thanks to the friend who sent this
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Not to be a party pooper but test positivity is going vertical in Ontario again.
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I fear what our pandemic response will look like under a national conservative government. For people in my field, memories of the weakening and muzzling of public health under PM Harper are pretty fresh. Vote, and vote wisely.
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Your periodic reminder that the time to act to prevent what we’re seeing right now was a month ago, and people who know what they’re talking about said so at the time. None of this had to happen. It’s criminal.
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It’s pretty clear that most people in Ontario don’t care about this, but I would note that covid hospitalizations in children < 10, and in elders over 70, are currently far higher than they were in summer of 2020, or summer 2021.
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Nobody ever says: "Yes, a few dozen people died of a communicable disease in our province today. But on the other hand, people need to be able to eat a cheeseburger indoors." Know why? Because it's obscene.
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Wheels now falling off. Not really much to say. Will keep providing data updates where possible but I don’t think you can turn this around now. The incompetence has been staggering. If people forgive/forget and re-elect these clowns, we really do have the government we deserve
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To kind friends writing "I'm sorry you have to deal with this stuff"...please don't be. Not my first rodeo, I have a thick skin, and the lashing out means we're being effective. Don't stop...keep the pressure up...actually, push harder, because we're getting there.
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This is an amazing figure. Countries that aimed for covid elimination actually had LOWER stringency of pandemic control over much of the pandemic. In other words, when governments try harder, life is MORE normal, not less (bottom panel)
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This is sort of adorable: @uoft has got rid of mask mandates on campus, but there’s no towel service in gyms “because of covid” Tell me you don’t know how this disease works without telling me you don’t know how this disease works
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Wow...my own hashtag :) Thank you all so much for your support, and for the many kind messages and emails. It's neat to wake up to a 1-2 thousand more twitter followers and all this kindness.
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I think there’s reason to worry that what sars-2 is doing to hearts it’s also doing to brains, including young people’s brains. I think western countries will look back on their current laissez-faire approach to this virus with great regret
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When did “conservative” shift its meaning from “it ain’t broke, don’t fix it” to “break it aggressively so we can privatize it”?
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It’s pretty astounding to me that we live in a rich province that didn’t just fail to make schools safer in the face of omicron, but actively made them less safe for our kids. It’s nothing short of monstrous.
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Your periodic reminder that Nunavut, NWT, Yukon, PEI, Nova Scotia, Newfoundland and Labrador, and New Brunswick share a federal government with the COVID-6, and they have controlled this pandemic as well as Australia and New Zealand. (Check the fridge, Doug).
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The saddest and most frustrating aspect of the pandemic right now is getting emails from people whose kids have neurological or cardiac issues, or have died, after seemingly mild covid. These are preventable injuries and deaths.
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Learning from pollsters today: an OVERWHELMING majority of Ontarians continue to mask in public indoor spaces. The figure is around 70%, despite no requirement to do so. Why are we allowing our province to be held back by a small and disinformed minority?
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Opinion: you don't get to play footsie with literal Nazis, and then clutch your pearls and wrap yourself in your Jewish heritage when you get called out. We have a word for that: shanda.
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This is just remarkable. SARS-cov-2 rna eliminated from hospital ward air by air filtration. Which also removed a number of other bacterial and fungal pathogens. medrxiv.org/content/10.1101/… The before-after here is amazing. A who’s who of nosocomial pathogens. @VicLeungIDdoc
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I just wanted to let you all know that I’m no longer going to wash my hands after I wipe, unless you ask me to
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For the “everyone’s gonna get omicron” crowd: maybe. But consider the difference between waves causing erosion over time, vs a tsunami. The issue is immediacy and magnitude. Especially when we have unused tools (like booster vax) that can blunt impact.
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Replying to @rupasubramanya
Well, no, Rupa. That’s why RSV disappeared during the pandemic. Having the virus filtered by the mask, and hence on the mask, means the virus didn’t get inhaled and make you sick.
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Calling it: if Ford is re-elected it’s going to be slash-and-burn for public health units in Ontario. I am not wrong.
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At last night's @OntEdWorkers town hall @birgitomo suggested that @fordnation, @Sflecce, @celliottability or others from Cabinet come spend 4 hours with her on an ICU shift so they can understand what's happening. How about it, leaders? 4 hours on a critical care nursing shift?
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If any journalists are interviewing folks who signed the Ontario doctor letter today, could you please ask them whether their school-aged kids attend public schools in our province? I have it on good information that quite a number of signatories do not. It's relevant.
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Stop. Voting. For. Assholes.
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It's a sad state of affairs when healthcare workers are leaking memos to me to get them on twitter, because (a) they can't speak out for fear of losing their jobs and (b) the number of journalists (while non-zero) who will follow up on this is quite low. Here's a @UHN memo:
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If we get our drivers' license sticker refund before the election, I will be dividing the amount in half; 50% to Ontario Liberals and 50% to the Ontario NDP. Would encourage others to do the same.
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Gotta say, making a distinction between 10,000 person indoor occupancy and 15,000 person indoor occupancy in Ontario based on whether patrons are sitting or standing implies no understanding whatsoever of what aerosol is or how it works. If you don't laugh you cry.
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Over 70% of Canadians think abrupt, premature abandonment of public health measures would be dumb, and they're right. Fixed it for you, @CP24.
Poll: Nearly 30% of Canadians say it's time to 'learn to live' with COVID-19 cp24.com/news/poll-nearly-30…
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Replying to @jengerson
Bad take. She did this in a clinic between patients. Frankly it’s great role modeling, and shows what a non-big-deal mask wearing is. I’ll be lecturing today in a mask, and wear it alone in my office at u of t because air is shared
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Now that Lancet covid commission has identified failure to recognize and act on airborne transmission as one of the key failures of the pandemic, perhaps we ought not look for policy guidance to people who still can’t say the word “airborne” Just a thought
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Hearing from a teacher in DMs who tested + for COVID Dec 31, remains symptomatic, and has been told to go to school tomorrow because that's 5 days. No follow up testing. The new Ontario. This is the antithesis of public health.
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The Federal government needs to invoke the Emergency Measures act and step in in Ontario. You can’t abandon Canadians to a government that doesn’t give a goddamn about them.
This is a must-watch. @DrKaliBarrett on COVID-19 in Ontario.
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40% of Canadians have “underlying medical conditions” I’m not sure people understand how offensive this is, and how it devalues a large segment of the population.
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The Premier failing to show up in the province’s second largest city, after it suffers a natural disaster, should be front page news. Right? What am I missing?
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I'm not Conservative, Liberal, NDP or Green. I just like competence and decency in government. Ontario needs a new government.
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Heartbreaking note from a teacher in southern Ontario. Kids from their school are in the nearest icu. The principal adamantly refuses to discuss the possibility of masks in schools. What have we become?
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Prediction: Other countries making Canadians get vaccinated to travel is going to do wonders for vaccine uptake in Canada (already very good).
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Seems to me the major story for the media now is that a bunch of hooligans can disrupt daily life in a major Canadian city, with no apparent effort to restore order from law enforcement.
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Failure of police to do their jobs takes us to a very dangerous place, because it creates a sense that the public needs to defend itself. The failures of leadership and derelictions of duty are just astounding.
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Our current government is NOT supported by 65-70% of people in Ontario. But they’re going to get another “majority” because @OntLiberal and @OntarioNDP can’t or won’t work together to show them the door. How depressing.
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Stop doing dumb shit and I’ll stop being negative
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Time for the anti-vaxxers to stay home. The rest of us deserve to get our lives back.
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Usually I hope my predictions are wrong. Not this one. I think kids have been the dark matter of the pandemic. I think vaccinating 5-11’s is going to be very very impactful in Ontario.
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This morning: A homeless man sleeping on the sidewalk had his arm amputated by a heavy truck driving into a construction site. People called 911 but were put on hold and told to leave callback numbers. If anyone has a more perfect metaphor for life in Toronto right now, LMK
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I'd like to thank the antivaxxer-loonbat brigade for allowing me to frame today's delicious @Chapmans_Canada ice cream purchase in terms of support for public health in Canada. #Yum.
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Canadians are being played for rubes on private sector takeover of healthcare. It may work. I think any of us who have worked in medicine on both sides of the border can tell you: be careful what you wish for.
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I don't know who made this but it's pretty much spot-on. h/t @ChasBeekeeper
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Insurance companies and actuaries are now doing the public health surveillance in western countries. Public health agencies are too busy hiding data and telling people everything is fine.
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Canada’s omicron (b1) wave is heading to the finish line. That’s great, but we’re wasting an opportunity to make this wave our last by using vaccines, clean air and testing.
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I don’t want advice on reopening or schools from people who can’t even acknowledge that covid is airborne
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This is just total crazypants stuff
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Don't get me wrong. Shutting down interprovincial travel protects other provinces from Ontario, and that's a very very good idea for Canada right now.
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Pediatric covid hospitalizations are rising quickly in Ontario. Well done, CMOH.
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Endlessly confronted by how frankly miraculous covid vaccines have been. I've spent most of today finishing a paper on covid in pregnancy. Had to drop a bunch of analyses related to vaccines because vaccinated pregnant people don't go to ICU in Ontario. Like: at all.
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Nobody to restrict outdoor stuff. The word "non-essential" ahead of construction is the tell. They're not closing construction...because it's all going to be essential. @JustinTrudeau please consider the Emergencies Act. We need leadership from a government that cares about us
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The blizzard of distraction coming out of @fordnation and his assorted flying monkeys is by design. It’s a comms strategy. They need to distract you from: 1. Botched vaccine rollout 2. Massive death toll in long term care 3. Muddled and confused back to school plan
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Here’s the thing: there’s not actually much uncertainty at all about the epidemiology of sars-2. If you wanted to save lives and protect health, the course of action would be clear.
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Anecdotally (reliable source) I’m hearing that some of the children with mystery hepatitis are now developing mystery aplastic anemia. If you think liver transplants are no big deal, wait til you find out about the minor procedure called “bone marrow transplant”
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I’m excited for Toronto media outlets to have the experts who told us all that omicron was no biggie back on the shows this week, so they can explain how they got something so obvious so completely wrong. And I guess maybe apologize for helping crash our health system into a tree
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The federal government bought 50 million popsicles, and gave them to me. I have them in my freezer. Yummy. When I got the popsicles, I told the feds I'd give them out for free. But I'm worried that that'll cut into the profits of my friend, who owns a chain of popsicle stores.
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For the same reason they avoid naming domestic terrorists, media outlets should consider a blackout on hospital protests. You’re giving the organizers what they want, and reinforcing bad behaviour.
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A bit of a thread about failure to innovate. For the past two years, we’ve had a remarkable decrease in transmission of flu, as well as a bacterium called Strep pneumoniae, which causes most cases of bacterial pneumonia for which a microbiological etiology is known
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Congratulations, @JustinTrudeau. Congratulations, Canada.
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With this mornings news about J and J vax, I’d like to reiterate how grateful we should be that Canada invested in a diverse portfolio of vaccines. Thank you @AnitaOakville @PattyHajdu @cafreeland
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Apparently this needs to be said: |-------———--| | PFIZER | | AND | | MODERNA. | | ARE | | INTER- | | CHANGEABLE| |--------———-| (\__/) || (•ㅅ•) || /   づ
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A reminder ahead of todays very serious Ontario press conference: masks are the easiest, cheapest tools we have for further reducing disease transmission right now
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This is so good. #BalancedResponse
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Long covid with neuro symptoms: Not real enough to be factored in to disease prevention plans Real enough for drug trials Cool
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The Moore Wave is here. Predictable, preventable, inexcusable.
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