Don Vinh
@DonaldVinh
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Infectious disease MD. Medical Microbiologist. Clinician-Scientist (Inborn Errors of Immunity). Clinical section head (ID-Heme/Onc/Transplant). FellowCIS. FIDSA
MUHC / RI-MUHC
Joined March 2016
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If “everyone is tired of wearing masks” means we don’t wear masks, the government should also know that “everyone is tired of paying taxes”
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My major concern: abandoning all public health/safety efforts, because of "endemic delusion", is essentially rolling out the red carpet for the next big surge (followed, of course, by the "we didn't see this coming" response).
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That's not how air works
Masks no longer mandatory in Quebec workplaces as long as there are physical barriers
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Blue surgical masks are NOT better than N95.
No physician wears a blue surgical mask to go into the room of a patient with tuberculosis, measles, or varicella (despite most being immune to the last 2).
Why?
B/c blue surgical masks do NOT protect against airborne transmission
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Stranger coming up to me, without a mask: "Hey! I see you on TV! Talking about COVID!"
Me: "Did you hear the part about me saying that we need to continue to wear 😷 indoors?"
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Very tragic:
One of my immunocompromised patients.
41 yrs old
Fully 💉
Caught COVID (suspected Delta; confirmation pending), before 3rd dose.
➡️ respiratory failure, needing ICU.
Then deteriorated. Found to have intracerebral bleeds
👇 is why we need to 💉EVERYONE. 😷. Distance.
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So, if the hepatitis/super-antigen hypothesis holds true:
COVID + adenovirus = bad.
We also know that
COVID + flu = bad.
I see a common factor here 🤔
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If these 13 suspected cases of monkeypox are confirmed, and the start of an outbreak, let’s hope that we’ve learned something over the last 2+ yrs in outbreak control
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The hospitalization “from” vs “with” COVID is irrelevant. Here’s why: Backlog (a simplified explanation):
Let’s say that, of the current hospitalizations, 75% are “with” (3/4).
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Risk for CoV-2 infection is 1000 times greater after exposure to airborne virus particles than contact with a contaminated surface
Monitoring SARS-CoV-2 in air and on surfaces and estimating infection risk in buildings and buses on a university campus
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Presser prediction:
* We didn't see this coming. But, it was expected.
* We're not going to re-implement safety policies. Everyone is individually responsible for their safety. If you want to know how to keep yourself safe, look at all the safety measures we removed, but do them.
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Beware the false dichotomy:
No one is saying that kids at home is better than kids in school.
Everyone is saying that kids SAFELY in school is better than kids in school
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Should we let people get infected, so they could develop immunity?
No. That’s the opposite of what medicine does.
We don’t encourage people to get UTIs or cancers to build immunity against future UTIs or cancer.
My latest 🤔 💭
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Je continuerai à porter un 😷 pour protéger mes patients et ma famille.
Pour les personnes Immuno-déprimées et leur famille, je vous conseille de faire de même.
On n’est pas encore sorti du bois!
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@frozen
@Jul101Vie
@CDCofBC
I don’t agree. Your immune system is not a muscle. You don’t lose it if you don’t use it (from being in isolation).
Proof? Astronauts. Antarctic overwintering Teams. Submarine crews. None show immune deficiency or immune paralysis after coming out of isolation.
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Good news: If all goes as anticipated, updated COVID 💉targeting XBB.1.5 may be distributed in ~2 wks in 🇨🇦. Appears to be effective against EG.5.
If we're going to capitalize on mRNA technology to 'rapidly' update 💉, the reg process will need to be more PROactive, not REactive
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Public health agencies, like the CDC, are struggling between scientific credibility and relevance, and job security.
Instead of leadership, we’re getting “Lord of the Flies”
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I wonder if McKinsey is behind the global "hospitalized with incidental COVID" movement
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How different the world would be if we stopped thinking “I have rights”, and instead thought, “I have obligations”.
Serving self vs. Serving others.
Only 1 leads to a better society.
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A ce stade, il serait plus sécuritaire pour nous de ne pas avoir d'agence de santé publique provinciale.
La Santé publique abandonne la période d’isolement de cinq jours via
@lp_lapresse
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Is it concerning that we have a federal reserve of maple syrup, but didn't have a federal reserve of PPE ??
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Why are we seeing an📈?
The 4 V’s:
Variants: BA2.12.1 and esp BA4/5
Vaccination: poor uptake of 3rd & 4th doses. Waning of previous dose (3+ months ago).
Vanishing Public Health interventions
Ventilation upgrades are lacking
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📈 in COVID
📈 in flu
Data showing COVID + Flu = ⬆️chance of death
Keep your😷indoors. Everywhere, including schools & workplaces.
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You know what happens when there is global inequity in research ?
Infectious Diseases 'over there' end up here, and then we find out our knowledge base on that germ is profoundly weak
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Can we at least see THIS one coming? 👁 👁
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@DrMakokis
@NeilMaha
I have had this happen to me SO MANY times. Literally, in the middle of talking (after having waited my turn), and then interrupted (intruded). Like I’m nothing. Worse, some of the sales people’s response is to kowtow to the intruder
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Le fait qu’ils soient capables de protester démontre - très clairement - que personne ne menace leur « ostie de li-bar-té »
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Dr Boileau à
@OFF_TLMEP
Décevant que
@guyalepage
posait des questions sérieux.
Et avec une période fixe pour répondre aux questions, la comédienne niaisait en parlant des 💉dans le café et qui a gagné la loto-vax.
On remplace le roi des fous avec l’idiote du village?
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If we have a provincial public health agency to manage COVID, but actually have no public health policy against COVID, and instead, it's an individual responsibility act, do we even need a provincial public health agency?
Why not re-direct funds to the actual health care system?
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When we hear "brace yourself for a difficult fall season w/ COVID", that's ~10 wks from now.
Is it possible that the 📈 NOW in community cases (based on wastewater data) & in hospitalizations is the start of that "fall crisis"?
Maybe we should be acting NOW, to mitigate it?🤷🏽♂️
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COVID hospitalizations clearly impact the health care system, beyond being hospitalized with lung infections "FROM" COVID.
Those who debate between “with” or “from” are disconnected from reality
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@WestcoastBCLife
@frozen
@Jul101Vie
@CDCofBC
I hope BC’s next strategy isn’t to release Salmonella into the food chain.... to build “immunologic” character 🙄
We avoid microbial pathogens b/c they are... pathogens.
Intentionally exposing society to pathogens is the antithesis of public health
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Potential solutions:
1) Hire more HCW personnel:
From where?
With what budget??
2) ⬇️hospitalizations of non-COVID cases: very tough.
Most people are admitted to🏥 b/c they need to be.
3) ⬇️hospitalizations of COVID cases (with/from):
THAT’s the point: 😷.💉,💨🪟
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"We cannot mandate what people wear.
It's a personal choice. If they want to wear😷, they can. If they don't, they don't. It's an individual responsibility."
Kippas and islamic veils, on the other hand....
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It’s official! Proud to be inducted as a fellow of IDSA, the world’s leading infectious disease society!
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Children CAN efficiently transmit COVID to adults...
Like EVERY other resp virus.
The chain here (camp -> child -> home -> adult) is concerning, as we are in summer camp season
Household Transmission of SARS-CoV-2 from Children and Adolescents | NEJM
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“Long COVID is 'not rare' and can develop after mild illness”
What is “Long COVID”, and what are the Canadian and Quebec governments doing to tackle it?
My thoughts 👇🏼
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Why are we not listening to the ventilation engineers?????
Here is more data.
What are we waiting for exactly?
🤷🏽♂️
Italian study shows ventilation can cut school COVID cases by 82%
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«L’immunité collective ne fonctionne pas du tout»:
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I hope that Sante Canada will equally approve and procure this vaccine to not only be congruent with NACI’s recommendations (non-preferential recommendation of all 3 💉), but to also give the public more choice
Today, we granted emergency use authorization for an updated Novavax COVID-19 vaccine that more closely targets currently circulating variants to provide better protection against serious consequences of COVID-19, including hospitalization and death.
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But the government is “afraid of angry voters”. “They’re not afraid of dead voters.”
Quebec avoids new COVID mandates ahead of fall election as hospitals fill up
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@Vadeboncoeur_Al
Et, à la fin de la journée... qu'est-ce que ça change si les hôpitaux débordent "avec" ou "à cause" de COVID?? Rien pour les TdS, le délestage, la rupture de service aux pts
C'est comme faire un débat si le Titanic coule à cause de l'iceberg ou à cause du trou causé par l'iceberg
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Opening windows as a ventilation strategy doesn’t quite work when the wind chill is -30C 🥶
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Peut être nous devrons cibler un standard plus haut que “on est aussi mauvais que les autres” ??
COVID au Québec : «on n’a pas un bilan pire qu’ailleurs», assure Luc Boileau
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Let’s be crystal clear:
You need a 3rd dose.
What if I... No! 3 doses.
But, the government said... 🛑. 3 doses.
The website says... ✋🏼. 3 doses.
The only people who don’t need 3 doses are immunocompromised people: they need 4.
"Regardless of age, reduction of the risk of death from Omicron relative to Delta more was more pronounced in people who had received a booster than in those having received only two doses"
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Au lieu de proposer de réduire les impôts, pourquoi un parti politique ne proposerait-il pas de dépenser de manière EFFICACE et RESPONSABLE les ressources et 💰 existantes ?
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People will believe a weather prediction from a groundhog, but not scientists telling you 💉saves lives??
🙄
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What an honour!
Thank you Canadian Foundation for Infectious Diseases and
@AMMICanada
!
An additional honour because it’s named after my previous program director and mentor
Thanks to all who nominated me, and who I’ve been fortunate enough to help guide over the years
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I’m going to continue wearing a 😷 to protect my patients, as well as my family.
For patients with weakened immune systems, and their family members, I would advise to continue as well.
We’re not out of the woods yet!
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Est-ce qu’on a perdu notre humanité envers les personnes hospitalisés, ceux qui sont décédés, et ceux avec les séquelles de COVID?
Bientôt 15 000 morts au Québec | « On a oublié les visages derrière ces chiffres »
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Let's also hope (really really hard) that 'experts' don't recommend to 'stay away from monkeys' as the major PH plan
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Hurting McGill and Concordia will NOT make the francophone universities stronger.
What a dangerous decision
Allison Hanes: Legault is setting up McGill and Concordia to fail
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2 days ago, our health care system was at the “point of no return”
Spoke about it on CNN
2 days later, everything is 👍🏼... 🤔
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M. Ministre: Peu importe « avec » ou « pour », ils sont « à l'hôpital » avec une maladie évitable, et les TdS doivent les soigner avec des mesures spéciales, qui enlèvent les soins des autres.
#COVID
Plus de 2000 Québécois hospitalisés
«Il y en a la moitié des hospitalisations ce sont des gens avec la COVID, ils ne sont pas à l'hôpital pour la COVID» -
@francoislegault
#polqc
#assnat
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Étiez-vous exposé à qqn infecté/malade (surtout une proche), mais vos tests étaient toujours négatifs? Nous aimerions vous étudier (et la personne qui était+)!
Contactez nous SVP: muhc.covidbb
@muhc
.mcgill.ca
L’énigme de ceux qui résistent à la COVID-19
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If we’re going to abandon public health measures, can we at least cancel the public health budget and do something useful with it, like transfer the funds to schools or hospitals?
Taxpayers are paying a lot for PH news briefings and PH coffee breaks during remote “work” 🛌.
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COVID is making a comeback
My thoughts below 👇🏼
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Si vous pensez qu'il faut être "malade" pour être "en bonne santé", il y a un problème majeur...
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If you've ever had a medical test done, you can thank a medical laboratory technologist.
Unsung heroes, in the labs, doing Micro, Hematology, Genetic, Biochem, or Pathology tests, so that you can have a diagnosis, and get the right treatment.
Thank you!
@cusm_muhc
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If you are an indoor space...
I. Do. Not. Want. To. See. Your. Nose.
Put your mask on properly.
Over your NOSE and MOUTH.
#CoverIt
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This is an alarming trend in many pediatric hospitals, including in Quebec.
Can we REALLY do *NOTHING* to alleviate the situation? 😷
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Quand on dit "on devrait se préparer pour un automne difficile", est-ce que ça se peut que cette "crise d'automne" est en train de débuter maintenant?
Peut être on baisse le rond maintenant, pour éviter l'eau en ébullition plus tard?
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Qqn m'a posé une question sincère sur la "dette immunitaire", selon laquelle la prévention des infections a affaibli le système immunitaire, ce qui explique les graves infections respiratoires que nous observons actuellement....
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So: Instead of 4 surgeries, only 3 COVID+ patients get done that day. Backlog -1 surgery
Now, imagine 10 OR rooms.
Are all 10 rooms at -1 by the end of the day? Depends on the number of patients “with” COVID.
Imagine the backlog of cases at the end of 1 week. And 1 month.
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I thought moving your clocks back 1 hour was REALLY disruptive.
Imagine moving it back 50 years
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Scenario 1: OR
Let’s say avg time for 1 operation: 3 hrs
In 1 day, assuming 12 hr use of an OR room: 4 surgeries should be done.
But wait! If there’s a patient “with” COVID, the OR room needs to be ventilated & staff restricted from OR space during that (say, total 1 hr).
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@GermHunterMD
Sorry to hear that AB can only manage 1 pediatric issue at a time: Sports injury vs. other diseases.
Using that same logic, Is Deena going to scrap the provincial vaccination program too?
Sorry, kiddo... you can either get your ankle sprain looked at, or the measles vax. Choose.
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The number of immunocompromised patients who have not had their 3rd or 4th doses is unacceptably low.
If you are in 1 of the following grps:
* Cancer
* On chemotherapy or immuno-suppressive medications
* Transplant (organ or stem cell or bone marrow)
You need 4 💉doses
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Anybody see a plateau ? 🧐
🤖 : 2994 hospitalisations (+117) dont 272 personnes aux soins intensifs (+9) (en date du 13 janvier 2022)
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@cdube_sante
Voici la faille dans la logique de SP:
Porter un😷 si vous avez des symptômes (recommandation
#3
), sauf si vous êtes un enfant à l'école (rec
#1
). Ceci, bien sûr, conduit à plus d'infections, chez les enfants à l'école, et c'est pourquoi les hôpitaux pédiatriques débordent.
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Scenario 2: That OR scenario also applies to rooms for: Bronchoscopy (to investigate that 🫁mass), gastroscopy (to find that bleeding ulcer), colonoscopy (rule out colon cancer), pulmonary function tests (to diagnose someone’s asthma), interventional radiology (for biopsies)
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Unfortunately, we’ve had patients (including young patients) die from post-COVID blood clots.
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Think of COVID as a toxic material (like carbon monoxide, radon, lead):
LESS is BEST
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Is there a real reason anyone uses "Microsoft Teams", other than to punish the people you're meeting with?
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Result: fewer “less urgent” hospitalizations (fewer surgeries, fewer chemotherapy). Impact? Backlog
That's presuming no nursing shortage.
Factor that in, and even fewer patients can be managed.
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Sign of a good education?
When I send my kids to school, and they're able to use their knowledge acquisition & critical thinking skills to autonomously decide to keep their masks on 😷.
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@Patrickdery
Je trouve ça incroyable à écrire, mais peut être on a besoin le retour de Horacio.. et vite? 🤷🏽♂️
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C’est quoi ce “nous” dans sa phrase?
Ce n'est pas un médecin qui s'occupe des patients.
Ce n'est pas un DSP qui a vu un rôle dans la prévention de la santé publique pour protéger le débordement de notre système de soins de santé.
C'est juste un idiot surpayé.
«Aidons-nous tout le monde.» En entrevue au «Devoir», le Dr Luc Boileau prévient de l’arrivée d’un cocktail de COVID-19 et de grippe pour Noël.
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Imagine their backlog at the end of 1 day or 1 week or 1 month. Depends on the number of patients “with” COVID.
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Ya think?
Quebec education ministry gave inadequate guidance to schools during pandemic: auditor general
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Well, if they care for 3 COVID patients, that’s 1 hour lost.
Who cares?
On a surgical ward, wound management can be an hour per patient. Same with tube management (Foley tubes, Jackson Pratt tubes, rectal tubes).
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On a chemo ward, a bone marrow biopsy (from prep to finish) can take 1 hr. Chemotherapy infusions or blood transfusions can take several hours (with vital signs assessment every hour).
If 1 nurse loses 1 hr per day (not even per shift), care of other patients may be compromised.
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Scenario 3:
Imagine a nurse who has to don/doff PPE every time they care for a COVID patient. At the end of 1 day, let’s say it takes a total of 20 minutes of his/her (I’ll use her hereafter) day for that donning/doffing per patient.
Who cares, right?
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C'est ça, la solution pour le bien-être des enfants?
Classes réfrigérées: c’était écrit dans le ciel, disent les partis d'opposition
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@OGdukeneurosurg
On the right: Both Eye Lid & Lower face affected = BELL’s palsy.
CN 7 damage. Can be painful, may require steroids, & supportive care. Resolves within a few weeks.
On the left: upper motor neuron lesion.
Left = worse
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Anyone else hearing that the fevers are not prominent and that the lesions are painful?
If so, that would be unusual for monkeypox (based on previous reports and published literature).
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@CJAD800
“any idea” ???
If only there was an idea that’s been vocalized in the last few weeks… 🤔
💡
😷
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SVP, lorsque vous êtes à l'intérieur, gardez votre masque.😷
Vous pourriez sauver la vie de quelqu'un
@CipoAPIQ
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Tomorrow, the eclipse passes.
Just a reminder:
Staring at the eclipse can damage your eyes permanently.
And, as per the example below, it can lead to irreparable brain damage:
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How come many “QC PH studies” that impact policy are not published in peer-reviewed, recognized scientific journals? Only on INSPQ website?
Maybe that speaks to their scientific rigour?
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1 M Quebecers sick with COVID
My 💭 on the current COVID / RSV / Flu issues, on yesterday's
@CTVMontreal
, and measures we (and PH) should take to mitigate its impact on our health care system
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@Jul101Vie
What we have seen, all too well during the pandemic, is that just because you have an “MD” degree, that doesn’t, in itself, actually mean you’re intelligent
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Look at that: Removing😷 in schools➡️📈in COVID cases (~45 cases/1000 students/staff)
Maybe Luc needs to read this?
Lifting Universal Masking in Schools — Covid-19 Incidence among Students and Staff
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Btw, LONG COVID does not seem to be limited only to people who had bad ACUTE COVID (requiring hospitalization).
People who had mild ACUTE COVID can still get LONG COVID (~10-30%).
Kids can also get LONG COVID.
You know what doesn’t cause LONG COVID?
💉💉💉
😷
💨🪟(ventilation)
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