THE FOURTH WAVE IS HERE!

Six hundred and eighty-nine cases today. This is a big and rapid surge. Remember that the fully vaccinated are very protected against the Delta variant. There may be some breakthrough transmissions but these breakthrough infections cause mild to moderate illness. The vaccines are less effective at preventing transmission with this variant but they are just as effective ( 93%) at preventing serious illness, hospitalization, and death. This link provides good information: https://covid-19.ontario.ca/data/hospitalizations The key is to be completely vaccinated. Find a location that gives vaccines and get one today. Until you are two weeks past your second shot ( which is 4 weeks after the first shot) you are not fully protected. Until then, we should all be wearing masks in public spaces. I am inclined to wear a mask or keep my distance in gatherings indoors or outdoors until this next wave passes. Do not be alarmed by the number of new cases each day. This is to be expected with this highly transmissible variant. One breath near someone who has COVID can lead to infection. Watch the number of hospitalized and in the ICU and remember that most of these folks are not vaccinated. God Bless them all. Remember that children under 12 are far, far less likely to become seriously ill with COVID-19. It is an extremely rare event despite the news reports coming out of the USA. If we are all vaccinated, we protect those that are not eligible for vaccination yet. Get vaccinated, enjoy the summer if you are vaccinated and remain steadfast and strong. We've got this. This week, a small group of individuals will be eligible for a booster shot. - People who have had transplants (including solid organ transplant and hematopoietic stem cell transplants) - People on this group of immunosuppressant drugs- An anti-CD20 agent (i.e., rituximab, ocrelizumab, ofatumumab) - People who are on table, active treatment (chemotherapy, targeted therapies, immunotherapy) for malignant hematologic ( blood) disorders - Residents of Long-Term Care Homes, High-Risk Retirement Homes and Elder Care Lodges. The minimum dose interval is 56 days (8 weeks) from their previous dose. Reach out to your primary care provider to learn more about how to get a booster if you are in one of these groups. Public Health will take responsibility for people in LTC and retirement homes. They do not need to call. At this point in time, two vaccines in healthy people provide good immunity to at least the 9 months mark. Stayed tuned as the smart people in charge of the monster decide when we will need boosters. Anne-Marie Please share. For non-Facebook users, you can find this post here: https://braceletofhope.blogspot.com/ And if you'd like to help Bracelet of Hope work towards making sure that Lesotho has access to these vaccines, donate here: https://www.braceletofhope.ca/ways-to-give/

Living Life with COVID until the fourth wave passes

Well Folks, it is going to be awhile before COVID-19 passes to a stage where it is endemic. What does endemic mean? It means that COVID-19 will not likely be eradicated for years to come. Instead it will be found regularly, and possibly seasonally among at risk people. The Delta variant has changed to goal posts. It is so much more transmissible than any other variant we have seen. Herd immunity will not be possible until vaccines are approved for use in kids and > 90 % are immune through illness or vaccination. What is herd immunity anyway? We have reached herd immunity with many other viruses as a result of vaccinations. Diseases like measles, mumps, rubella, diphtheria and pertussis are all illnesses rarely seen because most of the population is immune. These illnesses are harder to transmit so when say 75% of the 'herd' is immune as a result of immunizations or resolved infections, the rest of the at risk population, those who have not had the illness or not been immunized are safe. Here is a great definition: Herd immunity occurs when a large portion of the population (the herd) becomes immune to a disease, making the spread of disease from person to person unlikely. As a result, the whole community becomes protected, not just those who are vaccinated. There is a formula that is used to calculate the herd immunity threshold. It is 1–1/R0. I will leave this for the smart people to understand but, check it out. R0 is the R value or reproductive number which is the number of people 1 infected person can transmit the virus to if no protective measures are in place like masking or vaccines. The R value is used to calculate the % of people that need to be immunized to protect those who are not and push the virus into a slow, steady decline until it is eradicated or under such tight control that it rarely pops up. That's herd immunity. A new study published this month found that the delta variant is twice as transmissible as all variants that preceded it, with an R0 of 5. One person can transmit to 5 other people in a flash. (https://academic.oup.com/jtm/advance-article/doi/10.1093/jtm/taab124/6346388) That's very, very transmissible. It is way too easy to catch COVID-19 ( the delta variant). Masks need to stay on. We need to maintain our distance in a crowd or gathering if the vaccine status of the people around us is unknown. Once we reach >90% vaccinated, then we coast. There will be rare breakthrough infections but most will be mild. Few will required hospitalizations and only 3 % of the rare breakthrough infections will end up in the ICU. THAT IS WHEN WE CAN EXPECT COVID-19 TRANSMISSIONS TO ENTER A LONGTERM DECLINE. I like the sound of that; 'Longterm decline of COVID-10'. ( quoted and paraphrased from the Chief Medical Officer of Health on Ontario Dr. Kieran Moore) Greater than 90 % of the entire population, including children under 12, that is where we need to go. Vaccinating children under 12 is still months away. Children need to get back to school safely. At present, 65 % of all Canadians are fully vaccinated and 66% of all Ontarions are fully vaccinated. These numbers will shoot up once we get the kids under 12 involved. This is important. It is believed that, like last fall, the majority of the spread of COVID-19 to children will not be in the classroom setting but in situations outside the classroom like sleep overs, indoor birthday parties and gatherings and extracurricular activities. Vaccinated adults and masks will keep kids safe in school. Most kids can and do wear masks with ease. If your community has a high vaccination rate ( close to 90 % ) the kids are even more safe. The number we can change at this moment that will protect our kids in schools and out of school is the number of people OVER 12 that are fully vaccinated. At this time, 76 % of eligible Ontarions are fully vaccinated. Let's get that number to 90 % or more and our kids will be safe. If you are vaccine hesitant, get vaccinated for the safety of our children. The vaccine hesitant are not anti-vaxxers. They are hesitant for a variety of sound reasons. If you are one of the hesitant, let the protection of our children be what gives you the confidence you need. Yep, that's me. The past middle aged toilet paper bride and yes, that is a glass of wine in my hand. Everyone at this outdoor event was fully vaccinated. We can enjoy life in the context of COVID-19. We just need to be ever so careful. ( Photography by Alexandra Lennox. Thanks Alexandra!) Some great news, COVID-19 vaccines are now being rolled out in Lesotho and people are lining up in droves. Bracelet of Hope's mobile health unit is administering vaccines to people in remote areas. How cool is that!!! There is great hope. Anne-Marie Please share. For non-Facebook users, you can find this post here: https://braceletofhope.blogspot.com/ And if you'd like to help Bracelet of Hope work towards making sure that Lesotho has access to these vaccines, donate here: https://www.braceletofhope.ca/ways-to-give/

Fourth Wave and the fall.

 

Well, here we are. Wave number four. It feels different this time. It is different this time. Our current 7 day rolling average in the province is up to 427. We were as low as 151 in mid-July. At the end of April, the peak of the third wave, the 7 day rolling average was 4370! We crushed the third wave with vaccines and public health restrictions. Public health restrictions are eternally painful, bad for the economy, hard on the education of our children and young adults and terrible for our mental health.

I went to a wedding shower yesterday. Everyone was vaccinated and the event was held at Cassoulet Catering. It is a lovely venue with one large room that was basically open to the outdoors on both ends with dreamy gardens and trees surrounding us. Less than 25 indoors but much of the event was outdoors as we moved to the garden space for the silly games woman play at showers. I felt.....normal. I felt joy. I felt a little bit of hope for the future as this beautiful bride to be was celebrated properly with loving family and friends smothering her in love and laughter and in person.

That's what will be different this during this wave. We will have the ability to gather in person and as long as we do so with great care we will be safe. Showers, weddings, birthday parties, family gatherings, dinners in restaurants.. all of these will be possible as we move through this fourth wave provided that our vaccination rate continues to increase towards 90 % and we continue to wear masks in spaces where we are uncertain of the vaccination status of everyone around us. This ability to gather will protect us emotionally, allow our schools to get back to normal and allow our small and large business to have the ability to operating safely and consistently. It's the life blood of our community. I sure want it back. Being dressed as a toilet paper bride yesterday reminded me of how much I want it back.

For almost four straight weeks Ontario has seen increasing growth in our COVID-19 cases and with the number of new cases doubling every 10 days, we could see as many as 1200 new cases a day by the time school starts in a few weeks. To put this into perspective, the last time Ontario saw week-over-week case growth faster than what we are experiencing now was during a 10 day stretch in September of 2020 when the province ordered bars and restaurants to close down completely.

I really respect Dr. Peter Juni, scientific director of the Ontario Science Table. He has a sobering message for the unvaccinated: "If we continue in our current reopening path, the probability of the unvaccinated people across all age groups to experience infection in the next six to 12 months is 80 to 90 %. And the risk of complications from the delta variant in this unvaccinated group is tow to three times higher than with previous variants."

I talked to my epidemiologist husband about this yesterday and he agreed. Something called survival statistics that allows the smart guys in charge to determine that the probability of infection in the unvaccinated is 80 to 90 %. These stats are not just made up to set the fear of God into us. They are real and sound. It's sobering.

Juni describes our vaccine roll out as " absolutely successful". Vaccines will without a doubt make this fourth wave very different. Instead of focusing on the number of new daily cases, we need to focus on the number of hospitalizations. If the number of people without vaccine protection begin to become ill with COVID-19, our hospitals will fill up again. There are now 116 patients in hospital with COVID-19. If that number is driven up to 400 or 500, we will need restrictions imposed again.

Vaccines are of utmost importance at this critical time. Vaccination rates have slowed particularly among the youngest eligible vaccine cohorts 12 and up and particularly the 20 somethings.

I will post about the vaccine hesitant this week in an attempt to encourage them to get the shot. Stay tuned. In the meantime, enjoy the winding down days of summer and wear that mask when it is of utmost importance to do so.

Anne-Marie

Please share.

For non-Facebook users, you can find this post here:

https://braceletofhope.blogspot.com/

And if you'd like to help Bracelet of Hope work towards making sure that Lesotho has access to these vaccines, donate here:

https://www.braceletofhope.ca/ways-to-give/

 

The tipping point: My loving message to the vaccine hesitant.

Many times over the last several months, I have spoken to patients both young and old about their vaccine hesitancy. A few of them are in their 20's and I delivered all of them. What a privilege it has been to walk newborns through the first few decades of their lives. I have a special bond with these young adults. It breaks my heart to see them walking a dangerous path.

I think for the most part they are hesitant for several reasons. The most common I hear is that they are not confident in the science, they don't believe they are at risk ( the false assumption that this infects only the elderly and the frail), the vaccines were rushed and the vaccines are not safe. They all give me the same non sequitur: " I think I will just wait to see how this goes and get the vaccine when it appears to be really necessary.".

They are waiting for their tipping point. A tipping point is the point when a group rapidly and dramatically changes it's behaviour by jumping on the band wagon of a rapidly growing new trend, idea or behaviour.....like getting vaccinated during a pandemic that none of us have ever experienced before.

So, here is my heartfelt message to you, the vaccine hesitant; this is the tipping point. Now is the time to jump on the vaccination band wagon because in very short order as we see cases increasing everyday, and possibly bending towards a fourth wave, there will be two groups of people divided by vaccines: not the vaccinated and the unvaccinated but the vaccinated and the infected.

Based on tried and true scientific and epidemiological facts, those that are not vaccinated will eventually become infected. Even the vaccinated may get the Delta variant which is why wearing masks and staying physically distance in public remains vitally important. The vaccinated are far less likely to develop serious illness or require hospitalization. More on that at the end of this post.

More than 97% of people getting hospitalized with COVID-19 in the USA are unvaccinated and 99.5% of deaths are among the unvaccinated. (US Surgeon General Dr. Vivek Murthy). I am searching for the Canadian stats but they won't be far off.

All the common metrics of the pandemic in the province are increasing after months of decline. At present the number of people requiring hospital admission in this province is starting to increase with 89 in hospital, 115 in the ICU and 76 on ventilators (https://howsmyflattening.ca/#/dashboard). There were 106 in the ICU on August 3rd and 85 on ventilators.

At the end of July, only 0.5 % of new cases were among the vaccinated who had received two doses of vaccine at least two weeks prior to testing positive, according to Public Health Ontario. Ninety-five percent of new cases were in folks who had not yet received a dose.

My ongoing heartfelt message to you, the vaccine hesitant:

1/ These vaccines are safe with the number of side effects remaining consistently and extraordinarily low. Overall, side effects have been minimal with rare blood clots occurring in 1:600,000 with the AZ and J and J vaccine, non-life threatening myocarditis in 1:600,000 with the mRNA vaccines and true, life-threatening allergic reactions to the Pfizer vaccine is low as 2.5 per 1 million doses and these reactions were in people with a known allergy to PEG, an ingredient of the vaccine.

Minimal side effects to the vaccine, very true. What is not 'minimal' is the number of deaths due to COVID-19, which is 4.2 million world wide.

Vaccines are safe. COVID-19 is deadly, even in people under 30. Get the vaccine.

2/ These vaccines were not rushed, they were resourced. The mRNA technology used in both the Moderna and Pfizer vaccines has been developed over the last three decades. What used to take ten years to prove safe and effective took 9 months with the COVID-19 vaccines. Why? Because the world's entire vaccine scientific community focused on these vaccines and billions were invested. There are three phases to the scientific steps needed in drug of vaccine development. Each phase can take years to work through not because it takes that long to prove safety and efficacy but because it takes years for researchers to find the funds needed to move on to the next phase.

3/ Despite the latest news and research showing that even among people who are vaccinated, there is some risk of getting infected with the coronavirus, the most recent data from the US Centers for Disease Control and Prevention shows only about 6,600 breakthrough cases out of more than 163 million fully vaccinated people, and more than a quarter of those asymptomatic. Put another way: More than 99.99% of people who are fully vaccinated have not had a breakthrough case resulting in hospitalization or death. And yes, that's even taking into account the more transmissible Delta variant.

Vaccines are extremely effective even against the variants. Vaccines are safe. And I will repeat that COVID 19 is deadly.

This is the time. This is your tipping point. BE vaccinated, not infected. For those 20 and now 30 somethings that I delivered, your life has always been, in part, in my hands. That won't change no matter where you go or what you do. From my hands to my heart, please get vaccinated.

For those of us who are vaccinated, be of good cheer. That sounds ridiculous doesn't it. We will be wearing masks for a while. In the past, with each wave, increasing cases meant lockdowns and tight restrictions. I doubt we will need to go there again and I am not alone in this thinking. The high rate of vaccination in this province makes it very unlikely that we will need another blanket lockdown as cases grow. Stay safe. Wear a mask while around groups of people whose vaccination status is not known to you and be particularly careful with indoor gatherings unless everyone is double vaccinated with the last dose received more than two weeks ago.

Anne-Marie

Please share.

For non-Facebook users, you can find this post here:

https://braceletofhope.blogspot.com/

And if you'd like to help Bracelet of Hope work towards making sure that Lesotho has access to these vaccines, donate here:

https://www.braceletofhope.ca/ways-to-

The incredibly transmissible Delta variant and....chickenpox!

 

The news is not good but there is something we can do about it.

The Delta variant is more transmissible than......

related caronaviruses like MERS and SARS

ebola

the common cold

seasonal flu

the 1918 Spanish flu

and smallpox.

The Delta variant is less transmissible than.....

measles

and chicken pox....but not by much.

Remember the R value? It is the the average number of people that will be infected by one sick person. An R value of 7 means that, on average, one sick person will infect seven other individuals.

Measles is one of the most infectious pathogens we know about with an R value of 12-18. Measles is so contagious that up to 90 percent of people close to an infected person who are not immune will also become infected. ( stat from the CDC).

Chickenpox has an R value that ranges between 9 and 12. On average, for example, one child with chickenpox can infect between 9 and 12 other children in close proximity.

Do you remember 'chickenpox parties'? I do. Before the chicken pox vaccine, people would take their children to the home of an infected child so that their child could get chickenpox before the age of five when serious illness was less likely. It sounds archaic today. Imagine subjecting your child to that. Frankly, most of us got chickenpox just by sitting in the grocery cart while our parents shopped. It was everywhere at certain times of the year. No parties were really necessary but parents did panic if their child had not had chickenpox before they were school aged. I remember my children suffering for days with the 'minor' illness caused by chickenpox. I remember suffering myself.

Do you hear of cases of chickenpox or measles anymore? No. Not in this country. Why? Because of vaccines. The measles vaccine was created in 1963. The varicella vaccine, for chickenpox, was introduced to North America in 1995. Too late for my kids.

And COVID-19? The initial COVID-19 virus, R value of 2.3-2.7 the Alpha (United Kingdom variant), R value of 4-5. The Delta variant has an estimated R value of between 5 and 9.5. Very close to chickenpox and not so far off from measles. ( Centre for Disease Control and other sources).

We immunized the population against measles and chickenpox and these diseases are almost non-existent. We now need to rapidly immunize the population against the delta variant of COVID-19. Barriers to transmission reduce the R value to 0. Barriers like masks, distancing and immunity.

COVID-19 vaccines provide high levels of protection against severe disease caused by the Delta variant. The vaccines may be less effective at preventing infection or transmission as we have learned in the past week but they still prevent more than 90 % of severe disease.

One vaccine does not do the trick. The effectiveness of preventing severe disease after one dose of either a mRNA vaccine or the AZ vaccine is only 30 %.

Get two doses and please, get them quickly. Vaccines are widely available in Canada. We protected our children against chickenpox and measles. Let's protect the country from the Delta variant. It just makes good sense.

As for kids"

We are hoping that vaccines for kids will be available by November. Until then, I think children under twelve should wear masks in school. Hopefully, the fact that most of the adults in their life are vaccinated will add to their protection. The key is that we get to 90 % vaccination rate before schools starts. Then we can all breath a sigh of relief.

Corrections for my last post:

There are 36.6 new cases /100,000 in the USA.

Canada has an infection rate of 2.4 cases/100,000.

And, the delta variant is 50 % more infectious than the alpha variant.

Accuracy is key and thanks to a few of my nerdy science, statistics followers, this Facebook page remains accurate.

Please share.

Anne-Marie

Oh and who knew that basil grows this well in the garden. I will be in pesto heaven over the next few weeks!

For non-Facebook users, you can find this post here:

https://braceletofhope.blogspot.com/

And if you'd like to help Bracelet of Hope work towards making sure that Lesotho has access to these vaccines, donate here:

https://www.braceletofhope.ca/ways-to-