Good new, good news and more good news.

I wont't go to a restaurant today but if I could, I would and that makes me happy. I won't go to a gym today and I would't if I could but it makes me happy that others can. I am a cycling, cross country skiing fanatic. Some day I will need a gym where I can lift some weights and strengthen this aging body to keep it going. Best of luck to all of you who are opening up today. Thank you for hanging in there. I hope and pray we will never need to make you close your doors again. We need to learn to live with COVID-19 without the major disruption to so many of our lives. 1/ 59.1% of the eligible people in Guelph, and up, have received a booster dose. That's above the provincial average of 53 %. THIS IS VERY IMPORTANT- Two dose of vaccine are very effective (90%) at preventing illness caused by the delta variant but 99.7% of new cases in the province are caused by the Omicron variant. Two doses of vaccine provide zero protection against illness caused by Omicron. Which means that going about your daily business at this time when Omicron is circulating widely, your two vaccines provide NO PROTECTION against getting infected with the Omicron variant. Two vaccines do reduce your risk of becoming seriously ill from Omicron infection with 82 % protection against severe illness and death. To put it in a different perspective, two vaccines means there is a high likelihood that you will get Omicron and an 18 % chance that you will develop life-threatening illness from Omicron if you become infected. 2 doses plus booster are very effective for reducing severe illness with Omicron. A booster dose provides 61% protection against infection by Omicron and 95% protection against developing severe illness from Omicron. There are 6.3 million people in Ontario who have had their booster dose, 59 % in Guelph. Increase that number and our community is safe again. 2/ Most experts are now saying that we have passed the peak of the Omicron wave. It is safe to start re-opening. It will take longer to slide down the tail of this peak. Omicron is so transmissible and community transmission is still widespread but serious illness, hospitalizations and deaths are the events we want to minimize. These numbers are declining too with the number of daily deaths still remaining quite high. Over the month of February, we will see all numbers slowly decline but the key is that booster dose. Short post today. This week, I will try to post about Omicron's sister the BA.2 variant. It is a very close relative of the Omicron variant and early research suggests a booster protects just as well against it. The WHO has not declared it a variant of concern yet and it has been around since mid-fall. We shall see. Some great information was shared about masks and kids in school during our last webinar. I will repost it but I will also try to summarize the key points in another post this week. Be well out there, get boosted. Go out to a restaurant and support our local businesses. It is safe. Remember that you now need to present your QR code as proof of vaccination. There is no movement towards changing the fact that two doses means fully vaccinated. Anne-Marie Please share. If you would like to be apart of the important work that Bracelet of Hope does towards making sure that vaccines are distributed in Lesotho, you can donate here: https://www.braceletofhope.ca/ways-to-give/ For non-Facebook users, you can find this post here: https://braceletofhope.blogspot.com/ For mental health support here: https://familyserviceguelph.on.ca/ For local assistance with anxiety and depression: www.here4help.ca CMHA WW Website: www.cmhaww.ca Here 24/7 at 1-844-HERE-247 or www.here247.ca. And for post-secondary students, Good2Talk https://good2talk.ca/

Let's get back to some good news!

 

And of course, it's all about vaccines. We did not see Omicron coming but we also underestimated the effectiveness of our existing vaccines at preventing severe illness caused by Omicron. Future boosters may need to be tailored to target new and existing variants but it would appear that the vaccines we have will get us through. And then it is on to a new but manageable COVID 19 future; the post-pandemic era. After every big world event, a new and different world slips into place. The post-COVID era will look different and it will be different but generations before us have moved forward into their new worlds. Some had to re-build, re-invent, re-imagine and.....we will too. Some hard but hopeful facts: 1/ Our existing vaccines are not as effective at preventing infection but they do render COVID 19 as a mild to moderate upper respiratory infection; a cold, in most people. I have seen patients in my practise with COVID 19 divided into two groups: those with two vaccines and those with three. Their presentations differ only slightly. Those with two vaccines often need to be assessed. They have significant head-cold symptoms often associated with a cough that lingers, some shortness of breath that resolves and fatigue that lifts within weeks. I have not seen long-haul symptoms with this variant yet. We shall see. Those with three vaccines call in mostly because they are confused by a positive rapid test but their symptoms are so mild they are not sure what to do. They need reassurance and advice. Six million people have had a booster dose in Ontario. Many have been exposed to COVID 19 and by far, most are not suffering physically to any great degree. That's the story of Omicron. That's us, the boosted population and the double vaccinated population. We will move into the post-COVID world. We will reassess, adjust and build what I hope is a much better world with a much better future for our children and our grandchildren. There are bigger global threats that need to be addressed. My hope is that we will not to slip into complacency once the COVID-19 threat is behind us. Put your strength and talents to the other tasks that desperately need to be addressed, like climate change, global warming, a better health care system, appropriate use of our resources and ONE Health.....health for every human being and creatures on the planet. I could go on but I might sound a little preachy and big goals might be hard to imagine for most of us who are just dragging our tired selves to the end of this pandemic. But to the end we will go. 2/ Defence against hospitalization has held up remarkably well. Hospitalizations and ICU admissions have stabilized in the province. Thank you for getting vaccinated and for suffering through the most recent shutdowns. We did this. We saved lives collectively. You are a beautiful vaccinated bunch. If you are not vaccinated, come to the other side and join this group of game changers, these life-savers. A beautiful bunch. 3/ There will be future vaccines that will be specifically designed for Omicron and other variants. We have that technology and intelligence. Wouldn't it be grand if we could use the intellectual property of the world to create a better and more hopeful future. It is possible but not without a coordinated and focused effort. 4/ Boosters work. A new report from the U.S. Centers for Disease Control and Prevention found that while vaccine effectiveness against Omicron hospitalization fell to just 57 per cent in people who were more than six months past their second shot, a booster dose reduced the risk of serious illness and hospitalization by 90 per cent. Get boosted. Another study from CDC researchers published in the the Journal of the American Medical Association last week found three shots of mRNA vaccines were close to 67 per cent effective against symptomatic disease from Omicron compared to the unvaccinated. 5/ Limits on access to testing make it difficult to know where we are with Omicron, but the Ontario COVID-19 Science Advisory Table believes that new cases per million inhabitants have fallen by more than 50 per cent since hitting a peak of 1,000 per million in early January. Vaccines are the answer. We are getting there. Anne-Marie Please share. And a reminder about Wednesday's 'Finding the Balance during COVID-19' webinar with our special guest, Dr Matthew Tenenbaum. You can register here: https://us02web.zoom.us/webinar/register/WN_dLTpYNAUSZCMxW5BWCa80g Please share.

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

https://braceletofhope.blogspot.com/

For mental health support here:

https://familyserviceguelph.on.ca/

For local assistance with anxiety and depression:

www.here4help.ca

CMHA WW Website: www.cmhaww.ca

Here 24/7 at 1-844-HERE-247 or www.here247.ca.

And for post-secondary students, Good2Talk

https://good2talk.ca/

And now, Teachers and school staff and a return to school.

 

Two days ago, I wrote a lengthy post outlining the risks and benefits of sending your child back to school. The benefits far outweigh the risks. A quick summary from that post:

Kids are at extremely low risk of getting seriously ill from COVID-19 and at even lower risk of requiring hospitalization.

There is no longer an option of returning to school with no risks to your child but understand the risks. And remember the layers of protection the powers that be are putting into place which are: masking, testing, co-horting, vaccinations, staying home when you are sick.

These layers protect teachers and staff too.

So, how do we protect our teachers? First off all, I think it is important to review this graph again ( page 6 of this document)

https://covid19-sciencetable.ca/wp-content/uploads/2022/01/Ontario-Returns-to-School-An-Overview-of-the-Science_20220112-1.pdf?fbclid=IwAR2nKhzKQjmtG5TFwhRK2Lmy-K2QanBYkvKLUMyof1SvG9_uN484v0Itriw

The yellow bars represent the number of hospitalizations in your age group since the beginning of the pandemic. For example, in 40 to 59 year olds, there have been about 200 people hospitalized in the last 22 months which includes the time before vaccines and during the peaks of every wave when overall hospitalization rates were high. The risk goes up if you are over sixty and down if you are less than 40. The 20 to 49 year olds have about half the rate of hospitalization or 100 or so that have required hospitalization since the start of the pandemic.

You know where I am going with this. Two vaccines provide little protection against getting COVID-19. The rate varies from study to study but 3 doses reduce your risk of getting COVID by 11-30 %. But 2 doses still protect against serious illness. Here's the highlight; three doses reduces your risk of getting COVID-19 by 70 % and the risk of serious illness requiring hospitalization by 90-95 %. Older people, again, are at higher risk.

No one with three vaccines has required hospitalization due to COVID-19 with over 5 million doses given in Ontario. The patients I see at the office with COVID-19 are divided into two groups: those with two vaccines who have a pretty tough head cold, sore throat and cough and those with three doses of vaccine who have none to very mild symptoms.

Couple three vaccines with a properly worn N95 mask and your risk of getting COVID-19 in the classroom drops dramatically. I will search for an actual number for this risk but it's a beautiful day and the pond beckons me.

Add a properly sized HEPA filter to the classroom with three doses of vaccine and a properly fitting N 95 mask and I just don't think you will be at great risk of even getting COVID-19 and if you do, it will likely cause mild symptoms. You may be even more safe in the classroom than folks who head into a public space or to a gathering with a surgical mask and two vaccines which, at present, is what the majority of Ontarions have.

We will never prevent that transmission in schools entirely, just as there will still be teachers, adult school staff and children acquiring COVID-19 outside of the school setting.

And the story about HEPA filters? Growing evidence shows that they are effective at reducing transmission rates especially during the coming weeks when opening windows is not comfortable.

And finally, almost 70 % of the students in the Guelph Wellington Dufferin region have been received at least one dose and 83% of high school students have received two doses. Centennial has the highest double vaccination rate at 90 %. Once all these students have received two doses, their risk of transmitting to teachers and staff reduces, add a surgical mask and the risk goes down even further.

Would I go back to school tomorrow if I were a teacher or a staff member? Yes I would. Definitely. Just as I feel comfortable seeing sick patients with COVID-19 in my office, I would feel comfortable heading back to school. I have three vaccines and a tight fitting N95 mask as my shields of protection.

I hope to have time to do a youtube video on how to properly wear an N95 mask. Teachers and staff are not being given a fitted mask. That just means you will not be sitting down with an N95 fitting expert who makes sure the masks fits properly. In short, make sure the mask is small enough to fit the entire area around your mouth, under your chin and over your nose. No are should escape from the mask. It fits like a suction cup. If air cannot escape, air cannot get in, including air with COVID-19 virus circulating in it.

This links reviews how to wear an N 95 mask:

https://multimedia.3m.com/mws/media/1448498O/wear-it-right-putting-on-your-respirator.pdf

Back to it tomorrow. My best wishes to all of you. Your risks are low. Your student risks are low. And, thank you for educating our children. Their present well-being and future success depends on it.

Anne-Marie

Please share.

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

https://braceletofhope.blogspot.com/

For mental health support here:

https://familyserviceguelph.on.ca/

For local assistance with anxiety and depression:

www.here4help.ca

CMHA WW Website: www.cmhaww.ca

Here 24/7 at 1-844-HERE-247 or www.here247.ca.

And for post-secondary students, Good2Talk

https://good2talk.ca/

So much to unpack. This may take a few posts.

KIDS AND A RETURN TO SCHOOL So much to unpack. This may take a few posts. First and foremost, the Omicron wave will end and much sooner than you think. Admissions to hospitals are already starting to slow and Dr. Peter Juni, the scientific director of Ontario's Science Advisory Table, believes admissions will peak next week which may mark the peak of the Omicron wave. What does 'the peak' mean? It means the decline to the trough is coming and when it does, we will open up again and I believe that COVID-19 will begin it's descent to an endemic disease. Don't quote me on that but it all just makes sense. Schools should open on Monday. Get angry if you need to but please be polite in your comments. Anger usually comes from fear and make no mistake, we are all living with a whole new level of fear that no one has ever experienced before. But we can manage it. We are managing it. We will get there. Respect and kindness are healing to those to whom they are given. Let's unpack all the confusing information out there. Many of us use Ontario's Science Advisory Table as our go to for scientific, trustworthy, accurate and unbiased information. The people in this group are science superstars. I am summarizing information from this pdf released on Jan 12/22 entitled, 'Ontario Returns to School: An Overview of the Science'. You can stop reading this post and just read the pdf if you'd like. It is SPOT ON. For those of us who have been trying to find and follow the science, don't stop now. Teachers, school staff, students, parents.....don't stop now, keep following the science. https://covid19-sciencetable.ca/wp-content/uploads/2022/01/Ontario-Returns-to-School-An-Overview-of-the-Science_20220112-1.pdf 1/ Evidence shows that school closures are associated with substantial mental health and educational harms. 2/ Evidence suggests Ontarians aged 5-19 years appear to be at low risk of hospitalization and severe disease from Omicron. THIS RISK IS FURTHER REDUCED BY VACCINATION. I have seen this with my own eyes in the last two weeks. Kids with no symptoms or mild cold symptoms. No one seriously ill. And with two vaccines, kids and their parents who are surprised they tested positive. They are so well. 3/ Evidence suggests that closures of schools has a very small effect on reducing the spread of COVID-19 compared to other health measures like VACCINATION, good air filtration, masking with good quality masks, co-horting, testing and staying home when you are sick. These measures need to be the top priority as we open schools and it would appear that the Minister of Education has made it his top priority. God bless the educators and administrators who are now working day and night this week and this weekend to put these measures in place. 4/ School closures are associated with educational and social challenges for children and families. A good review of this is in the document. 5/ School closures are associated with serious risks for children. This is so important for those who are trying to decide whether or not to send your child back to school. The risks of continuing online learning now far outweigh the risks of COVID-19. THE RISKS OF KEEPING OUR CHILDREN OUT OF SCHOOL NOW FAR OUTWEIGHS THE RISK OF COVID-19. The proportion of children with clinically significant symptoms of depression and/or anxiety have tripled during the COVID-19 pandemic to 1 in 4 for depression and 1 in 5 for anxiety. As a physician who treats some of these kids, writing a prescription for anti-depressants for a 13 year old is heartbreaking. Fielding hundreds of calls a month from distressed parents and young people is distressing. I worry about this generation. So. What ARE the risks associated with sending my child back to school? Ontarians ages 5-19 are the LEAST likely to have serious disease with Omicron. Please study the graph on page 2 of this document: https://covid19-sciencetable.ca/wp-content/uploads/2022/01/Ontario-Returns-to-School-An-Overview-of-the-Science_20220112-1.pdf THIS IS THE MOST IMPORTANT PIECE OF INFORMATION THAT PARENTS NEED! Look at that graph. It is recent, dated Jan 10/22. That's approximately 1/100,000 cases of COVID-19 in this age group end up requiring hospitalization ( similar stats in other countries). Let's put that into even greater perspective: In Ontario, since the beginning of the pandemic, there have been 9 deaths reported in people under the age of 19, most of these people had underlying, serious health conditions and most before vaccinations were available. In Canada, there have been 23 deaths in people under 19 since the beginning of the pandemic and again most were unvaccinated and had underlying health conditions. https://www.statista.com/statistics/1228632/number-covid-deaths-canada-by-age/ I am not minimizing the deaths of these kids or the unfathomable pain and anguish their families now live with. God bless you. I am stating cold, hard facts but believe me, I am an empathic person who struggles with the pain of others Two vaccines reduces the risk of serious illness requiring hospitalization by 70 %. So, to summarize, the risk of people under the age of 19 developing serious illness requiring hospitalization is extremely low. The risk of death from infection is even lower and vaccines make these risks infinitesimally low (page 7 in this link). https://www.publichealthontario.ca/-/media/documents/ncov/epi/covid-19-daily-epi-summary-report.pdf?la=en&sc_lang=en&hash=6 There are 2 million school-aged children in Ontario. If one in four are now depressed, that's half a million kids. If one in five now suffer from anxiety, that's 400,000 kids. One in 100,000 kids ( mostly unvaccinated) end up in hospital with COVID-19, that's 20 kids out of 2 million. Again, I am not minimizing the suffering here. Cold, hard facts.... There is no longer an option of returning to school with no risks to your child but understand the risks. And remember the layers of protection the powers that be are putting into place which are not factored into any of the above numbers: masking, testing, co-horting, vaccinations, staying home when you are sick. Please review the key messages on page 10 of the Science Advisory Return to School Document. Very important. And finally this: Public health measures will mitigate Omicron transmission in schools; a number of these measures are underway or implemented- page 9 of the document. Your community leaders are focused on these measures. The risk is there. The risk is extremely low. We can and will mitigate that risk. Let's get these kids back to school and start putting Omicron and the educational, emotional and economic consequences of COVID-19 in our rearview mirror. Anne-Marie Please share. Feeling pretty hopeful after writing this. Thank you to all the teachers, school staff, school boards, all of our community leaders. Thank you, Thank you, Thank you public health and all of the healthcare teams who keep on going. You are all marvellous! Get your child vaccinated. It truly and dramatically reduces the risk and these vaccines are safe. No serious adverse events in 8.1 million vaccinated kids in the USA. For non-Facebook users, you can find this post here: https://braceletofhope.blogspot.com/ For mental health support here: https://familyserviceguelph.on.ca/ For local assistance with anxiety and depression: www.here4help.ca CMHA WW Website: www.cmhaww.ca Here 24/7 at 1-844-HERE-247 or www.here247.ca. And for post-secondary students, Good2Talk https://good2talk.ca/

UPDATE

 

(UPDATE:) WDG Public Health reports 90 per cent of people in region 12+ are now fully vaccinated

Thank you WDG. This is an amazing milestone. This is how we open schools safely. There are no ifs ands or buts. The safest school is the fully vaccinated school. That means that everyone who is eligible for two doses has them and everyone who is eligible for a booster has one. All of WDG's vaccine clinics are accepting walk in appointments for all school staff and all children who are eligible for a vaccine. Your child's safety in school is dramatically improved if the adults around them, including the adults at home, have been vaccinated. Come on everyone. There is no excuse for not doing the most we can to protect our children. No excuse! Get it done! Book online here: https://wdgpublichealth.inputhealth.com/ebooking For an updated list of who can walk in without an appointment, a list of WDG's clinics and their hours of operation click on this link: https://wdgpublichealth.ca/your-health/covid-19-information-public/covid-19-vaccine-information/drop-covid-19-vaccine-clinics. Please, for the sake of our children, make every school in WDG safe. And.... Ontario.....please follow our lead and do the same. Anne-Marie

Please share

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

https://braceletofhope.blogspot.com/

Hang in there. We are going to be just fine.

It was a tense day at the office. I can't help but chuckle at various points throughout the day because what I considered to be absolutely impossible and insane with respect to huge increases in the volume of calls and patient appointments pales in comparison to what we are facing now. It is.....remarkable may not be the correct word. I love my job but right now, the only way to survive is to laugh at myself and my anemic efforts to keep up. Add vaccine booster shots on top of the regular work we do.....if I don't laugh, I won't make it and not making it is just not an option.

So, why do I feel optimistic? Because Omicron is absolutely ridiculous in terms of it's transmissibility. It is burning through it's fuel, which is us by the way, so fast that it simply will not be able to keep up this pace. Hold on to your hats. This will be a wild ride but it most definitely will be over. In very short order, most of the population will be immune to Omicron either by vaccination with a booster dose or by natural infection. That's a massive wall of immunity which will subdue COVID-19 into an endemic disease that our health care system can manage. And this is happening world-wide. COVID-19 may have mutated itself out of it's job!

Some essential reminders:

1/ Two doses of vaccine are less than 20 % effective against the omicron variant. Twenty percent is very little protection. Individuals with three vaccines have a 75% reduced risk of becoming infected and by far the vast majority that do become infected after a booster dose are either asymptomatic or have very mild symptoms. The most important thing that you can do to get us to the end of this pandemic is to be part of that wall of immunity by getting vaccinated.

2/ For those who are starting their vaccine series, thank you. You will need at least 21 days between your first and second dose and then three months until your third. I spoke to several people today who have had two doses but just haven't gotten around to booking their third. Book it. For Wellington Dufferin Guelph, you can book online at this link:

https://wdgpublichealth.inputhealth.com/ebooking

Many of us are providing vaccinations through our offices and pharmacies continue to be huge players in vaccine efforts. Try both. Public Health now has several vaccine clinics. Book now.

3/ Here is a list of the main symptoms of COVID-19 infection caused by Omicron which now accounts for an astounding 97% of all COVID infections in Ontario. Omicron has euchred all other variants.

Most common-

Cough

Fatigue

Congestion

Runny nose

Less common-

Fever

Loss of sense of smell

Loss of appetite

Brain fog

If you have these symptoms, you likely have COVID-19 caused by the Omicron variant. Only people from high risk groups can access PCR testing through the provinces COVID Assessment Centres. For the rest of us, stay at home. Isolate. If you are double vaccinated, isolate for five days from the start of your symptoms. New evidence shows that people are most infectious early on with the Omicron variant. If your symptoms are worsening after 5 days, reach out for medical advice and remain in isolation until you have been assessed. Today, I spoke to many people with symptoms. Everyone had been vaccinated and everyone had mild cold-like symptoms. For unvaccinated people, isolate for 10 days. You are more infectious for a longer period of time if you have not been vaccinated.

This is the best link I have found that reviews the provinces new testing and isolation guidelines.

https://news.ontario.ca/en/backgrounder/1001387/updated-eligibility-for-pcr-testing-and-case-and-contact-management-guidance-in-ontario

4/ Isolation means the following:

Do not go to work.

Do not go to public areas including places of worship, grocery stores, pharmacies shopping malls etc

Do not have visitors in your home.

Cancel or reschedule non-urgent appointments. Where possible, arrange virtual appointments.

Do not take public transit.

Ask family/friends to drop off food or use delivery services.

Family members and close contacts should also isolate.

Here is what the end will look like. At some point, the World Health Organization will determine when enough countries have reduced their COVID-19 cases sufficiently, or at least, hospitalizations and deaths, to declare the pandemic officially over. When will that be? Sooner than you think despite how hopeless and dark things seem at present.

COVID-19 will not disappear, at least not in the short term but it will become manageable, treatable and preventable.

That's a triumphant trio.....Manageable, treatable and preventable. Nice ring to it and that is exactly where we are headed.

Anne-Marie

Please share.

Also, I need to thank everyone who donated to our vaccine efforts in Lesotho through this Facebook page. You donated over $31,000 in the month of December alone. Thank you.

If you would like to be apart of this vitally important work towards making sure that vaccines are distributed in resource poor countries like Lesotho, you can donate here:

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

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

https://braceletofhope.blogspot.com/

.