Projections:

This is an interesting graph. It looks at where hospitalizations may go in the next 6 weeks . The grey line shows us where we have been with respect to COVID- 19 hospitalizations with a peak in mid-January and a decline until mid-March. March 10th is when the Omicron BA.2 variant started it's rise. Mask mandates were lifted on March 21st in the province of Ontario and the graph shows the increase in hospitalizations, as predicted, two weeks later.

New modelling, as set out by Ontario's Science Advisory Table, paints a more alarming picture than the numbers released by the table last month. They estimated that there would be 800 COVID patients in hospital by May and 300 in the ICU. But then the BA.2 Omicron sub-variant became the dominant strain in the province and mask mandates were lifted.

Today, there are 1392 people in hospital with COVID-19 up 23 % week over week and the highest it's been since mid-February. Most likely case scenario is that we surpass 3,000 hospitalizations in May with 500 in the ICU. The worse case-scenario shows us reaching more than 4,000 hospitalizations with 600 in the ICU.

There is good news. Waste-water signals indicate that the sixth wave has peaked. This weekend may change that if folks gather without taking great care.

While presenting these numbers, the science table made it clear that masking in indoor areas “will substantially reduce the risk of getting and spreading COVID-19” and noted that the “community benefits from masking are most pronounced when adopted widely in public spaces, schools and workplaces.”

Hmmmmm. Looks like masks might be a good idea. They may just keep us moving past the peak of the sixth wave without becoming ill.

More good news and this is what we need to focus on for the future of this pandemic. This is why we should be cautiously optimistic about seeing the backside of this pandemic:

1/ It is likely that between 4.5 and six million Ontarians have contracted COVID-19 since Dec. 1, accounting for at least one-third of the province’s population.

2/ More than 7 million have received three doses and many of them will not contract COVID-19 even if exposed, most will avoid serious illness and hospitalization if they do contract COVID-19.

Epidemiologist can only take a stab at figuring out how many of us now have immunity but it could well be over 75% of the population. Are we building a strong wall of immunity against COVID-19 in the province? I hope so. Will this protect us from future waves? Possibly. Will this bring about herd immunity? Wouldn't that be grand but it is more likely that we will be able to push COVID-19 from a pandemic state to an endemic state which would allow us to move on with our lives with no restrictions; government or self-imposed.

Self-imposed mask mandates, crowd size limitations and social distancing is all we are left with right now but I think we should be continuing with restrictions, especially masking, so that we can minimize the number of hospitalizations and ICU admissions that will happen in the coming weeks, reduce serious illness and death and take the strain off an overburdened healthcare system.

It is up to us this weekend.

And another gentle reminder; get vaccinated with three doses. Up to 10 % of unvaccinated people who contract the virus end up with long haul COVID the most common symptom of which is extreme fatigue.

Anne-Marie

Please share and have a Blessed and safe Easter, Passover celebration or Ramadan.

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What's the deal on paxlovid and other updates.

I must apologize. I have ranted in the last few posts. Lashing out at bad government decisions is not usually my style and it feels undignified. I believe it was necessary and it may be necessary in the future. I can think of nothing more important than the health of our families and community and the education of our children .....other than God if you are a person of faith. Check out this link from Ryan Imgrund to see the huge percentage of children off sick right now ( due to COVID and other illnesses). https://twitter.com/imgrund/status/1514071441293074434?cxt=HBwWhICz7Yb9h4MqAAAA&cn=ZmxleGlibGVfcmVjcw%3D%3D&refsrc=email Up to 20 % of school staff in the province is off sick. There is a shortage of relief teachers so the remaining staff are struggling to keep up. I would imagine it is impossible to teach when the system around you is in utter chaos. As for the Ontario health care system? I will do my best not to disintegrate into a rant here. I cannot believe that after two years of managing the extra needs of my patients due to COVID-19 that those needs have increased exponentially in the last month. If you have time, read this CBC article and you'll get a sense of what it is like to be a family physician right now. https://www.cbc.ca/news/canada/montreal/first-person-family-medicine-quebec-health-reforms-technology-workload-1.6417193 I would imagine that being an exhausted emergency room doctor/ nurse or an ICU physician/nurse is getting to be an impossible and exhausting challenge right now too. Think of where we would be without education and healthcare. I had a conversation about this last night as I did my daily power walk with a dear friend. Without these precious provincial resources we disintegrate into chaos. We become a failed state with a reduced life expectancy, expanding poverty and homelessness with increasing hopelessness, helplessness and lawlessness. Is that what we want? Is that what we will allow? I share my deepest gratitude to the staff, teachers and healthcare workers who, after two long years, are still trying to hold these systems together while our leaders focus on their political aspirations. That's a small rant and I did my best to avoid it but there it is. Some real numbers.....because we need them. The estimated number of new cases of COVID 19 was 3764 yesterday which is up 548 over the previous week. This number likely exceeds 120,000 according to waste water signals in Ontario. The percent positivity is up to an astounding 18%. There were 1399 people in hospital with COVID -19 yesterday, up 271 from the previous week. ICU admissions were at their highest in 2 months at 190 up 17 from the previous week and the number of deaths at 13 up 4 from the previous week. No matter how you look at it, this is a sixth wave that is as punishing as the last. Only half the population had third doses at the start of this wave. March was a time to put a vaccine campaign together to encourage everyone to get a third dose. It was not a time for governments to leave us to fend for ourselves. Some updates: 1/ Everyone over 12 can now get a third dose. 2/ Everyone over 60 can get a booster dose ( fourth dose) 3/ Paxlovid is an anti-viral medication given to people with COVID-19 who are symptomatic and at risk for developing serious illness. It is not a preventative treatment. In order to receive this medication you must have a positive PCR test so, our assessment centres will now provide PCR tests to members of this symptomatic group. The test must be positive before paxlovid is prescribed. It is a five day course of treatment, one tablet twice a day for five days. Effective today, more high-risk, symptomatic groups are eligible to be tested and assessed for antiviral treatments, such as Paxlovid. -Immunocompromised people 18 years and over -People who are 70 years and older -People 60 and over with fewer than three vaccine doses -People 18 years and over with fewer than three vaccine doses and at least one risk condition such as a chronic medical condition To repeat. This medication is not for patients who want to reduce their risk of getting COVID-19. You must be symptomatic with a positive PCR test. Family doctors were a bit hoodwinked when it was announced this week that we would be ready to provide you with prescriptions for this medication. We may not be. This is a medication with many drug interactions and we are obliged to become knowledgeable about any new mediation before we prescribe. That may take many of us more than a day. For now, symptomatic people in the aforementioned groups can attend our COVID Assessment Centre for a PCR test. If it is possible a prescription can be written by your prescriber or the specialist they designate to prescribe. We are not miracle workers. We are human and what has been expected of us during this pandemic has required super powers we did not know we possessed. Oh for a government that respected us as humans. They don't. Easter weekend is almost upon us. The medical/scientific community fears that there will be a significant surge in new cases as we gather without mask mandates. Please be safe. Protect the vulnerable people in your group. Wear a mask for them. Keep windows ajar if you can. Air circulation reduces the risk of transmission. Spend some of your time together outside if possible. Avoid gathering if you are symptomatic or if you have a positive Rapid Antigen Test. People who have had three vaccines still have good protection against serious illness requiring hospitalization. COVID-19 is now everywhere. If you have not started a vaccine series, please consider it. If you have not received a third dose and you are in an eligible category, book it. It won't help you this coming weekend but it will be very helpful in the coming weeks as we ride the massive tide of this wave. Anne-Marie Please share.

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It's all about the viral load.

Not wearing a mask and allowing a rapid increase in infections and deaths does not lead to herd immunity. There are too many unvaccinated people on the planet for us to achieve that in the short term. Letting go of mask mandates was a political ploy. It had nothing to do with a scientific effort to obtain herd immunity. Pure political gain.

If you wear a mask and if you receive a booster dose, you may still be exposed to COVID-19 and you may still get COVID-19. It is all about viral load. The less virus that is pushed into your upper airway, the more mild the infection. Masks and vaccines protect you from receiving an enormous amount of virus at the time of transmission which drastically reduces your chances of developing serious illness from COVID-19. People who develop serious illness are 50 % more likely to develop long haul symptoms. The most common long haul symptom is chronic fatigue. By taking that mask off and avoiding a booster dose or any vaccinations, you are putting yourself at high risk for serious infection and chronic symptoms.

If we still had a mask mandate, mild infections would still occur in some allowing for more wide-spread immunity without the increase in serious illness, hospitalizations and death. By far, those who still wear mask who have been vaccinated, are getting mild cold- symptoms if any symptoms at all. That is scientific truth without the indecent self-serving political spin. Three vaccines reduces your risk of getting COVID-19 by up to 70 % and reduces your risk of serious illness and hospitalization by up to 95 %. Masks reduce risk. There is no doubt about that. We are seeing the serious consequences of removing the masks in real time as hospitalizations sore and infections in the province reach 100,000 cases a day.

Your health matters to me. The health of my community, my neighbours, my colleagues, friends and family matter greatly to me. No political spin. No self-serving power grab. Just sincere compassion and concern.

We need leaders in politics with the same self-less mindset. Where are they?

The choice is now ours. Make the right choice; wear a mask, get vaccinated and while you do that, vow to prevent the countless numbers of selfish, self-serving leaders from holding onto power regardless of the cost to you and me. Federal, provincial, conservative, liberal, NDP....whatever the stripes, we have the right to better leadership.

AM

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Concerned

 I am concerned.

https://covid19-sciencetable.ca/ontario-dashboard/

Let's keep an eye on the Ontario Science Advisory table as it moves from being hosted by the Dala Lana School of Public Health, a politically neutral organization, to Public Health Ontario which is an agency of the Government of Ontario.

I rely on the Science Advisory Table for clear, accurate, unbiased, non-partisan, science-based information. Can Public Health Ontario be politically neutral? Will we receive the information we need to understand how to protect ourselves now that most public health restrictions against COVID-19 have been lifted? I hope so. Will the fact that we are two months away from a provincial election muddy the waters and make obtaining accurate information very difficult?

I believe that science and medicine should remain separate from politics just as church and state be two separate entities.

Here is the information you should know today, the last day of the advisory table's existence as a non-political, neutral entity. Click on the above link.

For four days in a row, Ontario logged more than 3,000 new daily COVID- 19 cases, a number that is climbing despited limited PCR testing. Of those tested, there is a 16.7 % positivity rate which is very high. Dr. Peter Jüni, who heads the Science Advisory Table, believes that the real number of daily cases in Ontario to be around around 30,000 to 35,000 new daily cases based on testing for COVID-19 in waste water.

Hospitalizations due to COVID are climbing as well with 891 in hospital today, up 143 from a week ago. ICU admissions have climbed to 165 up 8 from last week.

Most of these increases are being driven by the BA.2 Omicron variant which is rapidly becoming the dominant variant in the country following the lead of our European partners.

It truly is NOT the time to be less careful. It is now our choice but for me and mine, masks are staying on in public for the foreseeable future. Make it a well fitting N95. If there are gaps in the mask, the new highly transmissible BA.2 variant will get in with ease.

It would appear, from early data, that mRNA vaccines offer a similar degree of protection against both Omicron strains. And, in review:

1/ Two vaccines provide little to no protection against getting infected with Omicron. ( BA.1 or BA.2) but two vaccines reduce the risk of hospitalization by almost 60 % and ICU admissions by 65 %. Two vaccines reduce the risk of dying from COVID-19 in people over 50 by 59 %.

2/ Three vaccines reduce the risk of getting COVID ( BA.1 or BA.2) by up to 70 %, two to four weeks after the third dose. Three doses reduce the risk of serious illness and hospitalization by up to 90% and three doses decrease the risk of dying of COVID-19 in people over 50 by 95% after two weeks.

https://ukhsa.blog.gov.uk/2022/02/10/how-well-do-vaccines-protect-against-omicron-what-the-data-shows/

https://www.nature.com/articles/d41586-022-00775-3

If you are not vaccinated, consider it.

Some good news. In Ontario, people over the age of 12 can receive three doses. Five to eleven year olds are eligible for two doses and there is no approved vaccine for children under the age of five. Not only are people under eleven far less likely to develop any serious illness from COVID-19 infection, two doses of vaccine in this age group remains very effective at preventing serious illness. Two vaccines are 90.7% effective at reducing the risk of getting symptomatic COVID-19 in this age group with no cases of severe illness at all in several studies.

Take home message: Our under 5- 11 year olds are well protected after 2 doses of vaccines and our under 5 year olds are at low risk of serious illness with no vaccinations. Our kids are OK even in the face of BA.1 and BA.2.

https://cps.ca/en/documents/position/covid-19-vaccine-for-children-and-adolescents

The above link takes you to some great information about kids and COVID in general.

The research on the BA.1 and BA.2 Omicron variants is in the early stages. Vaccines work against both but the information I have provided in this post is subject to change as our research evolves.

I would like to pay a special tribute to all the members of Ontario's Science Advisory Table. You have been a beacon of light in this crazy storm. Thank you for your intelligence, expertise and wisdom.

Here is a list of all of the members of this remarkable team:

https://covid19-sciencetable.ca/about/

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/