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/

This is Victor

 THIS IS VICTOR

Victor is the son of a friend of ours. He is in his late twenties. He has spent much of his teen years and young adult life helping people in the most desperate places in the world....and in a big way. Victor created a foundation called, "Canadians for Syria" through which he raised funds to sponsor 17 Syrian families to come to Canada. He has volunteered in Bangladesh and Palestine and he has worked with the International Rescue Committee. Victor is now a student of Public Policy at the University of Oxford in England. His focus is on migration issues. People like Victor have the power to change the world. Victor is of Polish decent. Of course, before a person like Victor turns 30, he would start a second foundation when war broke out in Ukraine. Two foundations before the age of 30......puts me to shame. A few days after the war started, Victor went to Poland to help Ukrainian families fleeing out of Ukraine. His new foundation is called, 'Hands on for Ukraine'. Through this foundation Victor is getting food, medical supplies, hygiene products into Ukraine and into the hands of Ukrainian refugees in Poland. Last week, Victor crossed the border into Ukraine to bring supplies to Lviv, a city that is currently the hub for the majority of refugees fleeing from Ukraine into Poland. And on his way back, Victor will bring Ukrainian refugees to Poland. If you believe that a good life is measured by good deeds, well, Victor has created an exemplary life. So far, Victor's new foundation has raised 20,000 pounds. I'd like to help him raise more. If the world has the capacity to overcome it's most daunting problems, we will need a billion 'Victors'. You can donate here: https://donorbox.org/handsonforukraine A four percent processing fee is required by this donation engine. To avoid paying that, you can e-transfer funds to The Guelph Academy of Music to which Victor has close ties using this address. info@guelphacademyofmusic.com Thanks for your help. 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/

To mask or not to mask

Soon it will be a personal choice. So, how do you decide? It's true that we are well past the peak of Omicron. All tracking numbers continue to decline but no longer at a precipitous rate. The curve is flattening. But, it is flattening at 1800 new, known cases/day. Hospitalizations are just under 800 in Ontario and ICU admissions still hover over 200.

We have done amazingly well, that's true. New daily cases went as high as 18,000 in Jan and that was just folks who tested positive, not those with no access to testing. Hospitalizations peaked at over 4,000 and ICU admissions at over 500.

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

That's a dramatic decline thanks to vaccinations and public health restrictions including masks in schools and public spaces.

Look at all three of these graphs which you can find when you click on the above link and scroll down:

1/Daily COVID-19 Hospital and ICU Occupancy in Ontario

2/Daily COVID-19 Deaths in Ontario

3/Estimated Rate of COVID-19 Cases per 1 Million Inhabitants per Day in Ontario

I see stabilization and possibly a continued, slow decline but COVID-19 is still definitely with us. There are still lots of cases under the line in each graph. It is still making people sick enough to require hospitalization and people are still dying. Masks should be at the ready. I think we should keep them on in certain circumstances until we see where we stand in the summer months or until the majority of kids over 5 are vaccinated. Keep them close until we have a vaccine for kids under 5. Most kids skate through a COVID-19 infection with little more that symptoms of a mild to moderate cold. Serious illness and death is very rare in kids under 11.

https://www.statista.com/statistics/1228632/number-covid-deaths-canada-by-age/

Here is my fear. When we eliminate masks and other public health mandates, my main concern is that we will have another wave in the fall. The immunity we have gained after three doses will likely wane by August according to research. If in the months leading up to our waning immunity our daily case counts increase because we have removed all restrictions too early, a pre-winter wave may happen as we move back indoors.

A new booster and then an annual booster will likely be available to all of us in the fall. It is also now known that 6 million people were infected with COVID-19 during the Omicron wave in Ontario. Add that, and there is cross over here, to the 12 million who have received 2 doses and the over 7 million who have received three doses and we have a lot of immunity built in to our population. BUT WE HAVE NOT REACHED HERD IMMUNITY. We are not yet in a position to rely solely on vaccines and natural immunity to keep COVID at bay. That is important to understand.

Once our vaccinations rates are over 80 % and possibly more, in all age groups, COVID-19 will be a manageable and perhaps seasonal illness, one that we need to live with. We will have to manage the risk and get on with our lives at some point. But, I don't think we are there yet. I will continue to wear a mask in stores, at work, in restaurants and theatres. If there is a frail or elderly person indoors, I will keep my distance and wear a mask there too. I would keep wearing a mask if I were a teacher in front of a class or if I get on a bus or into a cab. You get my drift.

Do I agree with masks no longer being mandated? Yes, I do. Mandates cannot be in place forever. In a free and democratic society like ours, they should be lifted as soon as possible and in this case, as soon as we are past the worst of the Omicron wave. Which is now. But that does not mean that masks should come off. It is time for us to take responsibility for our own well-being and the well-being of our family, friends and neighbours. You will soon be responsible for deciding when you need to wear a mask to protect yourself and others. Would I like to see masks stay on in schools? Yes. Vaccination rates need to be higher among school-aged children before I would take away the layer of protection provided by masks. It's all about finding a balance between the spread of the virus and our ability to protect and treat the vulnerable. In my opinion, there is still too much going on under the lines in those graphs.

For people who remain vaccine hesitant based on their concerns about the mRNA vaccines, there soon will be two more traditional vaccines available in our area: Novovax and Medicago. These vaccines are not available yet but they have been approved for use by Health Canada.

We have done extremely well as a country in fighting this pandemic which, by the way, remains a pandemic. We have lost so many things: Joy, a sense of security in our world and for some, in our relationships. Our sense of emotional, physical and economic well being and a confidence in the fact that all will be well, the future is bright. I have two sons. If they lived in Ukraine, they would be fighting a war. Perspective spurs us to take action when we witness the senseless suffering of others. Perspective also builds resilience. It can make our troubles seem minor in comparison. Some say that Canadians have lost their sense of politeness and kindness. We are angrier, more irritable, more prone to lashing out and being self-centred. Let's stop that nonsense, shall we? You feel better, you are healthier and your future is more hopeful when you remain polite, kind and patient.

And, as I used to tell my now adult children before they left the house, " Make good choices". Wear a mask when it makes sense to do so. Socialize responsibly, stay home if you have symptoms, get vaccinated and boosted. Get your children vaccinated. We have the tools we need to get to herd immunity, tools that we did not have in the winter of 2021. Let's keep using them even when we are no longer told we have to.

Most of all, be kind and patient whether you agree with the people around you being masked or unmasked. It will so be our individual choice and that choice should be respected.

Anne-Marie

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/

A COVID UPDATE

I have not posted any information about COVID-19 in a couple of weeks. My brain and heart have not been in the right place to even think of COVID outside of my clinic time. It's still out there but I can't think of anything worse than war. There are conflicts and wars all over the world at any given time. Most of these are civil wars or wars that do not involve powerful countries that are armed with nuclear weapons. The suffering, devastation and loss of innocent human life goes on everyday in these countries. Perhaps we have become too de-sensitized to the horrors of these conflicts. Perhaps there is just too much suffering in the world to keep track of. There is a scripture verse that I go to in my mind quite frequently now. John 16:33 “I have told you these things, so that in me you may have peace. In this world you will have trouble. But take heart! I have overcome the world.” Jesus speaks these words. My religion has been stolen by extremists recently but they have not stolen the incredible example of selflessness and sacrifice of Jesus Christ. Whether you believe he is the son of God or not, His story is so compelling. I strive to live by his example and believe me, that is not easy in our world today. My father was raised in German occupied Holland. He could barely speak about his childhood. When I was young, every once in a while we would watch a WW2 movie together. As I grew older, I couldn't stomach the scenes of torture, murder, starvation and suffering. And now, these same scenes play out all day long in real time; scenes that involve people that are just like us. Just like us. That's the difference. These aren't people who lived 80 years ago or people whose countries have been terrorized by war for decades. These are people just like us, just like our sons and daughters and their lives are being decimated in what seems like an instant. It is so close to home, so close to our hearts that we feel their terror and we grieve with them. I grieve with them. I cry for them. My heart aches for them. I pray for them: for more strength, more endurance, more courage and more determination. I pray for their leaders, for their president and for their beautiful, colourful, ancient culture. For their democratic place in this world and for the end of tyranny, anarchy, narcissism, racism, injustice and cruelty in the hands of powerful people whose focus in this world is to hold more and more power and wealth through oppression and war. We all suffer at their hands. Their greed threatens the existence of all of us, not just the people of Ukraine. It is remarkable how a pandemic that was recently terrorizing us is now, for most people, a walk in the park in comparison. But while we are distracted and devastated by this unprovoked war and the senseless attack on innocent people, we have come to the end of the Omicron wave. 85% of us have had two doses. Some regions have reached over 90 % double vaccinated ( well done Guelph) and in these highly vaccinated communities where more and more have received three doses, hospitalizations, ICU admissions, new daily cases have all dramatically declined. There has been a significant reduction in Global cases with our national cases dropping to 108/100,000 ( Ontario is 92.3/100,00). Reproductive values have dropped worldwide with Canada's R value dropping to well below one at 0,87. https://www.imgrund.ca/global-rt My favourite go-to website shows all numbers declining except vaccination rates that still continue to climb despite the protests and background noise and nonsense. https://covid19-sciencetable.ca/ontario-dashboard/ Scroll down on the above page to the graph entitled 'Estimated Rate of COVID-19 Cases per 1 Million Inhabitants per Day in Ontario'. That's a thing of beauty. Now scroll down to 'Test Positivity and Number of COVID-19 Tests in Ontario'. And finally, take a look at the graph, 'Daily COVID-19 Hospital and ICU Occupancy in Ontario'. All of these graphs show precipitous increases and then precipitous drops in all numbers. We decimated the Omicron wave. We crushed it. We did that. That's the power of good people working together for the good of all. Anything is possible. It is time to lift restrictions. It is that booster dose that really protects you from becoming seriously ill or requiring hospital/ICU admissions. From what I am seeing, Omicron is leaving folks with unusual and serious long-term symptoms like brain fog ( in the children and adults) and serious cognitive declines in people over 60. That booster is all important. Should we take masks off in public? That will soon be a personal choice based on your own risk assessment which I hope to review in detail in upcoming posts. I will be keeping my mask on in public spaces until the summer and only if we continue to do so well in our fight against COVID-19. For now, keep that mask on, get boosted and if you pray, pray for the people of Ukraine. Donate on their behalf. Unite as a community, all divisive issues put aside, to focus on the much greater needs of others. Happy Sunday. Anne-Marie

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/

Perspective....again.

In all this hostility and division, we may be missing some important and hopeful information. Let's not miss the good stuff because it may be the only thing that keeps us going.

These are dark days. It is so difficult to see Canadians so deeply divided. I will state my opinion clearly here and then, hopefully not again. Truckers are great people. Make no mistake about that. Their jobs are tough. They are often not paid well. They are often the victims of road hostilities at the hands of non-truckers on the road. They are often disrespected. I have heard so many stories. As we are about to see in the next few days, we need them. They deserve our respect.

They have the right to protest. We all do. But I don't believe the actions of a very small minority represent the ideals and intent of the majority. I worry that we are not hearing from the majority. Hostility and extreme actions make better news than the ordinary trucker, many of whom are vaccinated, who may have some legitimate concerns. It's sad that their voices may have been drowned out by the extremism and conflict.

Please know this, in the last number of years, as a result of listening to many stories, I have come to admire the work you do and how committed you are to delivering the goods and supplies that keep our economy running. I truly hope that your voices are heard.

As our eyes have been focused on Ottawa and now the Ambassador Bridge, we may not have paid attention to the progress we continue to make against COVID-19. It is actually quite remarkable. I continue to stand by the science. Vaccines, mandates, restrictions and vaccine passports have allowed us to tackle yet another wave. You and me and every law-abiding, hard working trucker.... we did that.

Read this and be ever so hopeful.

There are 2,059 people in hospital with COVID-19 in Ontario.

That's down from 2,254 yesterday and 2,939 a week ago. I am discouraged by events of the day but those numbers make me want to sing!

Of those that are hospitalized today, 44 % were admitted for other reasons but tested positive for COVID-19 on admission.

There are 449 patients in the ICU. There were 555 a week ago. Again, I have a singing heart.

These numbers continue to decline despite schools re-opening three weeks ago and restaurants re-opening last week. A slow and steady re-opening works. A slow and measured reduction in restrictions including mandates and passports will work. Make no mistake, every province is set to move away from mandates and passports in short order. Protesting may not have been necessary. We were heading in the direction the protestors wanted anyway and no, I am not speaking from a political point of view, I am speaking from a science and public health point of view.

And get this. Read this and sing. As of today, 89 % of Ontarians aged five and older have received one dose of vaccine, 84% have received two and 47 % have received three. Remember that two doses of vaccine do not protect you from getting the Omicron variant but they do reduce your risk of serious illness by more than 80 %. Three doses of vaccine reduce your risk of getting the Omicron variant by 60 % and the risk of serious illness and hospitalization by more than 90%.

That 84% number, that means that the vast majority of the population, including truckers, are vaccinated.

We are getting there!!

There were 1.3 thousand comments on a recent post of mine. I voiced my opinion about the protests in Ottawa. I will accept all of the comments including those that express a lot of criticism. If I use my right to voice my personal opinion on a very divisive political issue, I had better be ready to take the hard knocks. But there is one comment I will not accept. In that comment it is suggested that because of the leadership role I have taken as a physician involved in the fight against COVID-19 ( I am paraphrasing here) that I do not have the right to express my personal or political opinions.

We all have the right to voice our opinions, political and otherwise. We have the right to stand up for what we believe in and protest against what we don't believe in. We have the right to stand up against injustice, to support the people we love, to fight for the vulnerable and to work to change what needs to be changed. That is our right as Canadians who live in one of the oldest democracies in the world. We have the right to all of this but not if the way we fight harms others or undermines our democracy, our economy or the rule of law.

There is a peaceful and diplomatic solution to every problem and every crisis. That peace needs to start with each of us individually. Peace results from a deep understanding of who we believe to be our enemies. Peace is always achievable but it starts with you and me. With the words we use, the hand we extend and the trouble we take to understand our differences.

Let the virus be our enemy, not each other.

I pray for that peace for all of us tonight; a peaceful end to protests and a peaceful end to the pandemic.

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/

The post-pandemic era

"It's time to take the burden of 'saving' the healthcare system off individuals and push the government to improve it".

Dr. Suman Charkrabarti ( Infectious Disease Specialist- Trillium Health)

A quarter of Ontario's hospitals were already working beyond 100 percent capacity before the pandemic. That must change.

Some COVID-19 restrictions should be lifted but if we end mask and vaccine mandates too quickly or too early it would be like " playing Russion roulette. If it wouldn't be a complete public health disaster, that would just be by sheer dumb luck." (Dr. Peter Juni, scientific director of Ontario's Science Advisory table).

If we lifted all restrictions today, as some protesters are demanding we do, the outcome could be the best case scenario of a small and manageable increase in infections ( very unlikely given the nature or Omicron) or the worse case scenario with up to one third of Ontario's hospital beds filled with COVID-19 patients. Our provincial health care systems were very fragile to begin with, vastly underfunded and under-resourced. The pandemic exposed this fragility and made it necessary for ordinary people like you and me to sacrifice so much to keep one another healthy.

Had our healthcare systems been more robust and resilient, could we have avoided prolonged mandates? I think so. Do we still need them? Definitely, but not for long.

Stay the course. There are 2,230 people hospitalized with COVID-19 today; there were 3,019 a week ago. There are 486 patients in the ICU, the first time since Jan 11th that this number has fallen below 500. We did that without protesting a law breaking. We protected our fragile healthcare system and in so doing, took care of one another. Our science advisors and healthcare experts will lead us out of pandemic COVID and on to endemic COVID. We'll get there. Clear the streets. Let us get our work done.

Anne-Marie

Please share.