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HealthCare 365 Update
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Dear HealthCare 365 Family,

If you have any concerns about your health or questions for our team, please call the office or email your care coordinator. We are still working regular hours, but will try to deal with as much as we can virtually. We are here for you and are available to asses and assist with your concerns. The medical team will evaluate all health concerns virtually and determine if you require an office visit.

If you are having difficulty breathing or experiencing other severe symptoms please call 911 immediately.
A PERSONAL MESSAGE FROM DR. KOHUT

20 days ago, my heart raced as I watched in horror the violence unfold in Washington, DC. How could this be happening? How was this going to end? Did facts no longer have value in differences of opinion? Was the only response to those opinion differences, violence?

You ask…what does that have to do with COVID?  

The longer COVID 19 reigns out of control, public opinion about the management of COVID-19 becomes more vocal in its displeasure. Demonstrators protesting the wearing of masks and government interventions, march on city streets (peacefully mostly). A new flyer emerges in Toronto “Facts not Fear”. It claims to expose the truth about the COVID-19 epidemic in 5 major points. Misinformation spreads easily especially when nuggets of truth are mixed in with conspiracy theories or pseudoscience. “It’s garbage “states Infectious disease expert Dr. Isaac Bogoch: Read his evaluation

 In the absence of widespread vaccine availability and antiviral medication, non-pharmaceutical interventions (NPI) are the only options available to delay and moderate the spread of a respiratory virus in the population. The effectiveness of worldwide NPI government interventions against COVID 19 compiled from 226 countries are seen here. The ranking is from most effective to least effective.

The further left the horizontal line travels from the grey line, the greater the effectiveness of the intervention. The closer to the center, the less effective the intervention. Lines traveling to the right show that the measure is ineffective in combating COVID19. So what works?

  • Restricting small and mass gatherings
  • School closure
  • Control travel -border restriction, airport restriction
  • Quarantine
  • PPE (personal protective equipment)
  • Public education

 For more detailed recommendations about school closure please read this update from sick kids. 

Lockdowns and strong measures work. We all hate them. I hate them. If I have to cut my own hair again …. oy! But Look! Toronto has 1800 COVID cases today, down from the peak Jan 11, at 3555 cases. Although  modelling shows that overall COVID cases are declining, the majority of the new variants of COVID are changing the landscape and will very likely be the dominant version of the Virus in March. Strong measures prevent other surges of COVID cases. Temporizing leads to a surge of COVID cases and COVID related deaths, leads to COVID-19 restriction fatigue.This fatigue was evident when a million Canadians travelled this Xmas, despite restrictions, and cajoling…but 36 million Canadians “got it” and did not travel.

 

Vaccines, the light at the end of a tunnel!

A promising return to a more normal life!

Vaccine acceptance is required for community (herd) immunity. However, 20% of Canadians have said they will not get vaccinated if the vaccine becomes available. Vaccine hesitancy comes from a variety of sources:

  •  mistrust of vaccine benefit
  • worry about unforeseen future negative effects
  • a concern about commercial companies making profit, (the filthy lucre concept)
  • preference for natural immunity

We do not know the number of vaccinated individuals we need for COVID-19 herd immunity. We do not know how long the immunity lasts, and we do not know if we will need booster doses to maintain immunity. Is a COVID vaccinated individual less infectious if they get COVID?  we do not know, but I do know that if 20% of our population refuses the COVID vaccine, and others (up to 36 %) postpone due to lack of data or discomfort about attending large vaccination clinics (no judgement here) I have serious concerns in our ability to contain the virus.

How do we combat this hesitancy? Speak to us, your primary providers.

92 % of Canadians trust their Family Physician or Nurse Practitioners.

You turn to us for accurate information, when undecided about choices in treatment or vaccination. You ask for clarification, you ask questions. These conversations can create an opportunity to air concerns, become informed, even change an opinion.

I am repeatedly asked…when will my mother, father, or I can get the COVID vaccine?

I DO NOT KNOW! Family doctors do not know when they will be able to administer the COVID vaccine, because we have not been informed.

Did you know that there is no Family Doctor on the Ontario Vaccination Task force?

Family doctors are not even at the planning tables for Vaccine rollout plans!  Yet, Family doctors administer the bulk of vaccinations in this country.

A system that is predicated on primary care has not effectively involved primary care. Trust me, this is not sitting well with Family physicians.

Ontario College of Family Medicine is taking on this challenge. It is partnering with other primary providers and our political bodies to urge our Governments that Family Medicine, Nurse Practitioners, must be involved in further vaccine planning roll outs.

Vaccination of those living in congregate settings (retirement homes, long-term care homes, chronic care) is progressing at a snail’s pace. Only 48% of 72,000 long-term care residents have been immunized as of Jan 20 2021. Those that live in the community who may be no less vulnerable to COVID due to age and medical conditions, those vulnerable socially, economically, continue to be left out. Front line workers in hospitals are not all immunized. Community physicians are not immunized. Inequities to vaccine access continue. Delays in vaccine shipments do not help. Governments reminding us that there will be enough vaccine is not the same as having enough of the population immunized.

To date 1.8% of Canadians have been immunized.

Large vaccination clinics will supply the majority of vaccinations in Ontario (as they should) to reach large volumes of the population. I will be there along with many others. At some point vaccine administration may trickle down to the individual clinics.
 

Our staff, Tanya, Erin, and myself are here to answer your questions, to provide guidance, and help you plan to get the vaccine when it is available. In “Help me Rhonda” I will keep you updated on all aspects of COVID-19 in Ontario/Canada. When I am informed, you will be informed. Using the management systems developed in our clinic, all information about your COVID vaccination (once received) will be in your file, ready to access anytime if required.

 

In the meantime,

Stay well. Stay safe. Stay distanced. Practice good hygiene, Wear your masks.

Help us track COVID contacts. Download the COVID app.

V

Q/A about mRNA vaccine

1.Can the mRNA vaccine cause long term damage to the cells in our body?

The mRNA in mRNA vaccines do not get incorporated into our chromosomes and do not carry the potential for long-term complications, including potential for promoting tumour development. The injected mRNA survives less than 12 hours in our body. The mRNA vaccine has not been shown to trigger autoimmune antibodies that are responsible for many rheumatologic, skin, hormonal and Gastrointestinal disorders.

2. Are more serious reactions to mRNA vaccines being reported than in the initial vaccine studies?

 Serious reactions to mRNA vaccines continue to be very low.

Less than 1% of the population are reporting symptoms more severe than that seen with other vaccines.

The Systemic side effects (fatigue, headache, chills, and muscle pain) are more common after the second dose of the Pfizer vaccine and affect up to 50% of those immunized. These Symptoms are a sign that the vaccine is working. People over the age of 55 report less symptoms than younger individuals.
 

Health Canada has created a new website for tracking adverse reactions.

Johnson and Johnson vaccine, hot off the press this morning.

Johnson and Johnson vaccine is effective against COVID capable of providing protection against  moderate and severe disease. Though not as effective as the Pfizer vaccine . Although not as effective , it will still have an impact on  reducing the spread of the pandemic, see here.  There are massive inequities in distribution of the vaccine in the world, see here. This is  a problem for  all of us.  It leaves vulnerable to ongoing COVID  infections and Increases COVID mutation risk. Having a vaccine that  provides adequate protection is better than none.

Mutant COVID strains

British COVID B117 is 40% more transmissible than the wild strain, and may be more virulent (Cause more harm). The outbreak in the retirement home in Barrie and the recent outbreaks st Simon Fraser University in BC are linked to this strain. This increase in transmissibility will mean a more rapid climb in COVID cases. Concern mounts about another surge of infections in March. This is driving the tighter rules on travel, and the recommendation by scientists to stop all essential travel. Pressure is mounting to quarantine and isolate travelers. Improved viral detection is needed. Read more here and here .

Both Moderna and Pfizer vaccines remain effective against the new strain.

Moderna has already developed a new booster shot that it is testing against the South African COVID variant with good results. This confirms that tweaking the mRNA to adapt to new variants is relatively simple.
 

This live feed announcing new travel ban restrictions, read more here

ADDITIONAL RESOURCES

Here is the latest on Vaccine recommendations from Specialty groups.

On Jan 23 2021, while scanning my COVID information feeds an exciting headline jumped out. “Colchicine reduces the risk of COVID-19-related complications”. The info was coming for a press release from the Montreal Heart Institute. I was very excited!

However, the information about the trial was vague and lacked details. The usual scientific tools used in studies were not mentioned. How the population for the study was collected, was unclear. The research had not been put through a peer review process (a review by experts on the quality of the data gathered, and its interpretation, to ensure the highest scholarly standards). The Balloon had popped. Is this the manna from heaven that cures COVID-19, or is this the hydroxychloroquine of that past that proved to be bunk?  Strict analysis of the date will tell. Still, wouldn’t it be nice? Canadian research also…

 

If you have any questions please call our office and speak to our staff.

Wishing you health, safety and enjoyable family time!

The HealthCare 365 Team
Copyright © 2021 HealthCare 365, All rights reserved.


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