🚨At critical juncture in #COVIDBC, can still crush it down to close to zero in some areas of BC.

🚨Can't accept current case rates and percent positivity

🚨Must learn from other provinces and countries about what can be done.

Some suggestions in this thread: /1 https://twitter.com/AmyTanMD/status/1332818487706755072
1) Recognize aerosols as a big source of transmission!
https://time.com/5883081/covid-19-transmitted-aerosols/

2) Close indoor dining with govt $ supports to allow them to survive:
https://www.nytimes.com/2020/11/10/health/covid-indoor-venues-infections.html

https://www.cdc.gov/mmwr/volumes/69/wr/mm6936a5.htm

https://www.nytimes.com/2020/11/18/opinion/covid-restaurants-aid.html
/2
COVID-19 Is Transmitted Through Aerosols. We Have Enough Evidence, Now It Is Time to Act.

Aerosols are more important when it comes to transmitting COVID-19 than we thought six months ago—and we need to act accordingly.

https://time.com/5883081/covid-19-transmitted-aerosols/
Protect schools staying open given essential to society w caveats:
🚨must mitigate risk (masking in schools, ventilation, ⬇️class sizes)
🚨metrics for closing and switch to online if community and school transmission too high.
🚨Have options for parents https://www.mja.com.au/journal/2020/covid-19-children-and-schools-overlooked-and-risk
COVID-19, children, and schools: overlooked and at risk

COVID-19, children, and schools: overlooked and at risk

https://www.mja.com.au/journal/2020/covid-19-children-and-schools-overlooked-and-risk
With travel restrictions/14 d quarantine between health regions, VIHA could get to Zero quite easily & enjoy what Atlantic bubble had for months:
https://vancouverisland.ctvnews.ca/vancouver-island-s-top-doctor-proposes-14-day-quarantine-for-visitors-1.5193268

https://www.nytimes.com/2020/11/18/opinion/covid-halifax-nova-scotia-canada.html

Yes- I know the bubble has burst but optimistic will get it back by.../4
Vancouver Island’s top doctor proposes 14-day quarantine for visitors

Vancouver Island’s chief medical health officer is encouraging the province to impose a 14-day quarantine period for non-essential travellers to the island amid the recent surge in COVID-19 cases.

https://vancouverisland.ctvnews.ca/vancouver-island-s-top-doctor-proposes-14-day-quarantine-for-visitors-1.5193268
Early intervention in regions to crack down on gatherings BEFORE it's really out of control:
https://www.cbc.ca/news/canada/nova-scotia/restaurant-bar-closure-halifax-nova-scotia-covid-19-1.5813793
/5
Association calls for Halifax restaurants and bars to close amid COVID-19 spread | CBC News

The Restaurant Association of Nova Scotia is calling for restaurants and bars in the Halifax area to close to dine-in customers for at least the next two weeks.

https://www.cbc.ca/news/canada/nova-scotia/restaurant-bar-closure-halifax-nova-scotia-covid-19-1.5813793
Rapid testing for LTC to contain the current outbreaks+prevent worsening of this, then hospitals, schools, community:
https://time.com/5912705/covid-19-stop-spread-christmas/

Consider pooled testing for LTC, schools, hospitals to contain outbreaks
https://www.theglobeandmail.com/canada/article-provinces-explore-pooled-covid-19-testing-as-experts-say-canada-needs/

/6
How We Can Stop the Spread of Coronavirus by Christmas

We have a long road ahead before a vaccine is safe, effective and, most crucially, widely available. Here's how we can stop the spread of COVID-19 by Christmas.

https://time.com/5912705/covid-19-stop-spread-christmas/
We MUST ACT re LTCs!
Combo of outbreaks, pt deaths, staff shortages will continue to spiral: need to work on ventilation, PPE & staffing issues ASAP while driving down community spread.

To keep tabs on community spread, wastewater testing could help:
/7 https://www.cbc.ca/news/canada/ottawa/wastewater-levels-covid-19-1.5782488
Ottawa's wastewater suggests COVID-19 levels are plateauing | CBC News

Scientists measuring the levels of COVID-19 in Ottawa's wastewater say data suggests the recent surge of new infections in the city may be slowing, even plateauing.

https://www.cbc.ca/news/canada/ottawa/wastewater-levels-covid-19-1.5782488
Adapt the #COVIDAlertApp .
Contact tracing stretched, esp in Fraser Health, if can encourage +ppl to download, could help.

Summary:
Aerosols, spread in schools, masks to help in schools, ventilation in schools & LTCs, augment testing & tracing, indoor + travel restrictions /8
Most importantly:
We've learned over & over, the precautionary principle is key in #COVID19.

Remember nothing is perfect, no one thing will solve all issues.
But, let's not have perfection be the enemy of good!

All layers of prevention/intervention/management help! /Fin
@steeletalk @KathrynMarlow @cfax1070 @CTVVancouver @CTVNewsVI @cbcnewsbc @CBCVancouver @TheTyee @georgiastraight @VancouverSun @mijungleectv @richardzussman
@COVID_19_Canada @COVIDUpdate2020
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