Stefan Baral @sdbaral Twitter profile | Pikagi

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Stefan Baral

@sdbaral

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🇨🇦🇸🇪,MD,MPH FRCPC (CM) & CCFP (Fam Med), 🏳️‍🌈 ally No COI Papers: Course: COVID Talk:

I'm right here!

https://t.co/FPNVYMVqGb

Joined April 2009

Don't wanna be here? Send us removal request.

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@sdbaral

Stefan Baral

3 years

My Public Health Truths (a "living" thread). There are few "truths" in public health, but the following include those I have observed in quantitative & qualitative studies, community engagement, and program implementation independent of socioeconomic or geographic contexts.

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@sdbaral

Stefan Baral

2 years

I'm a vaccinated doctor who has vaccinated more people than 99% of doctors on this website and I think firing unvaccinated people is a terrible idea.

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@sdbaral

Stefan Baral

2 years

BY THE TIME YOU CLOSE YOUR BORDERS, THE VARIANT IS ALREADY THERE. (my first all caps tweet)

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@sdbaral

Stefan Baral

2 years

I don't know who needs to hear this, but a 2 week lockdown will not end the pandemic.

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@sdbaral

Stefan Baral

2 years

So I can scan the qr code, download the app, open the app, scan the qr code with the app to tell it what elevator I'm at, and then call the elevator. Or. I can push the button.

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Stefan Baral

2 years

I work at a shelter serving the elderly. Most have not seen their families since the 2019 holiday season. Almost 2.5 years. Anyone who says social distancing doesn't have costs should come by for a visit one day.

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Stefan Baral

2 years

So my wife has a cold and I asked her to isolate in the basement and she gave me the finger. Is that how it's supposed to work?

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Stefan Baral

2 years

Just so I understand the #omicronaffair well: 1) South African scientists characterize a variant. 2) The world blocks travel to EVERY Southern African country. 3) The world starts using the same sequencing strategy developed by South Africans and find lots of omicron. Right?

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@sdbaral

Stefan Baral

1 year

To be clear: I'm a parent. I'm an active clinician. I'm a public health scientist. I'm likely way left of you politically. I think the evidence of benefit of masking young kids is negligible and the potential for harms credible. And I don't want my kids wearing masks in school.

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Stefan Baral

2 years

If you are a doctor and still unwilling to see patients in person in September, 2022--time to find a new profession.

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Stefan Baral

2 years

In full disclosure, I have thought vaccine passports were a really problematic idea from the time that I heard the idea floated in April of 2020. But now, I think they are useless in terms of public health impact too.

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Stefan Baral

2 years

Just a FYI, I cannot be bullied. I am old, married, and with kids. I have three friends in my life including my wife and two kids and need no more.

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@sdbaral

Stefan Baral

1 year

Do Americans realize that foreigners (like me) need to be vaccinated to enter your country? In December, 2022.

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Stefan Baral

2 years

I'm a practicing physician and analyze data for a living and can't understand for the life of me why we would ever mandate young people to get a fourth dose (bivalent or not).

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Stefan Baral

2 years

Let me perfectly clear, I would be happy to chat with anyone about the benefits of vaccination but will never stigmatize them if they choose not to get vaccinated. I see no role for judgment and shame in medicine or public health. I never have and never will.

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Stefan Baral

2 years

The only reason for a government to maintain a state of emergency for COVID in October of 2022 is to circumvent traditional accountability mechanisms.

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Stefan Baral

2 years

That 2-4 year olds are the only group mandated to wear masks in New York City is more akin to religious dogma than empiric public health.

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Stefan Baral

2 years

I would love for us to stop referring to people who chose not get the COVID-19 vaccine as "the unvaccinated". It is a vaccine and not a personal attribute.

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Stefan Baral

3 years

#ZeroCovid will never happen. 1) Vaccines prevent severity, but less so infection. 2) Lots (and lots) of animal reservoirs. 3) Asymptomatic infection (especially with vaccines). No one likes #COVID19 , but it is time to accept that this virus is now part of this world. Forever.

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Stefan Baral

2 years

My experience having to wear N95s in outbreak settings only reinforces my perspective that making kids wear them all day long in school is ridiculous.

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@sdbaral

Stefan Baral

2 years

As a two doctor family, we made a calculated decision that loneliness would be worse for our then two year old than the risk of getting #COVID19 . I get that different parents would have made a different decision which is totally fine. Different strokes for different folks...

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Stefan Baral

2 years

I realize some unfollows coming up, but in the spirit of honesty: 1) I will only mask if I have to or the people I'm with prefer me to. 2) I will not avoid contact with anyone who wants to hang out. 3) I have never really believed lockdowns were an effective response strategy.

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Stefan Baral

2 years

The ongoing selective blockade of Southern African countries for a virus now identified in 53 countries is totally fucked up. #omicronaffair

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@sdbaral

Stefan Baral

1 year

Just a FYI that about 60-65% of people need to leave their homes for work so that 35-40% of folks can stay home with access to food, heat, water, transport, internet, and power. There was never a lockdown...it was just wealthy folks ordering in rather than eating out.

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Stefan Baral

2 years

My triply vaccinated mother was planning on staying home alone for new years eve. As a loving son, I reminded her that she's well protected from her vaccines and loneliness sucks. In the end, she had a potluck dinner with her best friends and they had a great time (in sweden).

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Stefan Baral

3 years

Just a FYI that testing positive for #SARSCoV2 with pre-existing immunity (vaccination/infection) and experiencing mild or no symptoms is a test result, not a disease.

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Stefan Baral

2 years

Just a FYI that the removal of vaccine passports doesn't change one's level of risk when eating at a restaurant.

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Stefan Baral

3 years

I don't know who needs to hear this, but the criminalization of transmission of a virus is never the right answer.

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Stefan Baral

3 years

My guess is that outdoor masking has not averted a single #COVID19 infection anywhere in the world.

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Stefan Baral

2 years

I cannot wait for the day when vaccine passports disappear and I can return to normal discussions with patients about why I think they should get vaccinated.

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Stefan Baral

2 years

Just a FYI that if someone has to bring something to your door, you haven't decreased absolute risk, you just offloaded it on to someone else.

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Stefan Baral

2 years

Masking likely represents the most ambitious public health intervention in history. An intervention we wanted all people: 1) to do multiple times per day 2) every single day 3) across a wide range of environments 3) with no clear end in sight It. was. never. going. to. work.

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Stefan Baral

3 years

Pro tip: for folks out there shaming the unvaccinated, it is not helping with vaccine uptake and it never will. Please stop. Ok, thanks.

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Stefan Baral

2 years

Yes, we wanted folks to get vaccinated. Many did. Some didn't. Time to let it go and rehire everyone who wants their job back.

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Stefan Baral

2 years

Canada is leading the world lifting the mask mandates on flights on October 1st. And by leading the world, I mean following the lead of Australia, Denmark, Switzerland, Germany, New Zealand, Singapore, Norway, Sweden, South Africa, Senegal, and basically every country on earth.

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Stefan Baral

2 years

I am a licensed and practicing physician in Canada and will never treat someone differently based on the health choices that they have made. That's not me being a nice person. That's the law.

@sdbaral

Stefan Baral

3 years

Line has been drawn. If Canada moves to a model where bad choices dictate access to care, I will stop practicing medicine here. Need a reminder on the five core principles of the Canada Health Act? Public administration Accessibility Comprehensiveness Universality Portability

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Stefan Baral

1 year

We closed schools, afterschool activities, sports, and outlawed playdates. We closed the fricking playgrounds. And people on this hellsite are trying to convince me that we didn't lockdown kids? GTFOH.

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Stefan Baral

3 years

If social distancing and masks were primary drivers of the decrease in influenza this year, why did it also disappear in Sweden?

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Stefan Baral

3 years

If I see another comparison of #COVID19 vaxxports to vaccine records or yellow fever, I might blow a gasket. 1) We have never needed Photo ID and vaccine records to go to a restaurant. 2) Yellow fever vaccine is available in abundance in all countries and doesn't limit movement.

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Stefan Baral

3 years

To be perfectly clear, I am deeply pro-vaccine and deeply against vaccine passports.

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Stefan Baral

2 years

Can doctors please go back to doing mostly in person care? Asking for...a lot of people.

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Stefan Baral

3 years

If Australia were Angola, we would have already sent in international peacekeepers.

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Stefan Baral

3 years

In real life, someone educated me that if we had just aimed for #COVIDZero , we'd have never needed lockdowns. I rarely engage, but asked about Australia. They said Australia only had a short lockdown and eliminated the virus. Then I realized...people just make this shit up.

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Stefan Baral

1 year

I still can't believe that we let some white dudes that like sushi or tried kimchee a few times tell us that people across Asia have been wearing masks regularly for decades and many folks accepted it as fact.

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Stefan Baral

2 years

Historically, we didn't teach about lockdowns as default public health interventions. But they are now part of the lexicon. My guess is in the future we'll teach that they mainly protect rich folks, increase disparities, and come at grave risks to overall health and wellbeing.

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Stefan Baral

2 years

I've got good news and bad news. If you're a fan, the good news is that I'll train this little one to be ready to start tweeting about public health and medicine in just 18 years or so. If you're not a fan, watch out as we made another!

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Stefan Baral

3 years

Just a FYI that one can be very pro-vaccination and appreciate that immunity from infection is real. Thoughts: 1) No sane folks seek to be infected 2) Immune system is more than a few antibodies 3) Downplaying infection-derived immunity is an unnecessary battle that burns trust.

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Stefan Baral

2 years

The last week has taught me that one in-person meeting is worth a thousand zoom calls.

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Stefan Baral

2 years

Pro-tip: if an epidemiologist now presents themselves as a political science and military strategy expert, ignore them. Sincerely, an epidemiologist.

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Stefan Baral

2 years

Doctors should assess sick people in person. (that's the tweet)

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Stefan Baral

2 years

When the Queen of England gets #COVID19 at 95 and vaccines allow her to keep working, we are in a new phase of this pandemic.

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Stefan Baral

2 years

At some point, public health really lost its primary customer. ie, the public. And I worry it will take a long time to get them back.

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Stefan Baral

3 years

I don't get why I would have spent a dozen years preparing to practice public health if sequential lockdowns were the default strategy.

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Stefan Baral

2 years

If I thought mask mandates as currently designed made a significant difference, I would be hugely supportive. But I don't. So I'm not.

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Stefan Baral

2 years

Dear primary care docs, It is time to go back to providing in person care. Sincerely, A primary care doc that constantly sees the fallout from predominantly virtual care.

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Stefan Baral

8 months

This week in Canada. 1) Accused the world's largest democracy of an assassination on Canadian soil without presenting any evidence and now we can't visit India. 2) Our parliament gave a standing ovation to a Nazi SS soldier. So how are things going in your part of the world?

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Stefan Baral

2 years

I'm a decent doctor and epidemiologist. I've seen too much data and had too many clinical experiences to judge people for health behaviors. Sex, drugs, and rock and roll (and vaccines)--whatever. If that's goodbye, totally understand! (You probably wouldn't like me anyway.)

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Stefan Baral

3 years

My guess is that naming, shaming, and blaming has not encouraged a single person to get vaccinated for #COVID19 .

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Stefan Baral

2 years

It's super interesting seeing doctors and scientists argue with others on this site and be hopelessly intellectually outmatched--and not understand how that is possible.

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Stefan Baral

3 years

Can I ask, where do homeless folks go during a stay-at-home order? Asking for 10,000 people in the city of Toronto.

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Stefan Baral

3 years

As a clinician who has been seeing people in person throughout #COVID19 and has been talking through vaccine hesitancy with folks...I would NEVER talk to or about people like this. It shames me. WTF.

@nowthisimpact

NowThis Impact

3 years

‘Grow the f*ck up and get the vaccine’ — These health care workers shared their honest thoughts about anti-vaxxers in this hilarious PSA on ‘Jimmy Kimmel Live!’

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Stefan Baral

3 years

Kids need other kids. That's the tweet.

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Stefan Baral

3 years

Worst public health response in history.

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@sdbaral

Stefan Baral

2 years

In case not obvious by now, waves of covid will literally never stop as long as we keep testing. That's the bad news. The good news is that these waves will continue to be less relevant from an individual and public health perspective.

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Stefan Baral

3 years

My guess is that if we focused on who and why people are at risk for #COVID19 rather than just how many people affected, our responses would look very different.

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Stefan Baral

2 years

I'm not sure who needs to hear this, but for essential workers parents with young kids, schools closing means they can't go to work. So who are essential workers? They keep lights and internet on, water, cars, and supply chain running, and beyond. Ie, they keep society afloat.

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Stefan Baral

2 years

When mandates go away, I won't wear a mask in clinical settings unless a patient asks me to.

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Stefan Baral

3 years

For those places pushing for requiring vaccine certificates for 5-11 year old children, I'm assuming that matching ID will be required to enter indoor spaces. So, how many 6 year olds do you know who carry ID?

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Stefan Baral

2 years

Let me fix this headline: Pandemic Learning Loss Is Not an Emergency If... 1) You don't have kids 2) You are wealthy and it was less likely to affect your kids (or kids you know).

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Opinion | Pandemic Learning Loss Is Not an Emergency (Published 2022)

In a vacuum, test score declines look like bad news. But none of this happened in a vacuum.

www.nytimes.com

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Stefan Baral

3 years

Big pharma should not guide health policy. (that's the tweet)

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Stefan Baral

3 years

Just a FYI, one can be both very pro #COVID19 vaccination and also be worried about the individual risk:benefit profile of #COVID19 vaccines in <16 yo.

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Stefan Baral

2 years

Just a FYI that in Ontario, doctors are not allowed to refuse care based on a patient's vaccine status or masking.

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Stefan Baral

2 years

I finally figured out that being called a covid minimizer on twitter has nothing to do with actually minimizing covid (I don't). Rather, the term seems to imply not being supportive of a restrictions-based covid response (yep, you got me).

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Stefan Baral

1 year

Ask yourself what's more likely: COVID-19 is unlike any pandemic in the history of our earth causing increasing immunosuppression with each infection until our species ceases to exist. Or. This is the first major pandemic in the social media age where everyone has a platform.

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Stefan Baral

2 years

While there is no doubt that third doses serve a critical role for many folks, I know of no evidence that suggests mandating it for all folks is appropriate.

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Stefan Baral

2 years

Sometimes it feels like the most consistent finding in #COVID19 is that if we dig a little, someone is using misery to make money.

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Stefan Baral

2 years

I've recently been in a mask optional place where new infections are dropping precipitously. Some folks wearing N95, others KN94, cloth masks, some below nose, and some below chin. Some just wearing a smile. No tension or anger in any direction. Soon we'll all get there!

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Stefan Baral

3 years

The odds of getting hurt crossing a street are infinitely higher than the odds of catching #COVID19 from a passerby.

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Stefan Baral

2 years

For almost two years we asked truckers to keep working without any protection or resources so other folks could stay home and still get everything they wanted. Yes, truckers would benefit from vaccination. But firing them if they don't? Not the public health that I trained in.

@sdbaral

Stefan Baral

3 years

Thanks to Transport Industry during #COVID19 Your industry: 1) delivers everything from batteries to bananas 2) involves high and difficult to avoid exposure risks 3) often not highly paid positions Without you, society would dissolve. (I have no financial/family connections)

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Stefan Baral

1 year

Just a FYI that nothing positive has ever come out of thinking about someone else as a vector of disease.

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Stefan Baral

2 years

It's almost like restrictions work better in mathematical models than in real life...

@EricTopol

Eric Topol

2 years

Shanghai is tracking Hong Kong @EleanorOlcott @imandylin2 and "Almost 200mn people and 23 cities are under full or partial lockdown"

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Stefan Baral

3 years

A #COVID19 bias that we have yet to really tackle is the "visible intervention" bias. The "visible intervention" bias drives us to do things like implement outdoor mask mandates rather than tackling the living and working conditions driving so many infections.

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Stefan Baral

3 years

Isn't it amazing that science figured out how to turn mRNA into life saving vaccines in under a year while not figuring out how to address the living and working conditions that drive incidence and disparities in basically every acute respiratory pandemic going back 100 years.

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Stefan Baral

3 years

Ultimately, we will be able to compare data from kindergarten and elementary schools in countries across Europe and North America. And my guess is that we will see that masking young children accomplished very little in terms of individual, school-level, or community benefits.

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Stefan Baral

2 years

Every pediatrician that I know wants their kids in school in person. I guess I never asked them whether: 1) they are part of the "open school" right-wing conspiracy. 2) they don't like their kids. I'll get right on that.

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Stefan Baral

2 years

As a long standing @NDP voter, I'm done with this party and am now officially politically homeless.

@RichardCityNews

Richard Southern

@RichardCityNews

2 years

NEW - NDP leader Andrea Horwath says she believes kids 5-12 should also have to show proof of vaccination in the same place as adults do. “I believe so, absolutely” she says. When asked when that should happen say says the advice of health experts should be followed.

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Stefan Baral

3 years

Just so I'm clear, are we planning on vaccinating young children to protect vaccinated adults?

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Stefan Baral

3 years

That's not how it works... That's not how any of this works.

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Stefan Baral

3 years

Let us not forget. On March 13, 2021, an outdoor vigil highlighting violence against women was shut down using violence against women in the name of public health. This is not the public health that I trained in or decided to dedicate my life to practicing.

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Stefan Baral

2 years

Flight attendants building seniority on regional flights like YYZ-ORD work hard dealing with short flights, varying rules of two countries, low salary, schedule changes, etc. Posting their photo puts them at risk and counters the rules. @united , stick up for your team next time

@united

United Airlines

2 years

@profamirattaran Hi Amir, thanks for bringing this to our attention. We've informed the appropriate teams for further review. ^JB

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Stefan Baral

2 years

It wasn't my undergrad, med school, residency, MPH, fellowship, or research that gave me insight into how misguided much of the #COVID19 response was. It was working in person with essential workers in March, 2020 and seeing how disconnected the guidance was from their lives.

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Stefan Baral

2 years

Is there a world leader that hasn't yet been caught openly breaking #COVID19 rules?

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Stefan Baral

2 years

Feeling bad for travel testing companies about the end of their grift is like feeling bad for a bank robber who got away with it and is chilling out on a beach somewhere.

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Stefan Baral

3 years

This is not public health.

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Stefan Baral

2 years

Experts knew 30 years ago that a virus like SARS-CoV-2 met exactly zero criteria for a virus that could be eliminated. Anyone who tells you differently (in 2022!!!) either has not read enough literature or is being disingenuous. You pick.

@sdbaral

Stefan Baral

4 years

#COVID19 currently meets basically no established criteria of a virus that could eliminated. Elimination is the ultimate goal in public health. Elimination carries huge competing health and economic harms to be considered when deciding whether to try.

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Stefan Baral

3 years

I have an only child. When the lockdowns first were put in place, his existing friends parents didn't want any engagement. All good! So we (both doctors) sought out parents who were up for outdoor playdates--and been having them for the last year. #COVIDIOTS #woulddoitagain

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Stefan Baral

2 years

Just a reminder that it is seriously cold out and that if folks don't have a QR code vaccine passport with matching ID, only allowed indoors to get takeout and then have to leave. I know this affects exactly no one reading this message--but just take a second to think about it.

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Stefan Baral

9 months

Seeing Mehdi Hasan turn to fringe scientists to argue that closing schools was the right decision is striking. It may get some likes on twitter, but the average person watching will remember what happened to their kids with closed schools and seal their distrust in legacy media.

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Stefan Baral

3 years

Risk assessment? Absolutely! Risk mitigation? Absolutely! Risk management? Absolutely! Risk communication? Absolutely! Risk Elimination? Impossible.

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Stefan Baral

3 years

I find the denial of the ongoing mental health crisis as horrific as the denial of #COVID19 .

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Stefan Baral

3 years

I can't believe this needs saying, but all people deserve the best health care services possible. No exceptions. None.

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