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Tara Kiran Profile
Tara Kiran

@tara_kiran

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family physician @UnityHealthTO , Fidani Chair in Improvement & Innovation @UofTFamilyMed , Scientist @MAP_Health @ICESOntario , mom of 3, tweets are my own

Toronto
Joined May 2012
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@tara_kiran
Tara Kiran
4 months
Over the last 16 months, our team has conducted the largest public engagement ever on the future of #primarycare in Canada Today we release our final report✨ 10,000 people 10,000 participant hours 1 vision for primary care 🧵
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@tara_kiran
Tara Kiran
3 years
A close family member, under age 50, lives in a GTA hotspot. They asked me how they could get a vaccine. I suggested their best bet was to follow @VaxHuntersCan How is it that the most important vaccination campaign of our lifetime is so reliant on a great group of volunteers?
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@tara_kiran
Tara Kiran
3 years
Like many parents, I'm struggling to understand why the Ontario government is so strongly against using rapid testing to prevent the spread of #covid in schools. THREAD 🧵
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@tara_kiran
Tara Kiran
3 years
How many hundreds of doses of AZ are in our fridges, set to expire in <2 weeks? We need to make a decision about them now. Let people make an informed choice on second doses or send the doses to a region/country where they will be used.
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@tara_kiran
Tara Kiran
3 years
When in doubt, presume COVID PCR (+), RAT (-) = COVID RAT (+), PCR (-) = COVID RAT (+), no PCR = COVID symptoms but no test available = COVID If any of these situations applies to you, please self-isolate for 10 days along with members of your household. Notify your contacts.
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@tara_kiran
Tara Kiran
2 years
The shortage of kids acetaminophen & ibuprofen has been stressful for parents Thanks to our amazing SMHAFHT pharmacists Brenda Chang, Doret Cheng, and Jon Hunchuck @UnityHealthTO @UofTFamilyMed for this handy resource on how you can split and/or crush adult tabs for kids
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@tara_kiran
Tara Kiran
2 years
“The primary role of public health is to reduce harm to the public, and to protect the most vulnerable in society in particular. It should not be about promoting personal preference for the privileged” —⁦ @picardonhealth ⁩ ⁦ @globeandmail
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@tara_kiran
Tara Kiran
3 years
In Ontario, we have many, many different queues to get a vaccine That means a system that is both inefficient and inequitable -Wasted time navigating -Potential double-booking & missed appts -Access easiest for those who are IT savvy, connected, have time, and speak English
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@tara_kiran
Tara Kiran
2 years
Why have so few Ontarians received Paxlovid, a drug that can reduce the risk of hospitalization for those at higher risk of #covid ? Here are some of my observations as a family doc 🧵
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@tara_kiran
Tara Kiran
3 years
The most efficient, effective way to get vaccines in arms for those 5-11 years? School-based clinics, starting with those in communities with higher cases Do PHUs have a plan? Would love reporters digging into this
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@tara_kiran
Tara Kiran
2 years
Almost a third of students were absent at our local school @tdsb this week Sick kids Lost learning Parental time off work Grandparents at risk More COVID everywhere We need to bring back #MaskMandates
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@tara_kiran
Tara Kiran
3 years
1. I've spent some time reviewing NACI's AZ recommendations today Here's why I think I will end up recommending AZ to the vast majority of my patients 40+ after an informed discussion (For context, I live & practice in TO)🧵
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@tara_kiran
Tara Kiran
3 years
Most of the AZ doses set to expire have already been distributed to small pharmacies & primary care clinics. If we don’t want to waste, using them for second doses is probably the only practical option. Those who had their 1st dose should be able to make an informed decision
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@tara_kiran
Tara Kiran
2 years
I wish @globeandmail had published a four-page opinion piece from Dr Allison McGeer on the important role of vaccines in reducing serious illness and death from COVID-19
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@tara_kiran
Tara Kiran
3 years
I’d love to see the Ontario government send an SMS and email to everyone 50+ who received a 2nd dose >6 Mo ago, asking them to get their 3rd dose, explaining why it’s important, how they can book, and where to find more info This should be possible with data from COVAXON
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@tara_kiran
Tara Kiran
4 months
Getting ready to start my day doing a job I still love. Being a family doctor Twenty years later, I would choose it again.
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@tara_kiran
Tara Kiran
3 years
With sky-high case counts, we decided to get our kids (8 and 11) their 2nd COVID vaccine today, ~4wks from their 1st dose An 8 wk interval was initially recommended b/c of theoretically lower myocarditis risk & better/longer immunity We opted for non-theoretical benefit NOW
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@tara_kiran
Tara Kiran
1 year
Everyone in Canada should have a family doctor, NP or primary care team they can see regularly when they need to Let’s set the goal and enact bold reforms to achieve it People in Canada are ready
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@tara_kiran
Tara Kiran
2 years
Primary care is the front door of the health care system But for too many people in Canada, that front door is now closed In my latest commentary @CMAJ , I propose some bold reforms to keep the door wide open 🧵 1/
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@tara_kiran
Tara Kiran
3 years
There seems to be a perception among the public that Pfizer is better than Moderna. Not true! Both have similar efficacy in trials and similar safety profile. Both use mRNA technology. Both are excellent choices. Really.
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@tara_kiran
Tara Kiran
2 years
Primary care is the foundation of the healthcare system Like a good building foundation, we forget about it when it’s working well It’s unseen, unsexy, and no one really wants to spend extra on it But, when it starts to crumble, the whole home can give way 🧵
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@tara_kiran
Tara Kiran
2 years
I've been thinking a lot about the patients in my practice who still say no to the COVID vaccine They are not anti-vaxxers Most have difficult lives—newcomers, BIPOC, histories of homelessness, trauma, poverty They (reasonably) mistrust gov't & are victims of misinformation
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@tara_kiran
Tara Kiran
3 years
If someone in your household tests positive for COVID-19 (by RAT or PCR), please self-isolate for 10 days—regardless of your vaccination status Unfortunately the advice on the @ONThealth website is outdated Instead, use this algorithm 👇🏽
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@tara_kiran
Tara Kiran
3 years
Every day I'm amazed at how many Ontarians step up to get vaccinated—first with one dose and now two—despite a system that is chaotic, confusing, and at times simply unfair Thanks to you, things are moving in the right direction
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@tara_kiran
Tara Kiran
3 years
Emotional as the youngest member of our family got his vaccine today Grateful to everyone who made this happen 🙏🏽🙏🏽🙏🏽 #teamtorontokids #vaccinateTO
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@tara_kiran
Tara Kiran
1 year
In 2002, I graduated from medical school and chose to specialize in family medicine. Why? At the core, I loved the idea of nurturing relationships to support people and communities. 21 years later, I still love what I do. ♥️♥️♥️ Happy #WorldFamilyDoctorDay !
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@tara_kiran
Tara Kiran
3 years
OK, I'm at a loss. It's time for the province to change its tune on rapid testing in schools. We need all the tools in the toolbox
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@tara_kiran
Tara Kiran
3 years
Pure joy to call my patients 80+ this evening and offer them an appointment at our #COVIDVaccine clinic @UnityHealthTO Most were surprised to get the call. All were eager. A few had q'ns that were easily answered. #primarycare #relationships
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@tara_kiran
Tara Kiran
3 years
There is an unfortunate narrative out there that family docs are not seeing patients in person and that this is leading to a rise in ED visits The *real* story is so much more nuanced Yes, some patients are struggling with timely access—but there are many factors at play 🧵
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@tara_kiran
Tara Kiran
3 years
At our clinic, we've been hearing a lot of concerns from patients about the AZ vaccine. Many are reluctant to take it at first but feel confident after a short discussion with their family doctor. Here is what I review during that conversation 🧵 1/
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@tara_kiran
Tara Kiran
3 years
With a record number of cases and rising ICU admissions, it pains me that there is so much AZ in the freezer It's time NACI & Ontario opened up AZ use to more age groups. People are capable of making an informed decision, weighing the growing benefits against the minuscule risks
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@tara_kiran
Tara Kiran
3 years
I've heard anecdotally that some family physicians are still taking a virtual-first approach, triaging who comes in-person It's time to switch to a patient-directed approach—where patients can tell the receptionist what they prefer (See: via @CMAJBlogs )
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@tara_kiran
Tara Kiran
3 years
As a doctor & mom, I'd love a plan that re-introduces in-person learning with strategies that minimize community spread: -better ventilation -more outdoor ed -use of rapid tests -more effective case/contact management -higher teacher:student ratio Is any of this on the table?
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@tara_kiran
Tara Kiran
2 years
Today, our 14 yo got her booster. She walked into our local pharmacy and got it by herself 🙏🏽🙏🏽🙏🏽 to #LawlorPharmcy @KyroMaseh who made it super easy I feel good knowing she's reduced her risk of getting COVID, missing school & transmitting COVID to others
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@tara_kiran
Tara Kiran
3 years
I want to start by acknowledging the confusion and frustration that the latest NACI statement has caused those who got the AZ vaccine—and the pharmacists and primary care clinicians supporting them As I write, I know many are on the phone rescheduling appts A few thoughts 🧵1/
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@tara_kiran
Tara Kiran
3 years
The UK has vaccinated 4x as many people as Canada A key ingredient in their secret sauce? #primarycare GPs have administered roughly 75% of all vaccines in the UK #trust #relationships
@MartinNMarshall
Martin Marshall
3 years
Last autumn NHS leaders predicted 20% of all Covid jabs would be administered from general practice centres. We’re nearly half way through the programme and the figure remains around 75%. Track record, local, trust. General practice needs to be supported to keep going.
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@tara_kiran
Tara Kiran
3 years
Mental health and addictions are inextricably linked to the social determinants of health This is borne out by research and also my own clinical experience Take these examples from my own practice 🧵
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@tara_kiran
Tara Kiran
1 year
Yesterday was #MatchDay , when graduating med students are selected into a residency program Sadly, more than 250 family medicine residency spots went unfilled nationally. 😭😭😭 This does not bode well in a time when >6.5 million people already don't have a family doc or NP.
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@tara_kiran
Tara Kiran
1 year
In 2021, family docs were being blamed for seeing too many patients virtually, purportedly causing more people to visit the ED Our latest research @JAMANetworkOpen @ICESOntario shows that simply was NOT true 🧵 w/ @RickGlazier1 @DrMichaelGreen1
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@tara_kiran
Tara Kiran
2 years
Are you confused about #COVID ? How do you know when you have it? Who can get a test? When to use a RAT? When to call a doctor? You're not alone. We @UofTFamilyMed @OntarioCollege have pulled together answers to common COVID Q's Here's a rundown 🧵
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@tara_kiran
Tara Kiran
3 years
I’ll end though as I started, acknowledging those who stepped up to take AZ—helping us achieve the highest rate of 1st dose coverage in the world—and the pharmacies and primary care offices answering their calls right now. 🙏🏽🙏🏽🙏🏽
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@tara_kiran
Tara Kiran
3 years
Proud of our team ⁦ @UnityHealthTO ⁩ ⁦ @UofTFamilyMed ⁩ who have vaccinated 30 shelter programs and 3 congregate living buildings in TO for a total of 1350 first doses to shelter residents and 125 to shelter staff! 👏🏽👏🏽👏🏽
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Tara Kiran
2 years
Hey primary care, There are new drugs that we can prescribe to (select) adults with COVID in the community Check out this useful 2-pager developed by our pharmacists Brenda Chang, Doret Cheng, Sharan Lail & Beth Leung at St. Mike's @UnityHealthTO @UofTFamilyMed Please share!
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@tara_kiran
Tara Kiran
3 years
Everyone is worried about the new variant, Delta What can we do about it? At our session this morning, Peter Juni @COVIDSciOntario had two clear messages: -prioritize 2nd doses where the Delta-variant is spreading (e.g. Brampton, Peel, Toronto) -reduce inter-regional travel
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Tara Kiran
3 years
If we want to vaccinate more people quickly, we need to give more vaccine to primary care Agree with ⁦ @BogochIsaac ⁩ in this ⁦ @CBCNews ⁩ article I’d add that giving more vaccine to primary care would also lead to a more equitable rollout
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@tara_kiran
Tara Kiran
2 years
To start, there has been too little public communication about treatments available, who qualifies & where they can access it We’ve tried to fill this gap with resources like this one via But we need a big multi-channel campaign
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@tara_kiran
Tara Kiran
3 years
I know some parents are reasonably worried about the risk of myocarditis following COVID-19 vaccination for children 5 to 11 Here's what we know about the risk and why experts think it will be much LOWER in this age group than with teens/adults 🧵
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@tara_kiran
Tara Kiran
2 years
Thanks to colleagues ⁦ @cdavidnaylor ⁩ ⁦ @DrFahadRazak ⁩ and Art Slutsky for countering the misinformation published in last weekend’s ⁦ @globeandmail ⁩ Vaccines have reduced serious illness and death from COVID-19. Period.
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@tara_kiran
Tara Kiran
2 years
Public education is crucial b/c the meds are only effective if given within 5 days of symptoms. And most people have received the message to not bother the healthcare system if they have symptoms and can manage at home. Now we want *some* people to call us ASAP
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@tara_kiran
Tara Kiran
2 years
You just found out your child has COVID. What should you do? How can you best care for your child? When should you call the doctor or take them to the ED? Our latest resource provides the answers 🧵
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@tara_kiran
Tara Kiran
29 days
How is that >98% of Danes have a GP? Part of the answer lies in their approach to training physicians. Here's a summary of some of what I've learned on my trip to Denmark 🇩🇰 🧵 (the photo here is a wall of some of the 170+ residents trained at the practice I visited)
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Tara Kiran
3 years
Special day at our community vaccine clinic run by Regent Park CHC ⁦ @FredVictorTO ⁩ ⁦ @UnityHealthTO ⁩ We hit 10,000 doses—and I got to end my shift vaccinating an extra special someone (dose 2!)
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Tara Kiran
3 years
We know that a recommendation from a trusted healthcare provider goes a long way towards building vaccine confidence That's why @NoahIvers and I drafted this letter to send to our patients, encouraging parents to say YES to the #covidvaccine for their kids age 5 to 11
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@tara_kiran
Tara Kiran
2 years
To date, we’ve used a paltry ~3% of Ontario’s supply of Paxlovid. There is lots of room for better
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@tara_kiran
Tara Kiran
3 years
Is it because community case counts aren't high enough for the tests to pick up enough cases to make it worthwhile? Well, if that's the argument then it makes even less sense to support rapid testing of vaccinated adults in workplaces
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@tara_kiran
Tara Kiran
3 years
I worry that we will once again have too many vaccines in freezers instead of arms - when we know speed saves lives. Why do we need to wait for an online booking system when our central database is ready & we have other ways to book. And why the delay?
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@tara_kiran
Tara Kiran
3 years
Is it because we have done everything we can to keep schools safe? No. We have masks, some distancing, some improvements in ventilation but still large class sizes and plenty of covid circulating in the community (figure via @dgurdasani1 )
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Tara Kiran
3 years
Is it because the tests are in low supply or too expensive to purchase? No. My understanding is the feds are purchasing and distributing the rapid tests to provinces
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@tara_kiran
Tara Kiran
2 years
Most people who become infected with COVID can recover at home without any treatment But there are now medications doctors can prescribe to keep high-risk folks from getting seriously ill Which meds? Who can get them? We break it down in our latest @
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@tara_kiran
Tara Kiran
3 years
If you have any symptoms--even if they are mild and even if you are doubly vaccinated--please self-isolate Get a PCR test if available If no PCR test is available, continue to isolate while you have symptoms (even if a RAT is negative)
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@tara_kiran
Tara Kiran
2 years
Current ED woes relate to: -a surge in respiratory viruses (eg RSV) -understaffing in ED and hospitals -understaffing in LTC and home care (leading to high ALC rates) -limited hospital capacity to start Let’s stop blaming family doctors
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@tara_kiran
Tara Kiran
2 years
5 million Canadians don't have a primary care home and that's a huge problem But arguing about whether we need more family docs OR more NPs in primary care to "fix" the problem is the wrong debate and a false choice We need BOTH—and a whole lot more 🧵
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@tara_kiran
Tara Kiran
3 years
Humbled to be named alongside so many people I respect and grateful to the 1000’s who have been part of the vaccination effort—scientists, healthcare workers, administrators, community leaders, advocates, volunteers & all who rolled up their sleeve 🙏🏽🙏🏽🙏🏽
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Tara Kiran
2 years
*NEW* Our latest study @AnnFamMed @RickGlazier1 shows that team-based primary care, coupled with payment reform, can improve patient outcomes & reduce ED use We desperately need to expand team-based primary care in Canada (a mega 🧵)
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Tara Kiran
3 years
Fri, 815am - 8yo says he has a sore throat and runny nose These symptoms are NOT on the school screener but we knew he should still stay home 845am - we notified the school and asked for a take-home test kit 9am - picked up this kit from the school office (thx @MGHToronto )
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Tara Kiran
2 years
Cuts to med school enrolment in the 90’s resulted in Canada losing part of a generation of doctors Now nearly 1 in 6 family docs are 65+ and nearing retirement—with too few docs in the pipeline to take over More great reporting @kahowlett @globeandmail
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@tara_kiran
Tara Kiran
3 years
Is it because we don't have the person-power to package/distribute the kits and interpret/action the results? No. Even if PHUs are stretched, it seems like there are many eager community volunteers
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Tara Kiran
3 years
Is it because experts disagree on how rapid antigen tests should be used to keep schools safe? No. The federal testing and screening panel issued recommendations about rapid testing in schools in March 2021 (!)
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Tara Kiran
3 years
Is it because what we've done in schools has worked to keep out covid and related outbreaks No. There have already been plenty of cases and outbreaks in school with classes sent home and education disrupted
@TorontoStar
Toronto Star
3 years
In the last two weeks alone, more than 1,500 cases have been reported in over 800 elementary, middle and high schools, including some 1,400 in students and 160 in staff.
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Tara Kiran
3 years
The latest policy @fordnation is not so much a failure to listen to science but a failure of common sense 3 days of paid sick leave isn’t going to help much when a typical isolation/quarantine is 10/14 days Without paid time off, many will go to work and so the virus spreads...
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@tara_kiran
Tara Kiran
3 years
A marginalized patient living in a hotspot didn’t know they were in a hotspot or that they were eligible to book a vaccine “I don’t want to wait in any lines. I just wanna come and get it from you when you have it” I didn't have vaccine but he left with an appt to get one
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Tara Kiran
3 years
Is it because of concerns about equity in access? Well, then implement a screening test strategy in all schools located in covid hotspots
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Tara Kiran
3 years
10. So if you're in the GTA or another region with medium or high covid transmission and are over 40 years of age and aren't shut-in at home all the time, the best vaccine is still the one that's first available to you
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Tara Kiran
3 years
Winter dressing is all about layering So is COVID protection Layer 1: Get your 1st/2nd/3rd doses of vaccine Layer 2: Wear good quality mask indoors Layer 3: Breathe fresh/filtered air Layer 4: Postpone or keep gatherings small @COVIDSciOntario
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@tara_kiran
Tara Kiran
2 years
Parents: this website is a great resource from @SickKidsNews that provides trustworthy advice on what to do when your child is sick They've just posted a new resource on using adult anti-fever tablets for kids h/t @allan_k_grillMD
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@tara_kiran
Tara Kiran
3 months
Primary care should be a legislated right. That >6.5 million people in Canada go without it is antithetical to the values people hold dear and the promise of Medicare Thanks @janephilpott for this terrific op-ed. I can’t wait to read your book!
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@tara_kiran
Tara Kiran
2 years
Things are changing fast. It's hard to keep up. Fear not. We have updated our resources based on new guidance issued by the province last week and the many questions we've received Here's a short summary 🧵 @OntarioCollege @UofTFamilyMed
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@tara_kiran
Tara Kiran
3 years
Is it because kids and parents already have easy access to PCR testing? Nope.
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@tara_kiran
Tara Kiran
1 month
Total health spending in Denmark 🇩🇰 is similar to Canada 🇨🇦, yet almost everyone in Denmark has access to primary care I'm here on a 9-day tour to learn how they make it work Today I met with Morten Petersen, CEO of , the Danish e-health platform 🧵
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Tara Kiran
3 years
85% of eligible Canadians fully vaccinated A kids vaccine approved in the US Low/declining cases in most regions Truly light over darkness Happy Diwali 🪔
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@tara_kiran
Tara Kiran
3 years
With new variants on the rise and a possible 3rd wave on the horizon, speed matters The faster we vaccinate, the more lives we save That's why we need to use all available resources—including family doctors My latest @TorontoStar
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@tara_kiran
Tara Kiran
3 years
I've been overcome with emotion these last few days immense sadness - for the lives lost anger - at our policy failures and their unequal impact frustration - still no #PaidSickDays guilt - could I have done more? hope - seeing so many colleagues working hard for better
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@tara_kiran
Tara Kiran
3 years
Not sure if you qualify for a booster vaccine dose in Ontario or what meds are considered immunosuppressants? @ONThealth has just released more specific guidance including a med list here:
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@tara_kiran
Tara Kiran
2 years
So how can we do better? There are the basic things—a public education campaign, a clearer website, easier-to-access centres But we also need to ramp up distribution channels Primary care professionals should be empowered to prescribe
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Tara Kiran
2 years
This headline is disappointing. Our research has shown repeatedly that the vast majority of family doc offices have been open to in-person visits through the pandemic Our team has been seeing +++ people with respiratory illness these last few weeks.
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@tara_kiran
Tara Kiran
3 years
Thanks @globeandmail for sharing the stories of some of the >5000 Canadians who lost their life in 2020 due to an opioid overdose — too many of them in the prime of their lives.
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@tara_kiran
Tara Kiran
22 days
Fun fact: nearly every person in Denmark 🇩🇰 has the name of their GP (or group of GPs) on their healthcard It's an organized system where 98+% have access to primary care. How do they do it? One key lies in how GPs are organized. 🧵 (photos of Christian Folsach's practice)
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Tara Kiran
3 years
Wouldn’t it be great if every Canadian could get a family doctor with the same ease with which you register kids for public school? Think it’s a dream? It doesn’t have to be My latest oped @TorontoStar w/ @docdanielle
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Tara Kiran
3 years
Humbled to be on the same list as so many who inspire me—like all-time greats @janephilpott @cdavidnaylor @AndreasLaupacis and next gen stars @jkwan_md @DanyaalRaza @chikastacypoet And of course my partner in life @IrfanDhalla Good thing I asked him out all those years ago
@MedicalPost
The Medical Post
3 years
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Tara Kiran
2 years
In Ontario, access to Paxlovid is via select COVID clinical assessment centres People self refer or they can be referred by their family doc But the MoH website doesn’t make it easy to know where to go
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@tara_kiran
Tara Kiran
3 years
I have huge respect for the individuals working with NACI. Now, >15 mo into the pandemic, they really need to be supported by savvier comms. They would also benefit from welcoming more members of the public, pharmacists & primary care clinicians to their deliberations 10/
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@tara_kiran
Tara Kiran
2 years
Lots of discussion about burnout in healthcare What is one thing we can all do to help? Be extra kind Especially to nurses, clerical, and other support staff who often bear the brunt of patient frustration There are big system problems. It's not their fault.
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@tara_kiran
Tara Kiran
3 years
Nearly 70% of parents are keen to have their children age 5-11 get the Covid vaccine 👏🏽 Top reasons ✅protect their kids from COVID ✅protect others in their family ✅prevent missing in-person school ✅more comfort taking their kids to public places
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@tara_kiran
Tara Kiran
2 years
When you look up COVID clinical assessment centres you get a list of “COVID assessment centres” together with “COVID clinical assessment centres” Both types offer testing but it’s only the “clinical” centres that can provide COVID treatments
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@tara_kiran
Tara Kiran
3 years
What are the medical exemptions to #COVID vaccination? In short: -anaphylaxis or serious allergic rxn to COVID vaccine or its components AND review by allergist -myocarditis/pericarditis with 1st dose Some helpful guidance for providers on pg 5-6 here:
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@tara_kiran
Tara Kiran
5 months
Family medicine is often seen as a "lesser than" specialty. In truth, generalism is more and more needed yet harder and harder to practice. Family medicine needs respect, pay and support commensurate with its value via @thewalrus cc @UofTFamilyMed
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@tara_kiran
Tara Kiran
3 years
Delighted that @docdanielle will be our new Chair @UofTFamilyMed —and my new boss! 👏🏽👏🏽👏🏽🎉🥳 A compassionate, visionary leader committed to equitable care. The perfect choice to lead our 1600+ faculty & ~300 residents to shape a better primary care system for all
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@tara_kiran
Tara Kiran
3 years
Our journey illustrates how important it is to give parents clear guidance on what to do if their kid has sx and provide easy access to PCR testing Felt super lucky to live in east TO where every school has school has take home tests thx to @MGHToronto @janinemccready + others
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@tara_kiran
Tara Kiran
20 days
What's a typical day in a GP practice in Denmark 🇩🇰 where 98%+ of people have access to primary care? Here's some of what I learned spending the day at a practice in Aarhus last month 🧵 (and yes, the space really is as beautiful as it looks in these photos!)
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