Dr. Clay Hammett - Family Medicine

02/12/2023

https://www.cbc.ca/amp/1.6743046

Folk musician Daniel Lapp has taken to playing a unique instrument, one that can be found on the beach.

07/12/2021

Real World Evidence for COVID-19 Vaccines
CLINICAL QUESTION

What is the real-world effectiveness for currently available COVID-19 vaccines?

BOTTOM LINE
Similar to clinical trials, real world cohort and case-control studies find COVID-19 infections are reduced by >90% with two doses of mRNA vaccines. Single doses of either mRNA or AstraZeneca vaccine decreases infections by ~60% and hospitalizations by 70-80%. Vaccine effectiveness appears similar for variants of concern and are safe for pregnant women.

EVIDENCE
From relatively short cohort/case-control studies or registries. Fully vaccinated defined as 7- or 14-days post-second dose.
Israel national vaccination (Pfizer) program of 6.5 million adults ≥16 years old.1 New COVID-19 cases in the program’s initial 10 weeks was compared to vaccine status. Full vaccination decreased risk of:
All COVID-19 infections: By 97%.
Hospitalizations and deaths: By 98% and 99% respectively.
Limitations: The same individuals contributed time to unvaccinated, partially vaccinated and fully vaccinated calculations.
United Kingdom case-control study, persons ≥70 years with COVID-19 (n=44,590) linked to vaccine status.2 Single dose of either Pfizer or AstraZeneca reduced:
Symptomatic infections: ~60% (~1 month after either vaccine).
Hospitalizations: 80% (either vaccine).
Death: ~85% [Pfizer (AstraZeneca death rates not reported)].
Ontario four-month case-control study, adults ≥16 years:3
Single-dose (Pfizer or Moderna) reduced:
Symptomatic infection: 60%.
Hospitalization or death: 70%.
Two-doses reduced:
Symptomatic infection: 91%.
Hospitalization or death: 98%.

CONTEXT
Findings similar to clinical trials.4
Variants of Concern (VOC):
Two doses of Pfizer or AstraZeneca reduces symptomatic delta variant infections or hospitalizations similar to non-VOC infections.5
Pfizer or Moderna vaccination reduces symptomatic infection or hospitalizations in four current VOC (alpha, beta/gamma, delta) similar to non-VOC.6
Two doses are better than one.6
Safety in Pregnancy:
35,691 pregnant women received Pfizer or Moderna vaccine (29% 1st trimester, 43% second trimester, 26% third trimester):7
Adverse pregnancy outcomes with vaccine same as baseline risk.7
Babies born to pregnant women with COVID-19 are twice as likely to develop severe perinatal morbidity and mortality.8
Pregnant women with COVID-19 have 50% greater risk of maternal morbidity or mortality.8
Pregnant women should be offered COVID-19 vaccine.9
Recommendations for vaccinated individuals available: Canada or United States.10,11

REFERENCES
Haas EJ, Angulo FJ, McLaughlin JM, et al. Lancet. 2021; Published Online May 5, 2021. https://doi.org/10.1016/ S0140-6736(21)00947-8
Bernal JL, Andrews N, Gower C, et al. BMJ. 2021;373: n1088. http://dx.doi.org/10.1136/bmj.n1088
Chung H, Nasreen S, Sundaram ME, et al. MedRxiv preprint May 24, 2021; doi: https://doi.org/10.1101/2021.05.24.21257744;
Kolber MR, Fritsch P, Price M, et al. Can Fam Physician. 2021; 67:185-6.
Stowe J, Andrews N, Gower C, et al. Effectiveness of COVID-19 vaccines against hospital admission with the Delta (B.1.617.2) variant. Available at: https://bit.ly/3xBEiXy Accessed June 29, 2021
Nasreen S, He S, Chung H, et al. MedRxiv preprint doi: https://doi.org/10.1101/2021.06.28.21259420; July 3, 2021.
Shimabukuro TT, Kim SY, Myers TR, et al. N Engl J Med. 2021; 384:2273-82.
Villar J, Ariff S, Gunier RB, et al. JAMA Pediatr. doi:10.1001/jamapediatrics.2021.1050
Poliquin V, Castillo E, Boucoiran I, et al. Society of Obstetrics and Gynecology. Statement of COVID-19 Vaccination in Pregnancy. Available at: https://bit.ly/3ebTUK3 Accessed June 8, 2021
Centre for Disease Control (CDC): Choosing Safer Activities. Available at: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/pdfs/choosingSaferAct.pdf?v=1. Accessed June 1, 2021
Public Health Agency of Canada (PHAC). Vaccinated Against COVID-19: What does it mean to me? Available at: https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/awareness-resources/vaccinated-against-covid-19-public-health-measures.html. Accessed June 27, 2021.

AUTHORS

Michael R Kolber, MD CCFP MSc, Paul Fritsch, MD CCFP, Jennifer Young, MD CCFP, Nicolas Dugré, PharmD MSc BCAPC, Alexander Singer, MB B*h BAO CCFP, Tony Nickonchuk, BSc Pharm

Public health measures to follow when you are not vaccinated, partially vaccinated or fully vaccinated against COVID-19.

06/30/2021

Only about 150 of the more than 18,000 COVID-19 deaths in May were in fully vaccinated people. That translates to about 0.8%.

06/16/2021

Greg Rickford Eric Melillo Are you on board? Only a political solution will end the difficulty of license portability for physicians across Canada. Canadians in provincial border regions deserve better access to healthcare.

Wilks said that digital healthcare systems in Canada should be able to speak across provincial borders

05/12/2021

We, the undersigned, Citizens of Canada and Indigenous Nations, call upon the Minister of Health to:
1) Immediately establish a reciprocal agreement between provinces, territories, indigenous and federal governments allowing doctors and nurses licensed in one permission to work in the other, on request, for the duration of the COVID-19 pandemic; and
2) Develop a plan to extend the reciprocal licensing arrangement to address ongoing need for in-person and/or virtual care throughout Canada, with particular attention to improving care in rural, remote, and First Nations communities.

There is no obligation on the part of the House of Commons or any Member of Parliament to authorize the publication of an e-petition or to present an e-petition or a paper petition to the House of Commons. Neither the House of Commons nor any Member of Parliament authorizing the publication of an e-...

03/31/2021

Virtualmdcanada.com

02/05/2021

Dear Patients and Friends,

With mixed emotions, I wish to inform you that I will be closing my Kenora family medicine practice on April 30, 2021. It has been my honour and privilege to serve the Kenora community for the past 15 years.

It is advisable that you find a new physician for future care as soon as possible. I encourage you to seek continuity of care by registering with Health Care Connect online at ontario.ca/healthcareconnect or by calling 1-800-445-1822. Health Care Connect maintains information on physicians in the area and can help with the process of connecting you with a new physician or primary care provider.

Patients that qualify for services offered through Waasegiizhig Nanaandawe’iyewigamig Health Access Centre (WNHAC); on reserve health centres; or community clinics (including Sioux Narrows Medical Clinic) are encouraged to seek care through those organizations.

After April 30, 2021, all of my medical records will be stored with the Sunset Country Family Health Team (SCFHT). Should you roster with another physician in Kenora, your medical records will be accessible to them. The SCFHT can provide you with a copy of your records or transfer your medical record to a doctor outside of the community, should you need. The staff at the Kenora Medical Associates or the SCFHT will gladly help you with this process and provide you with the necessary forms.

As your family physician it has always been my privilege and pleasure to care, support and advocate for you and our community. Kenora has been a great home and a wonderful place to raise my family. I will greatly miss my patients, soccer teams, running partners, and the many friends my family has made here. I wish you all the best. Take good care.

Clay Hammett, MD

01/13/2021

Here’s the actual Covid-19 Science Advisory Table report for those of you who want to look at the data reported in the media.

Essentially, our system wide ICU capacity for ALL illness is thin at best. And the new variant blows all our current measures out of the water.

The reality is that we likely need lockdown in place until there is mass vaccination. But the harm of an extended lockdown is also real.

You can see why this is such a difficult course to navigate for our political and health leadership.

12/06/2020

10/17/2020

Two and a half years ago I spoke up for NWO on TV Ontario - my plea; to build a positive working relationship with Manitoba.

It took me some time to find this in the archives so I’m posting it here for posterity (and a break from stories about Covid 19) as possibly my most famous moment working for our community and speaking up on behalf of working together. We are ALL at our best when we support each other and work together, no matter what the problem may be.

The Agenda discusses the challenges of keeping doctors in northern Ontario.