ICYMI, public health officials fear community transmission of B.1.1.7 (the "UK variant") is underway in Ontario.

I'll dissect each piece of worrying news from this story.

1. Simcoe Muskoka has so far reported 3 positive tests in individuals *with no known links* to the massive B.1.1.7 outbreak at Roberta Place LTC.

Two of those are linked to separate outbreaks of their own (a different LTC and a mental health hospital). Testing underway.
2. Of the 225 cases at Roberta Place, 100+ are confirmed or preliminary + for B.1.1.7.

42 household contacts of ppl linked to the outbreak are also COVID+. Public health unit is worried about keeping cases (which are all likely B.1.1.7) from rippling further into the community.
3. A case in Kingston area who tested positive for COVID "several weeks ago" was just discovered to be B.1.1.7. That person travelled to Simcoe Muskoka, but had not travelled internationally, according to the local health unit.

https://t.co/81h7PtyNx2
4. Overall, Public Health Ontario counts 47 B.1.1.7 cases as of yesterday -- these are only the ones confirmed thru full genome sequencing. Preliminary screening tests not included (yesterday's 99 in Simcoe Muskoka, for example).

Here's a breakdown by health unit courtesy PHO:
Side note: My story from 3 days ago (three years in COVID time) on why scientists say we more genomic sequencing and screening, faster turnaround, and better policies to stifle the spread of extra-contagious variants like B.1.1.7:

https://t.co/87Czw5uYRD )
5. Simcoe Muskoka's top public health official Dr. Charles Gardner, who is also on the province's public health measures table, said:

“If it isn’t spreading readily in our community now, it may very well do so in the near future."

@BogochIsaac: "The horse is out of the barn."
Gardner warned B.1.1.7 could quickly overwhelm dropping case numbers in Ontario, making school re-opening difficult & undermining vaccination efforts (especially combined with vaccine supply shortages).

So what do we do now?
The experts I have spoken to agree with this @bruce_arthur column: no one is *opposed* to border measures, but they will not stop the spread of B.1.1.7 alone. Too late for that.

Bogoch: “There’s no magic, right? We know how to control this."

https://t.co/0qSObJike5
My colleague @JacquesGallant reported on the possibility of restricting travel between provinces.

Dr. Gardner also spoke about restricting travel *inside* the province, between communities -- which he says would be controversial but worked in Australia.

https://t.co/0eViOe7ifT
We will likely get more positive tests for variants of concern in the coming days as the results of a PHO point-prevalence study trickle in: ALL ~2,500 COVID positive test samples from Jan 20 are being screened + sequenced for variants of concern.

Stay tuned.
Okay well it's been 10 minutes since I posted this, so obviously I already have two updates to report:

- Now 85 secondary contacts from Roberta Place (up from the 42). h/t @LapointeShaw
- Nine of York Region's 15 B.1.1.7 cases acquired in community:

https://t.co/tZWTewVFaR

More from Health

@SMILEWithmeNGO Hello @SMILEWithmeNGO I am glad to be here. Thank you for having me.

A very big welcome to everyone joining today’s conversation. Our guest today needs no introduction especially in the sphere of cancer control and advocacy. Welcome @runciecwc
#CheatCervicalCancer


@runciecwc Q1: So Runcie @runciecwc, we see all the amazing work you do as an advocate.
Can you share with us some of the work that you have been doing in cancer control in Nigeria?
#CheatCervicalCancer

@runciecwc That’s amazing. Your work speaks for you. Thanks for all you do.
Q2: What is this @WHO Global Strategy to accelerate the Elimination of CervicalCancer? Can you elaborate on it?
#CheatCervicalCancer

@runciecwc @WHO Q3: In your experience, so far what are the greatest challenges you have identified with cancer control in Nigeria?
#CheatCervicalCancer.

@runciecwc @WHO Q4: Interestingly, we have seen that your organization is part of the Coalition of CSOs against Cervical Cancer in Nigeria, @CervicalCancerN, what is the goal of this Coalition? #CheatCervicalCancer

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1/“What would need to be true for you to….X”

Why is this the most powerful question you can ask when attempting to reach an agreement with another human being or organization?

A thread, co-written by @deanmbrody:


2/ First, “X” could be lots of things. Examples: What would need to be true for you to

- “Feel it's in our best interest for me to be CMO"
- “Feel that we’re in a good place as a company”
- “Feel that we’re on the same page”
- “Feel that we both got what we wanted from this deal

3/ Normally, we aren’t that direct. Example from startup/VC land:

Founders leave VC meetings thinking that every VC will invest, but they rarely do.

Worse over, the founders don’t know what they need to do in order to be fundable.

4/ So why should you ask the magic Q?

To get clarity.

You want to know where you stand, and what it takes to get what you want in a way that also gets them what they want.

It also holds them (mentally) accountable once the thing they need becomes true.

5/ Staying in the context of soliciting investors, the question is “what would need to be true for you to want to invest (or partner with us on this journey, etc)?”

Multiple responses to this question are likely to deliver a positive result.