Candace McNaughton
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cdotmcnaughton.bsky.social
Candace McNaughton
@cdotmcnaughton.bsky.social
1.8K followers 7.5K following 680 posts
Emerg doc & researcher, UofToronto
-HTN; HF; health literacy & numeracy; emergency care

Views my own
Born @CO2 340ppm
#DavosSafe for all
@NashvegasEM on the bird app

"First do no harm" & "Hospes ultimus es"
(roughly: “Be the dead-end host”)

She/her
Posts Replies Media Videos
cdotmcnaughton.bsky.social
With alt text 😊
Abduction of Proserpina, by Giambologna, 1579 (from the @NortonSimon Museum in Pasadena), 📸 by @nturchiarophoto Photo of 2 outfielders colliding during game seven of the World Series, next to a sculpture of the abduction of Prosperpina
November 2, 2025 at 6:40 PM
cdotmcnaughton.bsky.social
Same… 😞

(Sharing your post with alt text 😊)
Quote from Paul Farmer: “the idea that some lives matter less is the root of all that is wrong with the world”
August 25, 2025 at 3:54 PM
cdotmcnaughton.bsky.social
I just…
Have we learned nothing???

We have the resources and more than enough evidence, why aren’t we using them?? 😵‍💫

“First, do no harm” should make it top priority to keep patients safe from hospital acquired infections!

www.archives.gov.on.ca/en/e_records...
Screenshot from a page in the inquest that was conducted following SARS1, now more than 20 years ago, when it was determined that use of airborne precautions likely would have prevented spread of pathogens in the hospital and avoided multiple illnesses and deaths
August 1, 2025 at 3:26 AM
cdotmcnaughton.bsky.social
Lots of variables, and a great question!

Reminded me of this 2021 modeling study that has motivated me to keep my respirator of better on in the hospital:

pmc.ncbi.nlm.nih.gov/articles/PMC...
We used epidemic data from the Diamond Princess cruise ship to calibrate a transmission model in a high-risk setting and derive the reproductive number for the model. We explain how the terms in the reproductive number reflect the contributions of the different infectious states to the spread of the infection. We used that model to compare the infection spread within a homogeneously mixed population for different types of masks, the timing of mask policy, and compliance of wearing masks. Our results suggest substantial reductions in epidemic size and mortality rate provided by at least 75% of people wearing masks (robust for different mask types). We also evaluated the timing of the mask implementation. We illustrate how ample compliance with moderate-quality masks at the start of an epidemic attained similar mortality reductions to less compliance and the use of high-quality masks after the epidemic took off. We observed that a critical mass of 84% of the population wearing masks can completely stop the spread of the disease. These results highlight the significance of a large fraction of the population needing to wear face masks to effectively reduce the spread of the epidemic. The simulations show that early implementation of mask policy using moderate-quality masks is more effective than a later implementation with high-quality masks.
July 22, 2025 at 3:42 AM
cdotmcnaughton.bsky.social
Can’t let this go…HCW should mask universally in hospital - No pt should risk an infection from us because we choose not to use widely available tech (more studies of mask effectiveness are NOT needed)

@n95anaesthetist.bsky.social
‪@molesen.bsky.social
‪@mark-ungrin.bsky.social

From the paper:
From the discussion: “Although not the primary focus or intent of our study, we additionally observed that the into the mask maneuver contained the respiratory plume well, thereby providing additional data advocating for the use of masks. Some participant maneuvers did not result in software-detectable plumes notably in the into the shirt and mask maneuvers. The maximal distance that was recorded was nearly the same for the elbow and shirt maneuver at 12 inches however, the MPA for the elbow was much greater and not reportable on the shirt maneuver. We also found that some unobstructed cough plumes and droplets dispersed beyond 6 feet, further questioning current recommendations of maintaining 6-feet physical distancing.” Wear a mask! (By that I mean a respirator) soooo many pathogens are airborne, patients should be safe from catching anything we HCW exhale when they seek medical care
July 21, 2025 at 9:22 PM
cdotmcnaughton.bsky.social
Like, 😳😵‍💫😖
Results: For 531,182 people, mean person-specific total health care costs were $513.83 (95% CI $387.37-$638.40) higher for test-positive females and $459.10 (95% CI $304.60-$615.32) higher for test-positive males, which were driven by hospitalization, long-term care, and complex continuing care costs. At the 99th percentile of each subgroup, person-specific health care costs were $12,533.00 (95% CI $9008.50-$16,473.00) higher for test-positive females and $14,604.00 (95% CI $9565.50-$19,506.50) for test-positive males, driven by hospitalization, specialist (males), and homecare costs (females). Cancer costs were lower. Six-month and 1-year cost differences were similar. Conclusion: Post-acute health care costs after a positive SARS-CoV-2 PCR test were significantly higher than matched test-negative individuals, and these increased costs persisted for at least one year. The largest increases health care costs came from hospitalizations, long-term care, complex continuing care, followed by outpatient specialists (for males) and homecare costs (for women). Given the magnitude of ongoing viral spread, policymakers, clinicians, and patients should be aware of higher post-acute health care costs following SARS-CoV-2 infection.
June 29, 2025 at 5:12 AM
cdotmcnaughton.bsky.social
Canada:

showyourstripes.info/c/northameri...
Graph of rising temperatures in Canada since the 1850s - very much not good :(
June 21, 2025 at 4:07 AM
cdotmcnaughton.bsky.social
Am I missing something, aren’t Dr. Cavallo’s findings (essentially) the opposite of how they were presented on the govt website??
In the paper, we analyze detail, micro data to track how importers, retailers, and exporter reacted to the tariffs from 2018 to early 2020 “At the border: nearly full pass-through of Terrace to US import prices. Foreign firms, especially in China, did not significantly lower prices to offset tariffs. The burden fell on US firms because the affected imports were mostly differentiated goods, for which substitutes are more difficult to find” “By contrast, US exporters did lower prices and response to foreign retaliatory tariffs, especially for agricultural and differ differentiated goods” “ what does this mean for the new tariffs? Expect higher costs for US importers, with uneven and gradual effects on retail prices. If tariffs persist, and firms can no longer absorb the costs, higher consumer prices are likely to follow.“
April 3, 2025 at 6:27 AM
cdotmcnaughton.bsky.social
In addition to all this, they make a statement about “tariff passthrough to retail prices [being] low,” citing Cavallo et al - but without actually including that in their references…so I looked it up…
“Recent experience with US Terrace China has demonstrated that tear passed through to retail prices was low (Caballo et al 2021) List of references, which does not include Caballo’s 2021 paper
April 3, 2025 at 6:17 AM
cdotmcnaughton.bsky.social
Timely! We just published something similar in Canada - a big 🚩that raises lots of concerns about the healthcare system:

pubmed.ncbi.nlm.nih.gov/39703807/
Table 2, which shows the adjusted risk ratio death/hospitalization is 1.14, and the adjusted risk ratio for death within seven days was 1.46, indicating a 46% higher risk of death within seven days of a left without being seen ED visit for patients during the time period of 2022 to 2023 compared to patients in the time for 2014 - 2020. This suggests that there is something riskier about a left without being seen ED visit since the onset of the pandemic, likely reflecting factors beyond just those of the emergency department. Figure one shows the number of ED visits per month overtime, with wide swings starting in 2020, And notably ED volumes had not returned to pre-2020 levels as of 2023. The lower line shows the monthly rates of left without being seen ED visits, with rapid rises in rates appearing to correspond with rapid increases in number of ED visits per month. this suggests that rapid increases in the number of ED visits per month, more than the total number of ED visits, may be related to more people leaving the emergency department without being seen. Also notable, the fluctuations in ED visits per month appear to correspond with pandemic waves in the early portion of the pandemic. People appear to have followed instructions to avoid emergency care, however, this appears to have had the unintended consequence of Leading to downstream effects such as long, wait times and more people leaving the emergency department, even though they may have needed emergency care.
January 17, 2025 at 9:27 PM
cdotmcnaughton.bsky.social
😣 devastating to live through this, watching in real time as oil use increases and outside CO2 levels continue to rise
Thanks to the relentless burning of fossil fuels, we are — right now, in real time — departing the Holocene epoch, the Goldilocks zone of relative climate stability that enabled us to build the world as we know it over the past 12,000 years. We must recognize this moment for what it is: the beginning of a new era of civilizational retreat, contraction and consolidation. Call it the post-Holocene. Climate scientists have seen this coming since the 1950s, and petroleum companies have been denying and deflecting the unwanted attention ever since. Failure of imagination is a human specialty. This perceptual glitch, which Nassim Nicholas Taleb calls the “Lucretius Problem” after the Roman poet and philosopher, occurs when we base our estimation of possible future extremes on limited past experience.
November 20, 2024 at 2:03 PM
cdotmcnaughton.bsky.social
How the War of 1812 ended in Toronto, from the Canadian perspective

*chef’s kiss* 😂
Historical market in downtown Toronto describing the the end of the War of 1812 (in the most Canadian way possible 😉) - Americans looked around for things to loot and burn, eventually got bored, and left
November 18, 2024 at 2:42 AM