It’s tough — even impossible — to predict exactly how Canada will fare in the fourth wave of the COVID-19 pandemic. And looking for clues from other countries only gets you so far.
Some regions are being overwhelmed, yet again, by this virus; others are avoiding catastrophe largely thanks to high vaccine uptake and other precautions. Widely different policy decisions and levels of restrictions also mean there’s no one-size-fits-all outcome.
So what will determine Canada’s experience in the months ahead?
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Multiple experts told CBC News that there are a few key factors in how the pandemic will play out as the delta variant continues spreading.
According to Matthew Miller, an associate professor of infectious diseases and immunology at McMaster University in Hamilton, there’s also good reason to hope that Canada might fare even better than many other countries with similar public health measures, thanks to our high vaccination rate and unique approach to immunizing residents.
“Vaccinated people in Canada are going to be much better off than vaccinated people almost anywhere else because of a reliance on mRNA, mixed-vaccine schedules and extended intervals,” he said.
“Obviously, though, as infectious disease experts and public health experts have rightly pointed out, a mixture of measures is still going to be required to control the pandemic effectively — and those are going to have profound influences on how we as a population experience the fourth wave.”
1. Vaccine uptake
Despite a sluggish start, Canada quickly became one of the most heavily vaccinated countries in the world against COVID-19.
Roughly 63 per cent of the total population is now fully vaccinated, and the number is slowly ticking higher.
While millions of people across the country remain unprotected, virologist Alyson Kelvin said Canada’s relatively high rate of immunization bodes well.
“We have fairly good coverage,” said Kelvin, who works with the Vaccine and Infectious Disease Organization (VIDO) at the University of Saskatchewan in Saskatoon.
“And the stats have come out that it seems we have better coverage compared to other countries — that’s going to be our biggest source of protection, that we were able to vaccinate so many people and, again, stop that chain of transmission of the virus.”
While high vaccination rates haven’t entirely blunted COVID-19 infections in other areas of the world, they have noticeably reduced cases of serious illness compared with earlier surges of the coronavirus.
In Spain, which has about a 66 per cent vaccination rate — a little higher than in Canada — the country’s latest wave of infections shot up the virus’s daily death toll, but nowhere near levels seen in earlier waves.
The heavily vaccinated U.K. also experienced a surge, then a dip before seeing another increase in cases this summer, but throughout it all, rates of hospitalization and death were far lower than earlier in the pandemic.
And in Iceland, where roughly 72 per cent of the total population is fully vaccinated, the rates of COVID-19 hospitalization remained low even as infections went up — and the country hasn’t recorded a single virus death since May.
McMaster University’s Miller said it’s crucial for Canada to get its vaccine uptake as high as possible by improving access, encouraging those who are still hesitant and even mandating vaccines in certain settings — particularly when it comes to persuading younger age groups.
“A little bit of pain with vaccine passports to do certain things that that demographic likes to do — go to clubs, eat indoors at restaurants — that’ll be enough to push those people to get vaccinated,” he said.
“That’s really where a vaccine mandate will make the biggest difference, I think, is in that younger group that are lagging a little bit behind right now.”
Already, there’s a patchwork of vaccination policies and mandates coming into force in health-care institutions, concert venues, universities and various levels of government across the country — but it’s not yet clear how much those efforts will increase uptake.
2. Delaying, mixing different vaccines
Canada’s vaccination strategy was quite unorthodox in several ways, giving Canadians the ability to mix between different forms of vaccine technologies and space out doses.
Born out of necessity during a shortage of supplies, the approach stirred up controversy and even derailed some Canadians’ travel plans after some countries and cruise lines refused to accept people who received two different shots.
But Miller — who is affiliated with Canada’s National Advisory Committee on Immunization but isn’t speaking on the advisory body’s behalf — said the recommendations were rooted in decades of vaccine science and could have a “profound influence on the longevity of the immune response.”
The unique road Canada took — allowing people to get second doses well beyond manufacturing guidelines, to a maximum of four months — is now likely a better bet than sticking to the speedy timelines used in clinical trials, he said.
“We know mixing and matching, we know that delayed prime-boost schedules really do give a better overall protective effect from vaccination,” Kelvin said, though she noted that more research is still needed.
Emerging studies, however, are starting to back up the early recommendations around mixing different vaccine technologies, with a focus on using the highly effective mRNA-based options, said Dr. Allison McGeer, a professor at the University of Toronto and an infectious disease physician at Mount Sinai Hospital in Toronto.
“From what we know about T-cell immunity and antibodies, probably the best two doses to have are AstraZeneca followed by one of the mRNA vaccines,” she said, referring to the Pfizer-BioNTech and Moderna vaccines. “So that was a really good choice for Canada, I think, to make that recommendation — and almost certainly better than two doses of AstraZeneca.”
McGeer said while Canada’s unique approach helped to get more shots in arms, she isn’t convinced it would necessarily make much of a difference in how the country fares in the fourth wave.
And Miller acknowledged that not every Canadian got their shot in the same manner, making it hard to know how the country’s strategies will play out.
“One complexity, of course, is that on the bookends of our vaccine rollout, there are exceptions, right?” he said. “So many health-care providers and long-term care residents got their vaccine in the recommended interval.”
3. Public health measures and restrictions
To buy time while more Canadians get vaccinated, multiple experts point to the need for certain public health measures to keep case growth at bay — not necessarily a full lockdown but some level of restrictions.
That means maintaining the basic day-to-day precautions Canadians now know well: mask-wearing, physical distancing, avoiding large gatherings and crowded settings.
“We really need to think about our current situation and how having layers of protective measures really keeps everybody safe,” Kelvin said.
“We’re in a different landscape right now where a lot of public health measures have been lifted.”
Bringing back certain precautions will be particularly crucial as millions of unvaccinated children return to school this fall, according to Miller, who also said that’s the issue bringing the most uncertainty to the months ahead.
Both vaccines and some level of restrictions should be used in tandem to put Canada in the best position as delta-driven cases keep rising, several experts agreed.
“If we are really concerned about protecting vulnerable populations — people in long-term care facilities, those people who are immunocompromised, such as transplantation recipients — these multiple layers will help protect them,” Kelvin said.
“So it’s all of our jobs to take part in this.”
Have questions about this story? We’re answering as many as we can in the comments.
Coronavirus: What's happening in Canada and around the world on Friday – CBC.ca
Surges in coronavirus cases in several U.S. states this week, along with staffing and equipment shortages, are exacting a mounting toll on hospitals and their workers even as the number of new admissions nationwide ebbs, leading to warnings at some facilities that care would be rationed.
Montana, Alaska, Ohio, Wisconsin and Kentucky experienced the biggest rises in new COVID-19 hospitalizations during the week ending Sept. 10 compared with the previous week, with Montana’s new hospitalizations rising by 26 per cent, according to the latest report by the U.S. Centers for Disease Control and Prevention (CDC) on Tuesday.
In Alaska, the influx is so heavy that the state’s largest hospital is no longer able to provide life-saving care to every patient who needs it, according to an open letter from the medical executive committee of Providence Alaska Medical Center this week.
“If you or your loved one need specialty care at Providence, such as a cardiologist, trauma surgeon, or a neurosurgeon, we sadly may not have room now,” the letter read. “There are no more staffed beds left.”
Some hospital workers have become so overwhelmed by the fresh wave of COVID-19 cases — a year and half after the pandemic first reached the United States — that they have left for jobs at retailing and other non-medical fields, Nancy Foster, vice president of quality and patient safety the American Hospital Association, told Reuters.
At the same time, distribution and other issues are leaving some hospitals short of oxygen supplies desperately needed to help patients struggling to breathe, Foster said.
On Friday, the hospital association held a webinar for its members on how to conserve oxygen, an effort to address a 200 per cent jump in demand at many hospitals, she said.
“There is a shortage of drivers with the qualifications to transport oxygen, and a shortage of the tanks needed to transport it.”
While there are some breakthrough cases among the vaccinated, Foster said most of the hospitalizations were among the unvaccinated.
New hospital admissions are still surging in several mostly rural and Midwestern states, even as the number of COVID-19 patients admitted to hospitals daily in the entire United States slipped to about 10,685 on Tuesday after cresting around 13,028 in late August, according to the latest data from the CDC.
What’s happening across Canada
- Health authority, N.B. working to meet demand for COVID-19 tests amid surge in cases.
- Outbreaks are ‘a weird moment’ for P.E.I. Here’s one expert’s advice on how to cope.
- N.S. reports 18 new cases of COVID-19 on Friday.
What’s happening around the world
As of Friday afternoon, more than 227.4 million cases of COVID-19 had been reported worldwide, according to Johns Hopkins University’s coronavirus tracker. The reported global death toll stood at more than 4.6 million.
The British government announced a major simplification of its rules for international travel on Friday, heeding complaints from travellers and businesses that its regulations aimed at staving off the spread of COVID-19 were cumbersome and ineffective.
Testing requirements will be eased for fully vaccinated arrivals to England from open countries, who will no longer have to take a COVID-19 test before travelling. Travellers will still need a test after landing, but from the end of October an inexpensive lateral flow test will suffice, rather than a more sensitive — but pricier — polymerase chain reaction (PCR) test. The new rules apply to travellers from Canada.
In the Americas, an influential panel of expert outside advisers to the U.S. Food and Drug Administration voted against approving COVID-19 booster shots for all Americans, but endorsing them for those 65 and over and for those at high risk of severe disease.
The decision marked a huge step back from the sweeping plan proposed by the Biden administration a month ago to offer booster shots of both the Pfizer and Moderna vaccines to nearly all Americans eight months after they get their second dose.
In Asia, Cambodia is vaccinating children ages six to 11 so students can safely return to schools that have been closed for months due to the coronavirus. Prime Minister Hun Sen opened the campaign Friday, with his grandchildren and young family members of other senior officials getting their shots.
Cambodia already has been vaccinating older children, and Hun Sen says he ordered health officials to study if children ages three to five can be vaccinated. Nearly 72 per cent of Cambodia’s almost 17 million people have received at least one COVID-19 shot since vaccinations began in February.
India gave a record 22.6 million vaccinations on Friday, three times the average daily total during the past month. The health minister called the vaccine milestone a birthday gift for Prime Minister Narendra Modi, who turned 71 and was criticized heavily for India’s dramatic rise in infections and deaths in April and May.
India’s previous vaccination peak of 14.1 million was reached on Aug. 31, with a daily average of seven million doses in the last 30 days.
'Trudeau is bad for Canada,' Singh says as Liberal leader asks progressives to unite – CBC.ca
NDP Leader Jagmeet Singh launched his most pointed attack yet on his Liberal opponent today, saying Justin Trudeau is a failed leader who is “bad for Canada.”
Trudeau, meanwhile, dismissed the NDP as an unserious option, saying the NDP has presented a vague plan to spend $200 billion more over the next five years while offering few details.
“We think Mr. Trudeau is bad for Canada because he’s failed on the crises and made things worse, not better,” Singh said, condemning Trudeau for voting against non-binding NDP motions on pharmacare and long-term care homes.
Singh also pointed to higher greenhouse gas emissions and a tax system he said is skewed toward the “ultra rich.”
“He is bad for Canada. He was an abject failure,” Singh said of Trudeau.
WATCH: Singh says ‘Mr. Trudeau is bad for Canada’
With just three days left in the 44th general election, Singh and Trudeau are scrambling to shore up support among the progressive voters who could decide which party governs the country after Monday’s vote.
Trudeau wants a majority government. Singh, meanwhile, is trying to avoid a repeat of the last election — which saw NDP support crater, leading to a loss of 15 seats.
Trudeau said a vote for the NDP would amount to a vote for the Conservatives because vote-splitting could put Erin O’Toole in the Prime Minister’s Office. Singh said left-wing voters shouldn’t fall for Liberal pressure tactics.
“The Liberal Party is not only the only party that can stop the Conservatives, but we’re also the only party with a real plan to get things done,” Trudeau said, pointing to experts who have criticized the NDP’s climate plan as unrealistic.
“Progressives are quite rightly worried. I know there are a lot of people out there who are torn. You don’t have to make an impossible choice and vote strategically. You can actually vote for the party that is going to stop the Conservatives and move forward with the strongest plan to get things done.”
Trudeau prompted this election last month, saying the opposition parties have blocked the Liberal agenda by delaying government bills and disrupting the work of parliamentary committees.
WATCH: A roundup of where the leaders were on Day 34 of the campaign
Since the election call, Trudeau has been asked over and over to explain why he’s sending Canadians to the polls during the fourth wave of the pandemic. The CBC Poll Tracker suggests some Liberal supporters soured on Trudeau after the campaign launch — and the majority government the party wanted may now be out of reach.
When asked Friday how he’d handle another minority government, Trudeau said he’s asking voters to return as many Liberal MPs as possible to prevent that outcome.
Singh dodged questions today about the concessions he’d try to extract from the next government in exchange for NDP support on confidence motions.
Singh said he hasn’t given this much thought because he’s running to be prime minister. Polls suggest the NDP will be hard pressed to do better than third place, let alone form a government.
Asked today why his campaign has failed to catch on with more voters, Singh said the election isn’t over.
“We’re working hard and the Liberals often take people’s votes for granted,” he said. “I’m always prepared to work hard.”
U.S. senators push Biden to lift border closure with Canada – CBC.ca
Four U.S. senators on Friday asked President Joe Biden to lift restrictions that have barred travel by Canadians across the northern U.S. border since March 2020.
Democratic Sens. Jeanne Shaheen and Maggie Hassan of New Hampshire, Jon Tester of Montana and independent Angus King of Maine asked Biden to allow Canadians vaccinated against COVID-19 to travel to the United States before October.
The border state senators said in a letter the restrictions have led to “economic and emotional strain in our communities.”
The senators added: “A plan with some indication of when your administration would feel comfortable lifting border restrictions based on public health data would provide clarity to businesses and families along the northern border.”
They also noted that Canadians can fly to the United States. “We struggle to understand the public health rationale for the disparate treatment in modes of travel,” the senators wrote.
NEW: Today I sent a letter to <a href=”https://twitter.com/POTUS?ref_src=twsrc%5Etfw”>@POTUS</a> urging him to lift restrictions on vaccinated Canadians’ travel to the U.S. by October. NH communities are hurting from the border’s continued closure – it’s time to create a plan to ease entry & get back to regular trade & commerce. <a href=”https://t.co/XzsCflA6QS”>pic.twitter.com/XzsCflA6QS</a>
The White House did not immediately comment on Friday, but White House coronavirus response co-ordinator Jeff Zients said on Wednesday that given the delta variant of the coronavirus, “we will maintain the existing travel restrictions at this point.”
U.S. officials and travel industry executives say the White House is set to renew the restrictions before the latest extension expires on Sept. 21.
In August, the United States again extended restrictions closing its land borders with Canada and Mexico to nonessential travel such as tourism despite Ottawa’s decision to open its border to vaccinated Americans. Canada on Aug. 9 began allowing fully vaccinated U.S. visitors for non-essential travel.
The United States has continued to extend the extraordinary restrictions on Canada and Mexico on a monthly basis since March 2020, when they were imposed to address the spread of COVID-19. The U.S. land border restrictions do not bar U.S. citizens from returning home.
The United States separately bars most non-U.S. citizens who within the last 14 days have been in the United Kingdom, the 26 Schengen countries in Europe without border controls, Ireland, China, India, South Africa, Iran and Brazil.
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