Maybe this is a peak. Not THE peak: we’ve been over peaks before, as the pandemic has rolled over two long years. But wastewater data analyzed by the province’s independent volunteer science table appears to be showing a plateau. There are other indications that we may be finding a limit on BA.2, the dominant variant in Ontario right now.
It would be good news. Not an end; not deus ex machina. Toronto’s 67-year-old mayor just tested positive, for goodness’ sakes, after a day of in-person appearances. But a peak would beat the alternative, because Ontario sure wasn’t going to do very much to stop the spread of the virus on its own.
And you can already see the road ahead: mission accomplished, off we go. We were already partway in that mind space, from the government on down. And while that might work on an individual level, regrettably, that’s not how communicable diseases work.
“We’d be foolish to think” this is over, says Dr. Isaac Bogoch, an infectious diseases specialist at Toronto General and the University of Toronto. “While it’s wonderful that there’s arrows pointing in the right direction, that this wave may have crested, and while all waves come to an end and this one will as well, we still have to have a strong medium- and long-term vision.
“Because there will be more variants, there will be more waves, and we have to build resiliency in Ontario and of course elsewhere in Canada and really at a global level to to help protect us against future variants and future waves. Which are going to happen.”
Indeed. People will set their own individual risk level with little actual information — how fast does your personal immunity wane? — and for many, it’s defensible. And much of society seems to be snapping back to its default setting of not thinking about the vulnerable unless absolutely necessary. It would be harder to reinforce public health, plan wholesale booster campaigns to address waning immunity, create truly effective communication channels and strategic flexibility, any of that. A truly effective booster campaign would be accompanied by three-dose vaccination passports. And it would be easy to simply mandate masks in places where people like cancer patients or the immunocompromised have to go, like grocery stores or pharmacies.
But no, we’re probably going to veer toward pretending this is over.
“I think that if you’re the government, you’re quite happy about this, because the sky doesn’t appear to be falling and you don’t need to change direction,” says Dr. Andrew Morris, a professor of infectious diseases at the University of Toronto and a member of the table, and the medical director of the Antimicrobial Stewardship Program at Sinai-University Health Network. “Right now you’ll have the blowhards of the world who say I told you this wasn’t a big deal and everything was going to be fine. And then you’ll have people who say I told you there’ll be tons of cases, and they’ll say that they were right.
“But there’s a huge amount of uncertainty. I think overall some of this is promising, but I think that this is still going to carry with it a fair amount of unnecessary deaths. We’re now entering the phase where to some degree, we just have no idea about the hidden pandemic. Right now the pandemic is increasingly becoming hidden from analysis, and it’s going to make it very difficult to sway government, because certainly in the next while, they’re not going to care.”
That uncertainty is reflected in the latest round of science table modelling Thursday, and the summary is easy: projections are much higher since masks were made voluntary, with median forecasts of 3,000 for a hospitalizations peak — the January Omicron wave set the record with over 4,000 — and 500 in the ICU.
The confidence ranges, however, are massive — ICU alone ranges from 250 to 1,000, which is two different universes. We can only see what’s coming in the crudest terms — wastewater going up, going down, holding fast, and whatever happens in the hospitals. Everything is anecdotal. Surgeries might be cancelled again, or not. Deaths and hospitalizations will rise some more before they stop, and Long COVID — which was detailed in the modelling, and remains the sleeping giant of this thing — is a lottery we’re all playing. But nothing will be done to slow this down.
“In both Denmark and the U.K. and other countries they’ve had this ongoing rise of deaths, and the person on the street doesn’t recognize it; they’re just saying, OK, that’s just how it is,” says Morris. “So people who are in the U.K. right now, unless they’re in the health-care system, they’re just saying this is how life is, and we’ve got freedoms and we’re gonna live our life, and if I’m boosted the risk to me is relatively low.”
A cresting of the wave, while unambiguously good news, would likely only accelerate that idea. And meanwhile, this wave isn’t over. Wastewater is a jumpy and imprecise measure, and there’s a holiday long weekend coming. Hospitalization and ICU numbers aren’t done rising. And as the science table noted, we’re already matching the peak of health-care worker infections right now.
A peak would be a relief, honestly. Maybe this is the start toward a fallow period, into summer with better weather and enough residual immunity, after a wave that plummets as quickly as it came. It would be nice. It would beat the alternative.
But this isn’t the last wave, or the last variant, no matter how much any of us would like to think it is. It’s not fun, but it’s true.
Bruce Arthur is a Toronto-based columnist for the Star. Follow him on Twitter: @bruce_arthur
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
