Visitors driving into La Crete are greeted by a wooden welcome sign declaring it “Alberta’s Last Frontier.”
The small town about 670 kilometres north of Edmonton — a tidy patch of light-coloured homes and orderly looking businesses — made headlines during the pandemic for its resistance to public health orders, and a number of its residents continue to defy them.
On a late November day, with temperatures hovering around -20 C, people rushed from vehicles into the post office, grocery stores, banks and other businesses with little evidence that anyone was wearing a mask.
More than two months after Alberta brought in its version of a vaccine-passport program, several restaurants in this community refuse to enforce it and continue to flout masking and capacity rules. At least one under a closure order was still open for dine-in service, with staff and customers unmasked.
La Crete is one of a handful of small towns in Mackenzie County, a massive stretch of farmland and forest in northwest Alberta that covers an area bigger than New Brunswick.
A year into Alberta’s COVID-19 vaccine rollout, the county makes up the bulk of what is the province’s least-immunized health region.
Just 29.6 per cent of the roughly 25,000 residents are fully immunized. It’s the only health region in Alberta where less than 30 per cent of the total population have had both doses — far lower than the provincewide total of 72 per cent.
Still, attitudes about COVID-19 and immunization in this vast region are not homogenous, and those diverse views have created challenges for those who live there.
At odds with neighbours, church
Daniel Wall, 35, has come to hate going into town.
His life on his farm with his wife and two young daughters is largely self-sufficient. A wood stove warms their living room, a cow provides more than enough milk for the family of four, and crates of vegetables for Wall’s market garden business are piled high in the room where his wife teaches music lessons.
He travels into La Crete about once a week to pick up other things they need.
Like most Canadians living in places with public health restrictions, he pulls on a mask when he goes into stores. In La Crete, he’s often the only one.
“I know what people are thinking: ‘You’re scared of the disease,'” Wall said in a recent interview.
Wall and his family are Mennonite, like many families who live in the farming community. But unlike some of their friends, relatives and neighbours, they try, for the most part, to follow the provincial public health restrictions in place to limit the spread of COVID-19.
Evidence from around the world has shown that masks reduce transmission of the coronavirus and that people who are immunized have far greater protection against COVID-19 and severe outcomes than those who are not.
“We essentially stopped going to church because the pandemic restrictions were that they were limited to a certain size — and none of the local churches that we know of were respecting that,” said Wall.
In December 2020, one local church, Grace Bible Fellowship, published a recording of a sermon by Pastor Mike Hovland where he described the province’s public health restrictions as “tyranny” and suggested church members should ignore them.
“Each of us need to answer these questions for our own selves, but I say our fellowship and our worship is much too important for us to obey these mandates,” Hovland said.
Wall said he has wrestled with the question of whether to fully follow public health restrictions, especially as his family members don’t have any medical conditions that put them at greater risk of severe illness or death from COVID-19.
But he also said he doesn’t buy into the conspiracy theories about the virus and vaccines that have been circulating among some residents of his community. He decided to get vaccinated and says he trusts health officials when they say people sick with COVID-19 have been overwhelming hospitals in urban centres.
“I have not felt that I have a freedom of conscience to go against the restrictions just from the limited perspective of what we have here,” Wall said.
Rate of COVID-19 remains high
Early in the pandemic, a high per-capita case rate and climbing deaths from COVID-19 in Mackenzie County worried health officials. By August 2020, Alberta Health Services was doing targeted outreach in La Crete, trying to dispel myths and rumours about the virus and encouraging people and businesses to follow public health restrictions.
In an interview this summer, Mackenzie County Reeve Josh Knelsen told CBC that some residents were taking precautions, but others weren’t.
“People here realize that bills must be paid. You can’t put life on hold, and you protect those that you can,” he said.
The per-capita case rate in the region has been among the highest in the province at times. Of the 3,328 recorded cases, there have been 53 deaths caused by COVID-19. In the city of Grande Prairie, which has twice the population and has had more than twice the number of cases, there have been a similar number of deaths: 55.
Wall attributes the resistance to public health measures and vaccines to a number of factors.
Resentment about economic impact is part of it, he said, but it’s been further fuelled by a belief that limits on church capacity curtailed religious freedom and what some see as government overreach.
“That really gave impetus to conspiracy theories and all of that stuff, saying that they’re just trying to restrict our rights and move us towards a communist state,” he said.
Cash vaccine incentive raised questions for some
Danny Friesen, 34, a Mennonite farmer and businessman in nearby Fort Vermilion, got COVID-19 himself last February. But it didn’t convince him to get vaccinated.
Despite evidence from health authorities around the world showing vaccines are safe and highly effective, and side-effects rare, news about breakthrough cases made Friesen question how well they work.
Also driving his skepticism is the provincial government’s offer of a $100 incentive to get vaccinated. Facing the lowest vaccination rate in Canada, Alberta introduced the incentive in early September for anyone who got either a first or second dose by Oct. 14.
“If they’re paying you to take a shot, something doesn’t quite add up,” Friesen said, standing on the banks of the Peace River in Fort Vermilion.
Friesen said when he contracted COVID-19, he stayed home for two weeks. But he doesn’t think the government has any business imposing quarantine rules and other public health restrictions, describing the rules as “two-faced.”
“You got the small business — it’s trying to implement the rules. And then you see [Premier] Jason Kenney and all these other big shots sitting with no masks on, no restrictions, Learjetting all over the world, crossing borders,” said Friesen, whose wife owned a restaurant in Fort Vermilion until recently.
The public health rules have meant Friesen has missed three funerals over the course of the pandemic due to capacity limits.
Currently, the province has prohibited indoor weddings and funerals unless the venue has adopted Alberta’s restriction-exemption program, which requires proof of vaccine or a negative test. Even then, they are limited to 50 per cent capacity.
But the province has allowed events such as NHL games to go ahead at 100 per cent capacity, as long as the venue has the restriction-exemption program in place.
Friesen finds it frustrating he has to miss important events while tens of thousands of people are allowed to gather in stadiums.
“Everybody has a story of it, and everybody’s getting sick of it,” he said.
Frank conversations a way to increase uptake
As the pandemic stretches on, though, the number of Mackenzie County residents willing to get vaccinated has slowly started to climb. Thirty-five per cent of all residents have at least one dose, up from 26 per cent in mid-November.
Pharmacist Keyur Shah said he saw a bump in people seeking vaccination at his Fort Vermilion pharmacy when the $100 incentive was announced in September. And he said it’s been steady since the introduction of Alberta’s restriction-exemption program.
“What our government is doing seems like it’s working,” he said.
When Shah talks to vaccine-hesitant patients, he said, they often have concerns about side-effects or questions around if it’ll work.
“I urge the patient, ‘Please get the vaccine, just to prevent any kind of hospitalization,'” he said.
Conversations about vaccines with local health-care workers whom residents already know and trust is a cornerstone in AHS’s efforts to increase vaccine uptake in the area, said Dr. Kathryn Koliaska, the medical officer of health for the north zone.
“It really is a conversation,” Koliaska said. “As the conversation evolves with the pandemic — and, quite frankly, as the pandemic evolves, too — different questions come up. And so to the best of our knowledge, to the best of the scientific evidence available, we will listen to questions and then answer them and respond to them.”
AHS staff want to hear the specific worries people have about the vaccine — whether it’s a rumour they’ve heard or something they saw on social media, Koliaska said.
“If someone has that in the back of their mind, any of the other information we present, does it really help until we’ve answered the question that someone’s really worried about?” she said.
Asked about the apparent widespread disregard for public health restrictions in La Crete, Koliaska acknowledged that legal options for enforcement exist. But it’s a “very, very challenging question,” she said.
AHS is better at education and service delivery, Koliaska said, and turns to enforcement only in a limited number of cases.
“Ultimately, what we care about in Alberta Health Services is about keeping people healthy and keeping people safe, keeping people out of hospital,” she said. “That’s what’s actually really important.”
A diverse community
Alberta’s Ministry of Health declined to provide a breakdown of immunization rates for different municipalities and First Nations within Mackenzie County, but visits to different communities across the county suggest attitudes about COVID-19 vary.
While there is a large Mennonite population, particularly in and around La Crete, the area is diverse. A Métis settlement and several First Nations call the region home, and between agriculture, forestry and oil and gas, many others come to the area for work.
One large sign near the Dene Tha’ First Nation band office at Bushe River encourages handwashing. Another directs workers arriving from outside the First Nation to check in for COVID-19 screening. Handwritten signs at a nearby convenience store post updates on case counts in surrounding communities.
In the community of High Level, masking in businesses is de rigueur, and local restaurant staff check for proof of vaccination.
The town is a hub for accommodations for workers, whose steady presence has helped restaurants and hotels in the northern town stay afloat, said Tareq Morad, president of his family’s hospitality company, which operates five hotels and attached restaurants in High Level.
When Alberta lifted nearly all public health restrictions over the summer, Morad said there was a surge in business as locals made their way back to his dining rooms.
But then came the restriction-exemption program, which requires restaurants to check for proof of vaccine if they want to open for indoor dining.
“Local traffic and demand really, really diminished due to low vaccination rates in our area,” Morad said.
Morad’s businesses enforce health restrictions, but he has empathy for people he’s spoken with who have various reasons for not wanting to be immunized. He feels for provincial decision-makers, too, he says.
“It’s a tough one,” Morad said. “There was no playbook for this, right?”
Wall and his family, meanwhile, are debating whether or not to stick to the rules and face another lonely winter without social gatherings.
“At some point we’re also humans, we have social needs,” he said.
PEI has the highest rate of COVID-19 cases amongst Canadian provinces – SaltWire Network
As of Jan. 21, P.E.I. had the highest reported rate of COVID-19 cases, with 1,050 per 100,000 people, of any province in Canada over the last seven days.
Only one jurisdiction, the Northwest Territories, surpassed the province’s rate of cases over the last week, with 2,024 cases per 100,000 people. The next closest province to P.E.I. was Alberta with 759 cases per 100,000.
But Susan Kirkland, head of Dalhousie University’s department of community health and epidemiology, said daily case counts and case rates do not capture the whole story.
“There does become a point where following cases – it collapses.”
Susan Kirkland, Dalhousie University Department of community health and epidemiology
Kirkland says it is now clear that community spread of COVID-19 is widespread in Atlantic Canada, including in provinces like P.E.I., where testing of incoming travellers had previously helped contain spread of the virus.
Kirkland said differences in testing criteria, as well as differing reporting details mean comparing case rates between provinces is becoming less and less useful.
While P.E.I. still allows PCR-RT testing for anyone with symptoms, Nova Scotia has limited PCR testing to specific vulnerable populations that are symptomatic. Rapid antigen tests are provided to the general population that is symptomatic.
In many provinces, daily positive case counts are not capturing the full number of people who have contracted the virus. New Brunswick has also stopped reporting daily case counts in COVID-19 briefings because of this, although the information is still available on the province’s website.
Kirkland said other indicators like hospitalization rates and test positivity are better indicators of how well a province like P.E.I. is faring amid the Omicron wave.
“Ultimately, what we are trying to do is stop the health-care system from (collapsing),” Kirkland said.
P.E.I.’s most recent test positivity rate was 20.7 per cent – significantly higher than all three other Atlantic provinces. There have been 19 hospitalizations since the first Omicron case was announced on Dec. 14.
After weeks of escalating case counts, P.E.I. Premier Dennis King imposed tighter public health restrictions on Jan. 19, closing gyms and in-room dining in restaurants.
Since Jan. 18, the P.E.I. government has stopped recording daily counts of outbreaks associated with long-term care homes, shelters, the provincial correctional centre and other congregate settings.
While the lack of daily reporting has occurred in conjunction with continuing escalating case counts, P.E.I. may not be the only province to have made a decision to report less information about outbreaks.
Nova Scotia is continuing to report daily positive cases associated with long-term care outbreaks, but the province has recently decided to not report school outbreak numbers.
As an epidemiologist, Kirkland said she was not sure what she thought of public health offices restricting reporting on outbreak case counts.
She said Atlantic Canadians have become used to COVID-19 being contained. This has made it difficult for public health offices to communicate that overall containment of the virus is less feasible, due to the higher transmissibility of the Omicron variant.
“I think that what public health is now doing is trying to turn the corner to say, ‘we have to start to learn how to live with COVID,’ ” Kirkland said.
“We have to deal with the things that we know will reduce risks – we have to wear masks. We have to improve ventilation where we can. We have to limit social contacts in areas where we can,” she said.
But Kirkland also believes governments are faced with the challenges of prioritizing a safe reopening of schools.
“Very often people will say, ‘why is it safe for kids to be in school but we need to close restaurants,’ ” she said.
“That’s not the point. The point is that the priority is to keep kids in school. So, we have to do these other things in the community so that kids can stay in school. Because that’s what we think is the most important.”
Now is not the time for vaccine mandates, even as vaccinations among children remain low: experts – CBC.ca
Less than half of Canadian children ages five to 11 have received their first COVID-19 vaccine dose, but Canadian experts say now may not be the time to start mandating them for students attending school in person.
In December, Windsor’s city council endorsed a recommendation from its health unit that all elementary school students be vaccinated before returning to school.
Meanwhile, in the United States, New York City now requires students to be vaccinated before taking part in extracurricular activities. California, which already has strict vaccine requirements for students, is mulling the addition of the COVID-19 vaccine to that list.
“For provinces that don’t have vaccine mandate policies, to start a conversation about vaccine mandates at a time where emotions are very heightened around vaccination is a risky endeavour,” said public health researcher Devon Greyson.
Greyson, an assistant professor of health communication at the University of British Columbia, has studied the efficacy of childhood vaccine mandates. They found that while uptake does increase, the boost can’t be solely attributed to mandates. Better communication, access and reporting systems also played a role.
In fact, in some jurisdictions, mandates did more harm than good by pushing some people away from vaccination, Greyson says.
“I recommend first really trying to build confidence in the population and make it as easy as possible for people to get vaccinated before considering a policy that has potentially negative consequences on children or parents,” they said.
No provincial or territorial governments have announced plans for a COVID-19 vaccine mandate in schools, but jurisdictions such as Ontario and New Brunswick already require vaccinations for certain preventable diseases in students entering the public school system.
Legislation to strengthen mandatory-vaccination rules for N.B. schoolchildren was proposed in 2020, but was defeated. “There are varied opinions, and very strong opinions,” Premier Blaine Higgs, who voted in favour of the change, said earlier this month on CBC’s Power & Politics.
Dr. Cora Constantinescu, a pediatric infectious diseases expert who counsels vaccine-hesitant parents, says that with lower vaccine uptake among five- to 11-year-olds — and children returning to classrooms — there’s an urgency get them vaccinated as soon as possible. But she stopped short of calling for a mandate.
While Constantinescu believes that a vaccine mandate could be effective she pointed out some children risk being kept out of the classroom as a result of such a policy.
Only about five per cent of children ages five to 11 have been fully vaccinated, according to the Public Health Agency of Canada. Prime Minister Justin Trudeau expressed concern over the low vaccination rate on Wednesday, saying that it puts society’s most vulnerable people at greater risk.
Access remains a key issue
In October, California Gov. Gavin Newsom announced that the COVID-19 vaccine would be added to the list of vaccinations required for students to attend school in-person. The policy will be enforced after the federal government approves the vaccines, and the state will grant exemptions for medical reasons, plus religious and personal beliefs.
Some school districts have already enacted mandates in the state.
Young children are particularly good at spreading respiratory illnesses — and that’s likely the case for COVID-19 as well, according to Annette Reagan, adjunct assistant professor at the UCLA Fielding School of Public Health in California.
She says that justifies the addition of COVID-19 vaccines to existing mandates.
“Increasing vaccination rates and stopping transmission in younger children is a good thing for our community, but it comes with the mandates,” said Reagan, noting that such policies limit parental autonomy.
The reasons behind low uptake among the pediatric group in Canada are varied, according to Greyson, but might be explained by timing and limited access to clinics.
Pfizer’s Comirnaty vaccine was approved by Health Canada for the five to 11 cohort in late November — just weeks before the holidays when non-emergency medical appointments tend to slow down.
Pediatric vaccine doses may also be less widely accessible compared to adult doses, said Constantinescu, making it more difficult for parents to get their kids immunized.
“The low-hanging fruit of vaccine uptake is always access,” said Constantinescu. “We have not made this as easily accessible as we could have.”
Constantinescu believes, however, that the narrative children experience more “mild” illness when they contract COVID-19 is a key factor behind the low vaccination rate — a message that parents should reconsider.
“We pray and hope that it’s just going to be a mild illness in most kids. That would be fantastic and I sure hope that, but we don’t know,” she said.
“What we do know is that the vaccine is safe and we have enough supply.”
‘It’s in the best interest of your child’
Perhaps the most significant risk that comes with vaccine mandates, however, is the potential for children with vaccine-hesitant parents to miss out on in-person learning.
Constantinescu argues that some children may not get the protection provided by vaccination or the benefits of learning in person.
With new evidence that negative side effects, such as myocarditis, are rare in the five to 11 bracket, she says now is the time to “shout from the rooftops” that vaccinating against COVID-19 is safe.
“This is the top vaccine-preventable threat to our children and we have a safe vaccine,” she said.
“We need to tell parents this is about protecting your child, first and foremost. It’s not about saving the pandemic, it’s not about saving the world.”
“This is because it’s in the best interest of your child.”
Written by Jason Vermes with files from Ashley Fraser, CBC News and The Associated Press.
Nova Scotia reports 11 people in ICU Saturday, total of 287 people in hospital with COVID-19 – CTV News Atlantic
In a news release Saturday afternoon, health officials in Nova Scotia said 82 people were admitted to hospital and are receiving specialized care in a COVID-19 designated unit. 11 people were reported to be in intensive care.
According to the province, the age range of those in hospital is 23-100 years old, and the average age is 67.
Of the 82 people receiving specialized care for COVID-19 in hospital, 79 were admitted during the Omicron wave.
There are also two other groups of people in hospital related to COVID-19:
- 84 people who were identified as positive upon arrival at hospital but were admitted for another medical reason, or were admitted for COVID-19 but no longer require specialized care.
- 121 people who contracted COVID-19 after being admitted to hospital.
The number of COVID-19 admits and discharges to hospital was not available Saturday.
On Jan. 21, the Nova Scotia Health Authority labs completed 3,682 tests.
According to a news release, an additional 502 new lab-confirmed cases of COVID-19 are being reported.
Of the new cases; 219 are in the Central Zone, 88 are in the Eastern Zone, 59 are in the Northern Zone and 136 new cases are in the Western Zone.
Nova Scotia remains under a state of emergency. Provincial officials first declared a state of emergency on March 22, 2020 and it has now been extended to February 6, 2022.
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