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So you got your COVID-19 shot. Does that mean life goes back to normal? – CBC.ca

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After Toronto family physician Dr. Tali Bogler received her final dose of a COVID-19 vaccine in January, she felt a newfound sense of relief — but also knew her daily life wasn’t going to suddenly change.

On an afternoon in late February, while still dressed in her bright blue hospital scrubs after a shift, she was cuddling one of her twin daughters while catching up with her parents on a video chat.

It’s the same kind of virtual family time Bogler has experienced throughout the pandemic. Being vaccinated doesn’t mean she’ll start seeing them in person without precautions any time soon, she said, since her parents won’t get their shots for months.

“It’s really hard,” she said, though acknowledging there’s also a sense of excitement for what’s to come. “This period of time, from now until September, I guess, when everyone else is vaccinated, is a transition period.”

More and more Canadians will be grappling with that sense of limbo in the weeks and months ahead after getting vaccinated and protected against COVID-19 while millions of others are still waiting for their turn.

“What does that normalcy look like?” asked Dr. Donald Vinh, an infectious disease specialist and medical microbiologist at the McGill University Health Centre.

“That’s a question that we are collectively struggling with.”

Dr. Tali Bogler, pictured with her daughter in their backyard in Toronto, video calls her parents who haven’t yet received the COVID-19 vaccine. (Sam Nar/CBC)

Experts who spoke with CBC News stressed that people still need to err on the side of caution and keep their guard up awhile longer, whether vaccinated or not, to protect those around them. 

But after a year of lockdowns and restrictions, there’s also bound to be plenty of friends and families hoping to spend time together once more Canadians start getting their shots — a reality that requires taking stock of everyone’s comfort level when it comes to risk.

“I do think we’re entering into a phase where people are more and more tired of having to deal with public health restrictions, and so we’re probably more likely to encounter that,” said infectious disease specialist Dr. Susy Hota, an associate professor at the University of Toronto.

“I think the important message to give people is that in the short term, nothing changes. So they have to live their lives the same way as they were before they were vaccinated, because it will take some time to get enough people vaccinated.”

Risk ‘quite low’ among vaccinated people

Of course, as time passes, more vaccinated people will know more vaccinated people, be it friends, family members or co-workers.

So, at what point can those groups of COVID-protected people start spending time together without the usual pandemic safety concerns?

“If your parents are older, and they’ve gotten vaccinated — and you’re vaccinated — the risk is quite low, especially if you are continuing publicly to maintain all the other public health measures,” Hota said.

But those situations won’t be common for a while, forcing friends and families to navigate a stark, two-tier world of protection levels. 

That means even while vaccinations scale up, public health measures such as mask-wearing and distancing from others are expected to stay in place.

“We often talk about herd immunity,” said Dr. Vinita Dubey, Toronto’s associate medical officer of health. “And that’s often what we really need to have before we can be confident that having so many people vaccinated is acting like that wall to keep COVID from coming back into our community.”

‘Nothing changes’ in the short-term until more people are vaccinated, says Dr. Susy Hota, medical director of infection prevention and control for the University Health Network in Toronto. (Craig Chivers/CBC)

While the vaccines in use so far are proving highly effective at stopping serious illness and death, they aren’t 100 per cent protective and don’t offer instant immunity. Researchers also still aren’t sure how much they might curb transmission of the virus.

“If it interrupts infection, then it’s kind of stopping that chain of transmission from happening, just by virtue of having fewer people who are going to get infected,” Hota said. “But there may still be some asymptomatic infections and some ability to shed virus.”

In Israel, where mass vaccinations are already taking place, the country’s largest health-care system has so far reported a 94 per cent drop in symptomatic COVID-19 infections — and early study findings suggest at least one vaccine may curb transmission, too.

Those results bode well, but it’s still going to take time to confirm them more broadly, Vinh said.

In the meantime, plenty of people waiting to get vaccinated will remain highly vulnerable to the impacts of a COVID-19 infection, be it lingering, long-lasting symptoms or a gruelling recovery following an ICU stay.

“People who have had cancer, people who had transplants, people who have genetic conditions,” he said.

Find ways to lower risk

At first blush, it’s probably not the news most people want to hear. Finally, at long last, vaccine shipments are ramping up and more residents will be rolling up their sleeves in the months ahead, yet nothing changes?

Hota said while it might feel that way at first, there’s likely going to be a slow and steady reduction in restrictions as vaccination campaigns roll out from high-risk age groups to younger populations.

“If you rush it,” she said, “you can jeopardize the whole approach.”

Dr. Dominik Mertz, an infectious disease specialist and associate professor at McMaster University in Hamilton, said it will become even more crucial in the months ahead to assess your comfort level around risk, and the comfort level of those with whom you’re considering spending time.

“Policy decisions aside, it’ll be a discussion,” he said. 

“Some families may decide, OK, my grandparents or parents are vaccinated — they’re high risk, but highly protected — and we as a family decide it’s OK meeting in their house.”

Care home workers get the Pfizer-BioNTech COVID-19 vaccine at a clinic in St. Michael’s Hospital in Toronto in late December. (Evan Mitsui/CBC)

But you can also make those efforts to start seeing each other without fully scrapping precautions, he said. Instead of meeting indoors post-vaccination, you could spend time outside where the transmission risk is lower.

“Maybe don’t take the full risk,” Mertz said. “Find something in between, where your personal needs are met but you don’t take the highest possible risk.”

And, he said, it’s important to pay attention to what’s happening in your broader community, not just your own social circle. 

High levels of community transmission would mean the chance of people you know being infected goes up as well. It’s a trend public health officials are watching closely given the cases of highly contagious variants already circulating, which could lead to another surge in cases.

WATCH | Pfizer-BioNTech vaccine may curb transmission, early research suggests:

New research conducted in Israel shows that if a person is infected with COVID-19 after receiving a single dose of the Pfizer-BioNtech vaccine there’s less coronavirus in the system, and that could mean the vaccine may help prevention transmission. 1:55

‘Normalcy is on the horizon’

With so much to consider, Canadians could face some frustration and ethical dilemmas over the next year.

Toronto resident Mary Ellen Abrams, who is currently living in a retirement community in Palm Springs, Calif., said she was surprised to get access to a local vaccination program during her stay in the U.S. — but then found herself stumped on what to do next.

“We’re all kind of saying, by mid-March, two weeks after the second dose, we should all be able to hang around each other, to go for dinner together,” said the 65-year-old. “They’ve opened up indoor dining here in California and we thought, ‘Gosh, can we do that?'”

She also wondered whether it would be safe to see her grandchildren in Toronto after she gets back and completes the mandatory hotel quarantine, since she hasn’t spent time with them in-person since last March, beyond saying hello on a front porch or during drive-by greetings.

Mask-wearing, physical distancing and other public health precautions will likely stay in place for some time as vaccinations ramp up, experts say. (Ben Nelms/CBC)

But finding answers to her questions hasn’t been easy, Abrams said, with little information available on any government websites about what you can or can’t do in your daily life post-vaccination.

“Everyone will want to be vaccinated if they know they can get their life back to somewhat normal,” she said.

Vinh said that scenario requires a little more patience to avoid giving the virus more chances to spread during what has the potential to mark a turning point in the pandemic.

“We don’t want to say, ‘Well, we have a vaccine coming and they say it is almost 100 per cent effective, and once I get my first shot I can go out and do my thing, my regular thing,'” he said. “Not yet, not yet.”

The payoff of getting your shot, for now, remains the personal protection it provides, not a sudden end to the pandemic for everyone in your life — even though that’s the ultimate hope for mass vaccination efforts.

Bogler, the Toronto physician and mother to twins, can certainly relate to that feeling.

Memories of her COVID-19 exposures at work are still fresh, including a stretch where she had to isolate from her daughters and partner for two weeks last year. But those close calls likely won’t be the norm for her anymore, taking a weight off her shoulders even as she continues masking, distancing, and staying apart from her parents awhile longer.

“Normalcy is on the horizon,” she said.

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Vaccinated should wear masks indoors in US COVID hotspots: CDC – Al Jazeera English

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People in parts of the United States where COVID-19 infections are surging should wear masks indoors even if they are fully vaccinated against the coronavirus, the country’s public health agency has advised.

Citing new information about the ability of the Delta variant to spread among vaccinated people, the US Centers for Disease Control and Prevention (CDC) on Tuesday also recommended indoor masks for all teachers, staff, students and visitors to schools, regardless of vaccination status.

“In areas with substantial and high transmission, CDC recommends fully vaccinated people wear masks in public, indoor settings to help prevent the spread of the Delta variant and help protect others,” CDC Director Rochelle Walensky told reporters during an afternoon news briefing.

The US is averaging more than 57,000 coronavirus cases a day and 24,000 hospitalisations, and public health officials for weeks have warned that COVID-19 infections are increasing, especially in parts of the country with low vaccination rates.

Walensky said while vaccinated Americans represent “a very small amount of transmission” – and stressed that the vast majority of new infections, hospitalisations and deaths is occurring among unvaccinated individuals – vaccinated people still have the ability to pass the virus on to others.

“With the Delta variant, vaccinating more Americans now is more urgent than ever,” she added.

Rising infections

The recent rise in cases comes after mask-wearing and other public health restrictions were loosened, and restaurants, bars and other venues reopened in many parts of the country amid a sharp increase in national vaccination rates.

The new CDC recommendations are not binding and many Americans, especially in Republican-leaning states, may choose not to follow them.

“This is not a decision that we … have made lightly,” Walensky said about the new guidelines, acknowledging that many people are frustrated by the ongoing pandemic. “This new data weighs heavily on me, this new guidance weighs heavily on me.”

US President Joe Biden welcomed the agency’s recommendations on Tuesday as “another step on our journey to defeating this virus”.

“I hope all Americans who live in the areas covered by the CDC guidance will follow it,” Biden said in a statement, adding that masking students in schools “is inconvenient … but will allow them to learn and be with their classmates with the best available protection”.

“Most importantly, today’s announcement also makes clear that the most important protection we have against the Delta variant is to get vaccinated. Although most U.S. adults are vaccinated, too many are not. While we have seen an increase in vaccinations in recent days, we still need to do better,” Biden said.

The CDC had advised people to wear masks for much of the pandemic in settings where they could not maintain six feet (1.8 metres) of distance between themselves and others.

In April, as vaccination rates rose sharply, the agency eased its guidelines on the wearing of masks outdoors, saying that fully vaccinated Americans no longer needed to cover their faces unless they were in a big crowd of strangers. In May, the guidance was eased further for fully vaccinated people, allowing them to stop wearing masks outdoors in crowds and in most indoor settings.

The guidance still called for wearing masks in crowded indoor settings, like buses, planes, hospitals, prisons and homeless shelters, but it cleared the way for reopening workplaces and other venues.

Subsequent CDC guidance said fully vaccinated people no longer needed to wear masks at summer camps or at schools, either.

Some municipalities and states have re-imposed mask mandates amid the recent increase in cases. [File: Brendan McDermid/Reuters]

Coronavirus vaccines are widely available across the US, and 60 percent of adults are fully vaccinated while 69 percent have received at least one dose, according to CDC data. But millions of people remain unvaccinated – and the recent increase in cases is especially pronounced in US states with low vaccination rates, such as Florida.

‘Wrong direction’

Dr Anthony Fauci, the White House chief medical adviser, warned during the weekend that the US was moving “in the wrong direction” on the coronavirus – and he urged people to get jabs.

“If you look at the inflection of the curve of new infections,” Fauci said in an interview on CNN’s State of the Union programme on Sunday, stressing that most infections are among Americans who have not been vaccinated.

“It is among the unvaccinated and since we have 50 percent of the country is not fully vaccinated, that’s a problem – particularly when you have a variant like Delta which has this extraordinary characteristic of being able to spread very efficiently and very easily from person to person,” he said.

Some municipalities and states have re-imposed mask mandates amid the increase in cases.

In St Louis, Missouri, a county-wide mask mandate took effect on Monday, requiring most people, regardless of their vaccination status, to wear a mask indoors and on public transportation.

Sixty percent of US adults are fully vaccinated while 69 percent have received at least one dose, according to data from the CDC [File: Karen Pulfer Focht/Reuters]

Los Angeles, California also recently reinstated its mask requirement, while the top public health official in King County, Washington, which includes the city of Seattle, last week asked everyone to wear masks in indoor public spaces – even if they are vaccinated.

Calls have also grown to require health workers, among others, to be vaccinated.

“Due to the recent COVID-19 surge and the availability of safe and effective vaccines, our health care organizations and societies advocate that all health care and long-term care employers require their workers to receive the COVID-19 vaccine,” a group of more than 50 healthcare organisations, including the American Medical Association, said on Monday.

That same day, the US Department of Veterans Affairs said it would require its doctors and other medical staff to get COVID-19 vaccines, becoming the first federal agency to impose such a mandate.

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BC Steps Up Measures to Increase Vaccinations – Yahoo News Canada

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British Columbia’s vaccination strategy is changing course to target the more than 900,000 eligible people who are not yet immunized against COVID-19.

The Vax For BC campaign will see mass vaccination clinics scale down to make way for smaller community-based clinics, drop-in centres and mobile vaccination clinics to meet people where they are.

The interval between shots will drop from eight weeks to seven, and as low as six in regions with particularly low vaccination rates.

And the province will make 20,000 shots available without appointments on “Walk-in Wednesday,” Aug. 4, in addition to freeing up more shots at every location for walk-ins.

“We are making it even easier for people to get vaccinated to protect themselves and their loved ones against COVID-19,” said provincial health officer Dr. Bonnie Henry on Tuesday.

More than 80 per cent of people over 12 in B.C. have received at least one dose of a COVID-19 vaccine, an effort that public health officials said should be commended.

But the missing 19.6 per cent, “those 900,000 are really, really important” to prevent a fourth wave of the virus in B.C., Dr. Penny Ballem said today.

“We’ve had incredible success and commitment by the public,” said Ballem, who is in charge of the vaccine rollout. “But we have to keep going, and we have to capture more people.”

Unvaccinated people accounted for about 78 per cent of COVID-19 cases between June 15 and July 15, despite representing only 19.6 per cent of the population.

Those who had a single dose accounted for 18 per cent of cases. And fewer than five per cent of cases involved people who were fully vaccinated.

Overall, vaccinations are preventing about 70 per cent of potential infections, according to recent provincial modelling.

“It is extremely important to get both doses of the vaccine,” said Henry.

The recent slow increase in daily and active cases is still largely driven by social gatherings and events with unvaccinated people, Henry said, most of which are in the Interior.

“We don’t yet have enough people with full protection that it can’t spread,” Henry said.

Increasing vaccinations is particularly important in the Northern and Interior Health regions, Henry said, where long travel times from small communities to existing clinics can make it difficult to get vaccinated.

The regional differences are stark. In Northern Health, 32.5 per cent of the eligible population has not received any vaccine, more than double the 14.8 per cent who are unvaccinated in Vancouver Coastal Health.

In Interior Health, where nearly two-thirds of recent cases have been located, 26.2 per cent of the population is unvaccinated.

When asked about how much of that is due to access and how much is due to vaccine hesitancy or anti-vax sentiments, Henry said the province estimates only about five per cent of people are staunchly opposed to COVID-19 vaccines.

The others, hopefully, can be reached by answering their questions about the vaccines and making it as easy as possible to get vaccinated by bringing the shots to them, she said.

“This is the time for us to say, ‘We can answer your questions,’” said Henry.

The province is not currently considering punitive measures, like mandating businesses to require proof of immunization for service, to encourage people to be vaccinated.

But Henry said businesses and events are within their rights to require vaccines for entry or separate vaccinated and unvaccinated customers.

“It is a choice not to get vaccinated, but there are consequences,” said Henry.

Health-care workers who choose not to be vaccinated will be required to mask and present negative COVID-19 tests, she added, and potentially barred from working in certain units.

“I have very limited patience for people in health care who are not vaccinated,” said Henry. “There will be consequences for that decision.”

Henry and Health Minister Adrian Dix noted that with increased vaccination and the province’s low and stable hospitalization rates, it is unlikely B.C. will see more restrictions or the mask mandate reinstated. The U.S. Centers for Disease Control recommended a return to mask mandates today.

“COVID is going to be with us for a while,” said Dix. “The pandemic, we hope, will not.”

Moira Wyton, Local Journalism Initiative Reporter, The Tyee

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COVID-19 in B.C.: New immunization campaign; cases among and measures against unvaccinated people; and more – The Georgia Straight

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With B.C. nearing the end of the fourth and final phase of its COVID-19 immunization plan, health officials provided an update on where the province is at with vaccinations and what it will do next.

At a news conference in Vancouver today (July 27), B.C. immunization rollout team executive lead Penny Ballem, B.C. Health Minister Adrian Dix, and provincial health officer Dr. Bonnie Henry provided updates about vaccination data and announced the launch of a new campaign that reflects a shift from mass vaccinations to reaching those who haven’t yet received vaccinations.

“With more than 80 percent of eligible people in B.C. vaccinated with their first dose and more than 60 percent fully vaccinated, we have made tremendous progress in our vaccine rollout,” Dix said.

Over 6.5 million COVID-19 vaccine doses have now been administered in B.C. As of July 26, 3,736,651 people (80.6 percent) who are 12 years and above have received their first dose and 2,840,194 (61.3 percent) have received their second dose.

While Dix, Henry, and Ballem thanked everyone who has received their vaccinations, and those working in the immunization program, all note that more vaccinations still need to be done.

B.C. provincial health officer Dr. Bonnie Henry, with B.C. immunization rollout team executive lead Penny Ballem
Province of British Columbia

“We now know that the majority of our new cases, some of which have increased in the last little while, are among people who have not yet received their vaccine,” Henry said.

According to data from the B.C. Centre of Disease Control (BCCDC), there were 1,210 COVID-19 cases among unvaccinated people from June 15 to July 15 while there were 499 cases among people who had only received one dose.

In comparison, there were 65 cases, or less than five percent of COVID-19 cases, from June 15 to July 15 were among fully vaccinated people.

During that same time period, Henry pointed out that there has been a “high rate” of unvaccinated individuals—137 out of 176 hospitalized cases, or 78 percent—who have been hospitalized in B.C. with COVID-19, and an additional 18 percent of those who have only received their first dose.

Henry also cited her colleagues in the U.S. who are seeing a “new pandemic” among those who are unvaccinated.

Ballem presented data about unvaccinated population numbers by regional health authorities.

In total, there are 906,722 British Columbians, or 19.6 percent, who have not yet been vaccinated.

The largest number of unvaccinated individuals is in Fraser Health 315,748—but that represents 18.4 percent of the population in that region.

Northern Health has the highest percentage of unvaccinated people, with 84,573 individuals, or 32.5 percent of its population.

Interior Health follows Fraser Health with 199,159 unvaccinated individuals, but follows Northern Health percentage-wise with 26.2 percent of its population unvaccinated.

Vancouver Coastal Health has 141,169 unvaccinated individuals, or 18.1 percent, which is about the same percentage as Fraser Health. 

Island Health has 166,123 unvaccinated individuals but that represents the lowest percentage in the province at 14.8 percent of its population.

Henry explained that there are vaccination challenges in Northern and Interior Health where there are small communities that are physically distant from each other, have lack of access to vaccines, or have been affected by wildfires.

B.C. immunization rollout team executive lead Penny Ballem, provincial health officer Dr. Bonnie Henry, and Health Minister Adrian Dix
Province of British Columbia

When asked if the province will take any punitive measures against those who are unvaccinated, Dix said that although vaccinations aren’t and won’t be mandatory in B.C., but “measures will be taken” to protect people from those who are unvaccinated, such as in longterm care facilities.

Henry explained that based on a survey, people have expressed a range of reasons why they remain unvaccinated, ranging from inconvenience of accessing vaccinations to lack of confidence in vaccines.

“It is choice to be immunized, but there are consequences for people who are not immunized,” Henry said, “and that’s going to be more important for us as we head into the fall, as we know that this virus will increase, as we know that we’ll likely see other respiratory viruses, and—incredibly important from my perspective—is protecting those people who we know may not mount as good an immune response from vaccine.”

Of the latter group, Henry said that includes seniors and elders, and those in longterm care and the healthcare sector.

As previously announced, Henry said that those working in healthcare who choose to remain unvaccinated will need to take additional prevention and control measures, such as wearing masks and regular testing, and that they won’t be permitted to work in specific settings.

“I have very little patience for people who are not vaccinated in healthcare,” Henry said, with a self-effacing chuckle.

Henry said that the number of anti-vaxxers in the province remains low, at about one to two percent of the population, which she said is a “very small percent” but that they are very organized and vocal.

Dix cited the example of measles immunizations amongst students in 2019, and that if there is an outbreak of measles, those who aren’t immunized will be excluded from school. Accordingly, he said that there will be similar consequences for not being immunized for COVID-19.

However, he also pointed out how young people responded to the measles immunization program and that he expects that those aged 18 to 24 will be more immunized than any other age group because of their willingness to participate in the program.

Citing the examples of recent clusters connected to nightclubs and gatherings in indoor settings with poor ventilation such as weddings or funerals, Henry said she is in support of businesses opting to require anyone to only admit people who are vaccinated.

“That gives people the level of comfort that they are in a safer environment,” she said. She added that if transmission occurs at a business, health officials will temporarily shut down the business.

The Vax for B.C. campaign, which will be aimed at reaching people who still need vaccinations, begins today and will continue throughout August, and will involve community events, vaccination vehicles, and mobile clinics across the province. More focus will be placed on local public health clinics, community outreach efforts, mobile programs, and pop-up clinics.

These events will permit all eligible individuals to drop in for vaccinations without appointments (although registration and booking with the provincial Get Vaccinated system is still encouraged).

The first provincewide Walk-in Wednesday will be held on August 4, which will make 20,000 doses available for drop-ins for anyone who is 12 years and above and is eligible for their first or second doses.  

A complete list of Vax for B.C. events throughout the province is available online

For today’s B.C. COVID-19 update, see this article

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