This is an excerpt from Second Opinion, a weekly roundup of health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.
Canadians are entering one of the most confusing chapters of the pandemic — and many may be left wondering why we’re not where we’d hoped to be after becoming one of the most vaccinated countries in the world.
Reports of waning immunity from COVID-19 vaccines, the potential need for booster shots and the possibility of breakthrough infections among the fully vaccinated may be leading many of us to second guess what we can and can’t do safely in the fourth wave.
And the more contagious, potentially more deadly delta variant has prolonged the pandemic, made daily life more difficult to navigate and turned back the clock on our collective plans to return to a relatively normal life.
“Everyone needs this damned virus to go away,” said Dr. David Naylor, who led the federal inquiry into Canada’s national response to the 2003 SARS epidemic and now co-chairs the federal government’s COVID-19 immunity task force. “But it’s not done with us yet.”
It was easy to think that once most of us rolled up our sleeves and did our part to get vaccinated and protect ourselves and our communities from COVID-19 that this would all be over, but the unfortunate truth is that we still have a ways to go.
“We need to rethink this,” said Linsey Marr, an expert on virus transmission at Virginia Tech in Blacksburg, Va. “It is emotionally upsetting because we thought we saw the light at the end of the tunnel — but apparently the tunnel is longer.”
Unvaccinated driving Canada’s 4th wave
The hard truth is that despite our collective efforts to stave off another wave of the pandemic through widespread vaccination, Canada is continuing to see a troubling rise in COVID-19 levels across much of the country.
Over the past week, new COVID-19 cases have risen to an average of 2,848 per day — an increase of 29 per cent over the previous seven days.
Daily hospitalizations have also climbed 39 per cent week-over-week to an average of 917 across the country, while ICU admissions are also up by an average of 29 per cent per day to 340 over the past week.
That’s despite having 66 per cent of the Canadian population fully vaccinated — a number that has plateaued in recent weeks, but is remarkably high nonetheless.
So why isn’t that enough? The answer lies with those who haven’t yet gotten a shot.
Since vaccines became available in December, just 0.8 per cent of cases, one per cent of hospitalizations and 1.4 per cent of deaths from COVID-19 have been in fully vaccinated Canadians, according to the latest available data from the Public Health Agency of Canada.
“When we look at where cases and certainly hospitalizations are showing up right now, we’re seeing massive over-representation in unvaccinated communities,” said Jason Kindrachuk, an assistant professor of viral pathogenesis at the University of Manitoba and Canada Research Chair of emerging viruses. “So the vaccines are working.”
But there are still millions of Canadians who have yet to get vaccinated — either by choice or due to a lack of access or eligibility — and that’s putting all of us at risk.
Unvaccinated Canadians pose risks to vaccinated
The bottom line is the vaccines aren’t perfect (and were never purported to be) and even the fully vaccinated are at some risk of COVID-19, which adds to the confusion of how Canadians should proceed in the weeks and months ahead.
Dr. Allison McGeer, a medical microbiologist and infectious disease specialist at Toronto’s Mount Sinai Hospital who worked on the front lines of the SARS epidemic in 2003, says the unvaccinated pose two different threats to vaccinated Canadians in the fourth wave.
“Firstly, they pose a direct risk of transmission, and while the vaccine is very effective at protecting you from serious illness and death — it’s not 100 per cent. Nothing in life is 100 per cent,” she said.
“The second thing that unvaccinated people do is they increase the spread of coronavirus in the population. So if you release restrictions, unvaccinated people contribute substantially more to the growth of transmission in the community.”
To put it bluntly, the longer the remaining Canadians put off getting a shot — and until we can get kids under 12 vaccinated — the more the pandemic drags on.
And while we’ve come a long way since the beginning of the pandemic, we’re still nowhere near where we need to be to control the delta variant.
“That’s very helpful and should mitigate the toll of the fourth wave compared to earlier waves,” he said. “But it makes no sense to leave a lot of immunological room for this virus to spread and cause more harm.”
Public Health Ontario, a provincial government agency, said in a recent report that the delta variant has kicked the possibility of herd immunity further down the road — meaning we now need 90 per cent of the population fully vaccinated to get there.
“Vaccines are not a panacea, but if everybody got vaccinated — this is done,” said Raywat Deonandan, a global health epidemiologist and associate professor at the University of Ottawa. “Despite the fact these vaccines aren’t perfect.”
Delta changing rules of the game
The problem we face at this stage of the pandemic is that delta has changed the rules of the game — raising the immunity threshold we need to hit, increasing risk in our day-to-day lives and meaning even fully vaccinated Canadians need to keep their guard up.
But instead of coming together in a cohesive way, the country is once again divided over vaccine passports, mask mandates and reinstating public health restrictions — leaving a patchwork system across the country that leaves room for the virus to spread.
Ontario and Alberta have vehemently rejected the idea of vaccine passports to date, although Ontario may soon change course, while British Columbia joined Quebec and Manitoba in announcing passports for the fully vaccinated in response to the fourth wave.
Saskatchewan announced this week that not only would it not be implementing vaccine passports — it also won’t reintroduce indoor mask mandates or lower capacity limits on gatherings despite rising COVID-19 levels.
“I’m really disappointed that some provinces have not moved forward with vaccine certificate programs. This isn’t about civil liberties. It’s like smoking in a crowded restaurant,” said Naylor.
“Vaccine certificates are also a spur to those who are unvaccinated or partially vaccinated to get on with protecting themselves and others. One can only hope all the premiers eventually wake up to the harm they are doing by side-stepping this sensible measure.”
WATCH | B.C. announces vaccine passport amid COVID-19 spike
The reality is that until that happens, Canadians may need to take matters into their own hands by using the proven tools we have at hand to blunt the worst of a delta-driven fourth wave.
“We have to appreciate that there’s a balance,” Kindrachuk said. “Vaccines are certainly an important way out of the pandemic for us, but they’re not the only way.”
Those tools include wearing high quality masks when needed, filtering the air indoors and avoiding crowded indoor spaces with poor ventilation — especially with the unvaccinated.
“Delta is obviously much more transmissible and the vaccine helps protect against that, but it’s not 100 per cent. So it almost puts us back where we were a year ago with a less transmissible virus and no vaccines,” Marr said.
“At the same time, it’s not as upsetting as the first time around because we know what we need to do.”
Coronavirus cases in Quebec rise by 821 with three new deaths and two more hospitalizations – CTV News Montreal
Quebec reported Saturday that 821 more people have tested positive for COVID-19 in the province, bringing the overall number of infections to 402,283.
Of the new infections, 609 people were unvaccinated when they received their positive result, 49 received one dose of vaccine more than two weeks prior, and 163 were double-vaxxed more than a week before the test.
Hospitalizations rose by two bringing the total number of people receiving care in the province’s hospitals to 264. The ministry reports that 36 people checked in for care, and 34 were discharged. Of the 36, 28 were unvaccinated, two received one vaccine dose more than 14 days prior and six got both jabs more than a week before entering the hospital.
There are 89 people in intensive care wards, which is six fewer than on Friday.
Three more people have died due to COVID-19, bringing that total to 11,321 since March 2020.
There are 508 active outbreaks in the province.
Quebec’s vaccination rate remains at 88 per cent for one dose of the eligible population and 82 per cent for both doses.
Spike in COVID-19 cases is pushing New Brunswick's health-care system to the limit – CTV News Atlantic
MONCTON, N.B. —
New Brunswick’s jump in COVID-19 cases has overloaded the health-care system this week.
The Horizon Health Network is now looking to hire more staff across the province to help with the growing demand for testing and vaccinations.
The health network has seen an increased demand in testing as COVID-19 cases have soared over the last month.
“Two weeks ago, if you wanted a test, you could walk in or call and get it at almost anytime you wanted,” said Dr. Jeff Steeves with New Brunswick’s Medical Society.
But now, assessment centres are seeing long line ups and delays in testing.
Steeves wants people to get the jab and practice caution during this time to prevent overloading the system even more.
“Remember, we were running short even before COVID, so we’re trying to maintain that,” Steeves said. “Therefore, we can’t divert the staff like we did before, hence the call for new staff.”
Horizon Health’s vice-president said in a statement Friday that they are currently looking to recruit staff at vaccination clinics, assessment centres and school clinics in Moncton, Saint John and Fredericton.
“Given the recent rise in COVID activity in New Brunswick, and the increased demand for these services, we are hoping to replenish our pool of available clinicians and administrative support staff as we ramp up activity at these locations,” said Jean Daigle.
Since the province announced proof of vaccination requirements this week, public health has reported a significant jump in vaccination appointments.
On Wednesday, 1,700 appointments were booked, while yesterday there were 1,929.
Health officials say prior to Wednesday’s number, the recent average for vaccinations was 600 bookings per day. On Thursday, 600 additional vaccines had to be delivered to a clinic in Moncton.
“Things have picked up dramatically,” said Fredericton pharmacist Alistair Bursary, who says they’ve been busy taking calls from people looking to get their first or second dose.
“So, whereas we were doing perhaps 10 patients a day on average now we are probably going to hit 40-50 just at our pharmacy alone,” Bursary said.
While the demand for services continue to climb, those working on the frontlines hope to get the help they need sooner rather than later.
Quebec reports 821 COVID-19 cases, three deaths – Winnipeg Free Press
MONTREAL – Quebec reported 821 new COVID-19 cases and three further deaths in its latest data on Saturday, as authorities expanded plans to use rapid tests in elementary schools to more regions of the province.
Health officials said hospitalizations increased by two to 264, while the number of patients in intensive care dropped by six to 89.
The province said about 80 per cent of new infections involve people who were not adequately vaccinated.
Quebec administered 19,662 vaccine doses on Friday and officials said 88 per cent of Quebecers aged 12 and older have received a first dose while 82 per cent have gotten both shots.
Health Minister Christian Dubé said in a tweet more than 1,000 of those doses went to health-care workers, with the province remaining firm on a plan to have all sector employees adequately vaccinated Oct. 15 or face reassignment or suspension without pay.
“It’s never too late to get the vaccine, it’s the best way to protect yourself and others,” Dubé wrote on Saturday.
The province conducted more than 32,000 tests on Friday and the positivity rate is 2.4 per cent.
Late Friday, Quebec’s Health Department said rapid testing in elementary schools will now extend to several administrative regions of the province where masking in classrooms is already mandatory.
In a statement, officials said the deployment will take a few weeks and include nearly 1,600 schools.
The provincial government came under criticism from opposition parties and school administrators on the rollout of the testing program.
The province appointed Daniel Paré, head of the vaccination campaign, to co-ordinate the deployment.
The Health Department said schools will have the tests and PPE needed to use the tests, reserved for students who develop COVID-19 symptoms during the day and training and protocols are being set up.
“They are a complementary tool to quickly detect cases and further protect students and school staff and ensure that young people continue to receive their education at school,” the department said.
The tests, which provide a result in 15 minutes, have been used in four neighbourhoods in Montreal and Laval since Monday.
Schools are expected to begin using the tests widely by the end of the month, when training of staff to use the tests is complete.
This report by The Canadian Press was first published Sept. 18, 2021.
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