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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.”
Despite 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. (Evan Mitsui/CBC)
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.
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.
Naylor says that even though Canada has vaccinated over 83 per cent of our eligible population with one dose and more than 75 per cent with two, that’s still not enough to stave off a fourth wave.
“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.”
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. (Graham Hughes/The Canadian Press)
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.”
B.C. has followed Quebec’s lead and will implement a vaccine passport system to access non-essential services. 2:43
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.
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. (Peter Power/The Canadian Press)
“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.”
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.
