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Figuring out where you’re most at risk of catching COVID-19 is more challenging than ever in Canada’s Omicron-fuelled sixth wave, and tried-and-tested strategies for avoiding infection are proving less effective in everyday life.
The rapidly spreading BA.2 subvariant has been evading all of our layers of protection — from vaccines to masks — and fuelling a surge of COVID-19 levels across Canada during a time of few restrictions.
But while attempting to avoid COVID-19 risk entirely isn’t realistic, abandoning strategies that have worked to lessen the impact of the virus isn’t either — making this phase of the pandemic incredibly difficult to navigate.
“We have not experienced what it’s like to live with this virus while we are doing this little to stop it,” said Dr. Jeremy Faust, an emergency room physician at Brigham and Women’s Hospital and a Harvard Medical School instructor who recently wrote about navigating risk.
“Never until now have we been in a situation in which we have the least amount of protection against infection and these variants that are just flabbergastingly contagious.”
Hard to judge, hard to avoid
Faust says because everyone has a different risk threshold in day-to-day life, trying to navigate the pandemic based on your presumed best interest is a “dead end” because many people are unlikely to have judged the situation correctly.
“We might be completely correct one day and be safe and be completely incorrect the next day and be either personally at risk or putting someone else at risk,” he said. “And it’s this variability that makes your head spin if you stop to think about it.”
Dr. Lynora Saxinger, an infectious diseases physician and associate professor at the University of Alberta in Edmonton, said part of the problem with Omicron is that it punches through all our layered protections “much more effectively than anything has before.”
“All of those layers still reduce your risk, it’s just that the assault on the layers is a lot more aggressive right now,” she said. “It’s like there’s a lot more shots on goal.”
“The risk of infection has gone up markedly over the past three months,” said Erin Bromage, an associate biology professor at the University of Massachusetts Dartmouth who researches infectious diseases.
“And it’s getting harder for those who have avoided infection up until now to continue avoiding infection.”
With mask mandates lifted in many places, some are going without, creating a situation with fewer protections against what doctors call a ‘flabbergastingly contagious’ virus. (Evan Mitsui/CBC)
Playing field ‘rapidly shifting’
Canada’s Chief Public Health Officer Dr. Theresa Tam said this week that average daily case counts, test positivity rates and wastewater signals are all signalling growing transmission across the country that requires the “layering of precautions” to drive infection rates down.
“There is still a lot we can do to dampen down the current trajectory,” she said during a press conference Wednesday.
“We know that using personal protective measures like masking helps reduce transmission. Likewise getting a booster dose doesn’t just protect you against severe illness, it also provides a level of protection against infection.”
But the effectiveness of masking in preventing the transmission of Omicron and its highly contagious subvariants isn’t perfect, and the protection against infection from boosters appears to be waning at a rapid rate.
Linsey Marr, a researcher on the airborne transmission of infectious diseases and a professor at Virginia Tech says that while masks have the same filtration level for any virus — our chance of infection could be higher with these more transmissible variants.
“One thing that might be different with the variants is that people could be shedding more virus into the air…. You’re exposed to more virus, so your chances of infection are higher,” she said. “Another thing that might be different is that the infectious dose could be lower.”
Marr said there seems to be a “significant change” with masks against Omicron and its subvariants, meaning a cloth mask that may have been somewhat protective before is no longer sufficient and that higher-quality masks may be necessary.
“The masks could help blunt it a little bit, but they weren’t going to stop this wave or prevent this wave from happening,” said Dr. Isaac Bogoch, an infectious diseases physician and member of Ontario’s COVID-19 vaccine task force.
“I’m very much in favour of indoor masking, I’m very much aligned with ‘the mask mandate should not have been lifted,’ but it would not have stopped or prevented this wave.”
WATCH | Canadians urged to get booster shots to blunt 6th wave:
Canadians urged to get COVID-19 booster shots to blunt 6th wave
4 days ago
Duration 2:00
All signs indicate Canada is going through a sixth pandemic wave, Dr. Theresa Tam confirms. Her message to Canadians: wear a mask and get boosted if eligible. 2:00
Additional booster doses of the vaccine are also beneficial in preventing severe disease across the population, but a large new Israeli study in the New England Journal of Medicine showed fourth-dose protection against infection waned after just four weeks.
The observational study focused solely on adults aged 60 and older and found protection against severe illness didn’t wane in the six weeks after a fourth dose, but the data was too limited to determine whether a second booster provided better long-term protection.
“I’m not surprised that fourth doses aren’t generating very durable protection against infection,” said Dr. David Naylor, who led the federal inquiry into Canada’s 2003 SARS epidemic and now co-chairs the federal government’s COVID-19 Immunity Task Force.
“Two shots were much more effective against Delta. What’s clearly changed is that two or even three shots won’t preclude getting any of the substrains of Omicron.”
Naylor said fourth doses make sense for elderly Canadians, the immunocompromised and those with comorbidities, adding that we should be cautious with Israeli data because of the different spacing of doses there and their sole reliance on the Pfizer vaccine.
“We also have lots more people now with hybrid immunity — one, two or three shots, plus an infection in the last few months that may be increasing their level of protection,” he said.
“It’s a rapidly shifting playing field.”
A well-fitting mask still filters the newer strains of coronavirus in the same way, experts say. But the effectiveness of masks has gone down, perhaps because the highly contagious strains means exposure to more virus particles. (Evan Mitsui/CBC)
Worth delaying infection if possible
So while avoiding COVID-19 infection may not be feasible for most people, delaying it until you’re as protected as possible has benefits — and there are still ways you can lessen risk.
“To try and avoid infection, people still need to avoid indoor spaces that are crowded or that create close contact,” said Bromage, who wrote a viral blog post in May 2020 shared by millions explaining the places people are most at risk of COVID-19 infection.
“When in those situations, people need to wear higher quality masks than they used previously — preferably N95 or equivalent — and limit the time in those spaces. Duration matters.”
Increased immunity, broader availability of COVID treatments and two years’ worth of knowledge among members of the medical community are also helping to ensure that when people do get sick, they’re getting the best possible care.
It’s still a crisis, but the situation in Canada and abroad is steadily improving, stressed Bogoch.
“I’ve spoken with people in their 80s, who are triple vaccinated, who got COVID… but who are going to recover from this infection without having to come to a hospital. That’s amazing,” he said.
“Before the vaccines were available, many of these people would have gotten very sick, landed themselves in hospital, needed an intensive care unit and many would have died.”
In Italy, one of the countries hard hit by COVID-19 early on in the pandemic — with one of the highest global death tolls — new research suggests vaccination efforts roughly halved the number of deaths.
Vaccines prevented some 150,000 fatalities last year, the country’s National Health Institute (ISS) estimated on Wednesday, as well as more than 500,000 hospitalizations and over 55,000 admissions to intensive care.
Experts are suggesting people continue to use precautions like masks and vaccines, because it’s still worth delaying COVID infection if possible. (Evan Mitsui/CBC)
Focus on being ‘maximally vaccinated’
Even though it’s tough to avoid catching COVID, it’s worth buying time if you can while the scientific community develops and approves drugs and treatments that could cut that risk even further, said Dr. Abraar Karan, an infectious diseases fellow at Stanford University in Stanford, Calif.
“The fact that they now have more knowledge in terms of how to treat COVID means that when they do have these big surges, there are tools that they can use to reduce the infection fatality rate,” he said.
“The most important thing is really focusing on, ‘What can I do to reduce my risk of severe infection should I get infected?’ And there you say, ‘OK, am I maximally vaccinated? And am I someone who should get tested early in case I’m eligible for a treatment?'” Saxinger said.
“And if you do get infected, rather than beating yourself up, make sure that you’re accessing all the available things that would be helpful.”
BUFFALO, N.Y. (AP) — Hearing the familiar sounds of clacking sticks and pucks banging off the boards and glass while watching Columbus Blue Jackets prospects from the stands of a cold rink on a warm late-summer afternoon was not enough to wash away the lingering residuals of grief for Don Waddell on Saturday.
That, the Blue Jackets’ general manager acknowledged, will take more time than anyone can guess — weeks, months, perhaps an entire season and beyond.
What mattered is how spending the weekend attending the Sabres Prospects Challenge represented a start to what Waddell called among the first steps in refocusing on hockey and the future in the aftermath of the deaths of Columbus star Johnny Gaudreau and his brother, Matthew, who were struck by a suspected drunken driver while riding bicycles on Aug 29.
“We got to play hockey,” Waddell said. “We’re not going to forget about Johnny and his family, the Gaudreau family.”
“Everybody knows that Johnny wants them to play hockey,” Waddell said. “And everybody’s rallying around that.”
The resumption of hockey in Columbus began last week, when most Blue Jackets players returned to their facility to be together and lean on each other at the urging of Waddell and team captain Boone Jenner. And it will continue on Thursday, when the team opens training camp, exactly three weeks since the Gaudreaus were killed.
“Tragic. Senseless. But now we got to focus on trying to get our team ready to play hockey this year,” Waddell said. “We all mourn and heal differently, but I think as a team being together like that is going to be critical for them to get moving forward.”
Waddell was general manager of the then-Atlanta Thrashers in 2003 when Dany Heatley lost control of his car and struck a wall, with the crash killing passenger and teammate Dan Snyder. In 2021, Blue Jackets goalie Matiss Kivlenieks died during a July Fourth fireworks accident.
Waddell placed the emphasis on himself and coach Dean Evason — both newcomers to Columbus this offseason — to guide the team through what will be an emotional season.
“Now, do I think there’s going to be some dark days? I won’t be surprised,” Waddell said.
Reminders of the Gaudreaus’ deaths remain apparent, and reflected in Buffalo on Friday night. A moment of silence was held in tribute to the brothers before the opening faceoff of a game between the Blue Jackets and Sabres.
Afterward, Columbus prospect Gavin Brindley recalled the times he spent with Johnny Gaudreau in Columbus and as teammates representing the United States at the world hockey championships in the Czech Republic in May.
“He was one of the biggest mentors for me at the world championships,” Brindley said. “I couldn’t tell you how many times we hung out with Meredith, pictures on my phone. It’s just so hard to look back and see that kind of stuff.”
The NHL and NHL Players’ Association are providing the Blue Jackets help in the form of grief counseling, crowd security at vigils and addressing hockey issues, such as potentially altering the league’s salary cap rules to provide Columbus relief from having to reach the NHL minimum payroll because of the void left by Gaudreau’s contract.
“The Blue Jackets, I don’t think anybody’s focused from an organizational standpoint, from a hockey standpoint as to what comes next, because I think everybody’s still in shock,” NHL Commissioner Gary Bettman told The Associated Press last week. “I don’t think anybody’s focused right now other than on the grieving part, which is understandable.”
Much of the burden has fallen to Waddell, who has been in discussions with the NHL and the NHLPA and dealing with outreach programs with the Blue Jackets’ partner OhioHealth, while also overseeing preparations for training camp and gauging his prospects in Buffalo.
There’s also his roster to attend to, which he said has two openings at forward, one involving Justin Danforth, who may miss the start of the season because of a wrist injury. Waddell didn’t have to mention the second opening.
Tiring and emotional as it’s been, Waddell found comfort being in his element, a rink, and looking ahead to the start of training camp.
“The guys are in really good shape. We’ve done a lot of testing already and they’re eager to get going,” Waddell said. “We have a reason to play for. And we’ll make the best of it.”
The Blue Jackets later Sunday signed veteran winger James van Riemsdyk to a one-year contract worth $900,000.
“James van Riemsdyk has been a very consistent, productive player throughout his career,” Waddell said. “Bringing him to Columbus will not only provide depth to our group up front, but also valuable leadership and another veteran presence in our dressing room.”
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AP Hockey Writer Stephen Whyno in New York contributed to this report.
PARIS (AP) — Paris Saint-Germain defender Nuno Mendes was the target of abusive and racist comments on social media after a French league game.
The club condemned the abuse and expressed its “full support” Sunday for the Portugal left back, who was targeted following PSG’s 3-1 win against Brest on Saturday.
Mendes, who is Black, shared on his Instagram account a racist message he received.
During the match, Mendes brought down Ludovic Ajorque in the box for a penalty that Romain Del Castillo converted to give Brest the lead.
“Paris Saint-Germain doesn’t tolerate racism, antisemitism or any other form of discrimination,” the club said. “The racial insults directed at Nuno Mendes are totally unacceptable … we are working with the relevant authorities and associations to ensure those responsible are held accountable for their actions.”
MONTREAL – Tadej Pogacar was so dominant on Sunday, Canada’s Michael Woods called it a race for second.
Pogacar, a three-time Tour de France champion from Slovenia, pedalled to a resounding victory at the Grand Prix Cycliste de Montreal.
The UAE Team Emirates leader crossed the finish line 24 seconds ahead of Spain’s Pello Bilbao of Bahrain — Victorious to win the demanding 209.1-kilometre race on a sunny, 28 C day in Montreal. France’s Julian Alaphilippe of Soudal Quick-Step was third.
“He’s the greatest rider of all time, he’s a formidable opponent,” said Woods, who finished 45 seconds behind the leader in eighth. “If you’re not at your very, very best, then you can forget racing with him, and today was kind of representative of that.
“He’s at such a different level that if you follow him, it can be lights out.”
Pogacar slowed down before the last turn to celebrate with the crowd, high-five fans on Avenue du Parc and cruise past the finish line with his arms in the air after more than five hours on the bike.
The 25-year-old joined Belgium’s Greg Van Avermaet as the only multi-time winners in Montreal after claiming the race in 2022. He also redeemed a seventh-place finish at the Quebec City Grand Prix on Friday.
“I was disappointed, because I had such good legs that I didn’t do better than seventh,” Pogacar said. “To bounce back after seventh to victory here, it’s just an incredible feeling.”
It’s Pogacar’s latest win in a dominant year that includes victories at the Tour de France and Giro d’Italia.
Ottawa’s Woods (Israel Premier-Tech) tied a career-best in front of the home crowd in Montreal, but hoped for more after claiming a stage at the Spanish Vuelta two weeks ago.
“I wanted a better result,” the 37-year-old rider said. “My goal was a podium, but at the same time I’m happy with the performance. In bike racing, you can’t always get the result you want and I felt like I raced really well, I animated the race, I felt like I was up there.”
Pogacar completed the 17 climbs up and down Mount Royal near downtown in five hours 28 minutes 15 seconds.
He made his move with 23.3 kilometres to go, leaving the peloton in his dust as he pedalled into the lead — one he never relinquished.
Bilbao, Alaphilippe, Alex Aranburu (Movistar Team) and Bart Lemmen (Visma–Lease) chased in a group behind him, with Bilbao ultimately separating himself from the pack. But he never came close to catching Pogacar, who built a 35-second lead with one lap left to go.
“It was still a really hard race today, but the team was on point,” Pogacar said. “We did really how we planned, and the race situation was good for us. We make it hard in the last final laps, and they set me up for a (takeover) two laps to go, and it was all perfect.”
Ottawa’s Derek Gee, who placed ninth in this year’s Tour de France, finished 48th in Montreal, and called it a “hard day” in the heat.
“I think everyone knows when you see Tadej on the start line that it’s just going to be full gas,” Gee said.
Israel Premier-Tech teammate Hugo Houle of Sainte-Perpétue, Que., was 51st.
Houle said he heard Pogacar inform his teammates on the radio that he was ready to attack with two laps left in the race.
“I said then, well, clearly it’s over for me,” Houle said. “You see, cycling isn’t that complicated.”
Australia’s Michael Matthews won the Quebec City GP for a record third time on Friday, but did not finish in Montreal. The two races are the only North American events on the UCI World Tour.
Michael Leonard of Oakville, Ont., and Gil Gelders and Dries De Bondt of Belgium broke away from the peloton during the second lap. Leonard led the majority of the race before losing pace with 45 kilometres to go.
Only 89 of 169 riders from 24 teams — including the Canadian national team — completed the gruelling race that features 4,573 metres in total altitude.
Next up, the riders will head to the world championships in Zurich, Switzerland from Sept. 21 to 29.
Pogacar will try to join Eddy Merckx (1974) and Stephen Roche (1987) as the only men to win three major titles in a season — known as the Triple Crown.
“Today gave me a lot of confidence, motivation,” Pogacar said. “I think we are ready for world championships.”
This report by The Canadian Press was first published Sept. 15, 2024.
