As frustration with the unvaccinated rises, experts admit that uncertainty is part of COVID-19 life
As health officials warn it could be spring 2022 — after six to eight more months of rolling waves — before COVID is tamed, and only then if 90 per cent of the population is vaccinated, animosity towards the wilfully unvaccinated is growing.
A new poll finds that a majority of Canadians believe that the unvaccinated are selfish, irresponsible and putting others at risk, a view the unvaccinated take strong issue with.
But do strong-arm tactics like vaccine mandates and passports work, or just entrench resistance and feed conspiratorial thinking? Some have argued that dividing people into the “risky” and “safe” underplays that vaccination may not fully stop transmission of the Delta variant.
Vaccines protect against serious disease, Harvard epidemiologist Michael Mina tweeted this week. “Vaccines may slow spread — yes,” he said. “But many policies across (the) US & elsewhere assume vaccines totally prevent spread. This leads to outbreaks among vax’d — which ultimately erodes trust in the whole vaccine effort unless the expectations are set properly.”
A preprint by a Canadian research network estimates that, by late summer, 60 to 80 per cent of the Canadian population will have some immunity to COVID, but that’s still insufficient to stave off a fall resurgence. How severe a rebound depends on the rate of waning immunity, the transmissibility of the hyper-contagious Delta, relaxing of distancing and other public health measures, and how well the vaccines hold up against infection and severe disease, they said. “To prevent large-scale resurgence, booster vaccination and/or re-introduction of public health mitigation may be needed,” the authors wrote.
A year and a half into COVID and there’s still so much unpredictability. Still, “uncertainty is part of COVID,” Toronto infectious diseases specialist Dr. Andrew Morris wrote in his weekly COVID emails.
To recap this past week alone: Quebec advised employers that it would be “prudent” not to bring office workers back just yet, given a rise in confirmed COVID cases and schools reopening, and that it would be left to employers to decide whether to require employees present vaccination passports for those wishing for a physical return to the office. Air Canada introduced a mandatory vaccination policy for all employees and new hires. No, testing won’t be an alternative, the company said in a release, and, except for those with a valid exemption, failure to be fully vaccinated by Oct. 30 will carry consequences “up to and including unpaid leave or termination.”
After rejecting a vaccine certificate system, B.C.’s Dr. Bonnie Henry introduced just that, Alberta announced plans to make proof of vaccination cards available (though a province-wide vaccine passport like Quebec’s remains a no-fly zone) and Ontario medical officers of health, weary of Ontario’s dithering, agreed to create their own vaccine certificates as the number of businesses and organizations requiring proof of vaccination swells.
Liberal Leader Justin Trudeau has vowed to make COVID shots mandatory for boarding planes or trains.
There’s a high level of tension and polarization between the vaccinated, a growing majority, and the unvaccinated, said Jack Jedwab, president of the Association for Canadian Studies. “It’s very difficult to have a conversation, because people have become very entrenched in that position — at this juncture, if they’ve not gotten vaccinated, they’re very entrenched in their position.”
Polling by Leger for the association suggests a majority of the vaccinated don’t think there’s a rights or civil liberties issue. “They’re not giving that argument any credibility whatsoever,” Jedwab said. “In a public health emergency, your purported rights are violating my desire to protect my health, which is superseding what you describe as rights.” The sticking point may be if a mandate threatens a person’s livelihood, and Jedwab expects the discord and tension will only grow as more people get vaccinated and as the unvaccinated feel more “squeezed.”
But it gets messy and murky. While there’s a core contingent of anti-vaccine groups trying to sow disinformation and distrust, “we can’t think of all of these people (the vaccine hesitant or reluctant) as being people who just read something on the Internet and they have decided the virus isn’t real,” said University of Manitoba virologist Jason Kindrachuk. “In a lot of cases there may be a vast, historical context behind all these feelings and reasoning.” Some of the frustration among the pro-vaccine, he said, is the realization that perhaps there was a more appreciable percentage of the reluctant than people realized.
Some concerns may not be totally irrational. Some women have reported unusual menstrual cycles, however studies so far have found no evidence COVID-19 vaccines affect fertility and the ability to have children. A huge new study from Israel appearing in this week’s issue of the New England Journal of Medicine found that while the Pfizer vaccine increases the risk of heart inflammation (about three events per 100,000 people vaccinated) the risk is several-fold higher among people infected with the SARS-Cov-2 virus (11 cases per 100,000). Infection with COVID was also associated with a substantially increased risk of other seriously bad things, like heart attack, blood clots and bleeding inside the skull or brain.
While a preprint paper published this week suggests immunity, including protection against a breakthrough infection with Delta, lasts longer after a natural infection than immunity after two doses of Pfizer, no one is suggesting COVID parties. “What we don’t want people to say is: ‘All right, I should go out and get infected, I should have an infection party,’” Michel Nussenzweig, an immunologist at Rockefeller University told Science magazine. “Because somebody could die.”
“When we look at the risks that come with being infected, all the data say getting vaccinated is your safest way to combatting the virus,” Kindrachuk said. “I think it’s tough to argue right now at all against vaccination.”
Dithering with COVID “would be a fool’s game,” Morris agreed this week. The virus has moved through the global population, it has continued to change with variants of concern and with increased transmission.
At the same time, a study published this week by the U.S. Centers for Disease Control found that the effectiveness of mRNA vaccines (Pfizer and Moderna) in preventing infections in frontline workers decreased from 91 per cent to 66 per cent after Delta became the dominant strain. The trend should be interpreted with caution, the CDC said — protection might also be declining “as time since vaccination increases.” And the vaccines remain very effective against bad outcomes, like hospitalization and death.
But reports of dwindling immunity and breakthrough cases are now driving debate over the need for boosters. In Israel, of 680 people hospitalized with COVID on Thursday, 331 were fully vaccinated. As Reuters reports, most severe breakthrough cases involve people over 60 who also have heart disease, lung problems or other underlying health issues. And despite alarming posts on social media about breakthrough cases in highly vaccinated populations, some context is missing: As an increasing percentage of the population is vaccinated, it follows that the proportion of vaccinated among the infected will also increase, because the shots don’t promise 100 per cent protection. Still, though severe cases are rare, Mina believes breakthrough infections aren’t as rare as they are being made out to be. “The continued message that breakthroughs are rare ultimately shoots us in the foot. They aren’t rare & public is seeing this,” he tweeted.
It’s important to monitor for waning immunity, Kindrachuk said. “We don’t have that one specific marker that says, ‘OK, you have X amount of this antibody so that gives you Y amount of years or months of protection.’”
And while the vaccinated can still spread the virus, they appear to be less infectious and clear COVID faster than the unvaxxed. Their infections also tend to be milder. “The only people that are really at risk are the unvaccinated,” said Eric Arts, a professor of microbiology and immunology at Western University.
“And, in certain provinces, we’re taking very serious steps to protect the unvaccinated by preventing their exposure to the virus and the vaccinated population,” he said. “It’s sad that we have to go to the extent to do that, to protect the unvaccinated. But that is what is necessary in this situation, until we get them vaccinated.” B.C., like Quebec before it, saw a jump in vaccination bookings after announcing its passport program.
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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.
The Canadian Press. All rights reserved.
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.
The Canadian Press. All rights reserved.
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