What Canada needs to do now to capitalize on low COVID-19 levels and keep them that way

In the past seven days, Canada has had fewer than 500 new cases of COVID-19 per day, fewer than 750 hospitalized patients and just 366 people in intensive care.

Ontario, the largest province in Canada with a population of nearly 15 million people No new deaths of COVID-19 on Wednesday for the first time in nine months.

“This is fantastic,” said Dr. Zane Chagla, MD, an infectious disease physician at St. Joseph’s Healthcare in Hamilton.

“This is in the context of not everyone being vaccinated, so it’s even more impressive. Vaccines are breaking down, they’re doing exactly what they’re supposed to do.”

But without a clear strategy to contain the spread of COVID-19 as more of the country reopens, experts say Canada is destined to repeat mistakes of the past by failing to protect the most vulnerable — which now includes the unvaccinated.

The delta variant has “moved the goal” in Canada

Dr. David Fisman, an epidemiologist at the University of Toronto’s Dalla Lana School of Public Health, says: more contagious and possibly more lethal A variant of the coronavirus known as Delta has “significantly moved targets” for the eradication of COVID-19 in Canada.

“A few months ago, my working assumption was that Canada would basically be done with this pandemic during the summer because we were going to vaccinate a lot,” he said, adding that individuals with delta are more likely to get Covid disease. -19.

‘Herd immunity has likely moved beyond reach’

Canada has so far fended off another surge in COVID-19 thanks largely to vaccines, but Fisman says Delta has raised Reproduction rate From about 2.4 to between six to eight, which means one person can pass it on to between six and eight other people.

Watch | What is known about the delta variable and what makes it different:

The respiratory specialist details what is known about the delta variant of the coronavirus, including what makes it different, how dangerous it is, and whether vaccines protect against it. 4:26

In addition to increasing transmissibility, Fisman and co-author Professor Ashley Tweety, an infectious disease epidemiologist and associate professor at the University of Toronto’s Dalla Lana School of Public Health, suggest, in New prepress study, which has not yet been peer-reviewed, those deltas also have an increased risk of hospitalization and death.

Fortunately, vaccines hold up well against variants, with another recent Canadian Pre-print study regarding vaccine efficacy, also awaiting peer review, indicating strong protection against severe disease from the Delta region and echoing previous global data from Countries like Israel.

“There is a possibility that people who have been vaccinated may be fine. They may appear to have a cold at the most,” said study co-author Dr. Jeff Kwong, an epidemiologist and chief scientist at the Toronto-based Institute of Medicine. Clinical Osteopathic Sciences.

“But people who haven’t been vaccinated can still get very sick from Delta and those are the people who are at risk of serious outcomes such as hospitalization or death.”

The challenge now lies with the millions of unvaccinated Canadians out there More at risk of contracting COVID-19 than ever – Despite hopes Canada can achieve the goal 80% of our eligible population has been fully vaccinated.

“Unfortunately, for a vaccine that is 90 percent effective, that won’t be enough,” Fisman said. “You have these pockets of weakness and you’re going to be under tremendous pressure to not shut things down again.”

Canada’s top public health official, Dr. Theresa Tam, has urged unvaccinated Canadians to get vaccinated now before the colder months arrive to avoid anything like the devastating fall wave that Canada experienced last year.

“We must maintain the momentum,” she said during a news conference on Thursday. “The best achievable goal, to beat highly contagious variants as we head for a fall inland, is to get the highest possible vaccine coverage as quickly as possible.”

But experts say encouraging unvaccinated Canadians to roll up their sleeves will only do so, and keeping COVID levels low will require a targeted strategy.

Schools most vulnerable to the spread of COVID-19

Children under 12 make up the single largest group of unvaccinated Canadians, due to their ineligibility for vaccination, and experts say they should be the first group for protection in the fall.

“Almost all of the outbreaks will be among school students, because those are the susceptible populations,” said Rewat Dionandan, an epidemiologist and assistant professor at the University of Ottawa.

“So we have to invest in ventilation, in small classes, high-quality masks, symptom screening and rapid tests for schools.”

A new study published by the US Centers for Disease Control and Prevention It found that using both HEPA and masking air filters reduced the risk of exposure to COVID-19 in a classroom-like environment by up to 90 percent.

In addition to schools, Fisman says the same precautions could be used in other places at increased risk of spreading the virus through the air — including office buildings, restaurants and bars — where concealment is intermittent and people come into close contact indoors.

“We really need to figure out how to make these places safe,” Fisman said. “There are a lot of vaccines out there, but with the variants this thing is not going to go away as I think a lot of us were hoping for in the spring.”

Boundaries are vulnerable to “import” variables

Importing new and existing variants from countries around the world presents another challenge to Canada’s ability to control COVID-19 in the future – especially with Pressure to reopen the escalating US border.

“We should look at border control more carefully,” Deonandan said. “Even if we put it under control in Canada, it’s raging all over the world. We don’t want to import cases.”

Fisman says Canada’s borders are another major weakness in the future, due to the recurring pattern of variables coming from abroad into the country in the past – More than almost any other country In the world.

“The United States is less pollinated than we are now — it will probably become a different factory in the fall,” he said, adding that Canada needed to address a “leaky quarantine system.”

“We need to be better at getting surveillance and coming up with smarter systems to actually do proper quarantine and track people as they cross borders.”

Fortunately, Canada is armed with an incredibly effective weapon against importing variants – vaccines – we just need to build a large enough immune border wall.

“The problem is that with travel, with the reopening of borders, there will be people coming in with infections as well,” Kwong said.

“But as long as people here are vaccinated, there will be nowhere for the virus to go.”

COVID-19 is now an ‘unvaccinated disease’

There has been a lot of discussion about The last batch of unvaccinated Canadians which must be accessed due to frequency or accessibility, but what is often talked about is that they are not one homogeneous group – which makes targeting them more difficult.

“The problem is that getting the last 25 percent is going to take us twice as much work as it took us to get the first 75 percent vaccinated,” said Sabina Vohra Miller, a pharmacologist and science interviewer with the South Asian Health Network. .

“There’s a whole bunch of different reasons why they don’t get pollinated. So we’ll have to kind of peel the layers and each layer is going to take a very targeted, very focused effort to get to it.”

Vohra-Miller says they could be elderly people at home or people with chronic medical conditions unable to get to vaccination clinics, workers without paid sick leave, or those who simply hesitate and benefit from a conversation with their doctor.

Regardless, a concern says that COVID-19 is “now becoming an unvaccinated disease” in Canada – a disease that previous protection measures had not addressed.

“Unfortunately, the solution will not be masking or physical distancing,” he said. “There will be antibodies in your blood.”

Possible ‘carrot’ passport vaccine in Canada

That’s why experts say Canada is at the most critical point in a vaccine launch, and eventual extension, and we need to do everything we can to get shots in the arms now.

“We really need to use every carrot and stick available to us in a society like ours to encourage people to get vaccinated,” Fisman said.

“It really means talking about selective access to the things that people like to do, like concerts, like restaurants, and maybe having a different set of rules for vaccinated and unvaccinated people.”

Manitoba became the first province to reveal a type of vaccine passport last month, by Allow fully vaccinated travelers to skip quarantine If they show evidence of vaccination. The federal government followed suit earlier this month for All travelers to Canada.

Now Quebec may take another step forward Require digital vaccine passports This would prevent non-vaccinators from some non-essential services – gyms, team sports and theaters, for example – as early as September.

Watch | What does Quebec digital vaccination passports mean:

Quebec’s health minister announced Thursday that Quebec may start using digital vaccination passports to prevent people who have not been fully vaccinated against COVID-19 from some non-essential services as early as September. 2:04

“If anyone knows anyone who has not yet been vaccinated, if you can beg them, urge them to do whatever they can to try to get them to get at least one dose,” Kwong said.

“It’s about finding people who haven’t got their first dose yet, whether it’s because they’re nervous, they don’t feel comfortable getting it or they haven’t had access to the vaccine yet — it’s time to get the he-she.”

This is an excerpt from Second Opinion, a weekly report on health and medical science news sent by email Subscribers every Saturday morning. If you have not yet subscribed, you can do so by clicking Here.