This Omicron wave should be different, with hospitals not overwhelmed. But “we have no situational awareness, and the public’s fed up.”
So there’s this Twitter account that tracks how New York Times headlines evolve as they are edited, and Tuesday the first version looked like this: The Best Time To Prepare For A Covid Surge Is Now. The edited version: The Next Covid Wave Is Probably Already On Its Way.
That’s it, all right: the surge is coming, and it’s here. Anecdotally COVID is racing all over the place, and why wouldn’t it? Omicron BA.2 is one of the two or three most infectious viruses humans have ever found, and two doses of vaccine has limited protection vs. infection, and Ontario, like many other jurisdictions, has removed almost all wide-scale public health measures.
The difference is this time, we’re not walking into the wave. It’s more of a sprint.
“The government has essentially removed any semblance of the fact that we’re still in a pandemic, right?” said Dr. Andrew Morris, a professor of infectious diseases at the University of Toronto and a member of the Ontario COVID-19 Science Advisory Table, and the medical director of the Antimicrobial Stewardship Program at Sinai-University Health Network.
“We still have not gone six months without a wave, but we’re acting like the Omicron wave was the last one, and there are zero hypotheses that that’s true.”
The good news is many of us are vaccinated. The bad news is that’s more or less the whole plan. The reason I say anecdotally is because PCR tests are limited — positivity on 15,515 tests was 16.7 per cent Thursday — and rapid tests aren’t generally recorded. Daily data is therefore of limited help, and we’re left with rising outbreaks in seniors homes and wastewater surveillance, with the GTA still closer to stable. We’re not just flying blind into this wave: we are flying blind by design, expecting an increase in hospitalizations.
“We don’t have good (anti-viral) drug delivery systems in place,” says Morris. “We don’t have (new) vaccinations. We don’t have the testing. None of this is currently in place right now. And we have a public who’s been led to believe that the pandemic’s over, and that not only is the pandemic over, but that the vaccines are of no value now.
“We have no situational awareness, and the public’s fed up. I get all this, like I really do. And I think the public deserves it should be allowed to be as free as is reasonably possible. But we do need some kind of system in place to be able to respond to that.”
This wave should be different. This time the modelling doesn’t say the health system will be overwhelmed because we have vaccines, and thank goodness for that. The science table modelled a relatively moderate increase in contacts (40 per cent and half unmasked with Omicron, 30 per cent and half unmasked with BA.2), and that may be what happens. Enough virus finds the vulnerable, though. We don’t know how many we have.
Which means we don’t wholly know what’s coming: the number of hospitalizations and deaths, the time to wave peak. Waning immunity could be a factor: in a U.K. study, ages 18-64 with three doses saw protection from hospitalization drop from 91 per cent to 67 per cent after 105 days, and we started that age group a little over three months ago. The protection recorded for older three-dose recipients was higher, 85 per cent, which makes you wonder whether behaviour played a role.
So we have a new virus, evolving and overlapping risk factors and protection, evolving behaviour, a lack of restrictions, and a lot of uncertainty. Improved weather will help, because COVID is really a disease of human behaviour.
And sure, we could have decided to do something short of this, but what? Reinstitute masking? (Does a government that is forbidding school boards from keeping mask mandates seem likely to do that?) Reinstitute widespread testing? (Probably not, given Omicron’s spread.) Reinstitute isolation? (Yes.)
Could we try to push people to get a third dose of vaccine, which restores a fair amount of protection against infection in the first place, by previewing future return of vaccine mandates for a three-shot minimum? (The government will not do this.) Could we improve ventilation? (We should be investing in ventilation and raising building standards on a massive scale, starting in hospitals and schools; in Italy they found improved ventilation could cut school transmission by up to 82 per cent.)
Preparing as if this was not the last wave would have been prudent — Dr. Angela Rasmussen, a virologist at the University of Saskatchewan’s Vaccine and Infectious Disease Organization in Saskatoon, says there are no guarantees a virus evolves to be milder, especially one that mutates this fast. Once it infects people, everything after that is not the virus’s problem.
“The question is not if we have another variant,” says Rasmussen. “I think the question is when, and how bad is it going to be? I think that if it is something that’s really bad, and it is something especially that really heavily impacts the vaccinated population, or at least the immunized population, it’s going to be really difficult to suddenly unroll all of these pandemic prevention measures after they’ve gone away. Finding money for them, communicating their necessity to the public.
“People are tired of the pandemic and I mean, I’m certainly tired of the pandemic. Unfortunately, it’s not over. And I think this giving people sort of the illusion that it is, is going to backfire big time if some of these protective measures have to come back.”
Hopefully we get lucky, and they’re truly gone. In the third wave, Solicitor General Sylvia Jones said the government was waiting for the modelling to show up in the hospitals, and didn’t believe it would. This time they expect it, but don’t think it will be too bad. Our vaccination levels may yet hold.
A plan for down the line would have been nice, though. This feels like a bit of a roll of the dice from some gamblers with troubled pasts hoping that this time, they can say COVID is over and actually be right. Let’s hope.
Article From: The Star
Author: Bruce Arthur
