Medical student Morgyn McKerlie draws outs COVID-19 vaccine at a drive-thru COVID-19 vaccine clinic at St. Lawrence College in Kingston, Ont., on Dec. 4.Lars Hagberg/The Canadian Press
Doctors are urging Canadian health officials to take immediate steps to contain a looming COVID-19 surge, including expanding booster-shot eligibility, providing better access to rapid tests and improving ventilation in schools and other buildings.
COVID-19 infections in many parts of the country, particularly Quebec and Ontario, are on the rise. The new Omicron variant, which is believed to be highly transmissible, has been detected in several provinces. And as the holidays approach and more people gather indoors, the virus may have more opportunities to spread.
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“I think it is inevitable that we are going to see surges in cases,” said Ilan Schwartz, an infectious-diseases physician at the University of Alberta Hospital in Edmonton.
Experts say the situation now is not like it was in early 2020, because the public now has access to vaccines and other tools that can help prevent lockdowns. But while Canada has a high vaccination rate – about 76 per cent of the population has received at least two doses of a COVID-19 vaccine – there are still significant numbers of unvaccinated Canadians. They could strain the health care system if the virus makes them severely ill.
“We need to be looking at individual pockets of communities that have lower uptake of vaccines,” Dr. Schwartz said. “Enough of these pockets will result in hospitals being inundated and overwhelmed.”
The anticipated spread of the Omicron variant could exacerbate the problem. New research shows that two doses of an mRNA vaccine may be enough to substantially lower the risk of severe illness from the variant, but may not be enough to stop many people from becoming infected and transmitting the virus to others who could become seriously ill, such as the unvaccinated.
One of the most urgent issues governments need to address, experts say, is the expansion of access to booster vaccine shots, which research suggests would ramp up immunity to Omicron.
Last week, the National Advisory Committee on Immunization recommended that provinces expand booster eligibility to all people 50 and older, as well as other high-risk groups, including front-line health care workers and adults living in long-term care or other congregate settings. NACI said provinces may also want to offer boosters to people 18 to 49, depending on local and individual circumstances.
“On a population level, having everybody get a booster would be helpful in preventing transmission,” Dr. Schwartz said.
Srinivas Murthy, a clinical associate professor at the University of British Columbia whose research focuses on pandemic preparedness and response, said Canadian health officials need to act now in order to prevent a new COVID-19 surge.
“What we really need to do is focus on these next few weeks,” Dr. Murthy said. “I’m nervous that we’re going to take shortcuts and really focus on just the usual stuff, making sure the economy hums along.”
Dr. Murthy said governments should ensure access to paid sick leave and rapid COVID-19 tests, with a particular focus on marginalized communities that have been hardest hit throughout the pandemic.
“If Omicron is here, it’s going to hit those communities hard. It’s not going to hit the rich communities hard,” he said. “All of those things we haven’t done so far, this is our opportunity to do it.”
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Governments should also continue to invest in better ventilation in schools and other buildings to prevent virus transmission, he said.
Governments are facing mounting pressure to provide widespread public access to rapid antigen tests before the holidays. The tests produce results in minutes, giving people who test positive plenty of time to call off plans to meet indoors with friends or family.
Nova Scotia has been using rapid antigen tests for months. The provincial government has been giving them out to the public as a way of helping people protect themselves and others. But the tests are difficult to access elsewhere. In British Columbia, top doctor Bonnie Henry said this week she’s not sure they are worth it, because most people who use them will test negative.
In Ontario, the government has said it has distributed more than 30 million rapid tests. But they’ve gone mainly to businesses and schools, while the general public has limited opportunities to purchase them for $40 each at Shoppers Drug Mart.
Online petitions calling on governments to “#FreeTheRATS” have popped up in recent days. Ontario’s science table has said the tests should be used once a week in schools to reduce transmission.
This country may have a few advantages over other countries experiencing surges in cases right now, Dr. Murthy said. Canada, he noted, was one of the few places to use an eight-week interval between first and second doses during the early vaccine rollout, a strategy that seems to have provided people with stronger immune responses than those who had shorter intervals. Dr. Murthy added that Canada was one of the first countries to start vaccinating kids aged 5 to 11.
Zain Chagla, an infectious-diseases physician and associate professor at McMaster University in Hamilton, called on governments to ramp up access to monoclonal antibodies, which can be given to unvaccinated people shortly after they test positive for the virus as a way of preventing severe illness. He said when Health Canada approves new oral antiviral pills to treat COVID-19, officials should also work to make them accessible quickly.
“If we’re trying to throw the kitchen sink at things not worsening, we should be scaling up things as fast as possible … making sure people who are high risk can recover at home,” Dr. Chagla said.
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