COVID-19 Blog Update (May 12th, 2021)

 In Blog

It’s been about a month since I last posted a COVID-19 update. On the surface of things, it would appear little has changed and there’s not much update to provide. But not so!

As we know, the provincial government issued a stay-at-home in April that is to last for 6 weeks or until May 20/21. The most common question I get from people is whether I think the stay-at-home order will be extended. Tough question!! We know that the government has been stung by delaying shutdowns, or prematurely reopening in the past especially around holiday weekends. When we lift lockdowns just before a holiday weekend it tends to lead to big spikes in COVID cases within a couple of weeks. For this reason, I could see the government of Ontario extending the stay-at-home over the Victoria Day weekend. We shall see…

Vaccination is the single biggest change that has come with this shutdown versus the others. As more and more people get vaccinated the risk of a COVID resurgence after we lift the lockdown lessens.

Last week Theresa Tam, Canada’s Chief Public Health Officer, stated that the most restrictive lockdown measures and workplace and business closings could be lifted once 75% of adults have had a first dose of vaccine and 20% have been fully vaccinated. As of last Friday the figures stood at 40% of Canadians have a first dose, 3% have been fully vaccinated. It is likely to be late June before we reach the threshold for vaccination she recommends.

Reopening prematurely, lifting restrictions too quickly, these are the things we need to be particularly careful about. I think there is virtually 100% agreement and consensus that whatever else happens, we do not want to see another shutdown in July. This is what has been projected if we reopen too quickly while COVID cases are still high, hospital ICU beds are still taxed and insufficient numbers of people have been vaccinated. The 7 day average of daily case counts in Ontario are still running in the 3,000 people per day zone. In a perfect world we’d see cases at a minimum in the red zone before considering reopening ie. 40 per 100,000. In Guelph, we have 87 per 100,000 at present (Ontario is 145 per 100,000). You can see that we have some way to go. Cases go up fast and come down slowly.

There is some concern that individuals who are vaccinated, especially if they’ve only had one dose, can still spread COVID-19. This is the reason we need to stay the course and continue to be cautious even if we’re vaccinated. We need to reach for herd immunity so that COVID-19 has a difficult time circulating in our communities. Various experts around the country have suggested that we need 70% of the population vaccinated, or 85-90% of adults vaccinated to achieve herd immunity. These numbers may need to be even higher with the variants now circulating.

On the good news front 42% of adults in Ontario have received one dose of COVID vaccine and 3% are fully vaccinated as of this week.

Indoors activities continue to be the greatest risk for spreading COVID-19 especially with new variants. This is because infectious aerosols and droplets from breathing, coughing, sneezing, and singing/talking can hang in the air and become concentrated the longer people remain in the same room together. Social distancing will not help if a room is contaminated. Continuous masking is essential as is adequate ventilation. Additionally problematic is the fact that viral loads are the highest the day before someone becomes symptomatic with COVID. So people are most infectious before they realize they’re sick.

Ultimately, the lesson is this: avoid all indoor activities with anyone outside your bubble. Period. Even when people are vaccinated, they can be vectors for spread, so vaccination will not protect the unvaccinated in an indoor environment.

Ventilation and masking are the key and the best way to achieve that is to be outdoors with a high quality triple layer mask if you’re getting close to within 2 metres of people outside your bubble.

There is also concerns that even more contagious variants may enter Ontario from outside Canada. This is another reason we need to remain cautious.

ArtMed generally provides services that are elective. For this reason we are closed at present for those services (but open for parking lot pickup and online sales). We will remain closed while a stay-at-home order is in effect. Our medical-aesthetic colleagues in other communities who operate at the highest standards of care are similarly closed at this time. Protecting our community is the highest priority to ArtMed and we will do everything we can to reach the goal of returning life to normal even if that means waiting a little longer. How long? We wait on the government and the science experts to provide guidance.

Also on the good news front, Health Canada has approved the Pfizer mRNA vaccine for children aged 12-15 years and they have begun trials for the next youngest group of children. Research shows the vaccine is extremely safe and effective in children. The more children that are vaccinated the greater the herd immunity for the broader community. Children tend to have low risks of becoming ill with COVID but this means they are more likely to be asymptomatic spreaders. Reducing this risk through vaccination will help a great deal.

On the topic of vaccines, there has been much controversy especially with respect to the Astra-Zeneca vaccine. I have given a few talks on this and counselled many patients with respect to COVID vaccines. In the end, vaccination is all about risk management. COVID-19 illness can result in very serious illness and lasting consequences and we increasingly see this in younger and younger people due to the severity of the variants.

The risk of vaccination by comparison, even the AstraZeneca vaccine, is astronomically small. Nonetheless, Ontario has decided to stop using the AZ vaccine for first doses out of an abundance of caution and because more and more mRNA vaccine supplies are rolling in.  Canada now leads the G20 nations in the average of daily rate of vaccines administered per capita.  Good news!!

For those who are vaccine hesitant it can be a difficult decision especially when the government and scientific community messaging has been changeable.  But new information becomes available all the time and a changing message means we’re getting the most up to date information.  But it can be confusing for those who are unsure.  Actively taking a calculated risk (getting vaccinated) versus passively accepting a calculated risk (acquiring COVID) are different decision making strategies. It’s hard for people to proactively take risk, it’s easier to passively take risk. But the passive route in this case is so much more dangerous and so much more likely to lead to a terrible outcome.

The AZ vaccine is an excellent vaccine as we’ve seen in Britain. Life has virtually returned to normal there and the majority of their population was vaccinated with AZ. By getting vaccinated with the first vaccine available as fast as possible, the British saved countless thousands of lives by preventing COVID infections and have been rewarded with a return to socializing and a reopened economy.  Hopefully our supply of mRNA vaccines will be uninterrupted and we can do the same.

So sit tight unless it is to go out to get vaccinated! In the meantime COVID cases are falling, there’s much to be optimistic about.

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