COVID cases are increasing as Canada reopens. And after?

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“It’s entirely up to us… I don’t think it’s inevitable that we have a bad fourth wave”

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By: Sharon Kirkey

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Epidemiologist Ashleigh Tuite is not surprised that COVID-19 infections are on the rise in Ontario. The situation in the province, and in several others, is unfolding exactly as planned.

“We are reopening,” Tuite said. Humans are engaging with each other again – indoor restaurants, gyms – and confirmed infections were always expected to increase, which is part of why the response in Ontario was so measured, she said.

“We didn’t tear off the bandage and went straight from step zero to step three,” said Tuite, of the University of Toronto’s Dalla Lana School of Public Health. “We took our time. “

The big question for Tuite: how is it going in the weeks to come? “Because even though we have a relatively highly vaccinated population, we don’t have enough vaccines to completely stop transmission, and we are starting to interact more. “

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Be careful. Remember, the winning Trifecta is getting the vaccine, getting tested often, and wearing a mask indoors. The Delta variant is one of the most infectious viruses in history. Don’t underestimate it, but don’t be paralyzed with fear either. The winning trifecta wins! https://t.co/N5VshnkZJB – Larry Brilliant MD, MPH (@larrybrilliant) August 8, 2021

Renowned epidemiologist Larry Brilliant, who helped the world eradicate smallpox, tweeted on Sunday that the Delta variant was one of the most infectious viruses in history. While 61 percent of Canadians aged 12 and over are fully vaccinated (as are 73 percent of Ontario adults aged 18 and over), “we need to reach 85.90 percent of the vaccinated population before we can discuss the issue. ‘herd immunity,’ said University of Ottawa epidemiologist Raywat Deonandan. “We are far from that.”

“Epidemics affect all susceptible populations, and who is susceptible? The unvaccinated, ”he said.

Ontario, British Columbia, Alberta and Quebec have all seen recent increases in the number of cases. On Sunday, Ontario reported 423 – more infections than reported in the same time last year, and the first time since mid-June, the province has recorded more than 400. Nationwide, the seven-day moving average of 945 new cases reported daily between July 30 and August 5 was a 48% increase from the previous week, according to the Public Health Agency of Canada. In British Columbia, where the hyper-contagious Delta variant accounts for 95% of COVID infections, 464 new cases were reported on Friday, while an increase in cases in the central Okanagan triggered new restrictions on bars , nightclubs and personal gatherings, indoors and outdoors. A predicted model British Columbia could see 1,000 new confirmed infections every day in September.

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Although the number of people in hospitals in British Columbia has increased slightly, and mainly in the unvaccinated 40 and 50 age group, the numbers do not follow the same trend as new cases – a phenomenon that the province’s public health officer, Dr Bonnie Henry, described it as an apparent “decoupling” of cases and hospitalizations.

Data from Ontario and the Public Health Agency of Canada show that the vast majority of reported cases, hospitalizations and deaths have not been vaccinated since the country’s vaccination campaign began on December 14.

From Tuesday morning, Ontario has started reporting ICU cases, hospitalizations and admissions broken down by immunization status. A recent Public Health Ontario The summary of infections after vaccination found that unvaccinated people are about eight times more likely to catch COVID, compared to double vaxxed. Among people 60 years and older, the unvaccinated are about 15 times more likely to be hospitalized with COVID compared to those fully vaccinated. Unvaccinated cases accounted for 95.4% of cases reported from December 14 through July 24 in Ontario. “Breakthrough” infections in fully vaccinated subjects accounted for only 0.5 percent.

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Tuite said Ontario was starting to see an increase in hospitalizations and intensive care admissions – “it looks like we are starting to see a slight increase” – and although the link between infections and hospitalizations has been weakened, she don’t think that’s the case. been “decoupled”, as Henry described it. Unvaccinated people are still just as likely to be hospitalized, and while vaccination significantly reduces the likelihood of serious illness, it does not reduce it to zero.

Nationally, between December 14 and July 17, 5,896 deaths from COVID were reported among the unvaccinated, compared with 89 deaths among the fully vaccinated and 561 among the partially vaccinated.

  1. Shoppers carry bags as they walk through Sherway Gardens Mall during the second phase of the reopening of coronavirus disease (COVID-19) restrictions in Toronto, Ontario, Canada on June 30, 2021.

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  2. Calgarians protesting recent changes by Alberta Health Services ending testing and restrictions for COVID-19 gathered at the McDougall Center on Sunday.

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The concern in September is that without layers of protection – masking, ideally small cohorts, improved ventilation, testing and a strong response to the outbreak – “you would expect a large number of children to be infected,” Tuite said. .

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“We are currently in a very uncertain time in the sense that it is entirely up to us,” she said. “I don’t think it’s inevitable that we have a bad fourth wave.”

Deonandan said an increase in hospitalizations for children’s hospitals in Florida and several other states in southern America is of deep concern.

“Previously, we could have said that children are not really vulnerable, they contract (COVID-19) but not really that much, and if they do contract it, they are asymptomatic, they are much less likely to be hospitalized”, Deonandan said. noted. “It doesn’t seem to be the case anymore, at least not to the same extent. “

Children under 12 are still not eligible for vaccines. “If we allowed the virus to spread without attenuation, we would expect very high attack rates in children,” Tuite said. “And what I think we’re seeing in the southern states is exactly that: you have high infection rates and you see these rare results more frequently, just because there are so many infections that occur.”

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Deonandan said vaccine passports are “kind of needed now, to coax a certain segment of the resistant vaccine into getting this vaccine.” Ontario Premier Doug Ford and Alberta Premier Jason Kenney have refused national passports for vaccines. Deonandan believes political leaders fear being characterized as limiting freedom. “I think this is especially true for conservative leaders whose identity rests on reducing government control, not increasing it.”

But infections are driven by human behavior as well as political decisions, he said. “Some people have returned to normal life, and I understand why; you feel doubly vaccinated, why not go back to normal? The sense of invulnerability experienced by fully vaccinated people is largely justified, he said. “But they interact with unvaccinated people to an unhealthy extent, and, in the context of Delta hyper-transmissibility, that’s what you get.”

His advice? Vaccinate and wear masks indoors until the number of cases decreases, especially when you are with people whose vaccination status is unknown.

“What I’m hoping is people get a glimpse of this – in Ontario the cases may go as high as 500, then the vaccination goes up dramatically and we’re cutting it down and leaving public health s. ‘take care of the rest,’ Deonandan said.

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