Most provinces have a painfully slow start that gives power-ups, and one expert warns that the new variant will make things ‘pretty ugly’

Dr. Andrew Morris is not surprised by the increase in COVID cases nationwide, from an average of 2,500 a day a month ago to 4,100 on December 13. “I’ve been saying for a long, long time that we would be getting into this situation,” says the Toronto-based infectious disease specialist, “and there is no plausible situation where we don’t have the same experience as Europe.”

Morris, who is medical director of the Sinai Health System Antimicrobial Management Program and the University Health Network, is referring to the rising case counts on the mainland a few months ago. In Canada, he says, “we’ve been fooling ourselves into thinking we could avoid this, and we’ve been prescribed steroids because of Omicron.”

The sadness surrounding our pandemic situation has deepened in recent days. On Friday, December 10, Dr. Theresa Tam, Canada’s director of public health, announced a new pandemic modeling, which foresees around 7,500 daily cases for January, although our transmission levels remain static. If transmission increases by just 15 percent, or if the new Omicron variant is established, that same model projects more than 12,000 cases a day before the New Year.

Omicron is definitely expanding rapidly in Canada. On December 12, the Ontario Science Board Estimate that the proportion of new cases of the variant in the province was 20% and that the count of cases was doubling every three days. The following day, that proportion had increased to 30.8 percent and their effective reproduction number (Rt) had increased from 3.32 to 4.01 (which means that each infected person infects another four); in contrast, Delta’s Rt is 1.09. The exponential growth rate is so fast that Omicron should overtake delta as the most prevalent variant in one or two days, according to Dr. Peter Jüni, director of the Science Table.

As researchers learn more about Omicron’s high transmissibility, and as the first data arrive on how vaccines are handling the latest variant of interest, the need to accelerate third doses becomes clearer. For Morris, being “fully vaccinated” now means having three doses of the COVID-19 vaccine, plus 14 days.

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However, overall launches of the third dose have been painfully slow: only seven percent of Canada’s total population has received third doses, to December 13.

Percentage of the total population with three doses of the COVID-19 vaccine

BC: 11%
Alberta: 11
Saskatchewan: 10
Manitoba: n / a
Ontario: 8
Quebec: 5
New Brunswick: 8
Nova Scotia: 4
PEI: 5
Newfoundland: n / a
Yukon: 21
Nunavut: 29
Nunavut: n / a

Source: COVID-19 Tracker Canada (data as of December 13); Statistics Canada

Morris cites two big mistakes made by Canadian governments in the past two months: minimizing the benefits of the third dose; and what he calls a “silly strategy” of delaying the launch of third doses until they see evidence in this country of waning immunity from two doses of vaccine, even though there was evidence around the world that such a waning would affect us.

“Those mistakes have brought us to where we are today,” he says. “There was no benefit in waiting; now they do not have the capacity to implement vaccines. “In fact, as demand increases, public health units are reporting that all available vaccine appointments have been booked through the New Year, although they are trying to open more spaces.

“The public is tired, they want to move on and enjoy life,” explains Morris. “The real problem is that the government doesn’t know what to do. They do not know how far to push the public, especially when they see that the capacity of the health system is not changing much ”. Because hospitalizations and ICU admissions are always delayed in increasing cases, Morris cautions, governments may not act until it is too late. (After a surge in hospital admissions from COVID forced Kingston, Ontario, to airlift ICU patients to other cities, covered private meetings for five people on December 14. At the same time, dinner in the indoor restaurant can continue, at least until 10 pm every night).

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“If you are only concerned about your personal risk, there is no reason why you cannot meet if you are well protected,” Morris says, adding that “the vaccine protection ring” should mean fewer cases of severe COVID, even when Omicron becomes more prevalent. He thinks that most people fully vaccinated with three doses will likely have no symptoms, or will experience mild symptoms, if they contract COVID-19, while those with two doses will likely have a mild form of the disease.

“I am pretty sure that people who, for whatever reason, are not being vaccinated will be get COVID, “he says. “The question we have now is: are they going to do it all at once thanks to Omicron? [holiday] parties? Or will it be slower so that our health care system is not completely affected? “Also, if governments don’t launch boosters ‘incredibly aggressively’ and inform everyone of how they are going to slow down transmission, he believes it is possible that almost everyone could catch.

“The problem is that if we start to see a substantial number of outbreaks, or even a spread of Omicron faster than necessary, this could end up putting massive pressure on the healthcare system.” In the past five weeks, we’ve averaged a substantially higher Rt value than that experienced last December, when the third wave crashed across most of Canada, causing hospitals to be overloaded and prompting government shutdowns, Morris explains. .

Now the healthcare system is even more fragile and he is more pessimistic than ever during this pandemic. When asked to describe the future of Canada, he uses two words: “Pretty ugly.”

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