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Pandemic Wind at Our Backs?

Good morning, and happy Memorial Day for our neighbours to the south! (It’s also apparently Web Designer Day, if you want to appreciate that special someone in your office…)

I hope you had a restful weekend, and are back rarin’ to go for another week! Today I’m going to try to sum up the state of the pandemic and provincial reopening plans…



Pandemic Précis

Since my Pandemic Précis last Tuesday (“Waiting to Exhale”), things have started to look better across most of Canada, while Asia faces new threats from rising variants that could eventually pose a challenge to our reopening efforts too…


Renaissance in Europe

Vaccination efforts are slowing in the US, thanks to vaccine hesitancy, but cases are near their pandemic low point thanks to a combination of immunization and summer outdoor activities. (Still, 1.9M Americans were travelling by air for the long weekend, which may stir up more interstate transmission in the weeks ahead.) Europe has seen the biggest decrease in cases, as vaccination rates accelerate and life begins to return to normal. (About 44% of European adults have received at least 1 dose.) Concerts have resumed in Italy, and Spain is hoping for a tourism renaissance – although the head of Spain’s health emergency coordination centre says “we should lower the tone of euphoria a little.”


Lockdowns Elsewhere

But Haiti has imposed a curfew and other restrictions under an 8-day health emergency. As hospitals overflow with COVID19 patients, Japan has extended its state of emergency in Tokyo and elsewhere for 20 more days – with the Olympics just 50 days away. And Malaysia is imposing a total lockdown, halting all business and economic activity for 2 weeks, in the face of record-high case counts. Authorities blame 24 clusters associated with the Muslim celebration of Eid for ~850 cases. Half of all COVID19 deaths in Malaysia have been reported this month alone.


India Variant Spreads

Even in countries that thought the worst of the pandemic was behind them, the B.1.617.2 (Indian) variant is sparking significant outbreaks and concern. The WHO reports the Indian VOC has now spread to 60 territoriesin 3 “lineages.” Melbourne Australia reinstated COVID19 restrictions last Tuesday in response to a fresh outbreak of 9 cases affecting one extended family, sparked by a traveller with the India variant. Thousands across the state of Victoria have been ordered to self-isolate and undergo COVID19 testing, and by Thursday 26 cases and 10,000 contacts were reported. Meanwhile, Britain is now seeing a third wave, with almost 7,000 cases of the variant, prompting local lockdowns in 8 regions. More than 38% of new cases in the UK are driven by the Indian variant, and the PHO warns it could soon account for 75% of all cases. The UK’s plan to ease restrictions further on Jun 21 “hangs in the balance.” (Sadly the UK’s first recipient of the Pfizer vaccine, William Shakespeare, passed away from a stroke last week.)


New Variant in Vietnam

Vietnam’s largest city is introducing new lockdowns starting today, as total cases in the country since the beginning of the pandemic have doubled in the past month, and outbreaks have spread to 30 cities. Labs report a new strain that is a “hybrid” of the UK and India variants, and more transmissible than previously known strains. “That the new one is an Indian variant with mutations that originally belong to the UK variant is very dangerous.”  CTV


“Scandalous Inequality”

WHO Director-General Tedros Adhanom Ghebreyesus warned last week that the world remains in great danger from COVID19, with more new cases so far this year than in all of 2020 – and 75% of vaccines administered in just 10 countries. “There is no diplomatic way to say it: A small group of countries that make and buy the majority of the world’s vaccines control the fate of the rest of the world.” So far the COVAX initiative has delivered only enough vaccines to 125 other countries to vaccinate ~1% of their populations.  CBC


Progress in Canada

Canada’s daily case counts have declined more than 70% since their all-time high Apr 15, and hospitalizations are down by a third. More than 60% of eligible Canadians have received their first dose of vaccine, and at the current pace 90% will have first doses by Jun 26. But following advice from NACI, most provinces announced last week that they would be accelerating the administration of second doses, cutting the 16-week wait period by as much as half (in BC and QC) and even to one-quarter (in ON). For some people, says premier Doug Ford, “Ontario is ready to deliver a two-dose summer.”

If vaccine shipments continue uninterrupted, Canada might hit 80% fully vaccinated by Sep 1, and 90% by Sep 11 – potentially permitting a much more normal fall term for CdnPSE. (More about that tomorrow!)


“Our efforts have got us well and truly over the peak of the third wave nationally and heading for a much better summer, if we can stay the course.”Theresa Tam, Chief PHO, Canada



Reopening Canada

The pace of vaccinations and new case counts have continued to improve across most of Canada, leaving us with the sense that (just maybe) the “wind” is finally “at our backs” after months of pandemic doldrums. (That sounds far more optimistic than Jason Kenney’s declaration that “the end is near.”) Immediately after the Victoria Day long weekend, many provincial PHOs announced reduced restrictions and plans for reopening…


“We’ve been walking into the wind for 18 months on this pandemic. It’s constantly like walking into the wind, and I think we’re starting to see the wind at our backs.”Alex Summers, Assoc MOH, Middlesex-London Health Unit



Yukon Nearing Normal

With unparalleled 75/70 immunizations, life started “nearing normal” in Yukon last Tuesday. Restaurants and bars have reopened at full capacity, and gyms, weddings and other events can draw up to 200 guests (with physical distancing measures).  CTV


BC Restart Plan

Last Tuesday, British Columbia unveiled a 4-step provincial restart plan contingent on vaccination and hospitalization levels. Effective May 25, indoor dining resumed for groups of up to 6, outdoor team sports are permitted again (without spectators), and organized outdoor gatherings of up to 50 are permitted. As early as Jun 15, if 65% of adults have their first doses, BC hopes to reopen movie theatres, permit personal outdoor gatherings of up to 50 and recreational travel across the province, and resume indoor fitness activities. As early as Jul 1, with 70% first doses, personal gatherings might be able to resume without limits, along with fairs and festivals – and the mask “mandate” might become a mask “recommendation.” (Plus grocery store directional arrows will disappear!) Finally, if all goes well, by Sep 7 BC might see a return to rock concerts, Hallowe’en parties, and spectator sports.  CTV  |  Globe & Mail  |


“We’ll be staying flexible because we know this virus still has some tricks up its sleeve, but I don’t see a situation where we’re going backwards unless things change very dramatically.”Bonnie Henry, BC PHO



AB “Open for Summer”

On Wednesday, Alberta premier Jason Kenney unveiled Canada’s most accelerated 3-stage reopening plan, with all major lockdown measures removed as early as Jun 30. (Critics say this is “completely irresponsible” and “aggressive to the point of recklessness,” purely driven by the desire to open the Calgary Stampede as normal, and improve Kenney’s public approval ratings.) As of tomorrow, patio dining can resume, retail and religion can reopen at 15% capacity, outdoor social gatherings grow to 10 people, and funerals to 20. (Why weddings are capped at 10 but funerals at 20 is a head-scratcher, but neither can have receptions.) Stage 2, once 60% of Albertans have their first dose, could begin as early as Jun 10, and would permit weddings of 20, outdoor receptions, indoor and outdoor sports, retail and religion at 33%, and the reopening of gyms, theatres, arenas and in-person PSE. Concerts or festivals of up to 150 people could also resume, with distancing and masking requirements. Stage 3, after 70% have their first dose, could occur “at the beginning of July or earlier,” and would lift ALL restrictions, including mask requirements. (That is when things will get really scary.)  Globe & Mail  |  Global


“Today, we are truly near the end of this thing. We are leaving the darkest days of the pandemic behind and stepping into the warm light of summer.”Jason Kenney, Premier of Alberta



“It’s not a race as to which province can do this the fastest. We will have, I think, a pretty good summer, but I think we’re setting ourselves up for a significant problem in the fall.”Noel Gibney, Co-chair, Edmonton Medical Staff Association



“Doors wide open, masks not necessary, yeehaw, let’s invite a hundred thousand people to the fairgrounds, all on the same day? That is not a thing you’re seeing in other jurisdictions.”Rachel Notley, Alberta NDP Leader




Easing up in SK

As of yesterday in Saskatchewan, limits on gathering sizes and indoor dining were raised, and group fitness classes and outdoor sports allowed to resume as the province entered Phase 1 of its 3-stage reopening plan. Phase 2 is scheduled for Jun 20, when retail can fully reopen (with physical distancing), bingo halls, casinos, receptions and theatres can reopen for up to 150 people, and indoor sports will also resume. Phase 3 will commence 3 weeks after 70% have their first dose, likely mid-July, and will lift most remaining restrictions.  CBC  |  CBC


Struggling with Schools in ON

Even though the province remains under a stay-at-home order until Jun 2, and ICU cases are still peaking, Ontario premier Doug Ford unveiled a 3-step plan for a “slow and cautious reopening,” starting with outdoor recreation May 22, and outdoor gatherings and dining around Jun 14. Ford seems to be struggling much more with the decision about allowing a return to K-12 classrooms before the summer break, writing 50+ medical experts and teachers’ unions for input last week and hoping for a “broad consensus.” (Apparently Ford is more cautious than his chief MOH David Williams – whom the premier will be replacing with an announcement expected today.) He reports that schools were the source of more outbreaks than workplaces in April, and that new modelling suggests that reopening classrooms in June could lead to daily case counts of 2,000-4,000 by the end of July. Ford is concerned about the B.1.617 (Indian) variant, and that just 41% of Ontario teachers and education workers have received even a first dose of vaccine. On the other hand, children’s health experts have been increasingly vocal about the “mental health emergency” among kids who have been out of classrooms since the April “March Break.” So far, only the Timmins area PHO has objected to reopening schools.  CTV News  |  Globe & Mail


“Freedom, with Caution” in QC

Now that 56% of the Quebec population has their first dose, premier François Legault announced last Tuesday that pandemic restrictions across 8 regions would be relaxed today (May 31), although Montréal and Laval will stay in the “red” until at least Jun 7. The border with Ontario remains closed to non-essential travel. Curfews (which had been in place since Jan 9) were finally lifted provincewide on Friday, as patio dining resumed at restaurants, and private outdoor gatherings of up to 8 were permitted. Large venues can now have up to 2,500, particularly for Saturday’s NHL playoff game. (sheesh!) Modellers warn that cases could rise again in June if the public doesn’t follow the rules closely, and that 89% of Quebecers aged 12+ will need to be vaccinated by Fall to prevent a fourth wave. (Quebec has reportedly also ordered hospitals to cut $150M from their budgets, prematurely trying to “recoup” some expenses of the pandemic while still in it.)  Globe & Mail  |  CBC


Phased Plan for NS

Last Friday, Nova Scotia unveiled a 5-phase reopening plan to begin Jun 2 with Phase 1, in which patio dining and K-12 schools reopen, retail at 25% and outdoor ceremonies can have up to 10 people. Gyms and sports practices can resume with groups of 10, and international students can apply to enter the province for the summer term. Phase 2, when 60% have 1 dose, will begin 2-4 weeks later, and would raise gatherings to 10 indoors or 25 outdoors, gyms to 50% capacity, and museums/libraries (strangely!) to just 25%. Indoor dining would be permitted to resume, and retail to return to 50%. Phase 3, once 65% have 1 dose, would reopen the Atlantic Bubble and permit gyms and retail to return to 75% capacity. (Yikes!) Phase 4, once 75% have 1 dose, would increase gathering sizes still further, allow retail to reopen with distancing measures, and other limits to rise to capacities still TBD. Finally, Phase 5 (with 75% of the population having 2 doses) represents “living with COVID.”  CTV


“Path to Green” in NB

On Thursday, New Brunswick unveiled its plan to lift all pandemic restrictions by as early as Aug 2, in a series of 3 stages in its “Path to Green.” Phase 1 could begin as early as Jun 7, if 75% have their first dose. (As of Sunday, 62.1% of eligible NBers had received one dose.) Outdoor gatherings would be permitted with 2m social distancing, and indoor formal gatherings at 50% capacity. Phase 2 could begin as early as Jul 1, if 20% of those aged 65+ have their second dose. At that stage, restaurants, gyms and salons will reopen at full capacity, with masks and contact lists required. By Aug 2, the province hopes to lift the state of emergency order, in place since March 2020, and return to “green” or normal operations.   CBC


“Moving Forward” in PEI

Prince Edward Island unveiled its 5-stage reopening roadmap, “Moving Forward,” last Thursday. Step 1 begins Jun 6, and raises personal gathering limits to 20 and organized ones to 50. (Weddings and funerals can have up to 150.) Although currently non-residents require special permission to visit the island, PEI hopes to reopen the Atlantic Bubble with Step 2 (Jun 27, with 80% first dose), with no isolation required for travellers with at least 1 dose of COVID19 vaccine. Larger gatherings would be permitted in Step 3 (~Jul 18), even more travel freedoms in Step 4 (~Aug 8, with 50% fully vaccinated), and no gathering limits at all in Step 5 (~Sep 12, with 80% fully vaccinated).  CBC



Caveats for Canada

Of course as usual, our political leaders are getting a bit ahead of the science when it comes to reopening, and 2 provinces are still coping with rising cases and restrictions…


Dark Days in MB

Manitoba extended holiday-weekend pandemic restrictions throughout last week as it reported the highest new infection rates in North America. “Our health system is facing critical pressures that are not sustainable.” K-12 schools will remain remote until at least Jun 7, and a ban on social gatherings will continue for 2 weeks. Armed Forces personnel arrived in MB on Friday for a 4-week mission, as 26 critical patients have been transferred to ON hospitals. Unfortunately, officials warned Friday that MB will be delayed in reaching its vaccination milestones due to supply chain disruptions.  Globe & Mail


Variant “from Away” hits NL

Newfoundland is grappling with a new cluster of 60 cases, driven by the B.1.617.2 (Indian) variant – and the PHO reports that “some” of those infected had already received their first vaccination. In all, NL has 93 active infections.  Globe & Mail


Vaccines take 4 Weeks

Too many provincial reopening plans use vaccination targets as the trigger, or allow 2-3 weeks after the target is reached, so that vaccinations have an opportunity to convey some level of immunity on recipients. But data show that protective immunity begins to develop 2 weeks after the shot, and gets considerably better after 4 weeks. Really, reopening plans should aim for 4 weeks after the immunization targets are met.  Global


Second Doses Matter

Particularly when it comes to the B.1.617.2 (Indian) variant, a single dose of vaccine offers far too little protection for most people. Canada’s chief PHO Theresa Tam is encouraging the provinces to aim for 75/20 vaccinations (75% of the population with a first dose, and 20% with a second) before lifting health restrictions – but most aren’t even including second doses in their reopening plans.


Masks and Distancing

Even as Canadians get their first and even second doses of COVID19 vaccine, physical distancing and mask wearing precautions (as well as some significant ventilation upgrades) will continue to be important to protect the most vulnerable. (The immunocompromised, those taking immunosuppressing drugs, those with weaker immune systems, etc.) What most health experts argue is pointless, however, is the relentless focus on “hygiene theatre” we saw last year, wiping down surfaces or using electrostatic sprayers. Regular handwashing should be sufficient to prevent fomite transmission.  CBC



COVID on Campus

In the 6 days since my last tally, I have seen just 3 more cases of COVID19 reported by CdnPSEs. (See my master spreadsheet for a running tally of 2,600+ cases in CdnPSE since Sept 2020.)  

McMaster U reported a student case on campus May 25.  Mac

Red River College reported a confirmed case at its Notre Dame campus May 25.  RRC

uWaterloo reported a case on campus May 28.  UW




As always, thanks for reading! I hope your week gets off to a great start.

Please do drop me a line if you spot something interesting, thought-provoking or cool affecting CdnPSE.

Stay safe and be well!



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