Monday, February 14, 2022 | Category: Eduvation Insider
You might be forgiven for thinking that the pandemic is almost over. With a few exceptions, most of CdnPSE is back on campus for F2F instruction, or working its way there. Premiers have been lifting restrictions in a mad scramble to appease disgruntled voters. (More about that tomorrow.)
So, when it comes to the COVID endgame, “are we there yet?” The answer is complicated…
I last summarized the state of the pandemic back around Groundhog Day (“Halfway Out of Our Burrows”). Since then, it’s only become clearer that we’re not fully out of the woods just yet…
Although much of the world is feeling optimistic that the end of the pandemic is nigh, there are regions still grappling with record-high case counts, hospitalizations and deaths. In the past 6 weeks, record daily case counts have been reported in Russia, Ukraine, the Czech Republic, Poland, Pakistan, Japan, Singapore, the Philippines, and Hong Kong. Malaysia hit a 4-month high, and Thailand a 3-month high. Vietnam saw cases surge after the Lunar New Year, and is warning that its healthcare system could be overwhelmed. Turkey has seen the highest daily death tolls in 5 months. Case counts are soaring in the Middle East, thanks to low vaccination rates (just 35%). Even New Zealand is seeing record levels of community transmission, and PM Jacinda Ardern cancelled her wedding in January.
“The COVID19 pandemic is now entering its third year and we are at a critical juncture… We cannot let it continue to drag on, lurching between panic and neglect.” – Tedros Adhanom Ghebreyesus, World Health Organization
Omicron Isn’t Milder
The so-called “Stealth Omicron” subvariant, BA.2, is spreading rapidly in Europe and Asia and seems poised to become the dominant strain. (It spreads even faster than Omicron classic, but does not appear to be more virulent. It does appear more adept at slipping past early detection from rapid tests, though.) Harvard medical researchers explain that, while Omicron infections appear to be causing milder illness than Delta, it’s not because of any intrinsic properties of the virus. Omicon’s apparent “mildness” can be explained by prior population-level immunity, breakthrough infections, and statistical distortions due to the rapidity of its spread, and proliferating cases among younger people. Studies controlling for these effects have concluded that Omicron is 75% as likely as Delta to cause hospitalization. The World Economic Forum explains that Omicron’s impact on the workforce has been anything but mild: this wave of the pandemic has tripledabsenteeism due to COVID19, resulting in shortages of teachers, bus drivers, and delays in postal delivery. Some US states have called in the National Guard as substitute teachers. Many jurisdictions have enlisted nursing students to work on the front lines, or allowed COVID-positive hospital staff to continue to care for patients. (Never mind the “Great Resignation” or intensifying faculty strikes.)
Third Time’s the Charm?
Studies suggest that third doses of COVID19 vaccine provide 90% protection against severe illness from the Omicron variant, and up to 75% protection against symptomatic infection – but that drops to 50% or less after just 10 weeks. (Of course, a recent study in Israel found that 4 doses provided 3x the protection.) So far, no Canadian province has changed its definition of “fully vaxxed” to include boosters, but some CdnPSEs have indicated that they expect anyone coming to campus to obtain the third dose when they are eligible (such as uSaskatchewan, or Brock U for students in residence). Last week, Trent U launched a contest to incentivize 3rd doses this month: “Get Boosted to Win an iPad.”
Our Patience is Done
It’s not just the truckers blocking border crossings and laying siege to capital cities – a growing share of Canadians have lost their patience with pandemic health precautions. A Leger poll last week found that 14% of Canadians want the government to “give us back our freedom” immediately, another 29% think it’s time to lift all restrictions and “learn to live” with COVID19, and another 43% want to see measures ease, carefully. Just 14% say they remain anxious about COVID19, compared to 32% who want to see governments lift allrestrictions, now. (Perhaps unsurprisingly, the anger is strongest among Albertans, and the unvaccinated.) More than two-thirds of us believe we’ve had COVID19 in the past 3 months, whether we tested positive or not. Global
“You can’t wish away a virus by honking horns.” – Ross Upshur, uToronto Dalla Lana School of Public Health
So, with most of us expecting breakthrough infections but mild symptoms (“Omicron fatalism”), there’s more and more resignation out there, accepting the reality of “living with” a new endemic disease. (In January, Angus Reid found that 71% of Canadians thought catching COVID19 was “inevitable,” and 40% would “rather get COVID19 and just move on with my life.” Likewise 80% of Australians expect to catch it in the next 6 months, double the numbers pre-Omicron.) Although “endemic” typically implies a stable, predictable, seasonal pathogen, and COVID19 isn’t quite there yet. Omicron BA.2 may drive another surge in infections when it arrives. And while the risk of death is comparable to influenza for fully-vaxxed adults, and even lowerthan flu for children, the unvaccinated remain at substantially greater risk. (In many ways, the unvaxxed aren’t entitled to think of the pandemic as over at all!) McGill microbiologist Donald Vinh warns that reopening, though tempting, could be “a poisoned apple,” that could lead to yet another pandemic wave.
“The (non technical) definition of endemic… is basically that it is the amount of disease from which people are willing to avert their eyes.” – Bill Hanage, epidemiologist, Harvard U
The Next Could be Worse
As diseases shift from pandemic to endemic, they often become less virulent and deadly – but not always. (That idea just appeals to optimists, and pandemic-fatigued pessimists.) COVID19 has demonstrated an ability to evolve rapidly, and with 47% of the world still not fully vaxxed, and the virus’ ability to jump into animal “reservoirs,” COVID has plenty of hosts to incubate new variants for years to come. The next wave of the pandemic will almost certainly be driven by a new strain that is even more contagious than Omicron, and more adept at breaking through prior immunity – but whether it will be more or less severe remains an open question.
“The next variant of concern will be more fit… more transmissible… The big question is whether or not future variants will be more or less severe.” – Maria Van Kerkhove, World Health Organization
Governments around the world are rushing to lift restrictions, end vaccine passports, and appease a public apparently overwhelmed by pandemic fatigue…
Across Europe, governments have been signalling that they now consider COVID19 an endemic disease, like influenza. In Spain, headlines call it the “flu-ization” of COVID, and their policies are being emulated in Switzerland, Portugal and Ireland. England has shifted from “Plan B” back to “Plan A,” living with endemic COVID19 – if only because further restrictions are “unlikely, unnecessary, and politically impossible.” (Even the requirement to self-isolate with COVID19 could end later this month.) Denmark ended all pandemic restrictions on Feb 2, deeming COVID19 no longer a “critical threat to society.” (Of course, this is the second time Denmark has done that: it lifted all restrictions in Sept 2021, but had to pivot weeks later in the face of the Omicron variant.) Unlike the rest of Europe, Sweden has even stopped testing for COVID19 outside LTC homes, because the cost is “no longer justifiable.”
“I’m happy that I can go out and be young again, that we can go out and do all the things we used to do.” – Stine Thrane Andreasson, Swedish student
Around the world, public health officials are transitioning from pandemic to endemic COVID19. The head of WHO for Africa, Matshidiso Moeti, said Thursday that the continent is “transitioning from the pandemic phase and we will now need to manage the presence of this virus in the long term.”
America Loses Patience
With 247,000 new COVID19 cases daily, the pandemic is far from over in the USA – but even Democrat governors have been quickly dropping mask mandates as they “bow to political reality.” (Whatever the CDC says.) The American public has simply lost patience with expert guidance and scientific evidence – and Democrats are worried about the Fall mid-term elections. A group of scientists and doctors calling itself “the Urgency of Normal” is urging a more nuanced approach to pandemic precautions, instead of the previous polarized, “all-or-nothing,” position, and a recognition that many other physical and mental health concerns should now take priority: “there’s no PCR test for despair.”
“A leader without followers is not very effective leadership, so somehow you have to strike the balance there to keep people following you.” – John Carney, governor, Delaware
“It fits with this wishful thinking narrative… that we can go back to normal, the worst is over — when in reality 3,000 people still die every day of covid and hospitals are still heavily impacted.” – Jorge Luis Salinas, hospital epidemiologist, Stanford U
Today and tomorrow, I want to survey the latest pandemic announcements and CdnPSE responses from coast to coast, starting on Canada’s “left” coast…
BC Shifts Its Thinking
British Columbia’s PHO Bonnie Henry and her team appeared at another virtual PSE Town Hall last week to explain the new phase of the pandemic (see below). The Omicron variant is so much more transmissible that our primary strategy to control COVID19 is no longer diminishing transmission, but vaccination, which is now the “definitive intervention.” The odds of exposure to Omicron are much higher, and widespread testing/tracing are no longer feasible. (Wastewater monitoring and rates of absenteeism are the clearest data available now.) That’s why public health is urging BCpses to return to the classroom: restricting F2F learning won’t actually limit transmission anyway. Structured settings like PSE classrooms, with masking and highly-vaxxed students, have always been among the least risky settings. The negative impacts of remote study and isolation on youth mental health now far outweigh the risks of returning to the classroom. And vaccine mandates unfairly punish some disadvantaged groups with limited access to vaccines, or legitimate historical reasons to distrust the healthcare system: “It’s incredibly important that we are not aggravating those inequities,” explains Henry. As for immune-compromised people, the new reality of COVID19 will be much like their risks from many other diseases pre-pandemic. BC’s PHO team seem clear that less-controlled social settings, such as crowded concerts or dining settings, are a very different matter than classrooms, and capacity limits and masking requirements will persist longer there. (This seems to be the inverse of many Democrat states south of the border, where mask mandates are staying in place for schools but not for retail and other businesses. Their rationale includes demands by teachers unions, and the fact that young children are not yet eligible for vaccines: “Children still need adults to look out for their health.”)
The PHO team does not seem to anticipate any future public health reasons to pivot PSE back to online learning due to Covid. Still, Henry emphasizes, the “unknowables” of the pandemic, and the need for health measures, will likely continue for about a year. (Apparently she’ll be announcing more plans for moving forward tomorrow.)
Rather than drown you with a 10-page issue today, I’ll continue this cross-country roundup tomorrow. Stay tuned… things have been particularly wild in Alberta and Saskatchewan!
It’s not my usual light fare, but this 1-hour video is definitely relevant if you’re looking to understand the PHO’s perspective on the pandemic today. Certainly it helped inform my summary above…
PSE Town Hall
UFV, with tech support from TRU, hosted a PSE Town Hall last week with BC PHO Bonnie Henry and her team, to address some timely questions about reopening campuses after the Omicron wave. (I summarize some of the key points above, under “BC Shifts Its Thinking.”) YouTube
As always, thanks for reading. May your week get off to a smooth start, without major ice storms, truck blockades or faculty picket lines in your way!
Stay safe and be well,
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