Good morning, and happy humpday!
Today is also “National Eat What You Want Day,” “World Ego Awareness Day,” and “National Root Canal Appreciation Day.” (Really?) In the midst of National Nurses Week, it’s also “National School Nurse Day” and “National Receptionists Day.” And if you haven’t blown all your cash at the Hallmark store on all of that, it’s also “Donate a Day’s Wages to Charity Day.”
Perhaps only slightly less anxiety-provoking than a root canal, this week I’ve been re-examining the state of the pandemic, wondering if I’m crazy to be booking in-person conference keynotes and board retreats this spring and summer (and wondering about the Fall).
As I said yesterday, Anthony Fauci is still declining invitations to prestigious gatherings, as infections climband the half of Canadians who haven’t been boosted are catching and spreading the latest Omicron subvariants.
Hospitals are bearing the brunt of this phase in the pandemic – but increasingly it’s pediatric hospitals that are being overwhelmed by children with COVID19. And sometimes their cases are surprisingly serious…
Even though the 6th wave of infections is ebbing in Canada, with declines in hospitalizations and deaths to follow, the healthcare front lines still have some major challenges…
COVID19 hospitalizations have been waning in most of Canada for some time now. Ontario reported just 1,167 this week, while Quebec is down to just 1,926. But pediatric hospitals are still facing new surges (see below).
Absent Hospital Workers
The bigger issue for hospitals now is the ongoing challenge caused by shortages of healthcare professionals, exacerbated by absences required by COVID19 infections. On Friday, Quebec reported 7,337 healthcare workers absent due to COVID19 (>3 for every patient in hospital).
Canadians postponed seeking medical attention for diagnosis during the pandemic, but also found workforce shortages, procedure delays and suspensions – all of which have contributed to a sizable backlog of non-emergency surgeries from coast to coast. The Canadian Institute of Health Information (CIHI) reported yesterday that surgical wait times are still persisting, particularly for elective surgeries like cataract removal, hip and joint replacements. “Even if we’re doing 110% of 115% of the usual… it’s going to take us 10-20 months to catch up on the backlog.” Several medical studies forecast that cancer surgery delays could affect patient survival, and estimate that 20,000 additional Canadian deaths from cancer could occur over the next decade due to COVID19. Global
“Even if we’re doing 110% of 115% of the usual… it’s going to take us 10-20 months to catch up on the backlog.” – Shaf Keshavjee, surgeon, University Health Network
A month ago, we knew that Omicron, and particularly its BA.1 and BA.2 subvariants, were driving the sixth wave – particularly by spreading far and wide to seek out the unvaxxed, and by reinfecting those with waning immunity. (I also noted that Omicron XE (a recombinant mix of BA.1 and BA.2) had been detected in the UK.) But it’s been almost 6 months since the WHO introduced us to the latest Greek letter, and in that time we’ve seen an endless stream of Omicron subvariants instead…
In the beginning, there was the original Omicron strain: B.1.1.529. (The latest research concludes that Omicron is no less severe than Delta or COVID classic, but much more transmissible.) Omicron begat BA.1, BA.2, BA.1.1, and BA.3. BA.2 was estimated to be 30-60% more transmissible than the previous subvariants, but it has continued to evolve to be even more transmissible. Omicron BA.2.12.1 has tripled case counts across the US, and sent hospitalizations up 20% already. It has all the strengths of BA.2, plus 2 new mutations that help evade prior immunity, and increase transmissibility by yet another 25%. BA.2.12.1 is poised to be the dominant strain in the US within weeks.
BA.4 and BA.5
A new surge of cases in South Africa is being driven by 2 more subvariants of Omicron, BA.4 and BA.5, which are estimated to be ~10% more transmissible than BA.2 and apparently able to evade much of the natural immunity from prior infection (although not from vaccination). So, although previous waves took it easy on South Africa because of prior infections, this one won’t: just 30% of the country is fully vaxxed. (Cases spiked 67% last week, to 32,000.) Worldwide, >300 cases of BA.4 and BA.5 have been identified, including 3 cases in Canada as of May 3 (although McGill infectious disease expert Donald Vinh says this is “really just a gross underestimate of what’s actually circulating”).
Cases of BA.4 and BA.5 have also been detected in New South Wales, Australia – where more than 11,000 people have now caught COVID19 more than once. Likewise, the state of Victoria reports almost 10,000 reinfections, and Britain has recorded almost 1 million. Thanks to Omicron, Quebec is also reporting 4-5% of all cases in the past 2 waves of the pandemic have been reinfections, sometimes within weeks of each other. (In those cases, a mild infection may not have prompted a robuse immune response, or immunity may not have had the chance to build.)
“Reinfections will become the norm.” – James McCaw, epidemiologist, uMelbourne
Evolution “Goes Viral”
After examining full viral genomes, Western U researchers have concluded that HIV-1 evolved “more like a dynamic social network… than a rigid tree” with recombinant variants creating “a web of intersecting subtypes.” Public health, epidemiology and virology experts need to bear in mind that “there isn’t just one tree, there is a whole forest depending on what part of the virus’ genome you are looking at.” Western News
Evading Rapid Tests
A new Harvard study warns that rapid antigen tests need “continuous assessment” and updating to keep pace with evolving COVID19 variants. The 4 rapid test brands they studied provided pretty solid sensitivity to the Omicron variant, but 3 of them were less sensitive to Delta. (This likely means rapid tests missed 20% or more of Delta cases in the past 2 waves of the pandemic.)
Should We Worry?
While the WHO is monitoring BA.2.12.1, BA.4 and BA.5, many experts assure us that at this point, worry is not justified. Major waves of this pandemic have so far been driven by new variants of COVID19, and not by subvariants. On the other hand, researchers are warning that BA.4 and BA.5’s ability to evade immunity gives them “the potential to result in a new infection wave.” Harvard infectious disease specialist Jacob Lemieux says the explosion of cases in South Africa is already “alarming” and “reminiscent… of the Omicron wave.”
Just 40% of Canadian children aged 5-11 are fully-vaxxed, and those under age 5 still aren’t eligible for any vaccine at all. That’s why…
Pediatric Hospitals Swamped
The combination of nursing shortages, infection control requirements and soaring COVID19 infection rates mean that most hospitals are under strain, but in particular children’s hospitals are feeling the brunt, as highly-contagious variants finally infect unvaxxed children. Toronto’s SickKids has up to 30% of ER staff isolating at home, while seeing “really high volumes of patients” (7,000 ER visits in April). London’s Children’s Hospital reports more COVID19 patients than at any point in the pandemic, and patients as young as 2 in the ICU. Pediatric ER wait times are surpassing 10 hours in Alberta, as triage lineups snake out the doors.
Shots for Tots
On Friday, Moderna submitted its application for Health Canada approval of SpikeVax use in children from 6 months to 5 years of age. (Currently the Pfizer/BioNTech shot is approved for children age 5+, and Modern for age 6+.) Modern’s clinical trials involved 6,700 children getting a quarter-dose of the vaccine, and they reportedly had immune responses equivalent to adults getting the full dose – although were only about 40% protected against infection. No participants, whether they received the shot or the placebo, developed any severe disease from COVID19 – although 25 Canadian children under age 11 have died of COVID19, 14 of them from the latest Omicron wave. Health Canada’s decision could take 3-4 months. Globe & Mail | Winnipeg Free Press | CBC
It’s a good thing, too, because the more we learn about the potential impacts of COVID19, the worse it looks…
Over 200 symptoms have now been attributed to post-COVID syndrome, including lasting sensory, cardiac, pulmonary and neurological consequences. Studies suggest about 30% of adults will suffer protracted consequences of COVID19, while 14 studies suggest it will be about 2-10% of children and adolescents. (A new UK study calculates that cognitive impairment due to long-COVID is “the equivalent of aging 20 years or losing 10 IQ points.”) Some children are presenting with heart failure a month after asymptomatic COVID infections – and often every diagnostic test comes back negative, making it even more of a mystery. Says one Cleveland doctor, “I’ve got 2 kids in wheelchairs… one kid on crutches… a kid who lost the use of her hands.”
“Cognitive impairment due to long COVID is the equivalent of aging 20 years or losing 10 IQ points.” – Tom Yun, CTV News
Like most people working in knowledge sectors like higher ed, I definitely can’t afford to lose 10 IQ points. And I would hate to wake up after a mild cold to discover I was thinking like a retiree…
I’m still working towards a conclusion, you may have noticed. Tune in next time – I’m looking forward to seeing where I land, too!
‘Tis the season for PSE commercials, it would seem, and I have a few dozen interesting examples piling up to share with you. Here’s one from a month ago…
Study Your Way
LaTrobe U (Australia) offers 3 learning models, like many PSEs in the wake of the pandemic: online, on-campus, or some blend of the two. What’s unique is that LaTrobe has branded it “StudyFlex™” and integrated it into the institution’s overall brand message, “LaTrobe By You.” LaTrobe emphasizes flexibility in delivery, schedule, specializations and interdisciplinary options. And this :30-sec spot has some slick editing and transitions to whet your videographers’ appetites, too! YouTube | LaTrobe
I’m convening a CMO Roundtable this week focusing on CdnPSE and Indigenous marketing. Most of the participants will have first-hand experience to share, but I’m on the look-out for useful research, insightful strategies, or notable examples of higher ed efforts reaching out to Indigenous audiences.
Please do drop me a line if you have suggestions!
As always, thanks for reading! With any luck, I’ll be back to you Thursday or Friday to round out this pandemic trilogy.
Meanwhile, stay safe and be well out there!
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