Tuesday, May 25, 2021 | Category: Eduvation Insider
Good morning, and welcome back!
I can’t remember the last time I took a week off writing this daily newsletter (it was likely around Christmas) but it certainly gave me a chance to fight back against the pandemic tendency to sleep too little, work too much, and skip the exercise. I’m back, feeling refreshed, back to my daily 5K runs, and finally with my first dose of Pfizer. (Not because I was vaccine-shopping, but because I thought I should let all sorts of front-line workers and vulnerable Ontarians get their shot before me. I’m one of the lucky ones, who has been able to work from home for 14 months and almost never has to leave the house.)
I’m also one of the lucky ones because today, I get to present (yes, of course virtually) on Postsecondary Post-COVID for the forward-looking folks at SAIT!
My Canadian readers will have had a nice long Victoria Day weekend – and some colleges shut down for Friday too, as an “employee appreciation day” or a “mental health break.” I hope, however long your break, you are feeling rested and ready for another… Pandemic Précis.
Since my last update a week ago, our progress against the virus is looking up, generally…
58/4 and Counting
Canada has now surpassed 25,000 COVID19 deaths, but also administered at least one dose of vaccine to 58% of the population (age 12+), and 2 doses to ~4%. (So, while we’re “halfway there” to first doses, we’re still less than a twentieth of the way to fully vaccinating the population.) The pace of vaccination is continuing to accelerate, though, and nationally new cases have dropped 25% over the past week. (Although the numbers being tested is also dropping in Ontario, concerning epidemiologists. People may be under the mistaken impression that testing is not necessary after receiving their first dose of vaccine.) This week, vaccine deliveries will ease after 1.4M doses were shipped early last week.
“I expect this virus will be with us with us for years, but how it impacts us will be very different than what’s happening right now. There may be times when people will need to stay home from school or work, they’ll need to wear masks in certain situations… These are all the things that we’re planning for contingencies in the fall.” – Bonnie Henry, BC Chief PHO
Since vaccinated students provide the best hope for a return to campus this Fall, it’s been wonderful to see vaccine eligibility extend to teenagers over the past 2 weeks. With the Pfizer vaccine approved for Canadians age 12-18, many provinces have opened up vaccinations to residents age 12+, including BC, Manitoba, Ontario, and Quebec (starting today). One Montréal health unit began vaccinating teens this weekend, and reports a lineup around the block. (Of course, they can book an appointment, but vaccine shortages could still mean a long wait for the shot itself.)
Mix & Match Vaxes
Preliminary results from studies in Spain and the UK have found that mixing AstraZeneca and Pfizer vaccines for first and second doses resulted in a “stronger immune response” (as much as 150x more antibodies) and more frequent mild side effects. Still, NACI advises that Canadians should ideally receive a second dose of the same vaccine as their first, although if that proves impossible they suggest matching Pfizer / Moderna or AZ / J&J (although shipments of J&J are still on hold over quality control issues).
“Roaring 20s” in the US?
By comparison, 37% of Americans have received 2 shots, and the daily pace of vaccinations has been declining since April. The CDC declared last week that fully-vaccinated Americans could resume almost all activities without masks or physical distancing – hoping to encourage more vaccinations, but potentially setting the stage for chaos. US restaurants report the crowds are “roaring back,” already “blowing past pre-pandemic numbers” in many states. (Now their problem is a shortage of 993,000 restaurant workers.)
“Free to Hug” in the UK
The British economy started to reopen last week after a 4-month lockdown, as restaurants, pubs and movie theatres reopened to the public. Boris Johnson advises people “cuddle cautiously,” as outdoor gatherings up to 30 people are permitted, and face coverings are no longer mandatory in schools. The economy has a long road to recovery though: besides the official COVID19 death toll of 127,679, the economy had its worst decline in 3 centuries, and the government spent hundreds of billions of pounds in emergency relief. Ministers will make a crucial decision about the final phase of reopening on Jun 14.
As the Canadian Chamber of Commerce demands more “optimism” from Ottawa, right-wing columnists point to the “miracle” of a post-COVID Britain, Israel and America as evidence that epidemiologists and public health experts are “smug in certain knowledge – against all evidence” that precautions must continue in Canada. (Critics also argue that Canada’s 75% vaccination target is too high compared to 30% in the UK and 37% in the US.) But it’s mistaken to argue that Canada is behind only in vaccinations: we are also (thankfully) behind in uncontrolled spread and mass deaths, with less natural immunity as a result. Yes, with even one dose of vaccine your chances of death largely evaporate, but there are plenty of other risks to COVID19 (see below). As 3 uToronto medical profs explain, “complacency could lead to a repeat” of last year’s fall and winter pandemic waves.
Worst-Case Scenario in Manitoba
Manitoba has become the North American epicentre of the pandemic, hitting record levels of new cases, ~5,000 active cases (half of them VOCs), and sending patients to Ontario in order to preserve ICU capacity. “We are at that worst-case scenario that all of us have been talking about and been concerned about as Manitobans.” On Friday, premier Brian Pallister asked Ottawa for up to 120 healthcare workers to help cope with the third wave. (Ontario and Nova Scotia had similar assistance last month, from the military and the Red Cross.) Manitoba tightened health restrictions for the long weekend, banning outdoor gatherings until tomorrow.
“COVID is evil. It robs your breath. It robs your strength. It robs your freedoms. It can take your life. There are real consequences to getting COVID and I don’t want those consequences to happen to you.” – Brian Pallister, Manitoba Premier
Perhaps because of the signs of progress in vaccinations and plateauing case counts, Canadian political leaders and the general public seem to be demonstrating yet again that they just can’t pass the marshmallow test. Despite loud warnings from PHOs that we need to stay locked down a while longer if we want to enjoy any kind of a normal August, people just can’t seem to wait…
Crucial Holiday Weekend
Canada’s PHO Theresa Tam warned Saturday that “maintaining precautions this long weekend remains critical for sustaining our progress” against the pandemic. In London ON, PHO Chris Mackie warned that “this is the weekend where we could blow it all,” the “biggest risk that we see on the immediate horizon.” Ryerson epidemiologist Timothy Sly expects a post-holiday spike about 6-10 days from now. (And based on what I’ve seen in my neighbourhood, it seems pretty likely.)
“Our actions this long weekend could not be more important. COVID19 resurgences have followed social gatherings during past holidays and long weekends. With important work we have left to do, this weekend is not the time to let our guard down.” – Howard Njoo, Deputy Chief Medical Officer, Canada
“This is the weekend where we could blow it all. We want to have a wonderful summer. We want to put this pandemic wave to bed. If we take risks this weekend, it jeopardizes all of that.”Chris Mackie, London Ontario MOH
Worldwide, political leaders have been impatient to reopen their economies and societies since the pandemic began. Medical experts are still pleading to cancel the Summer Olympic Games in Tokyo, where just 2% of the population is vaccinated and much of the country is still under a state of emergency. Aside from Manitoba, where the hospital crisis is impossible to ignore, other Canadian jurisdictions just can’t wait to start announcing reopening plans, or relaxing public health restrictions. (And the moment a plan is announced to lift restrictions a few weeks from now, plenty of covidiots decide that means they can do so today.) Saskatchewan unveiled its reopening plan early in May. Alberta is moving forward aggressively so that the Calgary Stampede can happen by early July. (In its 108-year history, only last year was it cancelled. Even when downtown Calgary was flooded in 2013, the show went on with the slogan “Hell or High Water.”) Even though the province remains under a stay-at-home order until Jun 2, 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. (Stage 2 begins when vaccinations hit 70/20, and stage 3 at 75/25.) With the highest vaccination rate in Canada (60% first doses), Quebec announced the “déconfinement,” with plans to end its 5-month curfew this Friday, and allow patio dining, inter-regional travel, and even up to 2,500 to attend large indoor or outdoor events (so long as they stay in “independent zones” of 250 people each, with their own entrances, washrooms and exits). Quebec’s 4-stage reopening plan seems to forecast 75/9 vaccination by Jun 25, at which point restrictions will be lifted on overnight camps, masks and distancing for those fully vaccinated. (And yet, to keep us confused, Quebec offers a completely different graph to represent what looks like different targets and timelines… sigh.)
“We will be back to quasi normal at the end of August if we have reached our 75% second-dose objective. But we have to respect the calendar and the measures until then.” – Horacio Arruda, Quebec Public Health Director
Of course, with mixed messages from various regions across the continent, people hear what they want to hear and make their own rules. In Alberta, Calgary pastor Tim Stephens of Fairview Baptist Church was arrested after months of encouraging his congregation to break PHO rules. In Quebec, 75 people were fined $135,000 for an illegal gathering about 100km north of Montreal on May 16. In badly-hit Manitoba, the Springs Church congregation still seems to be resisting public health advice and appears to have celebrated in in-person graduation ceremony for Springs College students. Even under a state of emergency, Ontarians drove hundreds of kms to beaches and cottages for the Victoria Day weekend. (Technically, they either need to be going to a second residence for urgent maintenance purposes, for less than 24 hours, or they need to stay for 14 days and quarantine.)
Nova Scotia has closed K-12 schools for the rest of this academic year. Quebec schools have stayed open most of the year, but 23,000 schoolchildren and 3,900 school staff have tested positive since the pandemic began. (And 4x as many may have been infected but never tested.) There’s no word yet on when K-12 students might return to classrooms in Ontario, although the provincial science advisory table calculates that reopening would spark an 11% surge in infections. On the other hand, almost all K-12 students are going back to class in Albertastarting this morning (aside from the Fort McMurray region). Alberta teachers’ unions object to the “yo-yo” effect, returning students and teachers to a system essentially unchanged since they left it weeks ago. (On Sunday, the Alberta Teachers Association passed a motion of non-confidence in the education minister, almost unanimously.)
As vaccination programs progress and case counts level off or fall in much of North America, the biggest risk to reopening plans is the threat of new VOCs – and one in particular…
The Double Mutant
Last week, India had the deadliest day of any country since the pandemic began: 4,500 COVID19 deaths were tallied on Wednesday (although it is thought they are 2-8x higher than officially reported). Many suspect a key pandemic driver in India is the “double mutant” variant (B.1.617.2) – but don’t call it the “Indian variant” or you’ll be censored on social media, by order of the Modi government. (For the record, I absolutely agree that we should not be stigmatizing or prejudging people based on their country of origin, but using the cumbersome numeric naming conventions just doesn’t work for my linguistically focused mind.)
By any other name, B.1.617.2 is up to 50% more transmissible (although data is still coming in), and is “outcompeting” other COVID19 strains. It is set to become the dominant strain in the UK, and could pose a “serious disruption” to reopening progress in the country. (Modelling suggests a more transmissible, immunity-escaping VOC could drive a bigger surge of hospitalizations than the second wave in January.) There have also been documented cases in Germany and Singapore, since such VOCs have “a biological passport for international travel and global spread.” For its part, Canada has banned private, commercial and passenger flights from India and Pakistan until Jun 21.
On the upside, though, early results from vaccine studies against the B.1.617.2 variant are promising. Public Health England reports that the Pfizer vaccine is 88% effective against symptomatic disease from the Indian variant (2 weeks after the 2nd dose), and the AZ vaccine 60% (compared to 66% against the UK variant). Both are about 33% effective after just the first dose. But that’s for infection and transmission – it is “likely” that both vaccines will protect against severe illness. (Clearly it’s crucial that we get to double-doses before the variant spreads widely.)
“The risks are not over. And we have seven billion people to take care of. And until we get mass vaccination everywhere, with open borders and travel and the evolution of viruses, there’s new risk.” – Stephen Hoption Cann, epidemiologist, UBC
Those who think we’ll be back to normal on campus by October, when most Canadians have their second doses, are assuming VOCs will not become a bigger threat, and are ignoring some other medical considerations…
Plenty of non-Fatal Impacts
Politicians across North America are rushing to reopen their economies and societies as quickly as possible, buoyed by the fact that hospitalizations and deaths are waning in most jurisdictions. But studies keep reinforcing that COVID19 can have severe impacts on people of all ages, affecting a wide range of organs and in particular, the brain and nervous system. One recent international study has found that 82% of patients hospitalized with COVID19 experienced neurological complications, ranging from the loss of smell to strokes or seizures, likely because of hypoxia. Likewise, a Georgia study measured reduced gray matter volume and persistent disability in some COVID19 patients. (You may remember “Worse things than Death” from my COVID101.)
Vaccines only build immunity in people who have a functioning immune system, without immunosuppressing prescriptions or diseases that leave them immune-compromised. COVID19 is more serious and lasts far longer in people with a weaker immune response, fuelling the development of more resistant variants. Only 15% of organ transplant recipients produced antibodies soon after their first dose of COVID vaccine, and 54% after the second. Cancer patients receiving chemotherapy or radiation treatments will be more vulnerable. It is estimated that about 3.6% of the US population is immunocompromised by HIV/AIDS, organ transplants and cancer treatments, but even more take immunosuppressive medications for IBD, rheumatoid arthritis, and more. Many immune-compromised patients are experiencing breakthrough infections of COVID19, even after being fully vaccinated. Doctors’ best advice? These people need to continue to behave as though they are not vaccinated at all.
The main reason COVID19 is likely to remain endemic, rather than being eradicated, is that it can persist in reservoirs of other species from bats and mink to cats and dogs. And plenty of coronaviruses are zoonotic, jumping from animals to humans, including those behind SARS (from civets) and MERS (from camels). A new Duke U study of Malaysian patients has uncovered a novel strain of canine coronavirus that appears to have leapt from dogs to humans in 2018. It appears to be a recombinant strain with fragments of both cat and pig coronaviruses, too. “So what does this mean? Well, you know, we don’t know exactly.” (Reassuring, huh?)
I think it’s fair to assume that some measures to reduce campus density, protect the vulnerable, and anticipate the next pandemic will mean that Fall 2021 is a “transitional” term, and that we never get quite back to normal. But I’ll cover the topic of Fall 2021 later this week…
It certainly appears that declining case counts and summer depopulation of campuses is having an effect on the spread of COVID19 on CdnPSE campuses: since last Monday, I have seen just 6 more cases announced. (See my master spreadsheet for a running tally of 2,600+ cases in CdnPSE since Sept 2020.)
Cambrian College reported a case on the Barrydowne campus May 17. Cambrian
Mohawk College reported 2 unconnected cases on its Stoney Creek campus May 17. (Email)
Trent U reported an employee tested positive May 13. Peterborough Examiner
uWaterloo reported 2 cases on campus on May 18. UW
On the heels of the moving Extra sugar-free gum commercial, featuring Celine Dion’s “It’s All Coming Back to Me Now,” Pepsi got in on the post-pandemic dreaming…
The Mess We Miss
Pepsi looks forward to a post-COVID “Tomorrow” (featuring the Broadway classic tune from Annie) in which we can once again feel carefree when stuck close to strangers, shouting in each others’ faces, grabbing seafood from a buffet or yes, sharing a can of soda. “Here’s to all the messes we never thought we’d miss and to finding our way back to a better tomorrow.” YouTube
As always, thanks for reading! I hope your (short) week gets off to a great start.
Please do drop me a line if you spot something interesting, thought-provoking or cool happening on your campus, or elsewhere in the world!
Stay safe and be well,
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