By Cecilia Nasmith
Like it or not, we all will be living with COVID-19.
The important thing for Haliburton Kawartha Pine Ridge District Health Unit Medical Officer of Health Dr. Natalie Bocking is to learn the smart way to live alongside the virus - “recognizing COVID is still here, but moving beyond the previous ways we were managing,” she said in a Monday interview.
Her advice is to be aware and be wise.
The preventive precautions that worked well for the last two years, like wearing your mask, continue to work for us.
“It's just that it's not a rule that we have to follow, so we are relying on individuals to make choices to help protect their communities,” Dr. Bocking said.
“We know some people will choose to wear masks, and some people will choose not to wear masks, but the hope is – based on what the risk is – they will make the informed decisions to continue with some measures.”
Social distancing (especially indoors), hand hygiene and staying home if you feel unwell are measures we have had all along. A more recent boon has been the vaccine.
Unfortunately, the figure on the health unit's website indicating what portion of the population eligible for a booster shot actually got it stubbornly refuses to reach the two-thirds mark. But Dr. Bocking pointed out that the important thing to remember is that those people most vulnerable to the most severe cases (like those of advanced age) are the ones who do get it – that would be more than 86% of HKPR residents aged 70 and older.
“We certainly have more people who have received their booster dose than in January, and more might have natural immunity from catching Omicron in January,” she noted.
Dr. Bocking always considered a rise in cases to be inevitable, once the province lifted masking mandates, indoor capacity limits and vaccination passport requirements. Already, the number of outbreaks they are monitoring has risen to five. And wastewater-surveillance data from Cobourg show the highest-ever presence of COVID indicators since this technology became one tool to monitor the progress of the virus, even higher than what it was at the height of the Omicron wave in January.
“What we don't know is what that will mean for people developing severe illness, how many will be admitted to hospital,” she said.
The sky-high case counts of the Omicron variant changed how we can monitor the COVID situation.
The simple daily report on new cases ceased to mean as much when the province restricted PCR (or, as Dr. Bocking refers to it, lab-confirmed) testing to certain eligible individuals, such as front-line health-care workers. Home tests became harder to get as the variant grew, but that meant nothing as far as official new-case counts go – anyone getting a positive result was not required to report it. Even if they had, there was no mechanism by which to do so.
Wastewater indicators do not translate exactly into figures that forecast what can be expected, Dr. Bocking continued, but it is one tool to keep an eye on things. Another is the positivity rate of lab-confirmed testing of those individuals who do meet provincial criteria for lab testing.
Unfortunately, while wastewater indicators are growing, test positivity rate is creeping up to 12% - not as high as the 20% level of January, but certainly on the upswing.
Dr. Bocking has always stressed that the real goal of the shots, the masks, the caution is not to stomp out COVID but to keep it at a level that does not overwhelm our health-care infrastructure to the point that care for all who need it is compromised.
That was the risk during Omicron, when hospitalizations in the HKPR jurisdiction were at their highest point ever during the course of the pandemic – the sheer numbers were of grave concern, even though the variant brought less risk of sever outcomes.
On that front, the new anti-viral treatments are welcome news. For those who are eligible for this new therapy – and who are smart enough to monitor their own health and know at a fairly early stage that they have COVID – it works well in preventing severe illness and even hospital admissions.
“Anti-virals were really just rolling out over the last couple of months,” she said.
They come just in time for the new BA2 subvariant and the lifting of public-health restrictions that, combined, increase the likelihood of continued cases and more hospitalizations.
“But hopefully not the same number, because we have better protection from vaccines and we have the anti-virals to prevent severe illness.”
Going forward, Dr. Bocking said, the first thing is to be aware of what's happening with COVID.
“If there's a surge, you know it's going on and you will be able to make the smart decision with that. If we know there's a lot of COVID going around and you are going to indoors locations with lots of other people not from your home, you will strongly consider wearing a mask.
“If you are not well or not feeling 100%, you would not take the risk of going out- stay home, at least until you can take a rapid test and be sure it's not COVID.
“At times where there is a lot of COVID activity, reconsider going to those really large social settings if they are indoors.”
It's similar to viruses like influenza in that there will be times when it's on the upswing and you know to be more cautious than usual until things calm down.
“It's a giant behaviour-change process for all of society,” Dr. Bocking said.
“We now are asking people to accept this level of risk that we did not want them to accept two years ago. It's a transition period, because COVID will still be here. We just have to be cautious and live alongside it.
“I think it's okay for transitions to take time. We know people won't change how they perceive things overnight, so let's collectively be patient and give it a couple of weeks and see where we are then.”
