By Cecilia Nasmith
With fall closing in, Haliburton Kawartha Pine Ridge District Health Unit Medical Officer of Health Dr. Natalie Bocking updated local media on Wednesday regarding the latest provincial approach to COVID-19.
Bocking calls it the All Respiratory Virus approach, with a eye toward an integrated effort to battle COVID-19 as well as the influenza that has long been an annual fall concern.
The focus now is to try to determine what influenza will look like, what COVID-19 will look like, and what other respiratory viruses (that may not be reported to public health but are nonetheless causing serious illness among young children and outbreaks in long-term-care homes) will look like.
The All Respiratory Virus approach comes with a few key messages, Dr. Bocking said.
1 – Stay home if you are sick, and remain home until it has been at least 24 hours since you have had a fever and at least 24 hours since your symptoms began improving. And if your symptoms included vomiting or diarrhea, make that 48 hours. Due to limited access to testing, those experiencing these symptoms may or may not have COVID, so this level of caution is indicated. “This is one of the most important messages, as people are often at their most infectious early on,” the doctor said.
2 – Wear a mask for 10 days after symptoms started, regardless of whether you tested for COVID and regardless of how that test came out. And avoid settings where there are people at much higher risk of severe illness from COVID – maybe skip that visit to a loved one in a long-term-care home, for example.
3 – Be aware of what's going on. Know whether COVID activity is increasing, know whether influenza activity is increasing. The health-unit dashboard will be updated in the next week or two to help you with this.
4 – Know whether you are eligible for anti-viral treatments like Paxlovid before you get sick. This is important for those at risk of severe illness, she said, so that if you do develop COVID-19 you can treat it more quickly. This step means contacting your primary care giver to ascertain that you are eligible for such treatment and to determine how to access it quickly.
5 – Be up to date with your vaccinations – for both influenza and for COVID-19. The universal flu immunization program is rolling out this fall, and recent announcements have been made regarding a bivalent vaccine for everyone over the age of 18 that contains elements of both the original virus and the BA1 subvariant. The ideal is to get it six months after your most recent booster for maximum immunity, though those at risk of severe illness can get it after three months.
“COVID-19 is still here,” Dr. Bocking stated.
“Provincially, what we have seen with this most recent wave of COVID-19 – whether you refer to it as Wave 7 or the third wave of Omicron or just another COVID-19 wave – this wave has not come down to base-line levels as quickly as some of our previous waves.”
This comes at a time when a new school year begins and fall weather makes people begin to gather indoors more, she pointed out.
“We certainly expect to see on-going COVID-19 activity and, quite potentially increasing over the next couple of weeks,” she predicted, adding some numbers to the picture.
Waste-water monitoring in Cobourg (as well as in Lindsay) has resulted in low numbers for viral indicators for the last couple of weeks. The test-positivity rate continues not to drop below 9.5% - the current 9.6 % level is lower than the provincial rate, though she expects that number may well begin to inch back up. And the five outbreaks they were monitoring have grown to nine with the number of new outbreaks declared in long-term-care homes. As well, the 11 hospital admissions over the past 14 days are a concern, given the stress already taxing the health-care system.
The subvariant currently circulating is BA5, and Pfizer is working on a vaccine with elements of that subvariant, but this will not be ready soon. People wondering whether to wait and hope for what promises to be quite an efficacious vaccine are advised instead to get the very effective Moderna bivalent vaccine now available in order to get protection sooner.
For those aged five to 17, the current recommendation is a booster dose six months after the initial two-dose primary series. For those aged six months to four years, no booster dose is recommended at this time.
The health unit is offering a number of clinics that can be accessed through the provincial booking system. However, the on-line system will only book appointments for those who got their last booster at least six months ago – if you feel you need your next shot sooner, book by phone through the provincial system.
Pharmacies will also have access to the new vaccine, as well some primary-care practices. And the GoVaxx bus continues to reach rural communities as well.
As for the flu shot, it is being rolled out to the most vulnerable first and should be available to the general population by November.
“There's not a single shot with both, but both can be given at the same time or during the same visit,” Dr. Bocking said.
“Continuing on the immunization theme, I did want to lend my voice to the messaging we are hearing from a number of different organizations relating to the importance of catching up on childhood immunizations.”
The interruptions COVID imposed on Canadian life mean that some routine inoculations a child might have gotten against such diseases as polio, measles, mumps and diphtheria were missed.
“We have not seen these diseases for many years, but we could stat to see them should we fall too far behind in catching up with our immunizations,” she warned.
The health unit has resumed its fall and spring immunization visits to schools, and is encouraging families with young children to ensure their vaccinations are up to date. If the family has no primary health-care provider, she added, the health unit does offer clinics that can help.
Asked if she is concerned that masking is now optional in school settings, Dr. Bocking reiterated that the rules that call for masking for 10 days after symptoms begin to improve apply to school children as well. Otherwise, she added, there are other tools in place for the children's safety – ventilation, vaccinations, hand hygiene and environmental cleaning, for example.
“This fall, as we see an increase (in COVID numbers), there might be times we encourage families to wear masks if they can until virus activity comes back down. The key is to be aware and be supportive and be mask-friendly,” she urged.
Looking ahead, she considers a good way to preview what we might be in for this fall is to look at what has been happening to countries in the southern hemisphere (like Australia).
“In many of these countries, they started to see influenza earlier than expected, so we might see that here,” Dr. Bocking said.
“We have not seen any countries that have seen a very significant surge in influenza, so I think we are quite hopeful that – with vaccines and awareness of other measures, including masking and hand-hygiene – it can help prevent the spread of influenza, so this season we won't see a sudden spike of a new strain of influenza.”
