Signs are emerging that indicate the start of a summer wave of COVID-19 in Ontario, warns the head of the province’s scientific advisory board.
Dr. Fahad Razak, scientific director of the science table, notes an increase in the COVID wastewater signal, increased test positivity, and an increase in public health units experiencing exponential growth in cases.
There has been a gradual increase in the wastewater signal across the province since early June along with the positivity of the tests which has increased over the last three or four weeks. Then there is the fact, he says, that about 40 percent of public health units now have more than one reproduction number, all of which shows that the province has entered another wave.
“Putting it all together, I think we’re seeing the start of a wave,” Razak said. “But it doesn’t seem to have the intensity in terms of amplitude or rhythm of what we saw with the start of the Omicron wave. It’s not clear how quickly it will increase and what the peak will be.
“Based on everything we’re seeing, both in Ontario and globally, it’s likely to be a less severe wave than we’ve experienced in the past with less direct pressure on the health care system.”
Razak’s red flag arrives when the National Advisory Committee on Immunization recommended this week that additional reinforcements be given to a larger part of the population in the fall. Other regions are also seeing an increase in hospitalizations driven by Omicron subvariants, including Quebec, which recently experienced an increase in community transmission and cases in health care workers.
Meanwhile, the World Health Organization reports that infections are growing in 110 countries driven by the BA.4 and BA.5 subvariants, leading to an overall 20% increase in global cases.
Several infectious disease experts say a fourth dose should now be offered to all residents before a possible wave of falls, while others say only those who are considered most at risk should receive a second boost.
“If you’re someone at higher risk or you’re in a situation where you’re very exposed because you’re on TTC twice a day, in and out of work or something, it would be very reasonable to go get that fourth shot. now, ”Razak said. “On the other hand, if you are at low risk and have very little daily exposure, it is reasonable to wait to receive this booster dose until you are closer to the fall or, more specifically, there is an increase.”
At a news conference Thursday, Dr. Theresa Tam, Canada’s director of public health, said the updated vaccines are the “foundation of our protection” and that those who received two doses and a booster vaccine had rates of hospitalization five times higher. lower than unvaccinated people during the Omicron wave in April and May.
He also reiterated NACI recommendations that people at risk for serious illness now receive a fourth injection, as reinforcements “increase protection by activating your immune response to restore protection that may have diminished over time.”
Dr. Gerald Evans, president of the Infectious Diseases Division at Queen’s University, said it is unclear whether the fourth doses will be effective enough against BA.4 and BA.5 for the older population. These subvariants have an alteration within their genomes, making it more difficult for antibodies to bind to ear proteins, making these variants more likely to evade the immune system, he explained.
Pfizer and Moderna are developing Omicron-specific vaccines, known as bivalent vaccines, that will likely be available in the fall. Both companies say they have tested their vaccines and appear to be very effective against Omicron, and plan to send their data to governments in the coming months.
“I totally agree that we should launch reinforcements in the fall,” Evans said. It predicts that a wave will occur in late fall or early winter, and another will follow in late winter or early spring because this is how COVID-19 virus has previously behaved, similarly to other diseases of the coronavirus category, he said.
The NACI also announced in a statement Wednesday that another dose may be offered to all people ages 12 to 65 in the fall, regardless of the number of previous doses, but that recommendation is “discretionary” and is not classified as a recommendation. strong.
These groups include all residents over the age of 65; people 12 years of age or older who have underlying medical conditions; Indigenous adults; racialized and marginalized communities that have been most affected by the virus during the pandemic; migrant workers; residents of reception centers, prisons and collective residences.
Recommendations will be given on the type of COVID-19 booster dose that should be offered as evidence of bivalent vaccines emerges.
The NACI said in a press release that “cases of COVID-19, including hospitalizations and associated deaths, are currently declining in Canada. However, the likelihood, timing and severity of a future wave of COVID- 19 are uncertain. “
Colin Furness, an infection control epidemiologist at the University of Toronto, said he fears the growing signs Ontario is experiencing could mean we are approaching endemicity.
“My belief is that when we took off our masks at the TTC, we started harmonizing different wastewater signals across the GTA. In other words, mixing people in the TTC will only make the signal from a water treatment plant residuals go down, it will make the others match, ”he said.
“If you think about it logically, this kind of timing, this is a path to endemicity. Not a wave that comes and then goes down, but a new normalcy where the line is flat but at a very high level.”
He added that the elevations of wastewater signs, as well as cases in public health units, reflect the fall in mask warrants earlier this month.
“It simply came to our notice then. It is the mentality that accompanies it. We see more and more people who should know better than behaving in crazy, risky behavior, “Furness said.” If I can be at the TTC and I don’t need to wear a mask, I can go out to dinner because it’s obviously less dangerous and if so, I can definitely go see a movie.
“It’s making self-destructive logic take over.”
Olivia Bowden is a Toronto-based Star journalist. Contact her by email: obowden@thestar.ca
Kenyon Wallace is a Star investigative journalist in Toronto. Follow him on Twitter: @KenyonWallace or contact him by email: kwallace@thestar.ca