Pandemic Update August 2021

I want to provide a pandemic update in response to the situation we are facing with a Delta-driven fourth wave.

BC is experiencing a surge of cases driven primarily by unvaccinated individuals and under-vaccinated communities. While BC’s overall vaccine coverage is world-class — 82% of eligible people have one dose and 72% are fully vaccinated — there are pockets where vaccination rates remain low, and children <12 are not yet eligible for vaccination.

While the Interior region has had the most cases per capita by far, the number of cases is rising in all regions. Pressure is building in some hospitals, particularly in the Interior. The BCCDC COVID-19 Regional Surveillance Dashboard provides data on cases, test positivity rates, and vaccination progress for each local health area:

BC data shows that the vaccines continue to provide significant protection even in the presence of the Delta variant. The source of clusters and outbreaks is unvaccinated, rather than vaccinated, individuals. Indeed, a number of recent long-term care outbreaks have been traced to unvaccinated staff members. The number of ‘breakthrough’ infections remains small in comparison to the millions of British Columbians who are fully vaccinated. Healthy vaccinated individuals with breakthrough infections have tended to have milder illness or no symptoms at all. Breakthrough infections with poor outcomes have tended to be among older patients with more comorbidities.

The PHO is ordering all staff in long-term care to be vaccinated by October 12. I have indicated to Dr Henry that doctors would support further and more aggressive mandates, including mandatory vaccinations across the healthcare and education sectors.

The federal government has announced mandatory vaccinations for federal workers, airline and train passengers. The province of Ontario is moving to mandate vaccines for all hospital and long-term care workers, as well as pausing their reopening plans. A number of Canadian universities are moving to mandate vaccinations and masks on their campuses. Even Alberta is taking a step back in response to the growing number of hospitalizations in that province.

It’s clear where the trend is going: mandatory vaccinations, vaccine passports, measures to protect schools and post-secondary institutions, and delaying  reopening plans until the situation stabilizes.

The province indicates that the guidance for the upcoming K-12 school year is nearing completion. While we would all like to see the guidance sooner, they are taking time to account for recent developments. I have spoken to the Medical Health Officers responsible for our largest school districts, and I am confident that they are taking the safety of our children very seriously. MHOs are doctors and parents too.

Let me digress a moment to discuss kids in more detail. Many of you are parents, and I know people are worried. The reports out of US states like Arkansas and Florida have been alarming. There are a few things to note. First, the vaccination rates in these states are appalling. Arkansas has fully vaccinated only 36% of its population. A few days ago, the Arkansas Children’s Hospital was reported to have 22 children admitted to ICU with COVID-19, half of whom were vaccine eligible but none had been vaccinated. Second, states like Florida have allowed COVID-19 to run wild, with tens of thousands of new cases a day. I have had no indication from any public health official in BC that these levels of infection would be tolerated. The boom was lowered in the Interior long before per capita counts rose that high. Third, there has been little COVID activity at Canadian pediatric hospitals throughout the pandemic. I spoke to a physician at BC Children’s Hospital who has seen zero cases of COVID in the past 30 days, despite liberal testing. He understands that there were only 2 positive cases across the entire emergency department for the month. Canada’s high vaccination rates and public health measures have largely shielded our children from harm – ongoing vigilance is so important. Vaccines are very likely on their way for under-12s, possibly by the end of 2021.

I appreciate that we would all like for this to be over. I understand the frustration, anger, and worry. I won’t sugarcoat a serious situation. However, by now we know what needs to be done to mitigate the spread of COVID-19. We have as much vaccine as we need. We are seeing a growing willingness to employ strong policy measures such as vaccine passports and mandatory vaccination in vulnerable settings. Doctors of BC will continue to advocate for measures to protect you, your patients, and all vulnerable people. I expect more announcements federally and provincially in the coming days and weeks.

- Dr Matthew Chow