Table of Contents
- The Crooked Timber of Mankind
- SARS – The illness is sudden acute respiratory syndrome, a serious illness systematically described during and after the SARS outbreak of 2002-2003. SARS affects the organs of the respiratory system, like an influenza, but is SARS-CoV-2 is not an influenza A virus.
- CoV – coronavirus. SARS-CoV-2 is a:
- 2 – The virus that caused the SARS epidemic in 2002-2003 was SARS-CoV-1.
- contagious – it infects people easily and infects more people; and
- virulent – many infected people experience severe symptoms.
An outbreak of an infectious disease is a crisis if the illness cannot be treated and or resolved naturally without consequences. Epidemics are outbreaks of infectious diseases that occur when the number of infected persons increases rapidly. Pandemics are large epidemics. SARS-CoV-2 became an epidemic in December 2019, and as a pandemic in March 2020. Features of this infectious disease were apparent by January 2020:
- Pre-symptomatic (infected, but not sick enough to show symptoms of illness) persons could transmit the virus;
- The virus was airborne – an infected person could transmit the virus by exhaling and an uninfected person could be infected by inhaling.
In many infectious diseases animals infect humans by transmitting a pathogen – e.g. mosquitoes carry a parasite that causes malaria – but humans with the disease do not transmit the pathogen. The SARS-CoV-2 disease began as a spillover, or zoonotic outbreak in Wuhan, a city on Yangtze river in Hubei province in central China in late 2019. Previously a related SARS-CoV virus had infected bats that denned in caves in Yunnan province in southwestern China, several hundred Km. from Wuhan. The bat virus had spilled over and infected miners working in bat-infested caves in 2012. Chinese scientists had collected sample of bat viruses since the outbreak of SARS in 2002, and had collected samples from the Yunnan caves. The lab leak theory explains how the virus reached Wuhan and spilled over more credibly than other theories. It was not supported by scientists at first, and discouraged to avoid antagonizing the Chinese government, or to minimize knowledge of the scope and risks of scientific research into viruses.
A widespread endemic disease with a stable number of infected individuals is not an epidemic. Since the beginning of the Covid-19 epidemic, scientists and pundits speculated – with wide publicity – that SARS-CoV-2 would become an endemic illness. Endemic refers to repeated infections by a pathogen that has not been eradicated – a pathogen that will infect humans for a long time or forever. Endemic diseases can be serious. People heard about endemic often and many people began to think it meant mild illness.
Infectious Diseases in History
Notable infectious diseases:
- The Spanish flu 1918-1920 (actually it orginated in the Kansas and went to Europe with Americans in WWI) was the largest pandemic of the 20th century. It was a zoonotic viral disease. The virus was an influenza A virus in the H1N1 lineage – crossover of a swine flu. The pandemic was controlled with public health measures, and ended when the virus stopped being transmitted to new victims. A vaccine was not developed or used.
- The viral disease smallpox caused several epidemics and pandemics. It was one of the first infectious diseases which was controlled by vaccination. It may have been extirpated.
- The bubonic plague, which ravaged Eurasia, in the Plague of Justinian and as the Black Death was caused by a bacterium hosted by lice that infest rodents. Infected lice are still passing on the disease to lice somewhere. A vaccine was developed, but vaccination against this illness is not common in the countries on the American continents.
- Tuberculosis is a bacterial disease. It has become rare in Europe and North America and can be treated but remains a serious public health problem in most of the world.
- Polio is a viral infectious disease. There were epidemics in the United States and Canada as recently as 1950. It has been controlled with a vaccine and was believed to have been extirpated in the Americas. In 2022 outbreaks were noted in Afghanistsan, Pakistan, parts of Africa, Israel, and the U.K. A case was recorded in the U.S.A.
Smallpox and other illnesses affecting Indigenous residents of the Americas were introduced by contacts with Europeans in the 16th,17th and 18th centuries. America’s distance from Europe, Africa and Asia protected the living residents of the lands now occupied by the USA and Canada from many later epidemics and pandemics. Americans in America were infected during a few major outbreaks of the infectious diseases above in the 19th, 20th and early 21st centuries. People in the other parts of the world were affected by pandemics and serious epidemics in the 150 years before 2020 including:
- “Russian Flu“, the viral pandemic in Russia and central Asia 1889-1890;
- “Asian Flu“, the pandemic outbreak of the A/H2N2 virus in southern China in South Asia 1957-1958;
- The 7th pandemic of the bacterial illness, Cholera, in Southeast Asia 1961-1975;
- “Hong Kong Flu”, a pandemic outbreak of the H3N2 virus in Hong Kong, China and South Asia 1968-69;
- 1977 Russian Flu, an outbrief of an H1N1 lineage virus, Influenza A/USSR/90/77
- HIV/AIDS, a pandemic outbreak of the HIV virus;
- SARS (Severe Acute Respiratory Syndrome), the 2002-2004 epidemic outbreak of the SARS-CoV-1 virus in South Asia;
- MERS (Middle East respiratory syndrome) a series of epidemics 2012-2021 on the Arabian peninsula associated with zoonotic outbreaks of the MERS coronavirus.
Some people survived diseases, and did not become reinfected. Eventually medical science explained the model of the immune system. Medical practitioners after trial and error experiments started vaccination against smallpox by the end of the 18th century.
Breakthrough infections occur when vaccinated individuals (or individuals believed to have recovered from an infection) becomes infected with the illness, because the indidual’s immune system, which has been strengthened by a vaccine or experience with an earlier infection has failed to provide complete immunity against the pathogen.
Covid-19 in 2019-2021
There had been no vaccines for the Covid-19 virus in 2020. The American government subsidized vaccine development and expedited regularatory processes. The Warp speed program affected the development of vaccines effective against the virus by the ended of 2020. The Pfizer and Moderna vaccines protected people from infection with the original virus, and provided protection from the severity of the illness caused by infection with some of the variants . The campaigns in the first part of 2021 to vaccinate adults in the USA and Canada, including BC, with two doses of those vaccines were regarded as successful. The leaders of drug companies said, in 2021, that they could produce new vaccines to immunize people against variants of Covid-19. The public health officials were hopeful.
When vaccines do not provide immunity, and an illness cannot be treated with a medication, healthy people should avoid contact with persons who can transmit the pathogen. Government heatlh officials/authorities used non-pharmaceutical interventions (“NPI”) in 2019 and 2020, mainly aimed at reducing social contacts:
- Lockdowns and some other NPIs shut down travel, hospitality and retail industries in North America and Europe. Lockdowns in Asia, including the Republic of China affected resource extraction, manufacturing, transportation and commerce.
- The American federal government and some other governments subsidized the development of vaccines, as noted.
- Other governments committed to buy the vaccines. The vaccines were developed, approved, manufactured, distributed and used by early 2021;
- Scrubbing surfaces and handwashing may have helped, but may have been theatrical;
- Masks initially said by public health officials in North America to not be to protect individuals from inhaling the virus and to not prevent individuals from transmitting the virus. Masks were policy in the Republic of China.
The initial North American public health advice may have been stated to prevent runs on masks in the early months before masks became more easily available but the public health advice and policy shifted:
In February and March , Fauci, the World Health Organization, and the CDC all recommended against protective masks for non-symptomatic members of the public. Their line was: don’t bother. On February 19, Fauci told USA Today, “In the United States, there is absolutely no reason whatsoever to wear a mask.” On March 8, as scientists estimated tens of thousands of undetected Covid cases in the US, Fauci told 60 Minutes, “There’s no reason to be walking around with a mask. When you’re in the middle of an outbreak, wearing a mask might make people feel a little bit better and it might even block a droplet, but it’s not providing the perfect protection that people think that it is.” In the same interview, laying the foundation for a fog of disinformation that is still very much with us, Fauci suggested wearing a mask might actually increase the risk of contracting the virus, “Often, there are unintended consequences — people keep fiddling with the mask and they keep touching their face.”
Two weeks later, at an April 3 press briefing, the White House reversed its guidance. Now authorities were advising us to wear “non-medical cloth” face-coverings in public spaces. (Fauci didn’t attend that briefing, prompting a round of “where is Fauci?” speculation from his fans on Twitter, but also sparing him the embarrassing display.) Surgeon General Adams, who had tweeted on February 29, “Seriously people- STOP BUYING MASKS! They are NOT effective in preventing general public from catching #Coronavirus,” acknowledged that the shifting guidance had been “confusing to the American people.” … And Trump, adopting a vague and unhelpful line on masks, one he’d maintain basically until contracting the virus himself, said, “It’s going to be, really, a voluntary thing. You can do it. You don’t have to do it. I’m choosing not to do it, but some people may want to do it, and that’s okay. It may be good.”
The flip-flop was a blow to the integrity of public health experts. It fueled and credited the suspicions of conspiracists — right-wing media outlets continue to insist that masks don’t help, cause health problems, and that mandating them is an oppressive imposition of the liberal nanny state. And it provided an opening for Trump to sow further doubt and confusion.Sam Adler-Bell, The Drift, January 24, 2021, Doctor Do-Little | The Case Against Anthony Fauci
Masking policy did not require highly effective masks, and was not enforced rigorously. Masking was an effective NPI in Europe, North America and other areas where vaccinations had been widely administered. NPIs became “mandates” in 2021:
- requiring proof of vaccination to work, enter public spaces or obtain services, and
- masking for access to places where people gather.
The mask mandate became a principal enforced NPI in the Canadian province, British Columbia (“BC”) by mid-2021 when over 70% of the adult population had received two doses of the approved vaccine. Combined with other measures, including investment in vaccines, moderate NPI measures worked. In the absence of provincial government rules, businesses could recommend that customers and visitors wear masks in indoor public places, but could not require it. The BC indoor mask rule was removed briefly in the summer of 2021, on the assumption that the vaccine program had immunized enough people to make the public safe. Masks became uncommon and public spaces including restaurants, food courts, stores and malls got busy. As the restrictions were lifted, infections went up. The BC mask mandate was restored by the end of August 2021, and several other NPIs were left in place until March 2022.
Several variants of Covid-19 caused by mutations were discovered; several variants were identified by the World Heath Organization as variants of concern. Several variants that evolved and circulated, including Alpha, Beta, Gamma and Delta. Several were virulent and contagious.
The Canadian federal government and provincial governments collected data about infections and severity of illness. The data was published on the Web in daily data dashboards through to the end of 2021
Covid-19 variant B.1.1.529, also known as BA1, (the standard Omicron), was reported in South Africa in November 2021. It spread rapidly. It appeared to become prevalent, and has mutated into new lineages. BA1 Omicron was more contagious than other variants, but less severe. The vaccines, although they did not provide immunity, mitigated the severity of respiratory symptoms in healthy young and middle aged adults. It was in Canada by November 2021. The need for boosters was clear by November. In January 2022, Canadian public health officials confirmed that Canada, like the USA, was experiencing a fifth wave of Covid-19 infection and illness. Canadian governments began to run to administer “booster” doses of vaccine in late December 2021 and January 2022. In BC 1st vaccine boosters (3rd shots) were administered in December 2020 and January 2021. The government did not get the clinics set up in time to administer the shots until the end of the year.
The journalist David Leonhardt argued, in the New York Times Morning Newsletter, that the Omicron variant was causing milder illness. He suggested that the great majority of people in America could live with Omicron:
Somebody infected with Omicron is less likely to need hospital treatment than somebody infected with an earlier version of Covid. …. Hospitalizations are nonetheless rising in the U.S., because Omicron is so contagious … …. Omicron is not just less likely to send somebody to the hospital. Even among people who need hospital care, symptoms are milder on average than among people who were hospitalized in previous waves. A crucial reason appears to be that Omicron does not attack the lungs as earlier versions of Covid did. Omicron instead tends to be focused in the nose and throat, causing fewer patients to have breathing problems or need a ventilator.
Dr. Leana Wen, Baltimore’s former health commissioner, wrote a helpful Washington Post article in which she urged a middle path between reinstituting lockdowns and allowing Omicron to spread unchecked. “It’s unreasonable to ask vaccinated people to refrain from pre-pandemic activities,” Wen said. “After all, the individual risk to them is low, and there is a steep price to keeping students out of school, shuttering restaurants and retail shops and stopping travel and commerce.” But she urged people to get booster shots, recommended that they wear KN95 or N95 masks and encouraged governments and businesses to mandate vaccination. All of those measures can reduce the spread of Covid and, by extension, hospital crowding and death.
What about elderly or immunocompromised people, who have been at some risk of major Covid illness even if they’re vaccinated? Different people will make different decisions, and that’s OK. Severely immunocompromised people — like those who have received organ transplants or are actively receiving cancer treatment — have reason to be extra cautious. For otherwise healthy older people, on the other hand, the latest data may be encouraging enough to affect their behavior. … Before Omicron, a typical vaccinated 75-year-old who contracted Covid had a roughly similar risk of death — around 1 in 200 — as a typical 75-year-old who contracted the flu. … Omicron has changed the calculation. Because it is milder than earlier versions of the virus, Covid now appears to present less threat to most vaccinated elderly people than the annual flu does. The flu, of course, does present risk for the elderly. And the sheer size of the Omicron surge may argue for caution over the next few weeks. But the combination of vaccines and Omicron’s apparent mildness means that, for an individual, Covid increasingly resembles the kind of health risk that people accept every day.David Leonhardt, New York Times Morning Newsletter, January 5, 2022, Omicron Is Milder
The medical/scientific view was cautious. A web page published by Johns Hopkins University discussed breakthough infections of omicron variants, and the known risks:
A variant of concern has been observed to be more infectious, and is more likely to cause breakthrough infections or reinfections in those who are vaccinated or previously infected. These variants are more likely to cause severe disease, evade diagnostic tests, or resist antiviral treatment. Alpha, beta, gamma, delta and omicron variants of the SARS-CoV-2 coronavirus are classified as variants of concern.
A variant of high consequence is a variant for which current vaccines do not offer protection. As of now, there are no SARS-CoV-2 variants of high consequence.
In November 2021, a variant of the SARS-CoV-2 coronavirus emerged and was named omicron by the WHO, which lists it as a variant of concern. Cases of the highly contagious variant, including a subvariant called BA.2, or “stealth omicron,” have caused surges of COVID-19, particularly in areas where safety precautions have been relaxed. “The omicron variant is responsible for the largest surge since 2019,” says Maragakis. “Omicron has a large number of mutations that all appeared at once. It’s very different from previous versions, including delta. It has over 50 mutations, many in the spike protein, which is how it gets into our cells in the first place. The spike protein is also one of the most prominent exterior features of the virus that our immune system recognizes, responds to and uses to develop antibodies. Unfortunately, omicron is a perfect storm: Mutations gave it the ability to escape weak immune responses AND become more transmissible from person to person.”
Omicron and BA.2: Do they cause more severe illness? Bollinger says, “The answer appears to be no. In fact, there is evidence that omicron may cause less severe disease than the delta variant.” “What we see is that omicron may have more of an affinity for our upper airways than our lower airways, and can be more easily spread through talking, coughing or breathing, especially from people without masks on. Omicron also may have more potential for airborne aerosolization of the virus, hanging in the air in indoor settings,” Maragakis says.
Are omicron and BA.2 more contagious than other variants of the coronavirus? Omicron and especially its subvariant, BA.2, are very contagious, more so than the original coronavirus or the delta variant.
“In the meantime, we need to continue all of our efforts to prevent viral transmission, by practicing safety precautions, vaccinating as many people as possible as soon as we can and encouraging boosters among those who are eligible,” says Bollinger. Ray concurs. “Vaccines and boosters are the medical miracle of 2020, but we also need to reemphasize basic public health measures. We have tools at hand that enable individuals to manage risk, including wearing high-quality masks or respirators. Those rated FFP2 or FFP3 are more protective than cloth masks, and often easier to wear. Hand-washing and avoiding large indoor gatherings, especially with unmasked people, are other ways to mitigate the risk of infection.” Maragakis says, “The basics work, and everyone should be aware that anyone can have this virus now. If you get yourself into that mindset and act accordingly, then if you get that call that someone you know is positive, if you’ve been vigilant, you can know you’re safer.”Johns Hopkins University, Health page, “COVID Variants: What You Should Know” as of April 2022
The CBC News Second Opinion post Almost half of Canadians may have caught COVID reported:
Canada’s bold decision to delay and mix doses of COVID-19 vaccines led to strong protection from hospitalization and death, but the emergence of Omicron and its subvariants rendered them less protective against infection than previous virus strains.
…. new study … published in Clinical Infectious Diseases, that showed two doses of mRNA vaccines or AstraZeneca “gave substantial and sustained protection” against hospitalization from Delta, up to November 2021.
While vaccine effectiveness against severe outcomes has held up well, two-dose protection against Omicron infection fell dramatically in December, dropping to just 36 per cent, according to one Ontario preprint study, with boosters raising it to 61 per cent. That significant hit to our population immunity underscored the need for boosters and left us highly susceptible to Omicron-fuelled fifth and sixth waves that have since ripped through the population.Adam Miller, CBC News, Second Opinion (column). April 23, 2022, Almost half of Canadians may have caught COVD
The CBC addressed Omicron variants and subvariants in another “Second Opinion” post:
“Let’s be honest, the virus is in control here, not us,” said Dr. Michael Gardam, an infectious diseases physician, medical director of infection prevention and control at Women’s College Hospital in Toronto and CEO of Health PEI. “We’re entirely at the whim of whatever random evolutionary events occur and it’s really hard to predict.”
Tulio de Oliveira, the director of South Africa’s Centre for Epidemic Response and Innovation, said South Africa has had a high level of population immunity with over 90 per cent estimated to have been previously infected, vaccinated or both. “That’s one of the reasons why we believe that the big Omicron wave that we had didn’t translate to a very high number of hospitalizations and deaths,” he said. “And BA.2, despite emerging and going on to dominate all the infections in South Africa, did not translate into an uptick of infection, which was very different in Europe, where they had a BA.1 wave followed by a BA.2 wave.” That double whammy of Omicron’s BA.1 and BA.2 hit Canada hard as well, fuelling a devastating fifth wave late last year that subsided right as BA.2 sparked a smaller sixth wave in April — but it also drove up our levels of population immunity. “It gives you a sense that the more people who are infected with this and are vaccinated, the better you are at weathering it,” said Gardam. “The hope is it starts to become like the other coronaviruses that infect us every year that cause colds … and eventually it’s pretty hard for the virus to come up with something so novel that you haven’t seen part of it before.”
As a result, Omicron and its subvariants completely changed Canada’s immunity landscape over the past few months. Previously, Canada was more in line with a country like South Korea given our high vaccination rates and previously low levels of prior infection, de Oliveira said, with much of the country seeing relatively low levels of COVID throughout the pandemic. With Omicron, we were more similar to countries like South Africa and the U.S. with much higher levels of population immunity — but our high vaccination rate protected us. “What that means is that potentially as new variants and subvariants of Omicron emerge … that may translate in a relatively high number of infections, but potentially not in a very high rate of hospitalization and death,” he said. “Look at wave one, it was a very small wave but there were a lot of hospitalizations,” said Gardam. “Then finally Omicron hit and the spike in infections was insane, but the death rate never got as high as it did in earlier waves. So we are getting better at fighting this off.”Adam Miller, CBC News, Second Opinion column, April 30, 2022, What could ‘COVID season’ actually look like, New variants, waning immunity make it hard to predict when the next wave will hit .
NBC News discussed remarks by Dr. Anthony Fauci, director of the USA National Institute of Allergy and Infectious Diseases April 27, 2022:
“Namely, we don’t have 900,000 new infections a day and tens and tens and tens of thousands of hospitalizations and thousands of deaths. We are at a low level right now,” he said. In comments Wednesday to The Washington Post, however, Fauci seemed to clarify his earlier remarks, saying that unlike the “full-blown explosive pandemic phase” during the brutal winter omicron surge, he was describing what appears to be a period of transition toward the coronavirus becoming an endemic disease. “The world is still in a pandemic. There’s no doubt about that. Don’t anybody get any misinterpretation of that. We are still experiencing a pandemic,” Fauci told the Post.
U.S. cases are far lower than they were in recent months. But health officials are keeping a close eye as highly contagious variants continue to spread. The Centers for Disease Control and Prevention says cases have risen about 25% in the past week. Meanwhile, Fauci decided not to attend Saturday’s White House Correspondents’ Association dinner amid concerns about COVID-19, telling The New York Times on Tuesday that his decision was based on “my individual assessment of my personal risk.”Associated Press/NBC News, April 27, 2022, Fauci Says U.S. Is Transitioning Out of ‘Pandemic Phase’ of COVID-19
The media began to mention “stealth Omicron”, the Omicron subvariant BA.2 which was more contagious than B.1.1.529, and more virulent, and other subvariants, . By early May 2022, Omicron variant BA 2.12.1 was the source of 43% of new infections in the USA. May 12, 2022, the news media reported “U.S. surpasses 1 million COVID-19 deaths: A look at the numbers“.
On May 16, 2022, Apoorva Mandavilli , writing in the New York Times “Daily Covid Briefing” addressed the implications of Covid-19 becoming endemic, noting:
This is not how it was supposed to be. Earlier in the pandemic, experts thought that immunity from vaccination or previous infection would forestall most reinfections. The Omicron variant dashed those hopes. Unlike previous variants, Omicron and its many descendants seem to have evolved to partially dodge immunity. That leaves everyone — even those who have been vaccinated multiple times — vulnerable to multiple infections. “If we manage it the way that we manage it now, then most people will get infected with it at least a couple of times a year,” said Kristian Andersen, a virologist at the Scripps Research Institute in San Diego. “I would be very surprised if that’s not how it’s going to play out.”
The new variants have not altered the fundamental usefulness of the Covid vaccines. Most people who have received three or even just two doses will not become sick enough to need medical care if they test positive for the coronavirus. And a booster dose, like a previous bout with the virus, does seem to decrease the chance of reinfection — but not by much.
At the pandemic’s outset, many experts based their expectations of the coronavirus on influenza, the viral foe most familiar to them. They predicted that, as with the flu, there might be one big outbreak each year, most likely in the fall. The way to minimize its spread would be to vaccinate people before its arrival. Instead, the coronavirus is behaving more like four of its closely related cousins, which circulate and cause colds year round. While studying common-cold coronaviruses, “we saw people with multiple infections within the space of a year,” said Jeffrey Shaman, an epidemiologist at Columbia University in New York. If reinfection turns out to be the norm, the coronavirus is “not going to simply be this wintertime once-a-year thing,” he said, “and it’s not going to be a mild nuisance in terms of the amount of morbidity and mortality it causes.”Apoorva Mandavilli, New York Times, Daily Covid Briefing, May 16, 2022, “How Often Can You Be Infected With the Coronavirus“
A criticism of the positivity of the USA:
BA.2.12.1 is quite distinct from Omicron BA.1 and BA.2. … there is a key, unique mutation L452Q. The other important Omicron subvariants currently, BA.4 and BA.5, have multiple different mutations (including L452R, F486V and R493Q) from BA.2, and account for the new wave of cases in South Africa, and more recently in Portugal, and have just been labelled as VoC (variants of concern) by the European Centre for Disease Prevention and Control. Both BA.2.12.1 and BA.4/BA.5 pose a further challenge to our immune system recognition, with minimal cross-immunity derived from BA.1.
… now multiple Omicron subvariants are outcompeting one another, predominantly because of more immune evasion, such that BA.2 with 30% more transmission overtook BA.1, and BA.2.12.1 (in parallel to BA.4 and BA.5) has a substantial transmission advantage over BA.2. …
… a breakdown of protection from transmission occurred with Omicron with “breakthroughs” in people with vaccination occurring quite commonly. That, and reinfections, were an unusual phenomenon (~1%) before Omicron. Now we are seeing people with 4 shots who are getting breakthrough infections, even at 1-2 weeks from their most recent shot, when there should be the maximal level of neutralizing antibodies induced. That’s not a good sign, relative to the 95% vaccine effectiveness we had against symptomatic infections against the ancestral, D614G, Alpha, and Delta (with a booster) strains.
… we have relied (and taken for granted) on vaccines to protect us from severe disease—to prevent hospitalizations and deaths. Prior to Omicron we could, with a booster, assume there was well over 90-95% vaccine effectiveness vs severe disease. It is clear, however, from multiple reports … that this level of protection has declined to approximately 80%, particularly taking account the more rapid waning than previously seen. That represents a substantial drop-off …
… we have a highly unfavorable picture of: (1) accelerated evolution of the virus; (2) increased immune escape of new variants; (2) progressively higher transmissibility and infectiousness; (4) substantially less protection from transmission by vaccines and boosters; (5) some reduction on vaccine/booster protection against hospitalization and death; (6) high vulnerability from infection-acquired immunity only; and (7) likelihood of more noxious new variants in the months ahead.
During the Delta wave in the United States, vaccinated individuals accounted for 23 per cent of the deaths, whereas this nearly doubled to 42 per cent during the Omicron wave. This is attributable to waning of protection, lack of boosters, and the diminished protection against Omicron (BA.1).
While the policy of zero Covid is untenable with Omicron … we should adopt the new policy of Zero Covid Deaths. This is diametrically opposed to Covid capitulation. This builds, in part, on the tools that we already have, knowing that the vast majority of deaths occur in people age 60 plus (92% of US hospitalizations have been in people age 50+). All such people need to have vaccination and booster coverage but our CDC has failed to convey their life-saving impact from the get go, a veritable booster botch job … we have 31% of Americans who had had 1 booster shot whereas most peer countries are double that proportion. And why we rank 60th in the world’s countries for boosters, and especially poorly among older Americans compared (<65%, age 60+) with many Western Europe and Asian Pacific countries (~85-90%). That doesn’t even speak to the need for a 4th dose in this high-risk group or that lack of intensive monitoring of our 7 million immunocompromised people who are not getting help to guide their protection with assay of neutralizing antibodies, or receiving Evusheld monoclonal antibody preventive protection. But well beyond the use of boosters and vaccines, and easy, rapid access to Paxlovid, we absolutely need an aggressive stance to get ahead of the virus—for the first time since the pandemic began—instead of surrendering. That means setting priorities, funding, and the realization, unfortunately, that the pandemic is far from over.Eric Topol, Substack, May 15, 2022, The Covid Capitulation
Katherine J. Wu wrote about vaccines and public health issues in 2022 in the Atlantic:
- February 24, 2022 “We Might Not Need Annual COVID Shots“;
- April 12, 2022 “America Created Its Own Booster Problems“;
- April 15, 2022 “Have We Already Ruined Our Next COVID Summer?“;
- May 4, 2022 “America Is Starting to See What COVID Immunity Really Looks Like“;
- May 13, 2022 “The U.S. Is About to Make a Big Gamble on Our Next COVID Winter“;
- May 23, 2022 “Vaccines Are Still Mostly Blocking Severe Disease“;
- May 27, 2022 “You Are Going to Get COVID Again … And Again … And Again“
- June 10, 2022 “A Negative COVID Test Has Never Been So Meaningless“
Ed Yong, also writing in the Atlantic, wrote :
… The CDC’s [Center for Disease Control] current guidelines effectively say that Americans can act as if COVID is not a crisis—until hospitalizations reach a high enough threshold. The country still may be heading to that point. Hospitalizations are climbing in 43 states, especially in the Northeast. In Vermont, the rate of new admissions has already neared the peak of the recent Omicron surge. Earlier this month, “three different emergency-room docs said this is by far the worst that COVID has been at any point,” Tim Plante, an internist at the University of Vermont, told me. “They’re bewildered that it’s happening again.” Meanwhile, people in most of New York City are now advised to mask indoors again, after rising hospitalizations triggered the CDC’s “high” alert level.
America’s current pandemic strategy is predicated on the assumption that people can move on from COVID, trusting that the health-care system will be ready to hold the line. But that assumption is a fiction. Much of the system is still intolerably stressed, even in moments of apparent reprieve. And the CDC’s community guidelines are set such that by the time preventive actions are triggered, high levels of sickness and death will be locked in for the near future. For many health-care workers, their mental health and even their commitment to medicine are balanced on a precipice; any further surges will tip more of them over. “I feel like I’m holding on by a thread,” Marina Del Rios, an emergency physician at the University of Iowa, told me. “Every time I hear a new subvariant is coming along, I think: Okay, here we go.”Ed Yong, The Atlantic, May 18, 2022, What COVID Hospitalization Numbers Are Missing
The journalist David Leonhardt argued, in the New York Times Morning Newsletter, that people could mask themselves but that mask mandates should end:
From the beginning of the pandemic, there has been a paradox involving masks. … Masks reduce the spread of the Covid virus by preventing virus particles from traveling from one person’s nose or mouth into the air and infecting another person. Laboratory studies have repeatedly demonstrated the effect.
In U.S. cities where mask use has been more common, Covid has spread at a similar rate as in mask-resistant cities. Mask mandates in schools also seem to have done little to reduce the spread. Hong Kong, despite almost universal mask-wearing, recently endured one of the world’s worst Covid outbreaks.
… the effect of vaccines on severe illness is blazingly obvious in the eographic data: Places with higher vaccination rates have suffered many fewer Covid deaths. The patterns are clear even though the world is a messy place, with many factors other than vaccines influencing Covid death rates.
The idea that masks work better than mask mandates seems to defy logic. … The main explanation seems to be that the exceptions often end up mattering more than the rule. The Covid virus is so contagious that it can spread during brief times when people take off their masks, even when a mandate is in place.David Leonhardt, New York Times Newsletter, May 31, 2022, Why Masks Work, but Mandates Haven’t
June 23, 2022 and 28, Katherine Wu wrote in the Atlantic:
At the start of the vaccination campaign, getting dosed up was relatively straightforward. In the United States, a pair of Pfizer or Moderna shots (or just one Johnson & Johnson), then a quick two-week wait, and boom: full vaccination, and that was that. The phrase became a fixture on the CDC website and national data trackers; it spurred vaccine mandates and, for a time in the spring and summer of 2021, green-lit the immunized to doff their masks indoors.
Then came the boosters. Experts now know that these additional shots are essential to warding off antibody-dodging variants such as the many members of the Omicron clan. Some Americans are months past their fifth COVID shot, and the nation’s leaders are weighing whether vaccinated people will need to dose up again in the fall. To accommodate those additions, the CDC has, in recent public communications, tried to shift its terminology toward “up to date.” Katelyn Jetelina, an epidemiologist at the University of Texas Health Science Center at Houston, prefers that phrase, because it “allows for flexibility” as recommendations evolve. It also more effectively nods at the range of protection that vaccination affords, depending on how many doses someone’s gotten and when their most recent dose was.
But fully vaccinated has been hard to shake, even for the CDC. The agency, which did not respond to requests for comment, maintains that the original definition “has not changed,” and the term still features heavily on CDC websites. Maybe part of the stubbornness is sheerly linguistic: Up to date means something different to everyone, depending on age, eligibility, health status, and vaccine brand. Fully vaccinated is also grabby in a way that up to date is not. It carries the alluring air of completion, suggesting that “you’re actually done with the vaccine series,” maybe even the pandemic overall, Jessica Malaty Rivera, an epidemiologist and adviser at the Pandemic Prevention Institute, told me. All of this may be partly why that uptake of boosters—which sound optional, even trivial, compared with the first two shots—remains miserably low in the U.S.Katherine J. Wu, The Atlantic, June 23, 2022, Five COVID Numbers That Don’t Make Sense Anymore
Today, an advisory committee to the FDA recommended that our current slate of shots be updated to include a piece of an Omicron subvariant, with the aim of better tailoring the vaccine to the coronavirus variants that could trouble us this fall. Neither the agency nor its outside xpert panel has yet reached consensus on which version of Omicron will be the best choice, and whether the next round of shots will still contain the original version of the virus as well. Regardless, a new formulation with any bit of Omicron will constitute a bet that these ingredients will better protect people than another dose of the original vaccine recipe, whose protective powers have been fading for many months.
Here in the U.S., vaccine enthusiasm has a pretty dire prognosis. Fewer than half of the vaccinated Americans eligible for a first booster have opted for one; an even paltrier fraction of those who could get second and third boosters are currently up to date on their shots. Among high-income countries, the U.S. ranks embarrassingly low on the immunity scale—for a nation with the funds and means to holster shots in spades, far too many of its residents remain vulnerable to the variants sweeping the globe, and the others that will inevitably come.
From the beginning, the messaging on COVID boosters has been a bungled mess. Originally, it seemed possible that a duo of doses, perhaps even a single shot, would be enough to block all infections, and bring pandemic precautions to a screeching halt. That, of course, was not the case. With the virus still spreading last summer and fall, experts began heatedly debating what purpose extra doses might serve, and who should get them—and if they were needed at all. Caught in the cross fire, the FDA and CDC issued a series of seemingly contradictory communications about who should be signing up for extra shots and when.
… By the end of 2021, the U.S. had a catchall booster recommendation for adults (and has since expanded it to kids as young as 5), but whatever the benefit of a booster might be, much of the public had disengaged. …
The shots have also become much harder to get. Mass vaccination sites have closed, especially affecting low-income and rural regions, where there’s a dearth of medical centers and pharmacies. Pandemic funds have dried up, imperiling shot supply. Ever-changing recommendations have also created an impossible-to-navigate matrix of eligibility. Since the booster rollout began, recommendations on when to boost and how many times have shifted so often that many people haven’t realized the shots were actually available to them, or were mistakenly turned away from vaccination sites that couldn’t parse the complex criteria dictating who was allowed an extra dose.Katherine J. Wu, The Atlantic, June 28, 2022, This Fall Will Be a Vaccination Reboot
July 11, 2022, Ed Yong wrote: in the Atlantic:
… Once more, the ever-changing coronavirus behind COVID-19 is assaulting the United States in a new guise—BA.5, an offshoot of the Omicron variant that devastated the most recent winter. The new variant is spreading quickly, likely because it snakes past some of the immune defenses acquired by vaccinated people, or those infected by earlier variants. Those who have managed to avoid the virus for close to three years will find it a little harder to continue that streak, and some who recently caught COVID are getting it again. …
The age of Omicron began shortly after Thanksgiving [November in the U.S.A.], as the new variant swept through the U.S., ousting its predecessor, Delta. That initial version of Omicron, now known as BA.1, was just the first of a mini-dynasty of related variants that have since competed against one another in a grim game of succession. BA.2 took over from BA.1, and caused a surge in the spring. BA.4 and BA.5 are spreading even more quickly: First detected in South Africa in January and February, they have since displaced BA.2 all over the world, leading to surges in both cases and hospitalizations. In the U.S., BA.5 now accounts for about 54 percent of all COVID infections, and BA.4, about another 17 percent. (Most of this article will deal with BA.5 alone because it already seems to be outcompeting its cousin.)
When people are vaccinated or infected, they develop antibodies that can neutralize the coronavirus by sticking to its spike proteins—the studs on its surface that the pathogen uses to recognize and infect our cells. But BA.4 and BA.5 have several mutations that change the shape of their spikes, which, like swords that no longer fit their sheaths, are now unrecognizable to many antibodies that would have disarmed older variants. That’s why, as many studies have now consistently shown, antibodies from triple-vaccinated people, or people who had breakthrough infections with earlier variants, are three to four times less potent at neutralizing BA.4 or BA.5 than BA.1 or BA.2. This means that most people are now less protected against infection than they were two months ago—and that some people who got COVID very recently are getting reinfected now. …Ed Yong, The Atlantic, July 11, 2022, Is BA.5 the ‘Reinfection Wave’?
In late April 2022, The New York Times noted:
After the W.H.O. began promoting the 70 percent vaccination goal [mid 2021], many lower-income governments adopted the target for their own populations. The Biden administration also endorsed it last September, setting a deadline of September 2022.
At the time, two doses of the vaccines from Pfizer and Moderna were understood to offer very strong protection against even mild disease, and there was still hope that achieving high levels of vaccination coverage would tame the virus. But the emergence of new variants and the spread of the virus in Africa changed the calculus.
The vaccine regimens that had been planned for the developing world offered little protection against infection with the Omicron variant. And as sub-Saharan African countries were shut out of vaccine distribution for much of last year, more and more Africans gained protection against the virus from natural infection, which studies have shown works as well as two mRNA doses in preventing infection. New data from the W.H.O. shows that at least two-thirds of Africans had been infected with the virus before the Omicron wave.New York Times, Daily Briefing, April 23, 2022, The Drive to Vaccinate the World Against Covid Is Losing Steam
On April 27, 2022, the European Commission’s heath commissioner announced “It is estimated that between 60 per cent to 80 per cent of the EU population has by now had COVID” (CBC World News U.S., European Commission estimate most of their populations have contracted COVID-19).
On May 18, 2022, the Associated Press reported:
“Prior increases of infections, in different waves of infection, have demonstrated that this travels across the country,” Rochelle Walensky, the [USA] CDC director, said at a White House briefing with reporters.
The pandemic is now two and a half years old. And the U.S. has seen — depending how you count them — five waves of COVID-19 during that time, with the later surges driven by mutated versions of the coronavirus. A fifth wave occurred mainly in December and January, caused by the Omicron variant, which spread much more quickly than earlier versions.
Some experts are worried the country now is seeing signs of a sixth wave, driven by an Omicron subvariant. On Wednesday, Walensky noted a steady increase in COVID-19 cases in the past five weeks, including a 26 per cent increase nationally in the last week.
Officials said they are concerned that waning immunity and relaxed mitigation measures across the country may contribute to a continued rise in infections and illnesses. They encouraged people — particularly older adults — to get boosters.Associated Press, CBC News, May 18, 2022, More Americans could be asked to mask up again amid renewed COVID challenges
June 15, 2022 the British news source the Guardian reported:
Although BA.2 continues to account for the bulk of UK infections, data from the Office for National Statistics up to 2 June suggests that Covid cases may be starting to rise again in England and Northern Ireland, driven by an increase in BA.4 and BA.5 infections. The trends were uncertain in Wales and Scotland. Also gaining ground in the UK are BA.5.1 (a child of BA.5), and the BA.2.12.1 subvariant (the USA’s dominant Covid strain), which the UK Health Security Agency is monitoring.
… scientists had hoped that high levels of immunity from recent infection with BA.2 and booster vaccines might be enough to prevent these newer variants from gaining a significant foothold here … with immunity from third vaccine doses waning in most population groups, and only the over-75s, and extremely vulnerable groups having been offered “spring booster” doses, this cannot be guaranteed. Neither is recent infection with the BA.1 or BA.2 Omicron variants necessarily protection against reinfection with BA.4 or BA.5.
According to research published in Science on Tuesday, natural infection with Omicron doesn’t produce a strong immune response, regardless of whether scientists look at antibodies or T-cells – meaning that people who have already recovered from an Omicron infection can quickly become reinfected. The findings, from Prof Danny Altmann at Imperial College London and colleagues, may help to explain why infection levels have remained high in countries such as the UK, despite so many already having been infected with it.
It also put paid to the idea that the virus is on the verge of merely turning into common cold. “It clearly isn’t, and there’s no pressure on it to do that, really,” said Griffin.
Even so, the rise of BA.4/5 and other subvariants by no means puts us back to square one. The UK’s population is, by and large, highly vaccinated, and previous infection with other variants will also count for something. Those who haven’t been vaccinated remain vulnerable, however.The Guardian, June 15, 2022, Is UK at start of new Covid wave driven by BA.4 and BA.5 subvariants
On July 1, 2022, the Associated Press reported :
Data released by Britain’s Office for National Statistics showed that more than three million people in the U.K. had COVID-19 last week, although there has not been an equivalent spike in hospitalizations. The number of COVID-19 deaths also fell slightly in the last week. “COVID-19 has not gone away,” said Dr. Mary Ramsay, of the Health Security Agency. “It is also sensible to wear a face covering in crowded, enclosed spaces,” she said. Britain dropped nearly all its coronavirus measures, including mask-wearing and social distancing, months ago and masks are rarely seen on public transport. The latest jump in coronavirus cases comes after an earlier increase of about 40 per cent last month, following the large street parties, concerts and festivities held as part of Platinum Jubilee celebrations marking 70 years of Queen Elizabeth’s reign.
British officials said the latest wave of COVID-19 infections was likely caused by Omicron subvariants BA.4 and BA.5. Omicron has tended to cause a milder disease than previous variants like Alpha or Delta, but scientists warn its ability to evade the immune system means that people may be more susceptible to being reinfected, including after vaccination. Despite widespread immunization across Britain, the protection from vaccines is likely fading and Omicron and its subvariants have evolved to become more infectious. Britain’s Health Security Agency said they were seeing more outbreaks in care homes for older people and a rise in admissions to intensive care units of people older than 65.
Globally, the World Health Organization said this week that COVID-19 is increasing in more than 100 countries. The UN health agency warned that relaxed testing and surveillance measures mean it may be more difficult to catch emerging variants before they spread more widely.Associated Press service, CBC News, July 1, 2022, COVID-19 cases up in Britain by more than 30 per cent in last week, data shows
By April 2022 the Omicron variant or subvariants had been detected in people in China. By the end of April the Chinese government had locked down Shanghai, Changchun, Jilin, parts of Beijing, and other cities, straining global supply chains, reported by the Associated Press and CBC World under the headline China manufacturing weakens further as lockdowns continue. The Omicron variant(s) spread in other East Asian countries:
- reported by the Associated Press and CBC World under the headline Taiwan faces largest COVID-19 outbreak yet;
- May 24, 2022, the Thomson-Reuters news service story was “Taiwan learning to live with record COVID cases, as mainland China continues strict controls“;
- North Korea,
- May 16, 2022, the secretive government admitted Covid-19 infections – “North Korea tally surpasses 1 million sick amid COVID-19 surge“;
- Republic of China,
- On May 10, 2022 the World Health Organization (“WHO”) was reported to have offered “rare criticism for China’s steadfast and strict COVID-19 measures“;
- May 31, 2022 (Tuesday), the Associated Press news service story was “Shanghai to start lifting 2-month COVID-19 lockdown Wednesday“;
- June 13, 2022 the Thomson-Reuters news service story was “Beijing races to test millions following COVID-19 outbreak linked to bar“;
- World Health Organization,
- May 22, 2022, a speech of the Director-General of the WHO to the World Assembly of the WHO was reported “The COVID-19 pandemic is ‘most certainly not over,’ WHO’s health chief says“;
The Covid-19 pandemic initially did not cause large numbers of infections in the 3 Canadian Prairie Provinces. Restrictions on travel isolated residents from infections. The governments were slow to impose other restrictions. Winters on the prairies are cold, and life moves indoors. The Prairie Provinces had increased rates of infection and hospitalizations in the winter 2020-21 The Prairie Provinces delayed taking further non-pharmaceutical measures. Provincial politicians blamed the federal government and even foreign governments for lack of preparation and delay in taking measures to mitigate the effects if the pandemic. On February 7, 2022 Saskatchewan became the first province to stop daily reporting of Covid-19 statistics, and report its Covid-19 data weekly. Manitoba followed in late March:
COVID hospitalization and death numbers, meanwhile, will only be reported once a week due to public health’s determination that COVID-19 is in the process of becoming an endemic disease. “Real-time data is less critical with endemic reporting. Instead, we would shift our focus to key pieces of information that will provide the most relevant epidemiological evidence and data for both the public and for decision makers,” said Dr. Jazz Atwal, Manitoba’s deputy provincial public health officer, on March 2. “Manitobans will see this shift in the days ahead as we focus on reporting on key trends, more vulnerable settings and other important indicators of COVID activity and severity in our province. Information about COVID will continue to be transparent and publicly available, but this is a part of a response that has to shift as well.”
Dr. Brent Roussin, the chief provincial public health officer, has stated it is up to individuals to make that determination on their own. “We’ve been able to change our approach from strict public health measures to public health recommendations. That guidance is now available online to help support people in their own decision making to assess their level of risk when it comes to things like mask wearing, physical distancing and how many people are comfortable gathering along with,” Roussin said on March 16.Bartley Kives, CBC News, March 27, 2022, The new COVID data frontier: Making evidence-based decisions in an era with less evidence.
Conservative (including neo-liberal and libertarian) residents of the Prairie Provinces had embraced the paranoid style of American populism long before Trumpism. Canadian prairie conservatives have been suspicious of “liberal” media, and elites conspiring to harm or exploit “common people” and deprive them of their freedom and comforts since the 1970s – and much longer. Conservative politicians on the Canadian Prairies have a history of distrusting the public service and controlling the narrative. Brian Pallister, the leader of the Manitoba Conservative party 2018-2021 was responsive to rural sentiment, business interests and anti-government rhetoric. He became embattled. At one point Pallister had complained, for some reason (populist elite-bashing?), that doctors were paid by the government. Pallister, like the coach or manager of a failing sports team, resigned.
Only a few members of the public accessed the dashboards and daily data reports. Dashboards did not work like a weather forecast or a map. Not even the most expert individuals were able to use the published data to make decisions to avoid risks about visiting the places there wanted to go. In the early stages of the pandemic when the original virus and the virulent variants were in the population the data legitimized NPIs, self-isolation, remote work and the use of the internet (Zoom, Teams) for meetings, and individuals to comply with NPIs until pandemic fatigue became overwhelming.
Public health officials shifted to maintaining that public health was a matter of making decisions about personal risk when the dashboards became a source of information that could be used to criticize public health officials and public officials. In early 2022, public health officials in the western Canadian Prairie Provinces said that Covid-19 (Omicron) was:
- an endemic illness,
- a mild illness; and
- people should live with it.
The stories were embraced by the renewed Conservative Manitoba government, business interests, and Canadian Conservative political leaders including Doug Ford in Ontario.
The BC emergency Public Health Order(s) requiring masks in indoor public places lapsed March 8, 2022. British Columbia changed to weekly reporting on April 7, 2022. The CBC BC News reported: B.C. moves to weekly COVID 19 reporting, changes how deaths are counted). The BC Provincial Health Office and the health Minister stopped holding press briefings. On Sunday April 17, 2022 when the BC premier confirmed the end of provincial public health restrictions in BC. (CBC story Horgan says B.C. at ‘good point’ in COVID-19 pandemic, but expert skeptical).
For the next 3 months the CBC in BC reported the BC Centre for Disease Control (“BCCDC”; BC government) weekly reports. The statistic of rates of infection were based on lab tests. The CBC published other articles until mid-May, including weekly health columns called Second Opinion (“SO”), by Adam Miller, based on a CBC Health newsletter by Adam Miller:
BC gambled that infections would decline in the spring and summer, and that the endemic illness was less severe than the illness caused by original virus. The government made some self-test kits available to the public, but the self-test results were not included in statistics. 2nd vaccine boosters (4th shots) have been administered to or made available to nursing home residents, persons over 70, First Nations elders and some individuals.
The CBC, like the privately owned media, sang the chorus to the song chosen by public health officials and politicians, that might be titled, like the song by the American folksinger Bob Franke, Alleluia the Great Storm is over.
Ontario (Central Canada)
Ontario had a fixed election date in May 2022. The government did not change provincial rules until after the election, when mask mandates begane to expire. On June 9, 2022 CBC Ontario published an article titled “Ontario should have extended masking for all high-risk settings, says new science table head“:
On Wednesday, the province’s chief medical officer of health announced most mask mandatory mask rules will expire Saturday, including on transit and in hospitals. Masks will still be required in Ontario long-term care homes and retirement homes after Saturday.
Dr. Fahad Razak, the new scientific director of Ontario’s COVID-19 science advisory table, told CBC Radio’s Metro Morning the provincial requirement could have been extended for at least four more weeks to help relieve some of the pressure on hospitals that will now have to enforce their own mask rules. “I’m heartened to see many hospitals have already announced that they will continue to require them,” Razak said Thursday. “I suspect you’ll see most institutions will require it.”
Dr. Kieran Moore, the province’s chief medical officer of health, said Wednesday that he made the decision based on high vaccination rates and improvements in the provincial COVID-19 situation. Provincial masking requirements in areas such as public transit, health care settings, long-term care homes and retirement homes were initially set to expire on April 27, but that deadline was extended earlier this year to June 11. “The province will continue to monitor for any significant changes, including any new variants of concern, to ensure we are adapting our response to protect the health and safety of all Ontarians,” he said. Rules requiring that people wear masks on public transit and most health-care settings will expire at 12 a.m. on Saturday. Mask requirements lifted in most other settings in March, along with essentially all other public health measures aimed at stemming the spread of COVID-19 in the province. Masks are still “strongly recommended” in high-risk congregate settings like group homes and shelters, his statement said.
The province has said organizations can make their own mask policies, and that people should keep masking if they are high-risk for the illness, are recovering from COVID-19, have symptoms or have been in contact with someone who has the illness. Directives around mask requirements for health workers will also expire on Saturday and be replaced by Health Ministry guidance outlining when masks should be worn in hospitals and other health workplaces.No byline, CBC (Toronto) News, June 9, 2022, Ontario should have extended masking for all high-risk settings, says new science table head
The next day, CBC Canada published an article suggesting abandoning the remaining vaccine mandates:
The waning effectiveness of vaccines to stop the spread of the highly infectious Omicron variant of COVID-19 could mean it’s time for federal policy makers to consider lifting vaccine mandates, some experts suggest. “It’s hard to really justify our mandates anymore,” said Dr Zain Chagla, an infectious diseases physician at St. Joseph’s Healthcare Hamilton and an associate professor at McMaster University. Toronto’s Pearson International Airport has recently been a scene of snarling air passenger traffic, causing long lineups and major delays.
While government officials have blamed staffing shortages for problems, some industry groups and politicians are laying the blame on COVID-related border restrictions including vaccine mandates that require travellers to prove their vaccine status using an app before entering Canada.While government officials have blamed staffing shortages for problems, some industry groups and politicians are laying the blame on COVID-related border restrictions including vaccine mandates that require travellers to prove their vaccine status using an app before entering Canada.
Scientists stress that the vaccines do hold up against what matters — severe illness, hospitalization and death. And Chagla said that when the Alpha and Delta variants of COVID-19 swept through, data showed that vaccination had a “profound effect” on stopping a significant amount of infections, and that people’s ability to transmit was reduced. Last month, in a editorial for The Globe and Mail, under the headline: “The logic behind vaccine mandates for travellers no longer holds,” Chagla wrote that with the Omicron variant, vaccine efficacy “wanes significantly” to help prevent transmission. He pointed to data from the UK Health Security Agency that he said showed the effectiveness of two or three doses of vaccine against spreading the Omicron-variant infection over time approaches zero.
… Dr. Nazeem Muhajarine, professor of community health and epidemiology at the University of Saskatchewan in Saskatoon, said that some research does indicate that vaccine booster doses do protect people from transmission of the virus. That’s why he believes “this last remaining vaccine policy should remain a little longer because the threat of COVID-19 and the harm it causes in terms of long COVID, deaths and hospitalization particularly in vulnerable people, elderly and in some cases in children hasn’t entirely disappeared.”
Yet, Dr. Amesh Adalja, an infectious disease physician and senior scholar at the Johns Hopkins Center for Health Security in Baltimore, questioned the value those mandates now serve in light of the Omicron variant and population immunity. “I think that increasingly it’s become less valuable than it was in the earlier eras in the pandemic, because the vaccine in the face of Omicron isn’t very great at protecting against infection, he said. Because the vaccines hold up against severe illness, hospitalization and death, Adalja said there is still great value for employers to insist their workforce be vaccinated from a work-safety standpoint. As for vaccine mandates for travel, “I think it has much less value,” he said. “I don’t think the ArriveCan [app] serves the same value that it once did.”
Appearing before a House of Commons health committee earlier this week, Canada’s Chief Public Health Officer Dr. Theresa Tam said the mandates were first implemented when there was a strong resurgence of the Delta variant and two doses of vaccines were very effective. But Omicron was the “game changer,” she said. “Given the reduced vaccine effectiveness, even with three doses against the Omicron variant, vaccines cannot prevent all transmissions alone,” she said. “So a layered approach has to be considered, including layering mask wearing, for instance. But these are the things that the relevant ministers need to consider.”Mark Gollom, CBC News, June 10, 2022, Vaccine mandates have been blamed for some of Pearson airport’s chaos. Is it time to drop them?
Public health concerns were “relaxed” to get the air travel industry back in business. The CBC Canada news story June 13, 2022 was “Ottawa set to announce end to vaccine mandates for domestic travel, outbound flights“.
May 25, 2022, the media were reporting that Covid-19/Omicron infections in BC were disrupting work across the economy: “COVID-19 continues to cause worker absences in many B.C. sectors“. The weekly story May 26, 2022 reporting the public data reports said:
Much of the provincial data, which includes cases, hospital admissions and deaths and is at least five days old, is in weekly reports from the B.C. Centre for Disease Control (BCCDC).
The province is reporting 1,358 new cases between May 15 and 21, based solely on positive PCR tests, for a total of 370,559 cases to date. That represents a decline of 17 per cent from the previous week’s retroactive case count of 1,644. However, because PCR testing is quite limited, the BCCDC points out the weekly case counts likely underestimate the actual number of cases. Numerous organizations in B.C., including B.C. Ferries, are reporting staff shortages due to the spread of the virus.
The number of people testing positive has seen a slight dip across the province. A total of 8.6 per cent of all PCR tests came back positive in B.C. as of May 21, compared to 9.7 per cent the previous week. Positivity rates vary across the province, with 14.9 per cent on Vancouver Island and 6.7 per cent in the Vancouver Coastal Health Authority.Akshay Kulkarne, CBC BC News, May 26, 2022, BCCDC reports dip in COVID-19 hospitalizations, 42 more deaths over the last week
On June 9, 2022 CBC BC published an article titled “B.C. Ferries cancels multiple sailings due to staff shortages” about one of the public services disrupted when workers are infected with Covid-19, presumbly the mild Omicron variant.
The CBC continued to comment on risk and risk control measures, but the material was in individual radio shows and CBC podcasts. Brian Goldman, the host of the medical podcast, White Coat, Black Art hosted a podcast interview published an episode of the related podcast, The Dose, June 15, 2022, as mask mandates in Ontario were terminated: What should I do when the mask mandates are lifted? In late June 2022, CBC health columnist/reporter Adam Miller wrote:
Canada is once again a hotbed for variants, with BA.2.12.1 now making up more than 40 per cent of COVID cases, while BA.4 and BA.5 are quickly gaining ground at more than 10 per cent combined in late May — a major jump from less than one per cent weeks earlier. But the latest available federal data is weeks out of date and modelling experts CBC News spoke to estimate the true proportion of BA.4 and BA.5 cases is more than 20 per cent — and could be as high as 50 — with one of them likely to become dominant in the coming weeks. “COVID-19 has shown us over the past few years that there may be more surprises ahead,” Canada’s Chief Public Health Officer Dr. Theresa Tam said during a press conference Friday. “The virus is still circulating in Canada and internationally and factors such as viral evolution and waning immunity are anticipated to impact COVID-19 activity moving forward.”
“Omicron has evolved and it’s so much different than our vaccines and infections prior to Omicron — the type of immunity that you got is just a different beast,” said Sarah Otto, an expert in modelling and evolutionary biology at the University of British Columbia. “And so what we’re seeing with vaccine protection is that it’s not so much the number of doses as it is how recent your last dose has been, and I think that’s because the neutralizing antibodies in our bloodstream, they’re not recognizing the virus as well.”
That’s why virologists and immunologists say timing our next shots ahead of another potential wave or when new variants start to rise in Canada is so important, so we don’t get caught scrambling to roll out doses in the midst of a rapidly worsening wave — like when Omicron first hit in December.Adam Miller, CBC News, June 23, 2022, Why the timing of your next COVID shot is so important
BC’s public optimism changed to concern that the situation was changing with notes of concern about the anxiety of some members of the public:
Fourth doses, the province says, are currently only available to .
With just two per cent of British Columbians fully vaccinated and boosted, the province is near last place among provinces when it comes to uptake for fourth COVID-19 vaccine doses, ahead of only Manitoba, according to most recent federal data from late May (data for that period is unavailable in New Brunswick, while Alberta reported its figures separately).
On Wednesday, Provincial Health Officer Dr. Bonnie Henry said the current stock of COVID-19 vaccines in the province are being prioritized for the roughly 1.2 million eligible vaccinated people who still haven’t received any boosters. “All adults need to get that third dose,” Henry told CBC’s On The Coast. “There’s about 1.2 million people in B.C. who’ve had two doses who have not got that first booster. “I would encourage people to do that now so that we use up this vaccine before it expires, and really focusing the fourth dose, that extra boost, for those people who really need it.”No byline, CBC News BC, June 23, 2022, 4th dose hopefuls will have to wait for booster shot, says Dr. Bonnie Henry, despite expiring stock
… people may not be thinking of the second booster — or fourth dose — right now because it’s summer, masking has been lifted and there’s a general vibe that COVID-19 is over. But … most health-care workers continue to see new cases of the virus and they are anticipating another wave this fall, when people move back indoors.
Currently only certain priority groups are eligible for the second booster in Ontario. … the government has not yet recommended second boosters except for certain priority groups. ….
CBC News contacted Ontario’s Ministry of Health’s and asked what the timeline is for health-care workers to be able to access their second booster of the vaccine. The ministry’s media office responded with the list of people who are currently eligible to receive a second booster and did not offer a timeline.
Ontario gives the vaccine to people 60 and older, which is already different than recommendations from NACI. The Health Canada guidance for second booster doses, updated in April, suggests people aged 80 and older should get the second booster and provinces and territories “may also consider” giving it to people 70 and older.Kate Bueckert, CBC News, June 23, 2022, Health-care workers call for access to 4th doses of COVID-19 vaccine but Ontario offers no timeline
At the end of June, advisers to the U.S. Food and Drug Administration recommended that the next wave in COVID-19 booster shots should include a component that targets Omicron to combat the more recently circulating subvariants. I linked to Katherine Wu’s writing in the Atlantic, including her article June 28, 2022 about the US FDA position on new vaccine and more boosters, above.
FDA scientists at the meeting suggested they preferred vaccines that will target the BA.4 and BA.5 Omicron subvariants, which are currently dominant, rather than the BA.1 Omicron variant that led to a massive surge in infections last winter. The fast-spreading BA.4 and BA.5 sub-variants of Omicron are estimated to make up a combined 52 per cent of the coronavirus cases in the United States as of June 25, the U.S. Centers for Disease Control and Prevention (CDC) said on Tuesday. The two sublineages accounted for more than one-third of U.S. cases for the week of June 18.
Dr. Isaac Bogoch, an infectious diseases specialist at Toronto General Hospital, told CBC News in an interview broadcast Tuesday that BA.5 represents “probably about 20 per cent of all COVID right now in Canada.” Health Canada tracking as of June 24 had tracked BA.5 in 15 per cent of all COVID-19 infections in the country, with eight per cent of cases characteristic of BA.4.
Pfizer, Moderna and Novavax presented data at the U.S. meeting. All three companies have been testing versions of their vaccines updated to combat the BA.1 Omicron variant. Moderna said it would be ready with a “couple of hundred million” of bivalent, or double-targeted, vaccines designed to combat BA.1 by September. It would be late October or early November if it needs to design a vaccine targeting the newer subvariants, the company said. Pfizer said that it and partner BioNTech already has a significant amount of BA.1 vaccine ready and is preparing to produce a large amount of vaccine targeting BA.4 and BA.5. It said either could be ready for an early October rollout. Both Moderna and Pfizer have said that their respective BA.1-inclusive vaccines generated a better immune response against Omicron than their current shots, which were designed for the original virus that emerged from China. They have said their new vaccines also appear to work against BA.4 and BA.5, but that protection is not as strong as against BA.1.Thomson Reuters service, CBC News, June 29, 2022, FDA leaning toward new COVID-19 shots that target original strain, emerging Omicron variants
The Canadian National Advisory Committee on Immunization (NACI) then announced:
People at high risk of severe disease from COVID-19 infection should be offered a booster shot this fall, regardless of how many boosters they’ve previously received … That group includes everyone age 65 and older, NACI’s updated guidance said. Everyone else — age 12 to 64 — “may be offered” the additional doses in the fall, NACI said.
NACI said it will provide recommendations on the type of booster to be given when evidence about multivalent vaccines — which prime the body’s defences against multiple variants, including Omicron and its subvariants — becomes available.
… recommended that booster shots happen in the fall because, as with other respiratory viruses, “incidence of COVID-19 may increase in the later fall and winter seasons,” and new variants of concern could emerge.Nicole Ireland, CBC News, June 29, 2022, COVID-19 boosters recommended for the fall, Canada’s vaccine advisory body says
The BC Minister of Health in the CBC provincial news July 4, 2022:
The subtitle of the article “10% of health-care staff were sick for at least a day last week”.
The provincial health-care system is getting ready for a fall wave and looking at a federal advisory body’s recommendations that booster doses be made widely available, Dix said speaking at a news conference Monday. Meanwhile, the B.C. COVID-19 Modelling Group, made up of interdisciplinary experts who work independently from the government, warns that a wave of COVID-19 driven by the more infectious and immune-evasive BA.5 sub-variant of Omicron is emerging.
Public Health Officer Dr. Bonnie Henry said two weeks ago that those hoping for a fourth dose would still have to wait until they are eligible. They are currently only available for people aged 70 and older, Indigenous people over 55, and people in long-term care — six months after their last booster.
Dix also said the province wouldn’t rule out bringing back masks in indoor spaces come the fall and encouraged people to get vaccinated.No byline, CBC News, July 4, 2022, Dix says B.C. could be distributing vaccines widely in fall due to third Omicron wave
The subtitle stated a fact about the effects of relaxing all NPIs: people are acting as if there is no risk of getting seriously ill.
In Ontario, July 6, 2022:
Ontario has likely entered a new wave of COVID-19 driven by the Omicron BA.5 subvariant, the province’s science advisory table said Wednesday, citing exponential growth in most public health units. The COVID-19 Science Advisory Table points to several key indicators that it says signal the beginning of a wave, little more than a month after the end of most public health measures, including mask mandates. For the first time since May, test positivity is above 10 per cent, the group of experts said in a series of tweets Wednesday. Wastewater signals are rising across the province overall and within most regions, it added. Around 80 per cent of public health units are seeing exponential growth in cases, though the group says the actual reproduction number is hard to nail down since the province moved to limit PCR testing.
Indications of a new wave in Ontario come as several G10 countries have already seen a jump in cases driven by Omicron subvariants, including France, the U.K., Italy, Belgium and Switzerland, among others.”We may be a couple weeks behind in this rise,” the advisory group said.
The group says current evidence does not suggest BA.5 is more severe than strains that drove previous waves or that it will lead to the level of hospitalizations seen at earlier points in the pandemic. “However, any surge comes at a time when hospitals are already dealing with staff shortages and record wait times — this impacts all of us,” the advisory table said. “And if BA.5 spreads widely, we may see a rise in deaths among higher risk groups such as the elderly as was observed during the previous waves.”No byline, CBC News, July 6, 2022, Ontario’s next COVID-19 wave is likely here, says science table, citing exponential growth in most regions
In Ontario July 8, 2022:
With lockdowns lifted and travel opening up, some First Nations in northwestern Ontario are seeing a surge in COVID-19 cases, just as the province’s seventh wave takes hold. There are 514 active cases in the region, a big jump from 124 reported just two weeks ago, said Dr. Lloyd Douglas, public health physician with the Sioux Lookout First Nations Health Authority. The spike in cases comes as public health officials in Ontario announced the province has officially entered its seventh wave, driven this time by the Omicron BA.5 subvariant. “Sadly yes, we’re in another wave,” Dr. Kieran Moore, the province’s chief medical officer, told CBC News on Wednesday after Ontario’s COVID-19 science advisory table pointed to exponential growth in most public health units. Douglas said a number of factors are at work that would explain the rise in remote communities in northwestern Ontario. “The regional chiefs rescinded the regional lockdown several weeks ago,” he said. “Travel is now reopened, and we have members of the community, rightfully so, travelling, getting their business done and coming back to the community. “Unfortunately, individuals would have gotten COVID and then be coming back,” Douglas said, adding that post-travel screening and quarantine policies are still in effect. Still, Douglas said, the case numbers are rising due to variants and waning immunity from vaccines.
“Even though the fourth dose has been available for community members for quite some time, the actual fourth-dose coverage is not where we would like it to be in comparison to … the second-dose coverage,” he said. “So there are multiple factors that have led to the uptake in some of our communities, and we expected to see a little bit of a surge after the communities would have opened up a bit.”Kris Ketonen, CBC News, July 8, 2022, COVID-19 cases surge in First Nations in northwestern Ontario amid 7th wave
In Ontario, July 7, 2022, direct discussion in the media of the Omicron BA.5 variant:
A highly transmissible variant of the coronavirus is spreading through Canada, driving another wave of infections, even among those who have recently recovered from COVID-19. The Omicron subvariant BA.5, and to a lesser extent, BA.4, is largely behind the latest wave — the seventh of the pandemic and the third since the arrival of Omicron. Both have shown an ability to evade the protection offered by previous infection. “The BA.5 subvariant has mutated to the extent that your body is not recognizing it and people are getting reinfected,” said Dr. Fahad Razak, an internist at St. Michael’s Hospital in Toronto and the scientific director of Ontario’s COVID-19 Science Advisory Table. “So you’re seeing this additional surge start in Ontario, and now it’s started in other parts of Canada as well. “The good news is that data emerging from countries where BA.4 and BA.5 have already taken hold, such as South Africa, suggest they are not more severe than previous Omicron subvariants or more likely to lead to hospitalizations.
This week, officials in Ontario, Quebec and British Columbia acknowledged that their provinces had entered into another COVID-19 wave.
… Hospitalizations are also climbing week over week in British Columbia, as well as in Ontario, where about 60 per cent of confirmed COVID-19 cases are the result of BA.5. None of the provinces said public health restrictions were forthcoming, at least not during the summer.Benjamin Shingler, CBC News, July 8, 2022, The BA.5 subvariant is fuelling another COVID wave
In BC in the CBC BC news report of the provincial weekly BCCDC report July 7. 2022:
B.C.’s health minister confirmed the province is entering its third wave of the Omicron COVID-19 variant as hospitalizations jumped 35 per cent in the last week. A day after Ontario announced its third wave, Adrian Dix said cases in British Columbia are also trending upwards, though not as significantly as hospitalizations.”We’re not seeing a major increase in critical care in the most severe outcomes for people who are in hospital and are positive for COVID-19,” said Dix in an interview with Early Edition host Stephen Quinn.
Dix did not hint towards any new public health measures being implemented to stem the new wave of Omicron being driven by the BA.5 subvariant, and said British Columbia continues to focus on immunization as its best defence against COVID-19, reiterating that vaccines continue to provide strong protection by making hospitalization five times less likely and death seven times less likely. “Those others who’ve been invited have been invited to get your fourth dose. Get your fourth dose,” said Dix.Eva Uguen-Csenge, CBC News (BC) July 7. 2022, B.C. enters third Omicron wave as COVID hospitalizations jump 35% over last week
On Friday July 8, 2022 the BC Health Minister held a press conference to announce that vaccination with 2nd boosters (4th shots) would be available more broadly, including to persons over 60 years of age. (A change from people age 70 and older, Indigenous people over 55, and people in long-term care — six months after their last booster). It will be weeks before the necessary Orders in Council are enacted, workers hired, venues booked, and the vaccination infrastructure is re-established. The government is concentrating on vaccinating young children in August 2022 with newest approved early childhood vaccines.
The government dusted off the vaccination online appointment system and began blasting out messages July 20, 2022 that booster vaccinations would be scheduled “in the fall”. The announcement of boosters became an announcement of boosters before winter.
The Crooked Timber of Mankind
The USA and Canada
By the spring of 2021, most individuals believed that their risk was low, and resented the restraints on their choices and activities. In the spring of 2022 politicians and public health officials in the USA took the position that Omicron is a minor flu and that the pandemic is over. American politicians believed that the public wants to be told the pandemic is over. Canadian politicians agreed, but have been as vague about it as they can be. Many people were tired of sifting conflicting advice. They were ready to travel, dine out, shop and socialize and enjoy their choices as consumers. People who were sure, for whatever reasons, that they had low risk were not willing to continue with NPIs. People are travelling to express their unhappiness with the way public health measures affected their lives by spending on travel and leisure.
There was compassion fade among adults of working age for the risks of the elderly and vulnerable individuals.
Libertarians, Populists, Anti-vax, Democracy
In February 2022, the news media in Canada reported the trucker convoy’s occupation of Ottawa and other populist protests against the measures that had been imposed by governments as conditions of work and travel – the requirements to prove vaccination, and wear a mask. The Canadian governments did not persuade all Canadians to accept that vaccination cards (and/or apps) and masks were necessary to protect the public from the risks of infection with the variants of Covid-19 reproducing in the population.
The protesters may have seen themselves as the leaders of popular movement. They might as well have been screaming “I’m as mad as Hell, and I’m not going to take it anymore”. They were driving trucks, blocking roads, blowing airhorns, demanding things and annoying people. The governments (Canadian federal, Ontario, City of Ottawa) dismantled the protests and charged the protest leaders with offenses. A few protest leaders will be punished, eventually, for breaking rules and annoying people.
The media’s interpretation of public disaffection with government, elites and modern life often seels addresses blame, and may involve conspiracies. The journalists who address mass movements are often puzzled by the way people react to the conditions of their lives.
People have been harmed financially by the effects of the pandemic. People were unable to work to earn money to pay rent and pay for food. The effects of the pandemic continue as a wave of price increases causes inflation of currency and erodes assets and means.
Through the pandemic, American libertarians embraced government’s use of goverment power to use public money to invent a vaccine while complaining that governments have not made the right moves to keep the economy growing to generate wealth for people who hold financial assets. A recent instance in an article by an avowed libertarian economist at the libertarian Mercatus Center of George Mason University:
Operation Warp Speed produced a new vaccine for a novel virus in record time but when Operation Warp Speed was disbanded by the Biden administration vaccine research and development slowed from warp speed to impulse power. It’s ridiculous that it is taking longer to develop and deploy tweaks to the mRNA vaccines to deal with new variants than it took to develop the original vaccines from scratch. By the time we get an Omicron-specific vaccine that variant will have disappeared. This is no way to run a civilization.
We should be investing in a universal vaccine for all sarbecoviruses (of which SARS-COV-II is a member) and, as I have long argued (and here) a nasal vaccine. We need not exaggerate, for the vaccinated the dangers are no longer acute but we should be better prepared for future variants and the savings from less sickness alone easily trump the costs. Indeed, the issue isn’t even so much the cost as the need to coordinate regulatory agencies, as OWS did, to speed approvals and reduce bureaucracy.Alex Tabarrok, Marginal Revolution, July 8, 2022, Operation Warp Speed Should Not have Been Disbanded
The public health authorities have supported masking by people who work with the public or in congregate workplaces. Masks are not protecting workers in a retail stores full of unmasked shoppers, and other public places. The pathogen is a highly contagious Covid-19 Omicron variant.
The public health experts recommend booster doses of vaccine to counter the risk of virulent symptoms, but vaccines are not available to most workers, and to persons who are vulnerable but not in the defined categories. In some Canadian provinces fourth boosters are available to persons over 60 – in denialist Manitoba the threshold is 50. In BC, the threshold age was 70 until July 2022 – and effectively remains 70 until the announcement becomes action. The disease has survived. A Red Queen?
The current policy of ignoring the pandemic except for promises of a more vaccine, some day, works at the price of sick workers and an increase in the risk of infection of people vulnerable to virulent illness.
The BC Health Minister’s July 8, 2022 was a messaging exercise to keep vulnerable workers and seniors placated.