Dr. Rose’s 2021 fall predictions

Dr. Greg Rose, QCH Medical Director of Infection Prevention and Control

We have had a fairly gentle summer at Queensway Carleton Hospital — with only three admitted COVID patients at QCH. However, since the latest reopening phase, the numbers are starting to climb, and once again, we see double digits in local case counts. Provincial numbers have more than tripled since July, and the Delta variant accounts for nearly all new cases.

Throughout the pandemic, we have looked to the United Kingdom, United States, and Israel for trends that may replicate in Canada. The surge in Delta in the UK and the US shows us that many people are getting infected even in populations with relatively high immunity levels.

The latest wave of COVID has shown a greater impact in younger patients than any wave to date.

In the US, pediatric hospitalizations are at record highs.

What we have learned from the UK is that the Delta variant is twice as contagious. Even in largely vaccinated populations, increased infections are causing large stress on the healthcare system.

What can we do?

Parents of young children that cannot be vaccinated should make sure everyone else in their lives is vaccinated and think carefully about what activities and travel you might be considering this fall. For unvaccinated or vulnerable people, I strongly recommend you reconsider any unnecessary travel and indoor activities and make sure that your children are wearing effective masks in school.

Vaccinations for younger children

Ontario has extended vaccinations to any child that will turn 12 by the end of 2021. Children born on or before December 31, 2009, are eligible to be vaccinated now.

We were hoping to hear news from Pfizer about vaccines for children aged 5 – 12 years, and 6 months to 5 years; however, it is unlikely that there will be any news until very late this year. It is also not clear when we may see data for the other vaccines such as Moderna.

Countering concerns about vaccinations

I tell people who are hesitant about getting vaccinated that the Delta variant of COVID-19 is as contagious as chickenpox, and 100% of unvaccinated Canadians got chickenpox. With this degree of contagiousness, it is highly likely that all unvaccinated, and incompletely vaccinated, individuals will get the COVID-19 virus.

Current vaccines remain effective against Delta — particularly in deterring severe disease and hospitalizations. Reported severe side effects remain very infrequent.

People often ask how it is possible that vaccines came to be so rapidly. The answer is cooperation on an unprecedented scale. Corners were not cut in the development of these vaccines. What was cut was red tape.

Modeling estimates that 95% of the population must be vaccinated before we reach herd immunity and expect to see our lives return to “normal.” Until then, we will require masking and social distancing to keep us safe.

What about “booster” shots?

Ontario has approved a third COVID-19 vaccine dose for vulnerable people due to heightened concerns over the Delta variant. Although UK and Canadian data show that, in general, two doses of approved COVID vaccines are still very effective against severe disease due to Delta, there are studies suggesting that vulnerable people might benefit from a third dose. No other additional vaccinations are proven necessary for the general population, and the focus remains getting first and second doses into unvaccinated people.

Hopeful thoughts

Our current local numbers resemble those from the US and UK a few weeks ago, but we can still turn this around. We beat the models before because we knew what to expect, and we learned how to prepare.

We can avoid the trends we see elsewhere by restricting close contact, high-risk environments, ensuring diligence in our masking and hand hygiene, and most importantly, increasing vaccinations. All the things that have kept us safe up to now will help keep us safe in the weeks ahead.

The future is mutable — all of our actions, even small actions, can benefit us 2-3 months from now.