[Dr. Dina News] New public health measures announced

Hello friends!

I hope you had a wonderful weekend, and your kids are thrilled to be back in school.

Let us review the bad news, the good news, the most common questions of the week, and my silver lining.

What is the bad news?

Almost 2.9 million cases of COVID have been confirmed in Canada, with over 32,000 deaths. Over 338 MILLION cases have been confirmed worldwide, with nearly 5.6 million deaths.

Over 86 million doses of COVID vaccines have been given in Canada, with 5.8 million in children. 87% of eligible Canadians (5+) have received one dose, and 82% have received both. Including kids, less than 5, 83% of Canadians have received one vaccine and 78% are fully vaccinated.

Almost 9.8 BILLION vaccines have been given worldwide, representing 60% of the world’s population receiving their first dose, and 52% are fully vaccinated.

Omicron continues to wreak havoc across the country. Despite isolation periods of 5-10 days, Omicron does not appear to be contagious for such a short period. You likely know many people who have or had Omicron. This is quite different from previous waves when you more likely knew someone who knew someone with the illness.

Across the country, there are record numbers of COVID-related hospitalizations. Staff shortages in hospitals and other healthcare settings are leading to medical backlogs and a continued stretching of resources.

There are over 4000 Ontarians currently hospitalized, and more than 600 are in the ICU. Some experts believe the pandemic is reaching its peak, and the rate of new hospitalizations is slowly decreasing.

The most common questions of the week

Could vaccine side effects be from the ‘nocebo effect’?

A new systematic review published in JAMA showed that the ‘nocebo’ effect accounts for 76% of common adverse effects from the COVID vaccine, including fatigue and headache after the first dose and 52% from the second dose. The nocebo effect is when a person experiences unpleasant side effects after being given a placebo. Essentially, negative expectations lead to symptoms.

When will public health measures ease up?

The Ontario government announced last week that starting January 31, 2022, public health measures will begin to ease. Ontario will follow a ‘cautious and phased approach to lifting public health measures,’ with 21 days between each step.

Effective January 31, 2022 (with proof of vaccination):

• Social gathering limits will be increased to10 people indoors and 25 people outdoors.
• Increasing or maintaining capacity limits at 50% in indoor public settings, including:
• Restaurants and bars (without dance facilities);
• Retailers (including grocery stores and pharmacies);
• Shopping malls;
• Non-spectator areas for recreational activities and sports, including gyms;
• Cinemas;
• Meeting and event spaces;
• Amusement parks, including water parks;
• Museums, aquariums, galleries, and zoos;
• Casinos and bingo halls; and,
• Religious services.
• Sporting events, theatres, and concert venues will operate at 50% seated capacity or 500 people (whichever is less).

Effective February 21, 2022

• Social gathering limits will be increased to 25 people indoors and 100 people outdoors.
• They are removing capacity limits in indoor public settings such as restaurants, indoor sports facilities and cinemas, where vaccines are required.
• Limiting capacity restrictions in most remaining indoor public settings where proof of vaccination is not required to maintain two metres of physical distance between individuals.
• Indoor religious services will be limited to the number of people to maintain two metres of physical distance or with no limit if proof of vaccination is required.
• Increasing indoor capacity limits to 25% in higher-risk settings such as nightclubs and wedding receptions where proof of vaccination is required.

Effective March 14, 2022

• Lifting capacity limits in all indoor public settings, including religious services. Proof of vaccination will continue to be maintained.
• Increase social gathering limits to 50 people indoors and no limits for outdoor gatherings.

Who can access the antiviral medication Paxlovid?

On January 17, Health Canada approved the antiviral Paxlovid. Ontario is expected to receive approximately 10,000 treatment courses of this treatment this month. Eligibility will be focused on adults with the highest risk of severe outcomes. It will not be accessible to healthy adults and children.

Will we reach herd immunity?

Omicron is not likely to lead to herd immunity against COVID-19. Herd immunity refers to when enough people become immune to a virus and can no longer spread effectively.

We have heard since the beginning of the pandemic that if enough people got COVID, we might achieve herd immunity. But as new mutations and variants emerged, and people have become reinfected with new strains, or infected after vaccination, the hope of herd immunity has decreased.

Omicron’s is even better than previous strains at infecting people who had COVID before or who are fully vaccinated. COVID will likely continue to mutate and find ways to break through our immune defenses.

On a positive note, prior immunity from a previous illness or vaccination does help boost immunity against COVID-19, so new infection is less serious if you are infected.

Unfortunately, immunity from the existing vaccines is relatively short-lived. The virus’s ability to mutate makes it less likely that a vaccine series will be enough to prevent infection long term. Either we will require ongoing boosters, or a new vaccine may be necessary. Vaccines are in development that may provide immunity against future variants or even multiple strains of COVID.

Am I at risk of losing my sense of taste and smell?

A study published in the journal Nature Genetics found potential genetic risk factors explaining why some people lose their sense of taste and smell from COVID and others do not.

Researchers used online surveys to collect self-reported data regarding COVID-related loss of taste or smell from more than one million 23andMe research participants. Over 69,000 had a positive COVID test. They compared those who had COVID with and without losing taste or smell.

Of the COVID infected participants, 68% reported a loss of taste or smell. 72% of women reported this symptom, and 61% of men did. The study notes that people of African American or East Asian ancestry were less likely to report loss of taste or smell than people of European origin.

By comparing genetic differences between the two groups, the study found a specific gene on a chromosome associated with smell brain cells (neurons) called UGT2A1 and UGT2A2. These appear to differentiate between those who do or do not have smell or taste changes from COVID.

The study may help researchers think about how COVID affects people in varying ways and how new treatments can help.

My silver lining

I celebrated my birthday on Friday. While we couldn’t party the way we wanted to, I was reminded how much love I am surrounded by. Friends, family, patients, and followers sent so many kind messages. I am so blessed and so grateful for you all. Thank you!

Have a wonderful week.

Stay healthy and safe!