Best wishes for this holiday season!
I hope you had a wonderful weekend.
I know many of you are stressed and anxious at a time when we should be joyous and celebrating the holidays. I’m sorry to be the bearer of bad news. You know I always tell you straight and provide you accurate, evidence-based information based on science and the experts.
Let’s review the bad news (spoiler alert: this week, there is a lot of bad news), the good news, the most commonly asked questions of the week, and my silver lining.
What is the bad news?
Over 1.85 million cases of COVID-19 have been reported in Canada, with over 30,000 deaths. More than 800,000 people have died in the United States from COVID. Over 272 MILLION cases have been reported globally, with over 5.3 million deaths.
The elephant in the room – Omicron
Omicron is quickly spreading across the world faster than any variant to date. More than 7000 cases have been reported in Canada so far, and Ontario saw a massive rise in cases to over 3,000 a day last week and a positivity rate of approximately 7%!
I have heard people dismissing Omicron as it ‘causes mild disease,’ though I suggest we take heed. The transmission rate is incredibly fast, and we are seeing less vaccine effectiveness. For example, in the United Kingdom, cases are doubling EVERY 2 DAYS (we’re almost at that rate in Ontario).
The WHO Director-General, Tedros Adhanom Ghebreyesus, said last week, “Even if Omicron does cause less severe disease, the sheer number of cases could once again overwhelm unprepared health systems.”
The head of the Ontario Science Advisory Table, Dr. Peter Jüni, said, “People cannot imagine the sheer scale of what we are talking about here…There is a myth out there that it’s mild. We need to address this myth now.”
Why are we so worried? Compared to the Delta variant (which was already more contagious and easily transmitted than the previous strains), Omicron multiples itself 70 times more quickly, and holds onto cells more tightly and can withstand antibodies (from vaccines) more easily.
New modelling shows that we may see more than 10,000 new cases a day in Ontario in the next two weeks. Omicron will soon become the dominant strain in Ontario. It can produce severe disease, and ICU occupancy levels may reach unsustainable levels by January.
Vaccines are effective against Omicron; boosters substantially increase protection from severe illness. Two doses help, but three doses are better. However, vaccination is not enough to slow this 5th wave. We need strong public health measures (such as decreasing contacts by 50% or more). Wearing high-quality masks, maintaining physical distance when indoors, improving ventilation, and improving access to rapid testing can buy us time to get more people triple vaccinated.
Dr. Dina, is there good news?
Over 73 MILLION vaccines have been given in Canada, over 5.8 MILLION to kids. 86% of people aged five and older have received the first dose, and 80.4% are fully vaccinated.
Worldwide over 8.5 BILLION vaccines have been given. 58% have received the first dose, and 48% are fully vaccinated.
Questions of the week
What do we know about Omicron so far?
• Omicron will likely be the dominant strain in the next 1-2 weeks.
• Omicron cases seem to double every 2-4 days.
• Each person with Omicron can infect 6-7 times more people than individuals with Delta.
• Close contacts are likely to be infected.
Severity of illness
• Danish studies suggest Omicron causes the same severity of illness as previous strains.
• Vaccine effectiveness against Omicron infection is lower than from Delta:
• Two doses – around 33%.
• Three doses – 70-75%.
• Effectiveness against hospitalization from Omicron – 2 or 3 doses 90%.
How can we keep numbers down and increase the chance kids can go back to in-person learning in January?
We hope to keep schools, workplaces, and other public places open by focusing on the public health measures we know work.
• Wear a well-fitted high-quality mask – please stop wearing fabric masks. There are not very effective and don’t usually fit as well as we want.
• I highly recommend KN95 for kids and adults. They are substantially more effective at preventing COVID infection, fit better, and are more comfortable.
• Continue to maintain physical distance and avoid indoor spaces where there is crowding.
• Increase ventilation in all indoor spaces.
• Increase access to rapid testing.
Do the vaccines work against Omicron?
Current data indicates that a two-dose Pfizer vaccine is 70% effective against severe illness, down from the 90% previously cited for other strains.
Importantly, it is only 33% effective against infection, down from 80% with other strains.
Vaccines help prevent infection, but more importantly, vaccinations help prevent severe illness and death.
Who can get a third vaccine dose in Ontario?
Individuals 18 and older who received their second dose > 84 days (three months) ago are eligible for a booster dose starting December 20, 2021.
Individuals who are moderately to severely immunocompromised may now receive a booster dose (a fourth dose) ≥168 days (six months) after completion of their primary three-dose series. Currently, there is a preferential recommendation for the use of the Pfizer vaccine for those aged 18 to 29.
The silver lining of the week
This week was stressful. Cases are going up, and many of you feel stressed right before holiday get-togethers. My silver lining of the week is that we have loved ones to share the joy with right now. Omicron may have messed up your holiday plans, and you may be celebrating with fewer people this year, but you can still share this time with those in your household. I have learned to savor the moments with my kids and husband, the (pseudo) quiet, the comfort of our home, and the blessings we have in life.
I am thankful for our health and our fortune of living in Canada. The last two years have highlighted how precious life and love are, and if you can share these days with others you cherish, that is a huge blessing.
I hope you have a chance to relax and enjoy your family this week.
Dina is a wife, mother of 4, and adrenaline junky. She loves to share children’s health information from her professional and personal experience. More About Dr Dina.