[DrDina News] The 4th Wave is Here!

Dr Dina News, Uncategorized

Let’s talk about kids’ safety and COVID’s 4th wave!


Hello friends!

I hope you had a lovely weekend with your loved ones.

Let’s dive into the bad news, the good news, the most common questions of the week, and my weekly silver lining.

What’s the bad news?

There have been over 205 MILLION cases of confirmed COVID-19 worldwide and over 4.3 MILLION deaths.

In Canada, we have documented 1.45 Million cases, and almost 27,000 people have died from COVID-19.

The fourth wave is here!

Experts say that Canada has officially entered the fourth wave, and it’s not looking so great. Recent data shows that the number of new cases demonstrates “a strong resurgence trajectory,” with the vast majority of infections in unvaccinated people aged 20 to 39. In addition, cases are rising across the country, particularly in Alberta, Saskatchewan, Quebec, and Ontario.

We spoke about Alberta eliminating isolation rules and abandoning COVID-19 testing, and luckily, they have changed their tune on this.

The United States is increasingly overwhelmed with COVID cases. Shortages of nurses, doctors, and other healthcare providers are leading some states to beg for help from other states and the country. Although the students in Texas are not mandated to wear masks in school, some school districts require them in defiance of the governor. In Florida, one church lost 6 of its members in 2 weeks, four of whom were under 35 and healthy. What a loss.

Health Newsletter

Health Newsletter


Dr. Dina, what is the good news?

In Canada, 82% of eligible people have received the first dose of a COVID vaccine, and 72% are fully vaccinated.

Health Newsletter

This is in stark contrast to the worldwide vaccine data. Worldwide, 4.6 BILLION doses have been given, with 31% of eligible people received the first dose and 16.1% fully vaccinated.

Continued vaccination, social distancing, and masking remain our best defense.


Questions of the week

What are the New Ontario Ministry of Health COVID-19 Guidelines?

New guidelines were released this week detailing what someone should do if they are exposed to COVID, depending on whether they are vaccinated or not and symptomatic or not.

The basic theme is that if you’ve been double vaxed, you are subject to fewer restrictions and more lenient isolation requirements than people who have not been vaccinated.

Here are the key points:

  • The self-isolation period is now 10 days and not 14 days.
  • Symptomatic people with gastrointestinal symptoms must have symptom improvement for 48 hours versus 24 hours for other symptoms.
  • People who have had a prior COVID infection (< 90 days ago, and medically cleared) are managed like someone who has received two vaccines. They are not required to isolate at home even after a high-risk exposure, as long as they are not symptomatic.

If you are exposed to someone who tests positive for COVID-19, you follow this flow chart.

[click to view the flow chart below]

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Rules for vaccinated people

If you are vaccinated, asymptomatic, and exposed to a confirmed case, you ‘likely’ don’t need to self-isolate, but you should get tested. These people are to self-monitor for symptoms over 10 days, wear masks, keep their distance, and follow other public health guidance.

If a vaccinated person is exposed to COVID and has symptoms, they should self-isolate and get tested. Family members do not need to isolate. If they test positive, they should self-isolate for 10 days. If the test is negative, they should isolate until 24 hours after symptoms improve or for 48 hours if the symptoms are gastrointestinal.

If family members are vaccinated, they do not need to self-isolate. However, if they are unvaccinated, they self-isolate until the negative test result is reported.


Rules for unvaccinated people

The rules are different for unvaccinated people.

If an unvaccinated person comes in contact with a confirmed case, they must self-isolate for 10 days and get tested immediately. If the test is negative, a second test is recommended on day 7 of isolation. They must isolate at least 10 days.

If the exposed person is asymptomatic, fully-immunized household contacts do not need to self-isolate. However, if the household contacts are not vaccinated, they should stay home except for “essential reasons” such as work or school during the exposed person’s isolation period.

If the unvaccinated, exposed person is symptomatic, their symptoms must be improving for at least 24 hours (or 48 hours for gastrointestinal symptoms) before ending isolation.


What is the guidance around outbreaks in schools?

An outbreak in school or day-care settings is defined as two or more lab-confirmed COVID-19 cases among students, staff, or visitors, where at least one case can be linked to the school, including related transportation like a bus.

Local public health units will be the ones to handle outbreaks. They may choose to restrict visitors, minimize movement of teachers between cohorts or limit the activities of students. Ontario says classroom and school closures will be avoided unless necessary.

Given that kids less than 12 will not be vaccinated, the recommendation is that students and staff who have symptoms of COVID-19 get tested and isolate while they await results, as in the case of the unvaccinated person above.

If a symptomatic student or teacher tests negative, they can return to school after symptoms have improved for at least 24 hours (or 48 hours for gastrointestinal symptoms).


How do we avoid getting COVID when so many American kids are getting sick?

With things off the rails in the U.S., many of us wonder how to prevent illness from the delta variant, which it has called “hyper infectious.”

Luckily though, we are not in the same boat as the U.S. Why? Because our vaccination rate is far higher, and by and large, we keep our distance and wear masks much more reliably than many areas in the U.S. Delta is still spreading here, but not at the same rate as down south. However, we must remain diligent as cases are increasing and this has many experts very worried.

Sadly, the CDC shows a 27% rise in 7-day admissions in childhood admissions age 0-17 years from July 28-August 3 to August 4-10.

Health Newsletter


When can kids get vaccinated?

Pfizer and Moderna are currently doing clinical trials to determine if their vaccines are effective and safe in kids under 12. (As always, I promise to update you as soon as we know more).


How do we protect kids now?

The best way to protect our kids is to keep the risk of exposure low. So get vaccinated yourself and encourage those around you too.

Continue to wear a mask, keep your distance, and practice proper hand hygiene. These public health strategies are still super important and helpful.


Are universities making vaccination mandatory?

Several Universities in Ontario announced that students, faculty, and anyone else on campus will need to be double vaxed to attend school. Guelph University, The University of Waterloo, Wilfrid Laurier University, Conestoga College, University of Ottawa, Western University, Ontario Tech University, and the University of Toronto require full vaccination status.


What’s the plan for mandatory vaccinations and vaccine passports?

The Canadian government plans to make vaccines mandatory across federal public service and require commercial air, train, and cruise ship passengers to be fully vaccinated by October. Federally regulated agencies such as Canada Post are expected to announce similar requirements soon. We will soon be able to get a government document displaying our vaccine history for international travel.


How are people doing after a third vaccine dose?

Israel (the model country for vaccine role out and research) has demonstrated that people who received a third Pfizer dose have similar or fewer side effects than they experienced after their second shot. This is great for so many of us who felt terrible after the second dose!

Another study this week found that a third Moderna vaccine provides a lot more protection in transplant patients than only two doses.


Sniffing out COVID?

This is just cool. A team at Vancouver Coastal Health (VCH) has trained dogs to sniff out COVID-19. The dog team is called… wait for it… Canines for Care. How cool!

Health Newsletter


Silver lining of the week

It’s nice outside.

Many kids are in camp or enjoying some time with friends.

School starts so soon, and life will feel different again. I am savoring the feeling of freedom as much as I can.

Cautiously optimistic.

Have a wonderful, safe, and healthy week, friends,

Dr Dina Kulik - Kids Health

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IMPORTANT UPDATE re. VIRTUAL CARE – The Ontario Medical Association and the Ministry of Health agreed that there would be changes made to the way that virtual medicine would continue as of October 1, 2022

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