National and provincial parks are set to gradually reopen across Canada, some businesses are opening their doors, and even restaurants in Alberta might soon be taking reservations.
But as we begin to reconnect, experts warn that we risk kicking off new outbreaks of coronavirus cases – sometimes called the “second wave.”
The number of cases reported daily in Canada has flattened and even begun to decline slightly, though there are variations from province to province. But reopening the country could change that, experts warn.
“There’s no certainty that we’ll have a second wave,” said Steven Hoffman, a professor of global health, law and political science at York University. But, “The more we lift our layers of protection that have been put in place over the last couple of months, the more risk we have of having clusters which then turn into outbreaks again.”
Caroline Colijn, an infectious disease modeller in the department of mathematics at Simon Fraser University, thinks that a “second wave” is the wrong way to describe the future of coronavirus in Canada. We’re looking at not a new wave of infections, she said, but a constant threat of new outbreaks as we remove restrictions because most of the population remains susceptible to the disease.
“But when you take the lid off, the sputtering is still there because it hasn’t cooled down.”
The World Health Organization is also warning countries about the risks of renewed outbreaks. At a press conference Wednesday, Dr. Mike Ryan, chief of the WHO’s emergencies program, said that as countries try to find a path toward a “new normal” they need to be prepared to be on that path for a long time.
“The reason why countries have gone into different forms of severe public health and social measures and lockdowns was to separate people so we could stop the virus jumping from person to person,” he said.
“If the virus is still present and you bring people closer together, you don’t have to be an astrophysicist to work out that the disease will move more easily from person to person in that situation.”
Safely removing restrictions means watching closely for new clusters of infections, lots of testing and carefully tracing everyone who an infected person may have come into contact with, Hoffman said. Even then, there is always a risk.
Contact tracing in particular gets exponentially more difficult the more active COVID-19 cases are around, he said. Tracking one person’s contacts is a lot simpler and requires more resources than tracking 100 people’s contacts and testing everyone involved.
Hoffman said that higher testing numbers in Canada show that our laboratory capacity has increased, though it’s still open to criticism. He thinks governments have done a good job at increasing the health care system’s capacity to deal with patients.
Provincial governments also need to be prepared to re-impose lockdown measures if necessary, he said. “I think it is very likely that we’re going to see a re-emergence of COVID-19 at some point in some place,” he said. “That’s why I think it’s really important that we are preparing Canadians for the likely reality that we may have to re-impose certain layers of protection that we’re about to start lifting.”
Colijn suggests that this could go on until there is a vaccine against the SARS-CoV-2 virus, something which is likely a year or more away.
Right now, she said, not enough of the population has immunity to the virus to stop it from spreading. While having more immunity in the population would help lessen the spread, we don’t want to just throw open the doors and have everyone just catch it, given the risks involved.
“We don’t want the exposure because it’s so dangerous,” she said. So far, more than 5,000 Canadians have died from COVID-19.
“We want that immunity – we want it through a vaccine.”
Over the next few months, she said, we will learn a lot about what kinds of activities, businesses and gatherings present the highest risk for transmitting the virus. And then, we can adjust our policies as necessary to lessen the risks.
A combination of good hygiene practices, like physical distancing and handwashing, along with public health measures like contact tracing, as well as more novel measures like testing wastewater for signs that people in a given area are infected, could all help to keep the overall number of infections down, she said.
This strategy though hinges on the promise of an eventual vaccine, something Ryan says is not a certainty.
“This virus may never go away,” the WHO official said. “HIV has not gone away, but we’ve come to terms with the virus and we have found the therapies and we have found the prevention methods and people don’t feel as scared as they did before.”
“If we do find a highly effective vaccine that we can distribute to everyone who needs it in the world, we may have a shot at eliminating this virus. But that vaccine will have to be available. It’ll have to be highly effective. It will have to be made available to everyone. And we will have to use it.”
There is an effective vaccine against measles, he said, but without strong public health systems to give it to everyone, measles still kills children around the world.
“I think it’s important to put this on the table: This virus may become just another endemic virus in our communities.”
Questions about COVID-19? Here are some things you need to know:
Symptoms can include fever, cough and difficulty breathing — very similar to a cold or flu. Some people can develop a more severe illness. People most at risk of this include older adults and people with severe chronic medical conditions like heart, lung or kidney disease. If you develop symptoms, contact public health authorities.
To prevent the virus from spreading, experts recommend frequent handwashing and coughing into your sleeve. They also recommend minimizing contact with others, staying home as much as possible and maintaining a distance of two metres from other people if you go out.
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